Published online January 26, 2009
PEDIATRICS Vol. 123 No. 2 February 2009, pp. 555-561 (doi:10.1542/peds.2008-0477)

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ARTICLE

Parenting Behavior Is Associated With the Early Neurobehavioral Development of Very Preterm Children

Karli Treyvaud, DPsych^a,b, Vicki A. Anderson, PhD^a,b, Kelly Howard, BSc^a,b, Merilyn Bear, RN^a, Rod W. Hunt, PhD^a,c, Lex W. Doyle, MD^a,d,e, Terrie E. Inder, MD^a,f, Lianne Woodward, PhD^g and Peter J. Anderson, PhD^a,b,d

^a Critical Care and Neurosciences, Murdoch Childrens Research Institute, Victoria, Australia
^b School of Behavioural Science
^d Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
^c Neonatal Medicine, Royal Children's Hospital, Victoria, Australia
^e Newborn Research, Royal Women's Hospital, Victoria, Australia
^f School of Medicine, Washington University, St Louis, Missouri
^g Department of Psychology, University of Canterbury, Christchurch, New Zealand

OBJECTIVE. There is an increasing focus on social and environmental factors that promote and support the early development of highly vulnerable children such as those born very preterm. The aim of this study was to assess the relationship between parenting behavior, parent-child synchrony, and neurobehavioral development in very preterm children at 24 months of age.

METHODS. Participants were 152 very preterm children (<30 weeks’ gestation or <1250 g birth weight) and their parents/guardians. At 2 years’ corrected age, parents/guardians and children completed a semistructured parent-child interaction task assessing dyad synchrony and parenting behavior (positive affect, negative affect, sensitivity, facilitation, and intrusiveness). Cognitive and motor development was assessed by using the Bayley Scales of Infant Development II, and the Infant Toddler Social and Emotional Assessment was used to assess socioemotional development (social-emotional competence and internalizing and externalizing behavior).

RESULTS. After controlling for social risk, most parenting domains were associated with cognitive development, with parent-child synchrony emerging as the most predictive. Greater parent-child synchrony was also associated with greater social-emotional competence, as was parenting that was positive, warm, and sensitive. Parents who displayed higher levels of negative affect were more likely to rate their children as withdrawn, anxious, and inhibited, but, unexpectedly, higher negative affect was also associated with more optimal psychomotor development. Parenting was not associated with externalizing behaviors at this age.

CONCLUSIONS. Specific parenting behaviors, particularly parent-child synchrony, were associated with neurobehavioral development. These findings have implications for the development of targeted parent-based interventions to promote positive outcomes across different developmental domains during the first 2 years of life for very preterm children.

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Key Words: prematurity • parent-child interaction • neurobehavioral • development • outcome

Abbreviations: MDI—Mental Developmental Index • PDI—Psychomotor Developmental Index • ITSEA—Infant Toddler Social and Emotional Assessment

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Accepted May 27, 2008.

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