Published online May 1, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. 1608-1617 (doi:10.1542/peds.2005-1284)
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The Role of Early Maternal Responsiveness in Supporting School-Aged Cognitive Development for Children Who Vary in Birth Status

Karen E. Smith, PhDa, Susan H. Landry, PhDb and Paul R. Swank, PhDb

a University of Texas Medical Branch, Galveston, Texas
b University of Texas-Houston Health Science Center, Houston, Texas

OBJECTIVES. To examine the relation between the pattern of maternal responsiveness that children experienced in the infancy, preschool, and school-age periods and growth in cognitive skills across 3–10 years of age and determine whether the relation differs by birth status.

METHODS. In 1990–1992, 360 children varying in birth status (very low birthweight [VLBW]; demographically matched controls) were recruited to examine parenting and birth status influences on development. This report includes children with observations of parenting at 6, 12, and 24 months and 3, 4, 6, 8, and 10 years and cognitive skills evaluated at 3, 4, 6, 8, and 10 years of age (71% of original cohort).

RESULTS. Four groups of mothers varying in the pattern of responsiveness displayed across the infancy and the preschool period were found. When controlling for school-age parenting and economic status, children parented with higher levels of responsiveness across both developmental periods, irrespective of birth status, showed higher levels in development than those who experienced responsiveness in only 1 development period or minimal responsiveness. Greater benefit was found for consistency in responsiveness for children born VLBW with less, versus more, severe neonatal complications. Inspection of the means showed that higher risk birth status combined with minimal responsiveness resulted in cognitive scores, on average, 14 points lower than when parented with consistently higher responsiveness.

CONCLUSIONS. Cognitive development for children born at VLBW, particularly those with less severe complications, are supported by consistently responsive parenting across early childhood in similar ways to those born at term. This effect persisted through 10 years of age even after school-age parenting and economic level. These findings have important implications for the timing (across early childhood) and content (responsive interactive behaviors) of early intervention to enhance the outcomes for children born at VLBW.

Key Words: very low birth weight • cognitive development • early maternal responsiveness • early childhood • poverty

Abbreviations: VLBW—very low birth weight • SES—socioeconomic status • HR—high risk • LR—lower risk

Accepted Oct 17, 2005.




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K. Lindstrom, F. Lindblad, and A. Hjern
Psychiatric Morbidity in Adolescents and Young Adults Born Preterm: A Swedish National Cohort Study
Pediatrics, January 1, 2009; 123(1): e47 - e53.
[Abstract] [Full Text] [PDF]