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Keep calm and stay withdrawn?

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Keep calm and stay withdrawn? investigating the discordance between maternal emotional availability and infant cognitive performance
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Investigating the discordance between maternal emotional availability and infant cognitive performance
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Vogeli, Joann McDonald ( author )
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English
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Cognition in infants ( lcsh )
Attachment behavior ( lcsh )
Mother and child ( lcsh )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

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The mother-infant dyadic relationship is important for the course of development of an infant, and the availability and responsiveness of a mother provides a foundation for the infant’s eventual development of self. The Emotional Availability Scales (EAS) were developed as a means of quantifying the mother-infant relationship while viewing interactions from a multi-dimensional perspective. There is an abundance of research supporting the positive relationship between optimal maternal emotional availability and an infant’s long-term cognitive performance; however, the current research sought to explore an explanation for some recent seemingly anomalous results, whereby infants of mothers who were less sensitive and who did not engage in optimal structuring were performing better than their peers on the cognitive portion of the Bayley Scale of Infant Development III (BSID-III). Based on developmental theories, two infant behaviors of task orientation (TSK) and non-avoidance (AVD) on the EAS were hypothesized to explain this counterintuitive relationship between four separate maternal features/behaviors (affect, sensitivity, structuring, non-intrusiveness) on BSID-III cognitive performance. Mediation analyses produced statistically significant results for three of the four models. There was a significant relationship between the maternal affect EAS domain and the Bayley Cog, with lower maternal affect scores related to higher Bayley Cog (R2 =.0459, F(1,86), p< .05, = -6.50). There was a significant relationship between the maternal sensitivity EAS domain and the Bayley Cog, with lower maternal sensitivity scores related to higher Bayley Cog (R2 =.0683, F(1,86), p< .02, = -5.74). Further, there was also a significant relationship between the maternal structuring EAS domain and the Bayley Cog, with lower maternal structuring scores related to higher Bayley (R2 =.0498, F(1,86), p<.05; = -.4.10). Mediation results, however, were mixed with the predicted mediators revealing only one relationship approaching significance for TSK and AVD predicting Bayley Cog when controlling for maternal sensitivity (R2=.09, F(3, 84) = 2.61, p = .057). All other mediation models failed to explain the relationship between the identified maternal EAS and infant cognitive performance.
Review:
These results are an important contribution to research because they provide evidence that an unexpected relationship exists between maternal emotional availability and infant cognitive performance. This suggests there may be a developmental process for infants that is not well understood and opens the door for a more comprehensive investigation of the mother-infant dyadic relationship beyond that of attachment theory.
Thesis:
Thesis (Ph.D.)--University of Colorado Denver.
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Includes bibliographical references.
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by Joann McDonald Vogeli.

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Full Text
KEEP CALM AND STAY WITHDRAWN? INVESTIGATING THE DISCORDANCE
BETWEEN MATERNAL EMOTIONAL AVAILABILITY AND INFANT COGNITIVE PERFORMANCE
by
JOANN MCDONALD VOGELI B.A., University of Colorado, Boulder 2010 M.A., University of Colorado, Denver 2014
A dissertation submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirements for the degree of Doctor of Philosophy Clinical Health Psychology Program
2017


2017
JOANN MCDONALD VOGELI
ALL RIGHTS RESERVED


This dissertation for the Doctor of Philosophy degree by Joann McDonald Vogeli has been approved for the Clinical Health Psychology Program by
Edward Dill, Chair Peter Kaplan, Advisor Kevin Everhart Jennifer Hamed Adams Jonathan Shaffer
Date: May 13, 2017


Vogeli, Joann McDonald (Ph.D., Clinical Health Psychology)
Keep Calm and Stay Withdrawn? Investigating the Discordance Between Maternal Emotional Availability and Infant Cognitive Performance Thesis directed by Professor Peter Kaplan
ABSTRACT
The mother-infant dyadic relationship is important for the course of development of an infant, and the availability and responsiveness of a mother provides a foundation for the infants eventual development of self. The Emotional Availability Scales (EAS) were developed as a means of quantifying the mother-infant relationship while viewing interactions from a multi-dimensional perspective. There is an abundance of research supporting the positive relationship between optimal maternal emotional availability and an infants long-term cognitive performance; however, the current research sought to explore an explanation for some recent seemingly anomalous results, whereby infants of mothers who were less sensitive and who did not engage in optimal structuring were performing better than their peers on the cognitive portion of the Bayley Scale of Infant Development III (BSID-III). Based on developmental theories, two infant behaviors of task orientation (TSK) and non-avoidance (AVD) on the EAS were hypothesized to explain this counterintuitive relationship between four separate maternal features/behaviors (affect, sensitivity, structuring, non-intrusiveness) on BSID-III cognitive performance. Mediation analyses produced statistically significant results for three of the four models. There was a significant relationship between the maternal affect EAS domain and the Bayley Cog, with lower maternal affect scores related to higher Bayley Cog (.R2 =.0459, /( l ,86), p< .05, (3 = -6.50). There was a significant relationship between the maternal sensitivity EAS domain and the
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Bayley Cog, with lower maternal sensitivity scores related to higher Bayley Cog (R2 =.0683, F(l,86),/K .02, (3 = -5.74). Further, there was also a significant relationship between the maternal structuring EAS domain and the Bayley Cog, with lower maternal structuring scores related to higher Bayley (R2 =.0498, F(l,86),/)<.05; (3 = -.4.10). Mediation results, however, were mixed with the predicted mediators revealing only one relationship approaching significance for TSK and AVD predicting Bayley Cog when controlling for maternal sensitivity (R2=.09, F(3, 84) = 2.61 ,p= .057). All other mediation models failed to explain the relationship between the identified maternal EAS and infant cognitive performance.
These results are an important contribution to research because they provide evidence that an unexpected relationship exists between maternal emotional availability and infant cognitive performance. This suggests there may be a developmental process for infants that is not well understood and opens the door for a more comprehensive investigation of the mother-infant dyadic relationship beyond that of attachment theory.
The form and content of this abstract are approved. I recommend its publication.
Approved: Peter Kaplan
v


DEDICATION
This dissertation is dedicated to my husband, Dave, and my son, Leo. You have remained by my side even when that was a very difficult thing to do, and for that, I am so grateful. Leo, thank you for showing me that The Worlds Okayest Mom is the perfect mom for you. May you go on to learn and grow, always knowing that you make the world a better place each and every day. Dave, I am not sure how we survived this journey, but here we are. Thank you for being a true equal partner and modeling to our son every day what a true man looks like. Thank you both for being the wind in my sail, and may our year of adventure turn into a lifetime of adventure together!
See the light where the sky meets the sea It calls me
And no one knows how far it goes If the wind in my sail on the sea stays behind me One day I'll know How far I'll go
~ from Moana
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ACKNOWLEDGEMENTS
I would like to start off by acknowledging my advisors, Peter Kaplan and Kevin Everhart. As I make it to the other side, I can say with sincerity that I appreciate you both pushing me to take those extra steps. To my dissertation chair, Ed Dill, your challenges have helped me to discover a higher level of researcher within myself. Jonathan Shaffer, thank you for your non-judgment and support through this process. And Jennifer Harned Adams, you are much more than a committee member. You have been a perfect mentor through my graduate school experience, and I thank you for the opportunities you have provided me to learn and grow both personally and professionally. Stephanie Hooker, there are no adequate words to acknowledge the level of support and consultation you have offered me through the years, so I will simply say thank you for showing me how to lean in. Kaile Ross, your peer mentorship during this process went well above and beyond what is typically expected, but you were always there to offer support and encourage me to recognize that a worthy researcher exists within me. Lacey Clement, and Tattiana Romo, you have been a lifeline through this process, never faltering when I was consumed with self-doubt. And last but certainly not least, Ryan Asherin. I have a tremendous amount of gratitude for your support during this journey. To all those mentioned and too many more to list, I cannot imagine a better group of people by my side through this graduate school process.
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TABLE OF CONTENTS
CHAPTER
I. BACKGROUND................................................................1
Purpose of the Current Study..............................................1
II. LITERATURE REVIEW.........................................................4
Emotional Availability....................................................4
The Dyadic Relationship.............................................4
Emotional Availability and Attachment Theory........................4
Emotional Availability Systems Approach.............................5
Background of Emotional Availability................................6
Emotional Availability Scales.............................................9
Emotional Availability and Maternal Psychological Functioning............13
Emotional Availability and Cognitive Development.........................13
Sensitivity and Emotional Availability.............................13
Sensitivity and Cognitive Development..............................14
Structuring and Emotional Availability.............................16
Structuring and Cognitive Development..............................18
Non-Intrusiveness, EA, and Cognitive Development...................21
Previous Findings Infant Lab at the University of Colorado Denver........22
New Views: Sensitivity, Scaffolding, Responsiveness, and
Infant Cognitive Performance.............................................24
Social Learning Strategies...............................................27
Current Study............................................................28
Aims & Hypotheses........................................................30
vm


III. METHOD...............................................................35
Participants.........................................................35
Data Collection/Procedures ..........................................38
Variables
Predictor......................................................42
Mediators......................................................43
Outcome........................................................43
Data Cleaning........................................................43
Data Analysis .......................................................44
Bootstrapping..................................................46
IV. RESULTS..............................................................48
Descriptive Statistics...............................................48
Correlations.........................................................49
Mediation Analyses...................................................50
Model 1........................................................51
Model 2........................................................53
Model 3........................................................54
Model 4........................................................56
V. DISCUSSION...........................................................58
Overview.............................................................58
Description of Results...............................................59
Explanation of Results...............................................60
Limits of EAS........................................................61
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Current Study Limitations............................................63
Current Study Strengths..............................................63
Future Research and Considerations...................................64
Conclusion...........................................................65
REFERENCES ................................................................67
APPENDIX
A. EAS Detailed Description.........................................79
B. EAS and Bayley Cog Demographic Table.............................82
C. EAS Frequency Distribution Charts................................83
x


LIST OF TABLES
TABLE
1. Demographic Characteristics (7V=88).........................................37
2. Emotional Availability Scale and Subscale Descriptions......................40
3. Descriptive Statistics of Maternal and Infant EAS Variables
and Bayley Cog.............................................................48
4. Inter-correlations, Means, and Standard Deviations..........................50
5. Regression Coefficients, Standard Errors, and Model Summary Information
for mediation Model 4......................................................57
6. Demographic, EAS, and Bayley Cog Data.......................................82
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LIST OF FIGURES
FIGURE
1. Maternal Sensitivity and Bayley Cog percentile rank........................23
2. Maternal Structuring/Non-Intrusiveness and Bayley Cog percentile rank......24
3. Infant task orientation, non-avoidance, maternal affect,
and Cog performance.......................................................31
4. Infant task orientation, non-avoidance, maternal sensitivity,
and Cog performance.......................................................32
5. Infant task orientation, non-avoidance, maternal structuring,
and Cog performance.......................................................33
6. Infant task orientation, non-avoidance, maternal non-intrusiveness,
and Cog performance.......................................................34
7. EAS Scoring................................................................42
8. Direct and indirect pathways between infant task orientation, infant
non-avoidance, maternal affect, and Cog performance.......................52
9. Infant task orientation, non-avoidance, maternal sensitivity,
and Cog performance.......................................................54
10. Infant task orientation, non-avoidance, maternal structuring,
and Cog performance.......................................................56
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LIST OF ABBREVIATIONS
AFT AVD BSID-III Cog COMIRB EA EAS IDS INT MDI PPD SC ID SEN STR TSK WPPSI ZPD Maternal Affect Infant Non-Avoidance Bayley Scale of Infant Development, 3rd Edition BSID-III Cognitive Performance Colorado Multiple Institutional Review Board Emotional Availability Emotional Availability Scales Infant Directed Speech Maternal Non-Intrusiveness Bayley Mental Development Index Postpartum Depression Structured Clinical Interview for Diagnosis Maternal Sensitivity Maternal Structuring Infant Task-Orientation/Concentration Wechsler Preschool and Primary Scale of Intelligence Zone of Proximal Development


CHAPTER I
BACKGROUND
Purpose of the Current Study
It is widely believed that the quality of the caregiver-infant relationship plays a primary role in the infants social, emotional and cognitive development (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1969; DeWolff & van IJzendoorn, 1997). A great deal of research has established that maternal emotional availability (EA) influences the quality of a childs attachment relationship with the mother. Less well established is the extent to which aspects of maternal behavior, including sensitivity, structuring, and non-intrusiveness affect cognitive development. Using the Bayley Scale of Infant and Toddler Development, Third Edition (BSID-III), the current research studied the relationship between maternal EA, as measured using the Emotional Availability Scales (EAS), and cognitive development of infants in their first year of life.
Biringen and colleagues (1990, 1993, 1998, 2002, 2008) developed a quantifiable system to assess the multi-dimensional construct of EA. The EAS measure the affect and behavior of both the mother and child from a dyadic framework, giving primary importance to the interaction, but allowing for observation from either side of the dyad. This multidimensional view of the dyad allows the EAS to be a valuable tool when researching various aspects and influences of the mother-infant dyadic relationship.
Currently, the literature would benefit from more research that provides a fuller understanding of how infants learn when faced with less than ideal maternal interactions. The long-term consequences on learning and social-emotional development are readily available (Ainsworth, Blehar, Waters, & Wall, 1978; Beck, 1998; Hanson, et al., 2013; Miller, Pallant,
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& Negri, 2006), but the research is sparse when looking at specific time periods in early infant development. In 2009, the Infant Lab at the University of Colorado Denver produced some seemingly anomalous results, in which the infants of mothers who were less sensitive and who did not engage in optimal structuring were performing better than controls on the cognitive portion of the Bayley Scale of Infant Development III (BSID-III). One possible explanation for these results is that the infant may recognize his or her mothers unavailability and shift focus to temporarily satisfy his or her desire to learn by exploring their environment. This unexplained developmental process provides a challenge to researchers to expand beyond traditional views and develop a more comprehensive view of infant development.
A replication of the findings from the Infant Lab would warrant future research to further establish an understanding the reasoning behind a mothers diminished availability. If postpartum mood and anxiety disorders play a role, this would open the possibility that there is an opportunity for intervention for mothers who are less emotionally available due to postpartum mood an anxiety disorders, and the infant would not go on to suffer from some of the known long-term consequences of being exposed to subpar early maternal interactions. Ideally, understanding the capabilities of an infants ability to make this shift would promote the likelihood that mothers suffering from postpartum mood and anxiety disorders would seek treatment, knowing that that their own emotional functioning is vital for long-term relationship with child and the childs own development.
The current research explored the concept of EA, along with its roots in attachment theory. From there, hypothesized links between EA, attachment, and the foundations of infant cognitive development were discussed. Specifically, evidence that EA constructs
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including sensitivity, structuring, and non-intrusiveness are related to cognitive development was reviewed. Preliminary data from the Infant Laboratory at CU Denver were provided, which are not consistent with the prediction that greater maternal emotional availability predicts faster or a higher level of cognitive development. The first aim of this project was to attempt to replicate this apparently anomalous result. The second aim was to use a revised version of the EAS to explore possible mediators of the link between maternal sensitivity and infant cognitive development. The selection of potential mediators from new EAS subscales were guided by some admittedly speculative but testable ideas about how apparent maternal insensitivity might accelerate child cognitive development. Finally, the overarching goal of this project is to gain a fuller understanding of the mother-infant dyadic relationship and to promote future research in potentially unexplored areas of infant cognitive development.
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CHAPTER II
LITERATURE REVIEW Emotional Availability
The Dyadic Relationship
The mother-infant dyadic relationship is important for the course of development of an infant, but much emphasis has been placed on the maternal functioning and in a unidirectional manner. It is important to view the relationship between caregiver and child from a dyadic perspective, with the parent and child having mutual influence on the relationship (Beebe et al., 2010; Bowlby, 1969; Field, 1994). An infants development is naturally dependent on caregiver interactions, which have emotional, behavioral, and biological effects on the infant (Emde, 1980; Mahler, Pine & Bergman, 1975). However, parent and child factors interact on many levels, and it is the interactions that affect the course of the childs abilities to recognize, express, and cope with emotions. An approach based on the concept of emotional availability (EA), and subsequent development of the Emotional Availability Scales (EAS), has provided empirical support to view the dyad as a true bidirectional relationship.
Emotional Availability and Attachment Theory
Emotional availability refers to Bowlbys (1969) theory of early expectations of the availability and responsiveness of caregivers, which provide the foundations of the childs internal working models of self and other. Bowlby considered the childs attachment system and the parent's caregiving system as complementary behavioral systems. In Bowlbys view, secure attachment occurs when a child has a mental representation of the attachment figure as available and responsive as needed. Infants are considered to be insecurely attached when
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they lack such a representation and expectation. Bowlby argued, as Freud had previously, that early attachment experiences are of special importance because of their implications for mastery, emotion regulation, and exploration (Bowlby, 1969; Weinfeld, Sroufe, Egeland, & Carlson, 1999). The early attachment relationship may serve as a foundation for learning emotional self-regulation, with emotion regulation denoting the ability to control and modulate emotional responses. Infants, initially unable to regulate their own emotions, need their caregivers to help them negotiate strong emotions such as distress, anger and fear (Weinfeld et al., 1999). Secure attachment provides a foundation for successful emotional regulation (Sroufe, 2005), which enables a child to explore her world from a safe base. This early exploration is seen as crucial to the childs cognitive, as well as emotional, development.
Emotional Availability Systems Approach
According to emotional availability theory, individuals cannot be understood apart from their interpersonal relationships (Beebe et al., 2012). In examining dyadic states, Beebe and colleagues noted that individual expectancies and partner interaction sequences are critical features of the mother-infant communication system. The infant has an inborn drive to order information, detect regularity, and generate expectancies. Mother and infant generate regular patterns of behavior over time, which in turn establish expectations about the others behavior. These early-established expectations set the foundation for the infants social interactions and regulation strategies in the larger social world (Sander, 1987).
Viewing the interactional nature of the dyad is important for understanding social, emotional, and cognitive growth trajectories for infants. However, much emphasis on the developmental patterns from infancy through childhood is often based on attachment theory
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alone, and factors other than maternal sensitivity have been shown to provide important contributions in this developmental trajectory (DeWolff & van Dzendoom, 1997). Additionally, there is a notable lack of research looking at emotional availability from an infant perspective. The current research placed an emphasis on the bi-directionality of this relationship, as well as distinguished both maternal and infant behaviors and the influence these have on infant cognitive performance distinct from level or type of attachment. Background of Emotional Availability
Emotional availability (EA) is a construct conceptually and empirically related to attachment (Emde, 1980) and first operationalized for research by Biringen and colleagues (Biringen & Robinson, 1991; Biringen, Robinson, & Emde, 1994). The foundation of the EA assessment comes from the integration of attachment (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1969, 1988) and emotional perspectives (Emde, 1980; Mahler, Pine, & Bergman, 1973). Mahler et al. (1975) used the term emotional availability to depict the supportive maternal presence in the context of childrens explorations and autonomy. The emotional availability of the relationship is thought to provide a secure base (Bowlby, 1973) for the child to explore, as well as the emotional resources needed for such explorations. Mahler et al. noted that infants use mothers as a point of orientation; by checking back with them periodically, this contact seems to enable infants to engage in pleasurable exploration.
In Ainsworth and colleagues original work classifying infant behavior regarding separation from caregivers (Ainsworth, Blehar, Waters, & Wall, 1978), attention was first given to the presence or absence of distress in the separation episodes. After refining the classification system, four dimensions of infant behavior and various classificatory groups and subgroups were identified, including: proximity and contact seeking behavior, contact
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maintaining behavior, avoidance, and resistance. Three types of maternal behavior measures were created, focusing on responsiveness to the infants crying, behavior relevant to separation and reunion, and behavior relevant to bodily contact (e.g., pickups and holdings). Further, Ainsworth et al. examined general maternal characteristics of sensitivity-insensitivity to the babys signals and communications (e.g., being alert to babys signals, responding appropriately and promptly), acceptance-rejection (e.g., the balance between mothers positive and negative feelings about her baby and if she can resolve her conflicting feelings), cooperation-interference (e.g., how they respect babys autonomy and essential separateness), and accessibility-ignoring (e.g., if she is able to attend to her babys signals despite other demands on her attention). Ainsworth cautioned that a mothers mere physical presence may not convey the desired sense of security to facilitate exploration. Subsequently, Sorce et al. (1985) hypothesized that not only is mothers physical presence necessary, but also her emotional availability. They defined emotional availability as a mother communicating through her ongoing behavior that she is aware of the infants presence, is monitoring ongoing activity and is available to respond empathically and appropriately.
Sorce et al. agreed with the theoretical position of Bowlby (1973) and Mahler et al. (1975) that the essential feature of the mothers availability is her willingness to respond to her infants signals on an emotional level.
Within the EA conceptualization, the mother-infant dyad is viewed a system whereby emotional transactions form the basis for mutually rewarding communication. The mother relies on cues in infant facial and vocal expressions to provide her with feedback that she uses to attempt to regulate infant affect. When well-timed, these attempts meet the intended goal of modifying the infants affect to a more pleasant state (Robinson, Little, & Biringen,
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1993). The caregivers emotional availability is considered important for the infants affect regulation (Field, 1994). The infants internal means of emotion regulation is established through predictable responsiveness to distress signals and sensitive interventions to engage the infant during alert periods. An emotion can be thought of as an organized reaction to an event, which is relevant to the needs of the individual (Watson & Clark, 1992). Therefore, by providing effective emotion signaling, a caregiver establishes the basis for experiencing self-efficacy (Robinson, Emde, & Korfmacher, 1997).
Everyday interactions between the infant and caregiver provide opportunities for experiencing security and trust, given the caregivers patterns of response to the infants signals. The consistency and patterns of caregiving form a template for the infant, which provides expectancies for emotional experience. Within the context of emotionally available caregiving relationships, the infant builds a sense of what is expected, and what feels right in the world (Robinson et al., 1997). Throughout the first postnatal year, emotions become more differentiated within the context of caregiving relationship experiences. Further, during the second year of life, the child also develops relevant skills through repeated experiences with emotionally available caregivers. There are several aspects of emotional availability and development during this early age period, including boundary setting, emotional regulation, and internalization of rules guiding social interaction (e.g., gaze behavior and aspects of turn taking), and overall facilitation of the development of cognitive functioning.
In discussing human infancy research, Sorce, Emde, Campos, and Clinnert (1985) proposed that an observer can identify emotional expressions with the assumption that the individual is reacting to relevant environmental circumstances, and that the individuals response to a wide range of emotions, rather than only to distress situations, is a key
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consideration. In 1980, Emde reviewed research and theoretical conceptualizations at the time, such as Sroufes (1979) organizational developmental systems perspective. This perspective viewed emotions as active, ongoing, and adaptive processes; as such, emotions serve both motivational and communication functions and principles of regulation are central. Emde (1980) highlighted that theorists focused on emotion and its development had moved toward a relational view that sought to understand processes of emotion in terms of person-environment relations. He further specified that emotions need to be understood in terms of goals and intentions of the individual in relation to the environment of objects or persons (Emde, 1980).
Emotional Availability Scales
The Emotional Availability Scales (EAS; Biringen, Robinson, & Emde, 1990, 1993, 1998) were developed in an attempt to capture qualities of emotional transactions in the dyad by examining the behavioral contributions of both partners, and emphasizes the dyadic quality of the parent-child interaction (Biringen, Robinson, & Emde, 1990, 1993, 1998). The EAS are a research-based means of identifying and understanding the quality of the caregiver/child dyadic relationship (Biringen, 2000; Biringen et al., 2014). With a focus on two-way healthy emotional relationship, communication through verbal and nonverbal means is observed, focusing on maternal sensitivity and responsiveness to infant cues (Biringen, 2000, Biringen et al., 2010).
EAS are a comprehensive means of approaching a parent and childs ability to interact on an emotionally productive level by evaluating the dimensions of maternal sensitivity, structuring, non-intrusiveness, non-hostility, child responsiveness, and child involvement, with each component differentiated from the other (Biringen, 2000). EAS
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measure each of these dimensions based on a series of relational observation points (Biringen, 2008). Of the six subscales, four place a primary focus on the caregiver (Sensitivity, Structuring, Non-Intrusiveness, and Non-Hostility) and two place the primary emphasis on the child (Child Involvement, Child Responsiveness). However, within any given scale, the complimentary qualities of both partners are assessed.
The inclusive and bi-directional nature of the EAS is one of the key features that helps provide more robust information than focusing on either the maternal or infant/child role alone, as the EAS requires acknowledgement of the mutual influence of behavior within the dyadic relationship (Easterbrook & Biringen, 2000). EAS not only take the interdependence of behavior into consideration, but also recognize that behaviors and responses are not unvarying. The optimal degree of the parent-child emotionally available relationship allows for shifts in behaviors based on age-appropriate qualities that are context-dependent (Easterbrook & Biringen, 2000; Biringen et al., 2000). This developmentally-appropriate approach is another feature that allows the EAS to add to the traditional attachment-theory-based observations, which focus on a stress-response to measure aspects of the relationship and the influence on infant development.
The EAS continues to be used as a valid and reliable measure of emotional availability in mother-infant dyads. Using the EAS, studies have examined the correlates and influence of emotional availability on a variety of developmental paths, including emotional regulation, infant sleep state regulation, infant visual-self recognition, toddler social behaviors, and toddler language development (Biringen, Derscheid, Vliegen, Closson, & Easterbrooks, 2014; Hanson, et al., 2013; Van Doesum, Hosman, Riksen-Walraven, & Hoefnagles, 2007; Kaplan, Burgess, Sliter & Moreno, 2009). However, there is a noted gap
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in the literature regarding specific maternal and infant behaviors and how these relate to the context of infant cognitive development. These areas can be explored through the EAS, and the current research sought to fill in this gap by investigating those infant behaviors that mediate the relationship between maternal behaviors and infant cognitive performance.
EA and Maternal Psychological Functioning
Postpartum Depression (PPD) can have debilitating effects on women, spouses or partners, and is known to have adverse effects on infant attachment and the mother-infant dyadic relationship. These effects, in turn, can lead to a variety of social and emotional deficits due to the lack of quality interactions and sensitivity of mothers toward their infants (Biringen, Derscheid, Vliegen, Closson, & Easterbrooks, 2014; Carter, et al., 2001; Cummings & Davies, 1994). Deficits in infant cognitive development have also been noted (Beck, 1998; Hanson, et al., 2013; Miller, Pallant, & Negri, 2006). Neglect can result from a lack of sensitivity on the part of the mother toward the infant (Van Doesum, Hosman, Riksen-Walraven, & Hoefnagles, 2007), and disruption in maternal emotional availability due to lack of sensitivity can carry through and negatively influence children in the preschool years and beyond (Trapolini, Lingerer, & McMahon, 2008). A disruption in the dyadic relationship in depressed mother-infant dyads is not limited to a lack of sensitivity (Biringen, et al, 2014), as caregiver intrusiveness, non-optimal structuring, or demonstration of hostility can also lead to difficulties with emotional regulation (Muscat, Obst, Cockshaw, & Thorpe, 2014) and other health concerns (Field, 1981; Lumeng et al., 2012).
PPD can cause a mother to miss or misinterpret cues from her baby (Murray, 2009). Mothers may perceive normal reactions in social reciprocity, such as lack of eye contact by baby to a mother with flat affect, as an indication that the baby does not love them (Reck et
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al., 2004). PPD has been linked to lower maternal sensitivity, defined as the ability to provide a warm and inviting environment for a child (Biringen, Robinson, & Emde, 2000). Too much or too little maternal structuring has also been linked to PPD, and the adverse effects of non-optimal structuring may be compounded by overly intrusive actions by the mother toward the infant (Kim, Mayes, Feldman, Leckman, & Swain, 2012). An intrusive style of parenting is related to, but distinct from low sensitivity. A parent may provide an overstimulating environment, and not recognize cues given by a child to stop (Biringen, 2000). Research by Ambrowitz et al. (2010) showed that more intrusive maternal interactions cause a distress response from infants and this provided feedback to the mother indicating that she was not competent due to her inability to soothe the baby. Overall, a mother is likely to perceive the negative affect of her baby as reflecting on her capabilities, leaving her feeling less adequate and increasing feelings of guilt, depression, and anxiety (Coleman & Karraker, 1997; Teti & Gefland, 1991).
There is a large body of research looking into the impact of PPD on maternal sensitivity (Bomstein, Suwalsky, & Breakstone, 2012; Chaudhuri, Easterbrooks, & Davis, 2009; Geert-Jan, Stams, Juffer, & van Ijzendoom, 2002; Kaplan, Burgess, Sliter & Moreno, 2009; Lovejoy, Gracyzk, OHare, & Neuman, 2000), but research is more limited when looking at EA as a whole, through all individual scales, and through individual item analysis. The negative impact of poor dyadic functioning has emotional, physiological, and health consequences (Biringen et al., 2014; Field, 1981; Lumeng et al., 2012). Children of mothers who demonstrate lower levels of sensitivity and heightened levels of intrusiveness exhibit more disorganized attachment (Geert-Jan et al., 2002), which can lead to higher risk for externalizing behavior in later childhood (Fearon, Bakermans-Kranenburg, van Ijzendoorn,
12


Lapsley, & Roisman, 2010) and less emotional competence (Volling, McElwain, Notaro, & Herrera, 2002). Ego-resiliency, or the ability to shift behaviors and adapt emotions appropriately, is diminished when an infant is subjected to less structuring and more intrusive parenting in early childhood and this subsequently alters the proper development of effortful control (Taylor, Eisenberg, Spinrad, & Widman, 2013). Though well established that there is a relationship between maternal psychological functioning and EA, further research is needed to identify the role of maternal affective functioning on infant cognitive development. The current research sought to identify the influence of certain aspects of maternal psychological functioning, such as maternal affect/warmth, on infant cognitive functioning.
Emotional Availability and Cognitive Development Sensitivity and Emotional Availability
Many studies investigating the relationship between maternal sensitivity and child cognitive development have their theoretical background in the attachment theory. As mentioned above, according to attachment theory (Bowlby, 1969; Ainsworth, 1972), maternal sensitivity plays a crucial role in determining her infants degree of exploration and affective engagement with new objects and people. The proposed mechanism is that as an infant forms an attachment bond with the mother, the mothers emotional availability provides a secure base from which the infant can explore and learn about her environment.
As a consequence, the secure child is likely to actively engage in new activity and exploration, which eventually leads to an enhancement in cognitive development (Ainsworth, 1974). Another possibility is that sensitive caregivers are good teachers, appropriately gauging their infants state and abilities in relation to the task at hand, and then structuring the learning experience to maximize the childs likelihood of success.
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Sensitivity and Cognitive Development
Sorce and Emde (1981) provided support for this hypothesis with their experimental study comparing the effect of mothers physical presence and availability with mothers physical presence and unavailability on 15-month-old infants exploratory behavior. They found that the infants displayed less pleasure and less exploration when mothers were physically present but unavailable by reading a newspaper and remained unresponsive to his or her requests for attention. Compared to the non-reading, sensitively responding mothers, those infants with emotionally unavailable mothers stayed closer to their mothers with less active interest in the play and fewer bids for their attention. Although the results of this experiment imply that an infant of an emotionally unavailable mother would be less willing to explore the environment, a critique of this assumption would be that the infant had never faced an unresponsive mother before, and this fabricated interaction is not indicative of how an infant would respond to a mother who regularly displayed a lack of responsiveness.
Moving beyond infancy, research by Matas, Arend, and Sroufe (1978) examined the relationship between the mother-child relationship and child cognitive competence with 2-year-olds using the Bayley Mental Developmental Scales (1st Ed.; Bayley, 1969; MDS) and four problem-solving tasks to assess the childrens cognitive abilities. The quality of the mother-child relationship and child attachment style was assessed using the Strange Situation (Ainsworth & Wittig, 1969) at 18 months, and sensitive maternal behavior was observed and rated by the researchers at age 2 using two seven-point scales: Supportive Presence (e.g., attentive and available to the child and mood setting, sharing the joy of his efforts) and Quality of Assistance (e.g., giving the minimal assistance needed to keep the child working, providing her child with the information he/she needs, in the way the child could
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understand, directing without solving it for him, giving space, good timing, and having
control of the situation).
According to their findings, the 2-year-olds classified as secure at 18 months showed highest mean scores of the Bayley MDI (Mental Development Index), although the mean differences were not significant. In frustrating and challenging tool-using/problem-solving tasks, the securely attached toddlers were significantly more enthusiastic, affectively positive, and persistent. Additionally, the securely attached toddlers exhibited less non-task behavior, ignoring of mothers, and noncompliance than the insecure groups. Attachment security at 18 months was related to the Supportive Presence scale at age 2 and Quality of Assistance at age 2 was related more specifically to the cognitive competence at age 2. This implies that structuring was more important to cognitive competence and that a feature of sensitivity is more related to attachment security.
Coleman et al. (2002) measured toddler cognitive performance as it relates to maternal behavior described as insensitive, which was operationalized as behavior through which a mother forcefully redirects the childs attention, ignores and reinforces the misbehavior; fidgets and shifts the childs body postures (distracting self-conscious behavior); and expresses displeasure, anger, and frustration in response to the childs task behavior. These insensitive maternal behaviors were negatively related to the toddlers scores on the Mental Development Index (MDI) of the Bayley Scales of Infant Development (BSID-II; Bayley, 1993).
In preschoolers, Fagot and Gauvain (1997) found that the maternal supportive instructional behavior at 18 months (measured by the Interactive Behavior Code, Fagot,
1983) predicted child performance on the cognitive problem-solving tasks at 30 months.
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Maternal cognitive assistance during the 18- and 30-month developmental period, which is described as task-relevant statements helping the childs accomplishments in a more effective or systematic way, predicted child cognitive task performance on the Vocabulary, Block design, and Arithmetic subtests on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI; Wechsler, 1967) at 5 years of age.
In research conducted with 40 month-olds, Smith, Landry, & Swank (2000) found that mothers with warm responsiveness and less restrictiveness across 6, 12, and 24 months had children with more optimal cognitive outcomes at 40 months. A similar study by Lewis (1993) also supported these findings with 4-year-olds. After controlling for early emotional and sensorimotor differences, maternal responsiveness at 3-5 months predicted higher competency in 4-year-olds, particularly in items involving perceptual performance. Structuring and Emotional Availability
The importance of the quality of a mothers early interactions with her infant is outlined in Winnicotts theory of Primary Maternal Preoccupation (1954). Winnecott asserts that a mother begins to develop a heightened level of self-preoccupation just prior to giving birth and into the immediate weeks following birth. In this heightened state of preoccupation, a mother appears to be in a withdrawn state from all others, which allows the mother to appropriately adapt to her infants basic needs. After this period of primary maternal preoccupation, Winnicott posits that a mother transitions to the good enough mother whereby a mother is recognized as imperfect, and this less than perfect mother is the ideal mother (Winnicott, 1960). Because of the previous maternal preoccupation, a good enough mother easily adapts to the needs of her infant. However, a good enough mother does not always accurately attend to her infants needs, but because a safe and comfortable
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holding space has been established, an infant can experience anxiety from not having his or her needs met at a manageable level. It is through this holding space that an infant learns to develop a sense of autonomous play (Winnicott, 1960; Abram, 2007). This leads to a mutual adaptation of mother and infant and is thought to be the foundation of emotional development (Abram, 2007).
The degree to which an infant feels secure or confident about his or her caregivers availability and responsiveness is related to the infants continued use of the caregiver for assistance in gaining affective and behavioral regulatory skills, forming close relationships with others, gaining a sense of autonomy, and engaging in exploratory behaviors (Denham et al., 1996; Sroufe, 1996; Zeanah & Zeanah, 2009). Part of this formation relies on the level, amount, and quality of maternal structuring, or scaffolding. The overarching mechanism suggests that it is through adult-child interactions and tutored/scaffolded experiences that children develop intellectually (Vygotsky, 1978). More specifically, children gain the most intellectually when they are taught using appropriate, structured experiences.
The theoretical root of scaffolding research originally comes from Vygotskys (1978) concept of the zone of proximal development (ZPD). The zone of proximal development refers to the parents sensitivity to the childs skill level and ability to provide the support and guidance to allow the child to progress to the next level. For example, if a child is capable of building a tower of two blocks easily and is attempting to build a tower of three blocks, the zone of proximal development is at this level. Thus, Vygotskian theory suggests that with the help of the parents who have sensitive knowledge and skills about the childs ZPD, children may successfully complete tasks that they cannot yet perform independently. This concept is most closely aligned with the EA maternal structuring scale (Biringen et al., 1998).
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Other structuring theories were developed by Dr. Maria Montessori (Montessori, 1967). Through naturalistic observation of the unteachable children, Montessori recognized a variety of sensorimotor behaviors that when nurtured, resulted in achievement test scores that were in line with typically developing students (Lilliard, 2005). Montessori focused on activities that confer learning through action (Piaget, 1970, pp. 147-8). Montessori believed that the optimal level of support from an adult for a child is fairly minimal. A maximum level of autonomy was hypothesized to best facilitate learning. Montessoris theory promoted choice in learning, and an uninterrupted period allowing for self-correction and exploration of the environment. This period allows children to become so engrossed with their task that they can appear to be excluding the caregiver or teacher, but are actually fully immersed and absorbed in the process of mastering a task. A mother may appear to be unavailable due to distancing or lack of interaction, but the nature of the EAS would account for this lack of interaction as the mother knowing the appropriate amount of structuring. A mother may not have this recognition of her infants abilities, and may even fail to meet EAS criteria for an optimally available and sensitive mother, but this may not necessarily be a detrimental approach. From this perspective, whether the mother is doing this on purpose in order to allow maximum autonomy, or doing this because she is distracted or otherwise withdrawn, a mother who is physically available to her infant but less emotionally available during some interactions may be promoting a more optimal learning environment for her infant, fostering independent exploration and growth.
Structuring and Cognitive Development
As Landry and colleagues (2000) note, the ability to interact independently without a high degree of structure and support from others is an important developmental goal.
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Reaching this goal requires the development of a range of cognitive processes including inhibition and executive functioning, and autonomous exploration is a primary step in developing these skills.
Neitzel and Stright (2003) found that maternal scaffolding behaviors were predictors of child cognitive awareness and management ability during four challenging cognitive tasks. Mothers who responded to their childs cognitive needs in a sensitive manner displayed more emotional support and less over-controlling behaviors. Neitzel and Stright (2003) concluded that mothers sensitive support influences children to put active effort on their work and allows them to be more efficient in their problem-solving behaviors when working on challenging cognitive tasks. Other studies link maternal scaffolding and instructional behaviors to cognitive development, finding that maternal behaviors that encourage a child to remain appropriately focused and to move onto more difficult tasks at an appropriate time, are positively correlated with cognitive performance (Beckwith & Cohen, 1989; Landry, Smith, Swank, & Miller-Loncar, 2000; Stams, Juffer, & van Uzendoorn, 2002).
Consistent patterns have been demonstrated regarding the connection of sensitivity and scaffolding in child cognitive development, and the quality of maternal behaviors on the mother-child dyadic relationship and child cognitive functioning continues to be explored. A mothers ability to provide guidance, encouragement through positive feedback, and the manner in which she provides instruction during problem solving tasks all play a role in scaffolding cognitive development (Meins, 1997; Neitzel & Stright, 2003; Wood, Bruner, & Ross, 1976). The parent may scaffold the childs behavior by verbal cues or nonverbal cues through a co-constructive process by taking into consideration the abilities of a child and structuring a task in accordance with those abilities (Hustedt & Raver, 2002; Montessori,
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1967; Pipp-Siegel, 1998; Vygotsky, 1934/1962;). Through this instructional interaction process, parents aim to extend the childs knowledge, reducing complexity, and transfer responsibility while providing emotional support (Bruner, 1986).
Prior research using EAS or other means has examined maternal influence during a collaborative task, typically during joint play, with a general consensus in reporting that maternal sensitivity and maternal structuring during a childs infant and preschool years influences later cognitive abilities (NICHD Early Child Care Research Network, 2005a). In one such study, Landry, Smith, Swank, and Miller-Loncar (2000), examined rural, low SES families to see if childrens later functioning was facilitated by certain maternal behaviors, namely maintaining childrens focus, responsiveness, and directiveness, during both collaborative play and daily activities. Maternal interaction style with 24-month-old children directly and indirectly influenced cognitive and social skills at 2 1/2 and 3 1/2 years. Landry and colleagues (2000, 2002) found when parents were better able to identify critical elements of the task, children were better able to sustain attention and organize strategies when attempting to solve the problem. This suggests that certain maternal behaviors may be more influential during earlier years (2 and 3 years) than later years (4 and 5 years), and that during developmental transitions, certain contexts can play lesser or greater roles in future development, and certain types of maternal behaviors would be more effective for younger children than for older children. Research looking at these effects during infancy warrants further exploration.
Although there is limited research utilizing the EAS, structuring, and cognitive performance, other research has frequently noted a relationship among cognitive, academic, and social skills and parental factors (Stevens, Blake, Viatle, & Macdonald, 1998; Tamis-
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LeMonda, Shannon, Cabrera, & Lamb, 2004), and supports maternal influence on the future development of infants problem solving skills (Freund, 1990; Hess & Shipman, 1965; Hubbs-Tait, Culp, Culp, & Miller, 2002). Dodici, Draper, and Peterson (2003) note a range of factors were related to future cognitive and social development; specifically, they report relationships between emotional tone, parental talk, engagement, parental guidance style, parental responsiveness, and parental sensitivity. The current research examined the mechanisms involved in the mother-infant dyadic relationship and cognitive performance by looking at infant behavior, specifically task orientation, as a mediator of maternal structuring (relative to scaffolding) and infant cognitive performance.
Non-Intrusiveness, Emotional Availability, and Cognitive Development
Probably the least studied EA concept as a stand-alone, maternal non-intrusiveness is equally important when viewing the whole of the dyadic relationship and potential influence on cognitive development. Attachment theorists hypothesize that exploratory behaviors should be related to cognitive development. Optimal sensitivity and structuring allow an infant to feel comfortable and explore the environment at an appropriately challenging level. Consistent with this, the American Academy of Pediatrics emphasizes the need for unstructured time without engagement from parents to promote proper social and cognitive development (Ginsberg, 2007). McFadden & Tamis-Lemonda (2013) looked at maternal parenting behaviors during mother-infant play and cognitive scores for infants at 15-months and 25-months. Interestingly, mothers depressive symptoms (e.g., withdrawn) were inversely associated with intrusive behaviors and predicted lower cognitive scores at 15 months, but not at 25 months. Marital status was inversely related with intrusive behaviors. Maternal warmth moderated the effect of intrusiveness on later child negativity, but for
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African American mothers only.
Older but relevant research has also found mixed results when it comes to intrusiveness and infant behavior outcomes. Fein and Fryer (1995) report that the effectiveness of maternal play styles represents an inverted-U-shaped function whereby distant or indirect mothers and mothers who are intrusive and tutorial have a negative influence on child symbolic play and behaviors. Mothers who offered direct suggestions, solicited pretend behaviors from their children, and participated in pretend exchanges had a positive influence on their children. From this, the general conclusion was that mothers are most effective when they provided moderate support or intrusiveness.
Previous Findings Infant Lab at the University of Colorado Denver
Although findings regarding optimal sensitivity, structuring, and to some extent, non-intrusiveness have been fairly stable over time, more recent findings go against the grain of the traditional notion that the higher levels of maternal sensitivity and scaffolding are more optimal for infant cognitive performance. In 2009, The Infant Lab at the University of Colorado Denver (Infant Lab) set out to study varying aspects of maternal emotional availability and infant learning. Based on previous literature, researchers expected to replicate the positive linear effects of sensitivity, structuring, and non-intrusiveness on infant cognitive performance. However, not only did the data lack significant correlations, there was a noted linear trend in the negative direction (see Figure 1 and Figure 2). Researchers were using the Emotional Availability Scales: Infancy to Early Childhood Version (EA Scales, 3rd ed.: Biringen et al., 1998) and infant cognitive performance on the Bayley scales (BSID-III) Cognitive Scale (Cog). The cause for this phenomenon is not readily apparent based on the literature. The current research sought to find factors that may influence these
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counterintuitive findings. With the development of the more robust 4th edition of the Emotional Availability Scales: Infancy to Early Childhood Version (Biringen, 2008), the current research attempted to replicate these findings.
baycogper
O Observed ---Linear
Figure 1. Maternal Sensitivity and Bayley Cog percentile rank R2 = 051, F(l,52),/?=.103, (3 = -.226
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baycogper
Figure 2. Maternal Structuring/Non-Intrusiveness and Bayley Cog percentile rank A2 = 068,^(1,52),/?= 113, (3 =-.220
New Views: Sensitivity, Scaffolding, Responsiveness, and Infant Cognitive Performance
Although the relationship between specific maternal behaviors and future cognitive development is fairly well established, questions still arise as to whether the research is providing an adequate picture of the direct influence of maternal behaviors on infant development. There have been few studies to examine the influence of maternal behaviors, specifically sensitivity, structuring, and non-intrusiveness, on the development of cognitive functioning (Assel, Landry, Swank, Smith, & Steelman, 2003; Landry, Miller-Loncar, Smith, & Swank, 2002). Of the studies that have examined the influence of maternal behaviors on the broad concept of cognitive skills, the majority have examined the social-emotional influence on cognitive skills, and little has been examined or established as to how specific maternal behaviors influence an infants strategic shift in learning and immediate cognitive performance.
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Traditionally, research has emphasized that maternal sensitivity, scaffolding and responsiveness play an important role for optimal cognitive outcomes (Beck, 1998; Hanson, et al., 2013; Miller, Pallant, & Negri, 2006). However, some recent research suggests that the relationship between EA and cognitive development is not strictly linear. Bomstein and Manian (2013) pursued this potential variation in parenting style by looking at mother-infant interactions in an ethnically homogenous sample of 154 mother-daughter and 181 mother-son infant dyads. Maternal responsiveness and maternal sensitivity were separately and independently evaluated. Maternal responsiveness was coded for the amount of time (in microseconds) it took for a mother to respond to particular infant behaviors. Maternal sensitivity was coded using the Sensitivity scale of the Emotional Availability Scales:
Infancy to Early Childhood Version (EA Scales, 3rd ed.: Biringen et al., 1998).
Bornstein and Manian (2013) found a threshold for maternal contingency, which is a parental quality of responding to infants cues (Keller, Lohaus, Volker, Elben, & Ball, 2003), and maternal sensitivity. When maternal response rate increased above this threshold, maternal sensitivity was deemed to be lower. Interestingly, correlation analysis did not produce significant results and implied that higher levels of response were consistent with higher ratings of sensitivity, and it was not until sequential analyses were performed that this threshold level appeared. Additionally, analysis showed that low-contingent mothers were deemed to be less sensitive, further emphasizing that a moderate level of contingency was related to a higher rating of maternal sensitivity. This research provides information to help drive the future direction of research in this area.
Further, in a separate 2013 study, Bomstein, Han, & Suwalsky looked at a developmental cascade, whereby infant physical development and exploratory behaviors
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predicted cognitive performance and academic functioning at 4 years, 10 years, and 14 years old. This effect was independent of gender, social competence, verbal intelligence, mothers supportive caregiving, and other demographic factors. Bomstein and colleagues concluded that early motor-exploratory behaviors had a positive influence on cognitive and academic performance. Consistent with attachment theory, and the theories put forth by Vygotsky and Montessori, the more willing and capable an infant was to explore their environment, the more opportunities there were for interactions and contact with novel aspects of the environment. This further demonstrated that learning is attuned to increased opportunities for manual exploration because the exploration creates an efficient means for gathering information(Adolph, Eppler, Marin, Weise, & Clearfiled, 2000; Bourgeois, Khawar, Neal & Lockman, 2005). In 2005, Striano & Bushnell found that infants who engaged in more manual object exploration were more proficient in extracting subtle differentiations in objects.
Taken together, previous research lays the foundation for the hypothesis that more task- oriented infants (i.e., an infant highly engaged in an object to the exclusion of others in the room) will demonstrate higher levels of cognitive performance on the Bayley scales (BSID-III) Cognitive Scale (Cog) because these infants are better positioned to seek out opportunities for perceptual and cognitive stimulation. Whether intentional or not, it is possible that maternal depression, lower sensitivity, less structuring behaviors, and more intrusive maternal behaviors could create an environment that affords an infant more autonomous exploration of his or her environment. A less sensitive or structuring mother would likely be taking a more backseat role, and this non-involvement could allow the infant more time to explore his or her environment at a more advanced level. Additionally, an
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intrusive mother may elicit a non-inviting response from her infant, and the infant may shift his or her attention from trying to engage the mother to being more focused on tactile exploration of the environment. Although contrary to most previous literature that report a positive linear effect of sensitivity, structuring, and non-intrusiveness, the current research attempted to demonstrate negative linear effects, consistent with the previous Infant Lab findings and based on Montessoris theory, through multiple mediation analyses.
Social Learning Strategies
To date, an overwhelming body of research regarding infant learning suggests that optimal parenting produces optimal results. More recently, the definition of what optimal parenting looks like has come into question, and the current research attempted to look at possible strategic shifts infants may make when faced with adverse situations such as maternal depression, low sensitivity, low structuring, or high maternal intrusiveness, and searching for opportunities elsewhere in their environment to facilitate the internal drive to learn. Much of this learning may be facilitated through social learning, whereby infants look to their primary caregiver to acquire skills (Sagi, Koren-Karie, Gini, Ziv, & Joels, 2002), and when the caregiver is low in sensitivity, structuring, or acts in an intrusive manner, infants will seek quality interactions elsewhere (Aviezer, Sagi-Schwartz, & Koren-Karie, 2002). When looking at social learning strategies of zebra finches, Griffith and Brown (2015) found when faced with early-life stress, young zebra finches sought tutors other than their parents. When compared to a no-stress control, zebra finches who experienced early stressors not only learned from another adult finch, but they also learned at a faster rate compared to their control peers who sought learning from their parents.
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Somewhat analogously, Kaplan, Dungan, & Zinser (2004) found that infants exposed to chronically depressed mothers not only failed to learn from infant-directed speech (IDS) from their own mothers, they failed to learn from IDS from all females regardless of depression. Furthermore, in a familiarization-preference paradigm, 4.5- to 13-month-old infants of depressed mothers who had been given a 1-minute presentation of an animated ID speaker subsequently preferred to look at a novel face, whereas infants of non-depressed mothers preferred the face of the ID speaker (Kaplan, Asherin, Vogeli, Fekri, Scheyer & Everhart, under review). Interestingly, these infants of chronically depressed mothers demonstrated learning from non-depressed fathers IDS. The research suggests that a shift in social learning strategy may be an adaptive behavior to seek a more advantageous source in an effort to fulfill the intrinsic desire to learn.
Even with emerging evidence that infants may be able to overcome factors that negatively influence engaging interactions with his or her mother, and may even adopt a more optimal learning style that allows them to supersede their peers in cognitive development, we are still challenged with disputing strongly held beliefs that make more emotional sense about how mothers should engage with their infants, and how infants will optimally respond.
Current Study
Despite a strong basis in the literature to predict that higher levels of maternal emotional availability would be correlated with relatively higher levels of cognitive development, preliminary data reviewed in Figure 1 above failed to show such an effect. In fact, there was a trend in the opposite direction: maternal emotional availability, as measured
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by a mothers rated sensitivity and structuring on the EAS, was negatively correlated with
BSID-III Cog scale percentiles.
The current study had two broad goals. The first was to attempt to replicate the 2006 Infant Lab preliminary finding of a negative correlation between rated maternal sensitivity (and structuring) and infants performance on the Cog scale of the BSID-III with a different sample. The second was to attempt to develop a preliminary understanding of this counterintuitive effect by testing predictions of a post-hoc explanation developed to explain the anomalous findings. Although most of the published literature was consistent with the prediction that greater emotional availability should predict faster cognitive development, the literature also contained hints that (a) the relationship between micro-coded maternal contingent responding to the infant and rated global sensitivity may be non-monotonic, such that too much contingency may be rated as less sensitive than optimal contingency, (b) mothers who seem low in emotional availability may actually provide infants with greater opportunity to explore their environment and possibly develop an object- rather than person-centered world orientation, and (c) infants of mothers who are low in emotional availability may behave as if they have shifted their social strategy to focus on interaction partners beyond the mother-infant dyad.
The current research examined the relationship between maternal sensitivity, structuring, and non-intrusiveness as it relates to infants cognitive performance. Based on the literature, one would expect to find a positive linear relationship between maternal emotional availability and infant cognitive performance. However, our preliminary data suggest otherwise. In addition to attempting to replicate the finding summarized in Figure 1 and Figure 2, the current study took advantage of refinements in the EAS to develop an
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understanding of potential underlying mechanisms. The EAS has over-arching scales that cover maternal sensitivity, structuring, non-intrusiveness, and non-hostility, as well as infant responsiveness to the adult and infant involvement of the adult. In addition, in its current version, each EA scale has its own set of individual subscales. The overarching scales and related subscales are presented in Table 2 in the Method section.
Through mediation analysis, specific infant involvement and infant responsiveness (e.g. infant lack of avoidance) and behaviors (e.g., infant task orientation/concentration) were observed to understand the mechanism by which specific maternal behaviors of sensitivity, structuring, and non-intrusiveness influence infant cognitive performance. For example, the Task Orientation/Concentration subscale on the Child Responsiveness scale enabled us to assess whether the children of less sensitive mothers are more task-oriented than children of more sensitive mothers, and whether this mediates the relation between sensitivity and Cog performance. The lack of avoidance subscale enabled us to test whether children of mothers displaying depressive symptoms (i.e., low affect) are rated as more or less engaging with their mothers than infants of mothers with a more balanced approach who display clear enjoyment of the child and interaction. Additionally, the lack of avoidance subscale helped ascertain whether child avoidance correlates with higher levels of cognitive development.
Aims & Hypotheses
The overarching hypothesis of the current study was that when faced with a non-optimal mother-infant dyadic relationship, infants adopt a lesser person-oriented approach, begin to exclude the mother, and search the environment for an alternate source to give attention. This alternate source, displayed as task-orientation (e.g., playing with a toy), can provide positive motor-exploratory benefits as well as facilitate autonomous exploration.
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Based on the literature and the previous and current findings of the CU Denver Infant Lab, the following are the aims and hypotheses of the current study:
Aim 1: To determine the relationship between maternal affect and infant cognitive performance. See Figure 3.
Hypothesis la: Lower levels of maternal affect will result in higher infant Bayley Cog percentile rank (path c).
Hypothesis lb: Infant task orientation/concentration and infant non-avoidance will mediate the relationship between maternal affect (al and hi) and infant Bayley Cog percentile rank (ci2 and b2). Mothers low in affect will have infants who are higher in task orientation/concentration, are more avoidant, and have a higher infant Bayley Cog percentile rank.
Figure 3. Infant task orientation, non-avoidance, maternal affect, and Cog performance
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Aim 2: To determine the relationship between maternal sensitivity and infant
cognitive performance. See figure 4.
Hypothesis 2a: Lower levels of maternal sensitivity will result in higher infant Bayley Cog percentile rank.
Hypothesis 2b: Infant task orientation/concentration and infant non-avoidance will mediate the relationship between maternal sensitivity and infant Bayley Cog percentile rank. Mothers who are lower in sensitivity will have infants who are higher in task orientation/concentration, are more avoidant, and have a higher infant Bayley Cog percentile rank.
Infant
Maternal c
Cognitive

Sensitivity Performance
Figure 4. Infant task orientation, non-avoidance, maternal sensitivity, and Cog performance
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Aim 3: To determine the relationship between maternal structuring and infant
cognitive performance. See Figure 5.
Hypothesis 3a: Lower levels of maternal structuring will result in higher infant Bayley Cog percentile rank.
Hypothesis 3b: Infant task orientation/concentration and infant non-avoidance will mediate the relationship between maternal structuring and infant Bayley Cog percentile rank. Mothers who are lower in structuring will have infants who are higher in task orientation/concentration, are more avoidant, and have a higher infant Bayley Cog percentile rank.
Figure 5. Infant task orientation, non-avoidance, maternal structuring, and Cog performance
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Aim 4: To determine the relationship between maternal non-intrusiveness and infant
cognitive performance. See Figure 6.
Hypothesis 4a: Higher levels of maternal intrusiveness will result in higher infant Bayley Cog percentile rank.
Hypothesis 4b: Infant task orientation/concentration and infant non-avoidance will mediate the relationship between maternal non-intrusiveness and infant Bayley Cog percentile rank. Mothers with more intrusive behaviors will have infants who are higher in task orientation/concentration, are more avoidant, and have a higher infant Bayley Cog percentile rank.
Figure 6. Infant task orientation, non-avoidance, maternal non-intrusiveness, and Cog
performance
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CHAPTER III
METHOD
Participants
Participants included mother-infant dyads who responded to an advertisement on Facebook and who were invited to the Infant Lab at the University of Colorado Denver to participate in a study regarding the effects of maternal depression on infant attention and learning. Of the 94 dyads who participated in this study, information for Bayley Cog performance and EAS video coding were available for 88 dyads. Demographic information collected included mean age of mothers, mean age of infants in days, infant gender, infant ethnicity, mothers education, family income, and marital status of mother.
Table 1 presents demographic information for the 88 dyads including mothers age, infant age in days, infant ethnicity, mothers education level, mothers marital status, and household income. Mothers ages ranged from 17 to 39 years, with a mean of 28.34 (SD=5.16). Infant age ranged from 114 to 410 days, with a mean age of 243.27 days (SD=90.0). Sixty-two of the infants were identified by the mother as White (70.5%), 13 as Latino (14.8%), 7 as African American (8%), 3 as Asian (3.4%), and 3 infants were identified as Native American (3.4%). The modal education level was 4.0 (earned bachelors degree), with 3.0 = earned an associates degree and 2.0= earned high school diploma. Fifty-five mothers reported being currently married (62.5%), 22 reported being currently involved with a significant other (25%) and 11 mothers reported not being currently married (12.5%). Median household income was in the $31,000 $40,000 range (n= 11, 12.5%), with reported household income ranging from $0-6000 (n=6, 6.8%) to over $50,000 annually (n=43, 49%). There were no differences as a function of maternal affect, sensitivity, and non-intrusiveness
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for infant age, maternal age, minority status, and household income. Although not statistically significant, mothers with a high school education or a 4-year college degree were more likely to have an infant engage appropriately in task orientation (p=.07), and mothers who were married were more likely than single mothers or mothers involved with a significant other to provide an optimal level of structuring (/i= 08), See Appendix B for a demographic table including EAS categorical information and Bayley Cog percentile rank for the 88 dyads.
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Table 1
Demographic Characteristics (A-88)
Frequency Percentage Min Max Mean SD
Mothers Age in years 17 39 28.34 5.16
Infant Age in days 114 410 243.37 90.90
Infant Gender (F/M) 50/50 50%/50%
Ethnicity (infant)
Caucasian 62 70.5%
Latino 13 14.8%
African American 7 8%
Asian 3 3.4%
Native American 3 3.4%
Mothers Education
(1) No High School diploma 1 1.1%
(2) High School diploma 30 34.1%
(3) Some College/Associates 9 10.2%
(4) Bachelors Degree 35 39.8%
(5) Masters Degree 11 12.59%
(6) PhD/MD/DO 2 2.3%
Family Income
(1) Less than $6k 6 6.8%
(2) $6k $10k 1 1.1%
(3) $1 lk $20k 8 9.1%
(4) $21k $25k 6 6.8%
(5) $26k $30k 3 3.4%
(6) $3 lk $40k 10 11.4%
(7) $41k $50k 11 12.5%
(8) More than $50k 43 48.9%
Mothers Marital Status
(1) Married 55 62.5%
(2) Involved with Sig. Other 22 25%
(3) Not Married 11 12.5%
Mothers Education coded from 1-6, presented next to education level Family Income coded from 1-8, presented next to income level Mothers Marital Status coded 1-3, presented next to status designation
5.35 1.18
6.27 2.25
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Data Collection/Procedure
Data from the current study were collected as part of study protocol 11-1641 approved by the Colorado Multiple Institutional Review Board (COMIRB). Mother-infant dyads were greeted by research assistants and asked to complete a study consent form approved by our institutional review board. The mothers then completed a demographic questionnaire and a self-report measure of depressive symptoms. With assistance from research personnel, infants completed a familiarization/preferential looking auditory attention paradigm before taking part in an assessment of cognitive development using the Bayley Scales of Infant Development III, administered by a trained graduate student. Mothers and infants were then recorded during a 10-minute semi-structured play session with a variety of age-appropriate toys available. Mothers were then administered a structured clinical interview by a graduate level student in clinical psychology to assess for a clinical diagnosis of depression. Total participation time lasted approximately two and a half hours.
Participants were compensated fifty dollars for their time.
Measures
Bayley Cog scaled scores were determined using the BSID-III manual and converted to percentile rank. A certified rater in EAS coding viewed a 10-minute, semi-structured play, dyadic interaction. The coder had no prior knowledge of the psychological assessment results (Beck Depression Inventory, Postpartum Depression Screening Scale, and SCID), and all efforts were made to limit knowledge of maternal diagnosis prior to coding. The coder administered 25 of the 88 SCIDs used to determine psychiatric diagnosis and delayed the dyadic coding the interactions for an average of 14.35 months after SCID administration.
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The six EAS include: Sensitivity, Structuring, Non-Intrusiveness, Non-Hostility, Child Responsiveness, and Child Involvement.
Subscales of the Sensitivity scale included: Affect; Clarity of Perceptions and Appropriate Adult Responsiveness; Awareness of Timing; Flexibility, Variety, and Creativity; Acceptance; Amount of Interaction; and Conflict Situations.
Subscales of the Structuring scale included: Provision of Guidance; Success of Attempts; Amount of Structure; Limit Setting; Remaining Firm in the Face of Pressure; Verbal vs. Non-Verbal Structuring; and Peer vs. Adult Role.
The subscales of the Non-Intrusiveness scale were: Follows Childs Lead; Non-Interruptive Ports of Entry; Commands, Directives; Adult Talking; Didactic Teaching; Physical vs. Verbal Interferences; and Made to Feel Intrusive.
The subscales of the Non-Hostility scale included: Lack of Negativity (face or voice); Lack of Mocking; Lack of Threats of Separation; Does Not Lose Cool; Frightening Behaviors; Silence; and Hostile Themes of Play.
The sub scales of the Infant/Child Responsiveness scale included: Affect/Emotional Regulation; Responsiveness; Age-Appropriate Autonomy Seeking; Positive Physical Positioning; Lack of Avoidance; and Task Oriented/Concentration.
The sub scales of the Child Involvement scale included: Simple Initiative; Elaborate Initiative; Use of Adult; Lack of Over-Involvement; Eye Contact; Body Positioning; and Verbal Involvement.
Table 2 provides a summary of the six scales and seven corresponding subscales of the EAS 4th edition. See Appendix A for a detailed description of the EAS scales and subscales.
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Table 2. Emotional Availability Scales and Subscale Descriptions
Sensitivity accurate reading of cues and expressing a range of emotions to establish a healthy connection Structuring Positive suggestions and guidance of child Non-Intrusiveness Being available without being intrusive
Affect looks at range from balanced and genuine to bland or depressed/withdrawn Clarity of Perceptions awareness of signals and responds appropriately Timing Aware of importance of timing Flexibility Play is fun and adult is flexible Acceptance spcaks/acts in respectful ways Amount of interaction right amount or too little Conflict moves conflicts to resolution Guidance proactive and appropriate variety of suggestions Success successful attempts of moving child to higher level Amount Right amount of structure or too littlc/nonc Limit Setting appropriate boundaries arc set Firm in Pressure can remain firm but connected in interaction (docs not cave easily) (Non)Verbal Structuring both, one, or neither channel used Peer vs. Adult Adult is clearly older and wiser Following Child Lead has an appropriate spacious quality Ports of Entry waits for optimal breaks to enter interaction Commands Dos used sparingly Adult Talking talking used as dialogue and not overpowering Didactic Teaching teaches without ignoring relating Interferences Only verbal and only when necessary Feel Intrusive child does or docs not indicate the adult is intrusive
Non-Hostility Displays of overt and/or covert hostility Child Responsiveness whether child responds to adult in positive way Child Involvement degree to which child involves the adult
Lacks Negativity in words or tone of voice Lacks Ridiculing mocking/ridiculing statements or behaviors Lacks Threat of Separation use of separation as a threat Lose Cool ability to maintain composure during stressful time Frightening evidence of physical or verbal assaultive behavior Silent amount of silence in interaction Themes play is appropriate but not malevolent Affect ranging from upbeat to inappropriate to sad/irritablc Responsiveness when adult initiates, child responds Autonomy right amount of age-appropriate seeking Physical Positioning seeks or avoids physical contact Role Reversal parent-like behaviors by child Lack of Avoidance attentive to play and does not exclude Task Oriented appropriate level of focus on object play Elaborative Initiative engages in elaborate way Simple Initiative child initiates the engagement Use of Adult Uses adult for emotional exchange and not as a tool Lack of Over-Involvement negative or overinvolving behaviors Eye Contact appropriate amount to none Body Positioning child positions body toward adult Verbal Involvement involves through talking/babbling


Dyads were given an appropriate score for each of the six scales and 35 subscales. Direct Scores reflect a measure of the overall nature of the interaction for that particular scale. Direct Scores range from 1-7, with .5 scores allowed. Subscales are scored either in a range of 1 through 7 (with .5 scores allowed) or 1 through 3. For Direct Scores and subscales rated 1 through 7, a score of 7 is optimal, scores between 5 and 6.5 are in the acceptable range, and scores 4.5 or below are indicative of a sub-optimal demonstration of the specific feature of emotional availability. For the subscales ranging from 1-3, a 3 would be the most preferred and optimal presentation, a score of 2 would be in the acceptable range, and a score of 1 designates either miss or sub-optimal demonstration of the behavior or emotional aspect being rated.
All scales and subscales on the EAS 4th edition are linear and framed in the positive direction (Biringen, 2008). For example, a high score on the Non-Intrusiveness scale would indicate a mother who is helpful and interferes only when necessary or asked. A low score on the Non-Intrusiveness scale would indicate a mother who intervenes often, regardless of necessity or invitation to do so. A score of 3 on the Task-Orientation/Concentration subscale would indicate the infant has a balanced level of interest when playing with a toy, whereas a score of 1 on this subscale would indicate the infant is more hyper-focused on the toy, to the exclusion of others in the room. The predictors in these analyses included maternal Affect (subscale of the Sensitivity scale), Sensitivity, Structuring, and Non-Intrusiveness. The mediators used in analyses included infant Task Orientation/Concentration and infant Non-Avoidance, both subscales of the Child Responsiveness scale. See Figure 7 for an outline of scoring for the scales and subscales of the EAS 4th Edition.
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| Sensitivity
Non-Hostility
Direct Affect
1 to 7
Clarity of Perceptions 1 to 7
Timing 1,2,3 "
Total Flexibility 1,2,3 ''
Acceptance 1,2,3 "
Amount of Interaction 1,2,3
Conflict 1, 2, 3

Structuring
Direct Guidance 1 to 7
Success 1 to 7
Amount of Structure 1,2,3
Total Limit Setting 1,2,3
0 Firm in Pressure 1,2,3
(Non)verbal structuring 1, 2,3 "
Peer vs. Adult 1,2,3 "

Non-Intrusiveness
Direct Following Child Leads 1 to 7 'l
Ports of Entry 1 to 7
Commands 1,2,3
Total Adult Talking 1,2,3
Q Didactic Teaching 1,2,3 '
Interferences 1,2,3
Feel Intrusive 1, 2, 3
Direct Lack Negativity 1 to 7
Lack Ridiculing lto7
Lack Threats of Separation 1, 2, 3
Total Lose Cool r 1, 2, 3
Frightening 1, 2, 3
Silence 1, 2, 3
Themes
Child Responsiveness
Direct Affect
Task Oriented
Child Involvement
Direct Simple Initiative
1, 2, 3
1 to 7
Responsiveness 1 to 7
Autonomy Seeking 1, 2,3
Total Physical Positioning 1, 2, 3
0 Role-Reversal V 1, 2, 3
Lack of Avoidance 1, 2, 3
1, 2,3
1 to 7
Elaborative Initiative 1 to 7
Use of Adult 1, 2, 3
Total Lack of Over-Involvement 1, 2,3
Eye Contact 1, 2,3
Body Positioning 1, 2,3
Verbal Involvement 1, 2,3
Figure 7. EAS scoring
Predictor. The current study had four predictors: Maternal Affect (AFT); Maternal Sensitivity (SNS); Maternal Structuring (STR); and Maternal Non-Intrusiveness (INV). Sensitivity, Structuring and Non-Intrusiveness are scales on the EAS. Maternal Affect is a subscale of the Maternal Sensitivity scale of the EAS. Because maternal mood in the postpartum period has been shown to influence child engagement and child cognitive outcomes, the current research is using this as a separate predictor in an effort to identify the presence of maternal depressive symptoms. Low maternal affect is indicative of a mother who is bland, neutral, inconsistent, or may seem to be cool or detached. Low Sensitivity is seen in mothers who do not accurately read the cues of their infant and lack of range of emotion in their engagement with their infant, which interferes with the ability to establish a healthy connection in the interaction. Mothers low in Structuring may have inadequate quality and/or quantity of structuring, or may be inconsistent with the style of structuring
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they provide. Mothers low in Non-Intrusiveness will be more didactic in their teaching style, demonstrate physical and/or verbal interferences, and through his or her behavior, infants will indicate that the mother is being intrusive by failing to respond to the mothers actions or providing signals such as moving away from the mother. All predictors will be assessed using the score assigned by the EAS coder.
Mediators. This study has two mediators: infant task orientation/concentration (TSK) and infant non-avoidance (AVD). Both infant task orientation/concentration and infant nonavoidance are individual subscales of the EA Child Responsiveness scale on the EAS. Both mediators will be assessed using the score assigned by the EAS coder. Lower scores on the task orientation/concentration subscale are indicative of an infant who is focused on an object of play to the exclusion of the mother, and lower scores on non-avoidance are indicative of a child who is not connected to the mother and/or may seem avoidant of his or her mother.
Outcomes. Bayley Cog performance was measured using the percentile rank based on the scaled score on the cognitive scale of the Bayley Scale of Infant and Toddler Development III (BSID-III). The BSID-III is an individually administered instrument assessing the developmental functioning of infants and children between 1 month and 42 months of age. The Cog scale is comprised of 91 items that assess sensorimotor development, exploration and manipulation, object relatedness, concept formation, and memory.
Data Cleaning
The full dataset was entered into SPSS. Data with missing values were coded 99999 in order to distinctly identify these items. The original dataset included 94 dyads, of which five dyads did not have EAS videos available for coding and one dyad was missing
43


BSID-III results due to an incomplete test. Because the mediation results were reliant on both EAS and Bayley Cog results, 88 dyads were included in the final analysis. Descriptive statistics including mean, median, mode, standard deviation, and frequency distribution charts were analyzed, and there were no identifiable outliers or data entry errors.
Data analysis
Data were analyzed using IBM SPSS Statistics version 24 (SPSS Inc., 2016). Descriptive statistics (e.g., means, standard deviations, frequency distributions) were calculated to describe the sample. Differences in demographic and clinical attributes across ethnicity, income level, education, and marital status were assessed by chi square tests for categorical variables.
Multiple mediation analyses were performed to detect indirect effects of maternal affect and behaviors on infant cognitive performance via infant behaviors. Mediation models are utilized to investigate whether certain variables can partially explain the relationship between two other variables. A mediator acts as a third variable and represents the mechanism through which an independent variable influences an outcome (Baron & Kenny, 1986; Hayes, 2013). A mediation model involves three key variables: an independent variable, X, a mediating variable, M, and a dependent variable, Y. Whereas in basic linear regression the X variable leads directly to the Y variable (i.e., direct effect or c-path), in this type of path analysis, the X variable leads to M, which in turn leads to Y (i.e., indirect effect or c -path). The mediator reduces the direct effect, thereby creating a statistically significant indirect effect (Jose, 2013). Additional independent variables, mediating variables, and other components can be added to the basic mediation model to create increasingly complex mediation models.
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Baron and Kenny (1986) propose a four step approach to mediation analysis. All steps were conducted as part of bootstrapping analysis using the PROCESS macro in SPSS. Step one included a regression analysis with X predicting Y for path c alone (IV is related to DV). For these analyses, hypotheses la, 2a, 3a, and 4a were tested using linear regression analysis to evaluate specific maternal behaviors as predictors of Bayley Cog percentile rank. Step two included a simple regression analysis with X predicting M to test for path a. Step three included a simple regression analysis with M predicting Y to test the significance of path b alone. Step four included examining the attenuation of the effect of X on Y when controlling for M. The purpose of Steps 1-3 is to establish that statistically significant associations exist between the variables to be included in the mediation analysis. If one or more of these relationships are nonsignificant, researchers usually conclude that mediation is not possible or likely (Jose, 2013; MacKinnon, Fairchild, & Fritz, 2007). Step 4 assumes there are significant relationships from Step 1 through 3. In the Step 4 model, some form of mediation is supported if the effect of M (path b) remains significant after controlling for X. If X is no longer significant when M is included in the model, the finding supports full mediation. If X is still significant (i.e., both X and M both significantly predict Y), the finding supports partial mediation (Hayes, 2013).
The current study proposed multiple mediators, and because of this, hypotheses lb, 2b, 3b, and 4b followed steps two through four, testing both a paths and both b paths simultaneously. The benefit of testing multiple mediators simultaneously rather than separately is that competing mechanisms are matched against one another, and significant results will signify that the mediation effect is independent of the effect of the other mediator (Hayes, 2013; Kenny, 2016).
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Bootstrapping
One assumption of regression analysis is normality. The goal normal distribution is to maximize the association (r) and statistical power (Tabachnick & Fidell, 2013). For multiple mediation analysis, the path of the indirect effects must follow a normal distribution; but, it is also assumed that total indirect effects are normally distributed. For indirect effects, it is also implied that there is not only a significant relationship between the mediator and the dependent variable, but also some direct relationship between the independent and dependent variable. One means of testing the indirect effect is bootstrapping (Preacher & Hayes, 2008). Bootstrapping is a non-parametric test, and therefore it will not violate the assumptions of normality because it accounts for skewness, and a and b do not have to be uncorrelated (MacKinnon, Lockwood, Hoffman, West, & Sheets, 2002; Preacher & Hayes, 2004). Bootstrapping is a technique involving a re-sample that randomly samples participants from the sample with replacement by creating 1000s of simulated datasets (Hayes, 2013), and it is a preferred method when working with small sample sizes (Kenny, 2016). Additionally, bootstrapping has a lower Type II error rate and has greater statistical power than the traditionally used causal steps approach by Baron and Kenny (1986) (MacKinnon, Lockwood, Hoffman, West, & Sheets, 2002; Preacher & Hayes, 2004, 2008; Shrout & Bolger, 2002).
The bootstrapping method acts as if the sample is the population and simulates samples from that population. Correction for bias is made, because the mean of each bootstrapped distribution is not exactly equal to the indirect effect. Bootstrapping provides point estimates and confidence intervals by which one can assess the significance or nonsignificance of a mediation effect. Point estimates reveal the mean over the number of
46


bootstrapped samples. A confidence interval is generated to determine if zero falls between the resulting confidence intervals of the bootstrapping method. If zero is not in the interval, one can confidently conclude that the indirect effect is different than zero. The current research used the PROCESS macro in SPSS (Preacher & Hayes, 2008) for bootstrapping to test for the significance of mediation. Tests of indirect effects were conducted using a bootstrapping method performed in line with recommendations by Preacher & Hayes (2008), with k= 5,000 re-samples and 95% bias-corrected and accelerated (BCa) confidence intervals (Cl) used to evaluate indirect effects. BCa confidence intervals include corrections for median bias and skew (Efron & Tibshirani, 1993). The use of 95% confidence intervals is equivalent to testing for significance at the .05 level.
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CHAPTER IV
RESULTS
Descriptive Statistics
Analyses were conducted to address the four Specific Aims and test the related hypotheses. Table 3 presents the descriptive statistics for maternal and infant EAS variables, as well as Bayley Cog for the sample (7V=88). Mean scores on maternal EAS variables ranged from 5.34 to 6.42 out of a possible 7. Modal infant EAS variables of non-avoidance and task orientation were both 3 out of a possible 3. Mean Bayley Cog was 66.16th percentile, ranging from 1st percentile to 98th percentile. See Appendix C for frequency distribution charts for all six EAS variables.
Table 3
Descriptive Statistics of Maternal and Infant EAS Variables and Bayley Cog.
(JV= 88) Min Max Mean Mode SD
Maternal EAS Variables
Affect 3 7 6.42 7 0.78
Sensitivity 3 7 5.97 6 1.08
Structuring 2.5 7 5.98 7 1.29
Non-Intrusiveness 3 7 5.34 7 1.29
Infant EAS Variables
Non-Avoidance 1 3 2.59 3 0.69
Task Orientation/Concentration 1 3 2.49 3 0.69
Infant Bayley Cog .01 .98 .66 .75 0.24
Maternal EAS Variables based on scores ranging from 1-7 Infant EAS Variables based on scores from 1-3
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Correlations
Pearsons product-moment correlations were analyzed to examine existing relationships between the four predictor variables (Affect/AFT, Sensitivity/SEN, Structuring/STR, Non-Intrusiveness/INT), two mediators (Non-Avoidance/AVD, Task Orientation/TSK), and the outcome variable (Bayley Cognitive Percentile Rank/COG). As predicted, Bayley Cog was negatively related to maternal affect, maternal sensitivity, maternal structuring, infant non-avoidance, and infant task-orientation/concentration (r =-.209 to -.261). Contrary to what was predicted, Bayley Cog was not significantly correlated with maternal non-intrusiveness. All predictor variables on the EAS were significantly positively related to each other (r = .247 .671), meaning that mothers with higher EAS maternal affect scores were more sensitive, better at structuring, and less intrusive. All predictor variables and mediator variables were positively correlated with one another, thereby validating grounds to proceed with Step 1 of mediation analysis. Because all predictor and mediation variables, apart from INT, were negatively correlated with the outcome variable (COG), there was support to proceed with mediation analyses for all hypotheses except for Hypothesis 4, as the relationship between INT and COG was not initially demonstrated. Means, standard deviations, and inter-correlations among variables are presented in Table 4.
49


Table 4
Inter-correlations, Means, and Standard Deviations
Diagnostic Sample (N= 88) COG AFT SEN STR INT AVD TSK
Bayley Cognitive Percentile (COG) -
Maternal Affect (AFT) -.214* -
Maternal Sensitivity (SEN) -.261* .671** -
Maternal Structuring (STR) -.223* .643** .781** -
Maternal Non-Intrusiveness (INT) -.126 .247* .390** .326** -
Infant Non-Avoidance (AVD) -.217* .360** .468** .438** .375** -
Infant Task Orientation (TSK) -.209* .253* .384** .284** .319** .595**
Mean 66.16 6.42 5.98 5.64 5.57 2.59 2.49
SD 23.68 0.78 1.08 1.29 1.11 0.52 0.69
*p = <. 05
**p = <.01
AFT, SEN, STR, INT based on score 1-7, with score < 5 considered non-optimal AVD and TSK based on score 1-3, with score < 3 considered non-optimal
Mediation analyses
Once significant relationships between each pair of variables were established, each mediational model was individually tested as part of the bootstrapping technique. To examine Step 1 and 2 of the mediation effect of infant EAS domains on maternal EAS domains and Bayley Cog, Bayley Cog was regressed onto each specific maternal domain and both infant domains of the EAS such that the maternal EAS domain was entered in at Stage 1 and infant EAS domains were entered in at Stage 2. The four mediation models were then analyzed, examining the parallel mediation effect of two infant EAS domains on the relationship between four maternal EAS domains and Bayley Cog. The confidence interval estimates are reflective of the 5000 resamples, and the point estimates indicate best
50


estimations of single sample population parameters. Mediation was considered to have occurred if the 95% BCa confidence intervals generated by the bootstrapping method did not contain zero.
The following are the mediation analysis results for each Aim and Hypothesis:
Model 1
Aim 1: Identify mediating effect of infant task orientation and infant non-avoidance on maternal affect and Bayley Cog.
Hypothesis la: Lower levels of maternal affect will result in higher infant Bayley Cog percentile rank (path c). Hypothesis la was supported. There is a significant relationship between the maternal affect EAS domain on Bayley Cog, with lower maternal affect scores related to higher Bayley Cog R2 =.0459, F(l,86), p< .05, (3 =-6.50.
Hypothesis lb: It was predicted that Infant task orientation/concentration and infant nonavoidance would mediate the relationship between maternal affect (al and hi) and infant Bayley Cog percentile rank (a2 and hi). Mothers low in affect would have infants who are higher in task orientation/concentration, are more avoidant, and have a higher infant Bayley Cog percentile rank. Our mediation model was not supported. Maternal affect was significantly related to both proposed mediators (Mi AVD: R2=.06, F(l, 86) = 5.87, p < .02, (3=23; M2 TSK: R2=. 13, F(l, 86) = 12.80, p < .001, (3=24), as well as significantly related to Bayley Cog R2=. 05, F(l, 86) = p < .02, (3=.23. The total effect of maternal affect on Bayley Cog (c path), (3 = -6.50, p < .05, became non-significant (c path), (3 = -4.59, p = .08, when the mediators of infant task orientation and infant non-avoidance were included in the model. However, the total indirect effect through the two mediators was not significant in this model (95% BC/CI of Mi = -4.65 to 1.53; M2 -3.30 to .50). These results indicate that infant task
51


orientation and infant non-avoidance do not significantly mediate the relation between maternal affect and Bayley Cog.
See Figure 8.
Figure 8. Direct and indirect pathways between infant task orientation, infant non-avoidance,
maternal affect, and Cog performance
Total effect of X on Y = c
Indirect effect of X on Y through Mi = albl
Indirect effect of X on Y through M2 = a2b2
Direct effect ofXon Y = c'
*p<.05
**p<.01
***p<.001
Model 2
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Aim 2: Identify mediating effect of infant task orientation and infant non-avoidance on
maternal sensitivity and Bayley Cog.
Hypothesis 2a: Lower levels of maternal sensitivity will result in higher infant Bayley Cog percentile rank. Hypothesis 2a was supported. There is a significant relationship between the maternal sensitivity EAS domain on Bayley Cog, with lower maternal sensitivity scores related to higher Bayley CogR2 =.0683, F(l,86),/?< .02, (3 = -5.74
Hypothesis 2b: Infant task orientation/concentration and infant non-avoidance will mediate the relationship between maternal sensitivity and infant Bayley Cog percentile rank. Mothers who are lower in sensitivity will have infants who are higher in task
orientation/concentration, are more avoidant, and have a higher infant Bayley Cog percentile rank. Our mediation model was partially supported. Maternal sensitivity was significantly and positively related to AVD and TSK (Mi AVD: R2=.06, F(l, 86) = 5.87, p < .02, b=.23; M2 TSK: R2=. 13, F(l, 86) = 12.80, p < .001, b=.24), as well as significantly and positively related to Bayley CogR2=.05, F(l, 86) = p < .02, b=.23. However, TSK and AVD were not significantly related to Bayley Cog (Mi: b=-.0314,/?=.49; M2 TSK: b=-.0332,/?=.59). The final model including maternal sensitivity and the predicted mediators revealed that the relationship between TSK and AVD and Bayley Cog was not significant when controlling for maternal sensitivity; R2=.09, F(3, 84) = 2.61,/? = .057. Adding TSK and AVD to the model reduced the strength of the relationship between maternal affect and Bayley Cog (b = -.0422; t = -1.61,/? = .11). These results suggest this model is approaching partial mediation. See Figure 9.
Infant
Maternal c
Cognitive
-5.74*
Sensitivity Performance
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Figure 9. Infant task orientation, non-avoidance, maternal sensitivity, and Cog performance Indirect effect of X on Y through Mi = albl Indirect effect of X on Y through M2 = ci2b2 Direct effect of Y on Y= c'
*p<.05
**p<.01
***p<.001
Model 3
Aim 3: Identify mediating effect of infant task orientation and infant non-avoidance on maternal structuring and Bayley Cog.
Hypothesis 3a: Lower levels of maternal structuring will result in higher infant Bayley Cog percentile rank. Hypothesis 3b was supported. There is a significant relationship between maternal structuring EAS domain on Bayley Cog, with lower maternal structuring scores related to higher Bayley R2 =.0498, F(l,86),/i<.05; (3 = -.4.10.
Hypothesis 3b: Infant task orientation/concentration and infant non-avoidance will mediate the relationship between maternal structuring and infant Bayley Cog percentile rank. Mothers
54


who are lower in structuring will have infants who are higher in task
orientation/concentration, are more avoidant, and have a higher infant Bayley Cog percentile rank.
Our mediation model was not supported. Maternal structuring was significantly related to both proposed mediators (Mi AVD: R2=.06, F(l, 86) = 5.87, p < .02, (3=23; M2 TSK: R2=. 13, F(l, 86) = 12.80, p < .001, (3=24), as well as significantly related to Bayley Cog R2=.05, F(l, 86) = p < .02, (3=.23. The total effect of maternal structuring on Bayley Cog (c path), (3 = -4.10,p < .05, became non-significant (c path), (3 = -4.01, p = .19, when the mediators of infant task orientation and infant non-avoidance were included in the model. However, the total indirect effect through the two mediators was not significant in this model (95% BC/CI of Mi = -2.36 to 0.27; M2 -3.08 to 1.34). These results indicate that infant task orientation and infant non-avoidance do not significantly mediate the relation between maternal structuring and Bayley Cog. See Figure 10.
Maternal c
Structuring -4.10*
Infant
Cognitive
Performance
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Figure 10. Infant task orientation, non-avoidance, maternal structuring, and Cog performance Indirect effect of X on Y through Mi = albl Indirect effect of X on Y through M2 = ci2b2 Direct effect of Y on Y = c'
*p<.05
**p<.001
Model 4
Aim 4: Identify mediating effect of infant task orientation and infant non-avoidance on maternal non-intrusiveness and Bayley Cog.
Hypothesis 4a: Higher levels of maternal intrusiveness (as reflected by lower INT EAS score) will result in higher infant Bayley Cog percentile rank. Hypothesis 4a was not supported. Lower maternal non-intrusiveness scores were not related to higher Bayley Cog at a statistically significant level R2 =.0158, F(\,86),p = ,24(ns); (3 = -.2.69.
Hypothesis 4b: Infant task orientation/concentration and infant non-avoidance will mediate the relationship between maternal non-intrusiveness and infant Bayley Cog percentile rank.
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Mothers with more intrusive behaviors will have infants who are higher in task orientation/concentration, are more avoidant, and have a higher infant Bayley Cog percentile rank. Because this model failed to produce significant results at step one, a mediation effect could not be demonstrated. However, there was an observable linear trend that supported this hypothesis. Table 5 presents the regression results.
Table 5
Regression Coefficients, Standard Errors, and Model Summary Information for mediation Model 4__________________________________________________________________________________
Consequent
Mi(TSIO A7TAVD) Y (Bavlev CoCT
Antecedent P SE P p SE P P SE P
X (INT) ai .176 .047 .003 a2 .201 .064 .002 c -.820 2.47 .741
Mi (TSK) bi -4.01 4.53 .378
M2 (AVD) b2 -6.08 6.22 .331
Constant iMi 1.61 .266 .000 /M2 1.37 .365 .003 iy 96.45 15.42 .000
R2 = 1.41, F(\, 86) R2 = .102, F(\, 86) R2 = .059, F(3, 84) =
= 14.09,/? < .01 =9.16, p <.01 1.13, p = .167
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CHAPTER V
DISCUSSION
Overview
The current study proposed and tested the hypothesis that when compared to peers with optimal mother-infant interactions, infants faced with less emotionally available mothers will make a strategic shift in learning and explore his or her environment more, resulting in increased cognitive performance on the Bayley Scales of Infant Development III (BSID-III). The overarching goal of this study was to replicate counterintuitive findings from the Infant Lab at the University of Colorado Denver that lower maternal sensitivity and structuring was related to higher Bayley Cognitive percentile rank (Bayley Cog). Additionally, the current study set out to identify mediating factors in infant behavior that would help explain the relationship between less favorable maternal behaviors, as outlined on the Emotional Availability Scales (EAS), and higher Bayley Cog.
Regarding infants shift in learning, the current study looked at infant behaviors of task orientation and non-avoidance, as identified on the Child Responsiveness scale of the EAS, as potential mediators between maternal affect, maternal sensitivity, maternal structuring, maternal non-intrusiveness and cognitive development. Using the EAS, videos of 88 mother-infant dyads were coded, rating both the maternal and infant behaviors. EAS scores for maternal behaviors were input as predictors in four separate mediation models, with the scores for the infant behaviors entered as parallel mediators for each of the four models.
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Description of Results
Results of the current study not only replicated the previous findings by the Infant Lab indicating a trend that lower levels of maternal sensitivity were related to higher Bayley Cog but found this association to be statistically significant. Additionally, maternal affect and maternal structuring produced similar results, demonstrating a significant relationship between more blunted or mixed affect and lower quality of structuring behaviors and higher Bayley Cog. Unlike predicted, maternal intrusiveness was not predictive of higher Bayley Cog, but there was a notable linear trend, which may warrant further study with a larger sample size.
The multiple mediation analyses produced mixed results. Infant task-orientation and infant non-avoidance failed to explain the relationship between maternal affect, maternal structuring, and maternal non-intrusiveness and Bayley Cog. Results did indicate that infant task-orientation and infant non-avoidance are approached significance as a mediator when explaining the relationship between maternal sensitivity and Bayley Cog. Apart from maternal non-intrusiveness, all variables were correlated with one another at a significant level. On all mediation models, the relationship between infant task-orientation and infant non-avoidance and Bayley Cog (6-path) was no longer significant when accounting for maternal behavior (X). Overall, the models tested failed to explain the relationship between lower levels of maternal affect, sensitivity, and structuring and increased infant cognitive performance at a statistically significant level, suggesting that proposed mediators do not play a role in this counterintuitive relationship.
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Explanation of Results
One possible explanation for this failure to identify the predicting mediating variables is that both infant variables are on a scale of 1-3, and there was only one infant who fell in 1 category for infant non-avoidance. The bootstrapping technique may have identified this mediator as dichotomous due to the non-normal distribution, with many of the 5000 iterations only including two potential variables to predict the outcome. To account for this possibility, variables were transformed to be normally distributed, and post hoc analyses produced nearly identical results. This supports that bootstrapping accounted for data that were not normally distributed. It is more likely that the mediators (M) are so highly correlated with the predictor (X), and this accounts for the correlation between M and Y. Therefore, when both are in the model, the variance of M is soaked up by the variance of X and Y. Additionally, due to the single time point nature of the design, it is difficult to identify a mediator that explains this relationship outside the specific time-frame of testing.
Another potential explanation for the failure to support the hypothesized mediation effect may lay with the mediators themselves. The maternal factors of the EAS provided support for the predictive relationship between X and Y, the counter-intuitiveness of this relationship seems to indicate that likely mediating factors exist, but observable factors of the EAS do not explain this relationship. As a post hoc analysis, infant age was converted from days to months to more clearly identify if age were influencing performance on the BSID-III, however, results remained normally distributed. Looking beyond the EAS, videos of the mother-infant dyad for those infants with the five highest and five lowest Bayley Cog were reviewed, attempting to observe if there were any identifiable trends or mannerisms in
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mother, infant, or both. There were no overt or consistent trends in behaviors among either group, but review of these videos did help to create potential mediating explanations.
A possible explanation for this counter-intuitive relationship in the mother-infant relationship is that the mother is aware of her infants advanced cognitive capabilities but appears to be less sensitive because she is allowing her infant to engage more autonomously in his or her environment (K. Everhart 2015, personal communication). The mother of an advanced infant may either consciously or unconsciously behave in a manner that fosters the infants learning level, and thus, she may step back with the confidence that her infants needs are being met. A possible way to account for this would be interviewing the mother at the beginning of the session, asking questions regarding her perception of her infants level of learning and cognitive functioning. Careful consideration should be given to this hypothesis because albeit a small sample of post hoc observation (n = 10), mothers with lower sensitivity scores (SEN < 5) also appeared to have more mixed levels of affect. In fact, in post hoc regression analysis, maternal affect was predictive of maternal sensitivity R2 = .451, A(l,86) = 70.62, p <.001. The EAS coding does account for varied levels of interaction, and a mother does not need to be fully engaged at all times to be considered sensitive. However, because the EAS cannot identify the reasons for a mother appearing withdrawn or less sensitive, future research would benefit from exploring the mothers interpretation of her infants abilities.
Limits of EAS
The EAS does provide a comprehensive view of the mother-infant dyadic relationship, but it is limited in some areas such as identifying joint attention (K. Everhart 2015, personal communication). Joint attention is an interactive behavior of shared attention
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on an object or event with a mutual understanding that this a shared interest exists (Sheinkopf, Mundy, Claussen, & Willoughby, 2004) and plays an important role in maternal sensitivity and structuring. Joint attention generally begins to emerge around 9-months of age and is well established between 12-14 months of age (Slaughter & Mcconnell, 2003). Infants exhibit interest in an object and pair this with an eye gaze toward an object and a caregiver with the intention of sharing some aspect of the object, rather than simply trying to communicate a desire to engage with the object alone (Henderson & Jennings 2003). This early form of social interaction can also be seen when a parent or caregiver presents an object and the infant looks at the object and then looks back to the parent as a form of interactive feedback, a phenomenon known as social referencing.
Although social referencing may be partially assessed through the Eye Contact and other features of the Infant Involvement scale of the EAS, overall, the EAS does not provide an adequate means of identifying joint attention. Understanding the early development of joint attention might add to understanding critical time periods in infant development. Because of the younger age of the current sample, a follow-up or longitudinal study identifying the presence or absence of joint attention in the current sample would help identify if there is a downshift in Bayley Cog related to joint attention. If infants who were previously performing better than peers failed to develop quality joint-attention skills and subsequently had lower Bayley Cog, this could help to identify the possibility of a time-sensitive period in which infants can compensate for diminished maternal interactions. This would further support the idea that a mother should take measures to improve her own emotional functioning and interactive skills and her infant may not realize long-term ramifications from less robust interactions.
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Current Study Limitations
The current study is not without limitations. Given the relatively small sample size (n = 88) and the narrow range of demographics of mothers and infants, a larger sample may provide a more detailed view of demographic and behavioral variables that influence the mother-infant relationship and infant cognitive development. Along with longitudinal research to see if the demonstrated effect is sustained over time, a replication of the Bomstein and Manian (2013) study may further clarify the role of maternal contingency and provide a viable explanation of the relationship between maternal sensitivity and infant cognitive development. Additionally, the single time point design has limits in that only a specific timeframe in the mother-infant relationship was captured, and factors such as time of day, illness, teething, and stressful life events may have influenced the results. Furthermore, the current research did not account for infant temperament, which is known to have an impact on maternal engagement with an infant (Feng, Shaw, Skuban, & Lane, 2007). Future research would benefit from including measures to identify infant temperament, as well as maternal perceptions of the ability to confidently engage in a quality relationship with their infant. Current Study Strengths
Strengths of the current study include not only the successful replication of previous research findings, but findings adding to the research on maternal influence on infant learning. Previous research has examined ways mothers adapt to an increase in infants cognitive skills by adjusting the nature of scaffolding (Goldberg, 1977), but research is limited when looking at how infants may adapt their learning strategies when they have an unavailable mother. Indeed, research supports that a healthy attachment relationship in infancy is pertinent to learning, health, and social and emotional functioning for the child
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(Biringen et al., 2014; Field, 1981; Lumeng et al., 2012). Therefore, it is important to continue to add to the literature regarding multi-dimensional factors that influence maternal mental health and infant learning.
Future Research and Considerations
Interestingly, maternal sensitivity was the only one of the four proposed models that approached significance, and future research would benefit from teasing apart which maternal behaviors and interactions have a greater influence on infant cognitive performance. It is possible that equal weight should be placed on all areas, but also possible that given the young age range, sensitivity may be more important than structuring, particularly because areas such as joint attention have not been well established yet.
One important factor to address regarding these results is that although lower maternal sensitivity, structuring, and mixed/diminished affect were associated with increased performance on the BSID-III, the mean scores on the EAS were still within an adequate range for expected behaviors in the mother-infant relationship. Additionally, the mean Bayley Cog for infants of mothers with optimal EAS scores were still in the average to high-average range. Overall, most mothers placed an adequate maternal interaction range, and there was no evidence that optimal maternal interactions negatively impacted infant cognition and learning. Compared to the overall sample (n = 88) with a mean Bayley Cog of 66.16, mothers with an affect score in the expected range of 5-7 (n = 87) had infants with a mean Bayley Cog of 65.95, whereas mothers in that same range for sensitivity had infants with a mean Bayley Cog of 63.89 (n = 74), and infants with mothers scoring in the expected range on structuring had a mean Bayley Cog of 64.13 (n = 68).
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Moving forward, it will be important to focus on the long-standing effects that maternal emotional difficulties such as postpartum depression have on an infants future social, emotional, and cognitive development, and equally important to identify opportunities for intervention to support these mothers. Timing of depression is important for these longterm effects (Brennan et al., 2000; Kurstjens & Wolke, 2001; Sohr-Preston & Scaramella, 2006), and the current findings support the idea that there is a developmental process we do not fully understand. This process may be a window of opportunity for depressed/non-engaged mothers to attend to their own emotional needs without the guilt and concern about failing to provide a fruitful learning environment for their infants. The infant may adapt to his or her emotionally unavailable mother and shift focus and approach in an effort to continue fostering learning. A mother may not have the emotional capacity to be available for her baby during infancy due to a number of factors (e.g., depression, anxiety, life stressors including traumatic event or SES). By working with mothers to optimize their own social and emotional functioning early on, there is the potential to not only improve the mother-infant relationship, but also potential to offset any negative influence a less emotionally available mother may have on her infants long-term healthy developmental processes and relationships throughout the lifespan.
Conclusion
In conclusion, the relationship between EA and the development of a quality attachment relationships is well established in the literature. The current study set out to take both a broad and focused view on the variables involved in how maternal affect and behaviors influence learning and cognitive development for infants. Although the mediation hypotheses were not supported, the data provided evidence that there is an unexpected
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association between lower levels of maternal sensitivity, structuring, and affect on an infants cognitive performance. These findings are important to the research, highlighting the potential for a critical time period when infants may make a shift in learning and not realize any immediate effects of an emotionally unavailable mother on learning. The current study may have produced more questions than explanations, but the findings help advance the area of research in infant development and maternal mental health by seeking alternatives beyond the traditional attachment-theory and recognizing the likelihood that areas of oversight exist when it comes to the ideal mother-infant interactive relationship.
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APPENDIX A
Maternal Sensitivity refers to a mothers ability to pick up on infant cues, provide warmth and soothe distress, and to be responsive in a variety of situations through quality affective interactions with her child. An optimally sensitive mother creates a genuine and positive affective environment for the infant, demonstrates a clarity of the infants needs and expressions, and provides appropriate responsiveness to these needs and emotional expressions. Subscales of the Sensitivity scale include: Affect; Clarity of perceptions and appropriate adult responsiveness; awareness of timing; flexibility, variety, and creativity; acceptance; amount of interaction; and conflict situations.
Structuring involves creating learned opportunities through adequate guidance and scaffolding. The mother demonstrates successful attempts of following the infants lead, and sets appropriate limits to discourage maladaptive behaviors. This is done while allowing the child autonomous pursuits and exploration, yet maintaining the older and wiser framework (Bolby, 1969) in an optimal parent-child relationship. Subscales of the Structuring scale include: provision of guidance; success of attempts; amount of structure; limit setting; remaining firm in the face of pressure; verbal vs. non-verbal structuring; and peer vs. adult role.
Non-Intrusiveness refers to the appropriateness of directedness on the part of the mother, providing balanced stimulation. In an optimal non-intrusive relationship, there is a lack of over-directedness, over-stimulation, interference, and over-protectiveness. The non-intrusiveness scale also holds a high respect for the autonomous pursuits of the child. Overly-involving acts by the mother are alone not be problematic, particularly if warranted by the
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childs age or developmental abilities, but when they persist in the face of unwelcoming cues by the child, they are considered intrusive. Non-intrusiveness differs from structuring in that the latter is focused on guidance and the former is more about behavioral interference. The subscales of the Non-intrusiveness scale are: Follows childs lead; non-interruptive ports of entry; commands, directives; adult talking; didactic teaching; physical vs. verbal interferences; and made to feel intrusive.
Non-Hostility refers to both overt and covert hostility that can be expressed in language, impatience, or anger. Adult hostility need not solely be directed at the child; rather, any acts of anger, impatience, or boredom in the presence of the child is considered hostile in nature. Cummings (1987) introduced the idea of background anger and the negative influence this can have on child development. Therefore, any observable signs of hostility are considered when observing the mother-child relationship. The subscales of the Non-Hostility scale include: Adult lacks negativity in face or voice; lack of mocking; lack of threats of separation; does not lose cool; frightening behaviors; silence; and hostile themes of play.
Child Responsiveness refers to the infants reaction to parental bids for engagement, and the expression of pleasure that accompanies this reaction. The focus is on the emotional and social responsiveness of toward the mother. Both affect and responsiveness are considered, and a lack of positive emotional expression or ignoring a mothers invitation to engage is considered non-optimal. An optimally responsive child is one who is happy in the presence of the mother and is emotionally and behaviorally responsive to the mother. The Child Responsiveness sub scale is closest to the attachment theory view of the secure/insecure child (Biringen, 2008). The subscales of the Infant/Child Responsiveness scales include: Affect/emotional regulation; responsiveness; age-appropriate autonomy seeking; positive
80


physical positioning; lack of avoidance; and task oriented/concentration.
Child Involvement refers to extent to which a child seeks to engage the mother in play as well as other means of actively seeking engagement by the mother. In infants, this may be demonstrated through looking and babbling, and in older children this will include both positive verbal and behavioral means to engage the caregiver. Optimal involvement of the parent by the child lacks negative involving behaviors, and includes appropriate autonomous exploration, engaging the mother at a developmentally appropriate level (Biringen, Robinson, & Emde, 2000). The subscales of the Child Involvement scale include: Simple initiative; elaborate initiative; use of adult; lack of over-involvement; eye contact; body positioning; and verbal involvement.
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Table 6. Demographic, EAS, and Bayley Cog data
Variable Optimal Affect Optimal Sensitivity Optimal Structuring Optimal Non- Intrusiveness Optimal Non- Avoidance Optimal Task Orientation Overall Sample
N=88 87 74 68 69 53 53 88
Infant Gender (F/M) 43/44 37/37 36/32 36/33 24/29 28/25 44/44
(45%/50%) (50%/50%) (53%/47%) (52%/48%) (45%/55%) (47%/53%) (50%/50%)
Age of Mother (yrs.) 28.34 28.49 28.19 28.68 28.87 28.68 28.34
Age of Infant (days) 241.84 239.84 233.72 246.59 233.02 224.7 243.27
Bayley Cog 65.95 63.89 64.13 64.22 61.49 62.25 66.16
Infant Ethnicity
White 62 (71.3%) 51 (68.9%) 46 (67.6%) 50 (72.5%) 37 (69.8%) 37 (69.8%) 62 (70.5%)
Latino 12(13.8%) 12 (16.2%) 11 (16.2%) 8(11.6%) 8(15.1%) 8(15.1%) 13 (14.8%)
African-American 7 (8%) 5 (6.8%) 5 (7.4%) 5 (7.2%) 4 (7.5%) 5 (9.4%) 7 (8%)
Asian 3 (3.4%) 3 (4.1%) 3 (4.4%) 3 (4.3%) 2 (3.8%) 1 (1.9%) 3 (3.4%)
Native American 3 (3.4%) 3 (4.1%) 3 (4.4%) 3 (4.3%) 2 (3.8%) 2 (3.8%) 3 (3.4%)
Marital Status
Married 54 (62.1%) 45 (60.8%) 40 (58.8%) 43 (62.3%) 32 (60.4%) 33 (62.3%) 55 (62.5%)
Unmarried 11 (12.6%) 9 (12.2%) 9(13.2%) 10(14.5%) 7(13.2%) 6(11.3%) 11 (12.5%)
With Partner 22 (25.3%) 20 (27%) 19 (27.9%) 16(23.2%) 14 (26.4%) 14 (26.4%) 22 (25%)
Mothers Education 5.37 5.47 5.41 5.51 5.53 5.34 5.35
Family Income 6.25 6.0 6.06 6.46 6.36 6.15 6.27
Optimal EAS scores for Affect, Sensitivity, Structuring, and Non-Intrusiveness range from 5-7 Optimal EAS score for Non-Avoidance and Task orientation is 3
oo
to
Appendix B


APPENDIX C
Bayley Cognitive Percentile Rank
Affect Score Number of Cases Mean Median Std. Deviation Minimum Maximum Range
2.5 -- -- -- -- -- -- --
3.0 1 84.00 84.00 -- 84.00 84.00 0.00
4.0 -- -- -- -- -- -- --
5.0 8 75.12 75.00 9.44 63.00 91.00 28.00
5.5 5 66.40 75.00 29.01 16.00 91.00 75.00
6.0 23 71.08 75.00 24.89 1.00 98.00 97.00
6.5 1 95.00 95.00 -- 95.00 95.00 .00
7.0 50 61.50 63.00 23.77 9.00 95.00 86.00
Total 88 66.15 75.00 23.67 1.00 98.00 97.00
Bayley Cognitive Percentile Rank
Sensitivity Direct Score Number of Cases Mean Median Std. Deviation Minimum Maximum Range
2.5 -- -- -- -- -- -- --
3.0 1 84.00 84.00 -- 84.00 84.00 .00
4.0 13 77.69 75.00 15.67 50.00 95.00 45.00
5.0 3 75.00 75.00 -- 75.00 75.00 .00
5.5 12 70.08 75.00 24.57 16.00 95.00 79.00
6.0 19 63.21 75.00 30.36 1.00 98.00 97.00
6.5 8 63.87 69.00 26.59 9.00 91.00 82.00
7.0 32 60.93 63.00 21.31 9.00 95.00 86.00
Total 88 66.15 75.00 23.67 1.00 98.00 97.00
83


Bayley Cognitive Percentile Rank
Structuring Direct Score Number of Cases Mean Median Std. Deviation Minimum Maximum Range
2.5 1 84.00 84.00 -- 84.00 84.00 .00
3.0 7 81.28 75.00 12.40 63.00 95.00 32.00
4.0 12 67.33 75.00 24.42 16.00 91.00 75.00
5.0 4 79.25 79.50 13.57 63.00 95.00 32.00
5.5 13 69.15 75.00 25.76 9.00 95.00 86.00
6.0 21 60.09 63.00 27.18 1.00 98.00 97.00
6.5 6 69.50 75.00 24.26 25.00 95.00 70.00
7.0 24 61.08 63.00 21.70 9.00 91.00 82.00
Total 88 66.15 75.00 23.67 1.00 98.00 97.00
Bayley Cognitive Percentile Rank
Non-Intrusiveness Direct Score Number of Cases Mean Median Std. Deviation Minimum Maximum Range
2.5 -- -- -- -- -- -- --
3.0 1 75.00 75.00 -- 75.00 75.00 .00
4.0 18 73.11 75.00 21.54 25.00 95.00 70.00
5.0 17 62.70 75.00 28.15 9.00 91.00 82.00
5.5 9 59.44 55.00 18.25 37.00 84.00 47.00
6.0 18 70.94 69.00 18.02 37.00 98.00 61.00
6.5 4 64.75 62.50 17.42 50.00 84.00 34.00
7.0 21 75.00 75.00 28.88 1.00 95.00 94.00
Total 88 73.11 75.00 23.67 1.00 98.00 97.00
84


Non-Avoidance Score Number of Cases Mean Bayley Cognitive Percentile Rank Std. Median Deviation Minimum Maximum Range
1 1 50.00 50.00 -- 50.00 50.00 .00
2 34 73.91 75.00 18.73 25.00 98.00 73.00
3 53 61.49 63.00 25.46 1.00 95.00 94.00
Total 88 66.15 75.00 23.67 1.00 98.00 97.00
Task Orientation Score Number of Cases Mean Bayley Cognitive Percentile Rank Std. Median Deviation Minimum Maximum Range
1 10 75.30 75.00 16.76 50.00 95.00 45.00
2 25 70.80 75.00 20.06 37.00 98.00 61.00
3 53 62.24 75.00 25.71 1.00 95.00 94.00
Total 88 66.15 75.00 23.67 1.00 98.00 97.00
85


Full Text
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DISS_submission publishing_option 0 embargo_code third_party_search Y
DISS_authorship
DISS_author type primary
DISS_name
DISS_surname Vogeli
DISS_fname Jo
DISS_middle
DISS_suffix
DISS_affiliation University of Colorado at Denver
DISS_contact current
DISS_contact_effdt 04/01/2017
DISS_address
DISS_addrline PO Box 883
DISS_city Nederland
DISS_st CO
DISS_pcode 80466
DISS_country US
DISS_email jo.vogeli@ucdenver.edu
future
04/01/2017
PO Box 883
Nederland
CO
80466
US
jo.vogeli@ucdenver.edu
DISS_citizenship
DISS_description page_count 98 doctoral external_id http:dissertations.umi.comucdenver:10824 apply_for_copyright no
DISS_title Keep Calm and Stay Withdrawn? Investigating the Discordance Between Maternal Emotional Availability And Infant Cognitive Performance
DISS_dates
DISS_comp_date 2017
DISS_accept_date 01/01/2017
DISS_degree Ph.D.
DISS_institution
DISS_inst_code 0765
DISS_inst_name University of Colorado Denver
DISS_inst_contact Psychology (Clinical Psychology)
DISS_processing_code D
DISS_advisor
Kaplan
Peter
Dill
Edward
DISS_cmte_member
Everhart
Kevin
Harned Adams
Jennifer
Shaffer
Jonathan
DISS_categorization
DISS_category
DISS_cat_code 0622
DISS_cat_desc Clinical psychology
DISS_keyword attachment theory, emotional availability, infant learning, maternal health
DISS_language en
DISS_content
DISS_abstract
DISS_para The mother-infant dyadic relationship is important for the course of development of an infant, and the availability and responsiveness of a mother provides a foundation for the infant’s eventual development of self. The Emotional Availability Scales (EAS) were developed as a means of quantifying the mother-infant relationship while viewing interactions from a multi-dimensional perspective. There is an abundance of research supporting the positive relationship between optimal maternal emotional availability and an infant’s long-term cognitive performance; however, the current research sought to explore an explanation for some recent seemingly anomalous results, whereby infants of mothers who were less sensitive and who did not engage in optimal structuring were performing better than their peers on the cognitive portion of the Bayley Scale of Infant Development III (BSID-III). Based on developmental theories, two infant behaviors of task orientation (TSK) and non-avoidance (AVD) on the EAS were hypothesized to explain this counterintuitive relationship between four separate maternal features/behaviors (affect, sensitivity, structuring, non-intrusiveness) on BSID-III cognitive performance. Mediation analyses produced statistically significant results for three of the four models. There was a significant relationship between the maternal affect EAS domain and the Bayley Cog, with lower maternal affect scores related to higher Bayley Cog (R2 =.0459, F(1,86), p< .05, = -6.50). There was a significant relationship between the maternal sensitivity EAS domain and the Bayley Cog, with lower maternal sensitivity scores related to higher Bayley Cog (R2 =.0683, F(1,86), p< .02, = -5.74). Further, there was also a significant relationship between the maternal structuring EAS domain and the Bayley Cog, with lower maternal structuring scores related to higher Bayley (R2 =.0498, F(1,86), p<.05; = -.4.10). Mediation results, however, were mixed with the predicted mediators revealing only one relationship approaching significance for TSK and AVD predicting BayleyCogwhen controlling for maternal sensitivity(R2=.09, F(3, 84) = 2.61,p= .057). All other mediation models failed to explain the relationship between the identified maternal EAS and infant cognitive performance.
These results are an important contribution to research because they provide evidence that an unexpected relationship exists between maternal emotional availability and infant cognitive performance. This suggests there may be a developmental process for infants that is not well understood and opens the door for a more comprehensive investigation of the mother-infant dyadic relationship beyond that of attachment theory.
DISS_supp_abstract
DISS_binary PDF Vogeli_ucdenver_0765D_10824.pdf
DISS_restriction
DISS_repository
DISS_version 2011-11-08 15:37:33
DISS_agreement_decision_date 2017-04-13 20:22:32
DISS_acceptance 1
DISS_delayed_release
DISS_access_option



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+, -EG5>224%$#@-E9.B-EG+>;0" %*40$0##$"*1$%('$!"(1$% 2"%1!##2("!$#(/$%!?$!)$0!10')=#@%7'!)4 !"!)*141%/2'!?$()$"(#&!" "!#2%#'$70'!2"% )4!/%$%('#*22%"$: "*!"-EFG; "%""!#!("10*#4%"%$0!"/!(#0(#!?(/! )/($!"('&'*!1!)*"4( 1%''(%"($ !$(#@$21('')*"4I%$2'(7 $0(4!!"('1%#!#*#"!2%"$4$0($ /($!"('#!#$ $()/($!"('#$"*1$*"4)*" 4(10')=#&($()2"!#10%%'!("# &'*!1!#'($!"1%4$ !('$!#:n("' 0')("!!#!("10!$7%"@+,,D(; %!#*10#$*)()"/$07(@()''!"<% 1(":+,,,;!?(/!)"*"(''%7 &(/'!#$%#!!&10')"!=#'($!"&*1$%47(# &(1'$($!)1!"$(/($!"('!0( %"# (/!'/($(410')"!=#&%1*#"!#2%# !!## ())"!1$ !!##)*"4%$0 1%''(%"($ !2'(())('(1$ $!#($!"(' $!"(1$%#$'!7$0+.(/#<

PAGE 34

+!%)(0(%("!"(M(/+,,.;()#*22% "$#/($!"('&'*!1!%$0!&*$*"! )! !'%2/!$%&&($#=2"%'!/#%' 4#@''#:"! *)-EE,>!##M02/(-EGD> *#<($*'2*'2M''!"+,,+;n%)1n" (2!"()!$!"#%:+,,9;%$!("(4! %&&(1$%"#7!"!"!'($!)$%&*$*"!1%4$ !()#%1 (')! !'%2/!$>#2!1&1(''$0!"!2%"$ "!'($%#02#!$7!!!/%$%('$%!2("!$('$('@ !4(4!/!$2("!$('4*)(1!#$'! 2("!$('"!#2%# !!##()2("!$('#!#$ $ 0!1*""!$"!#!("10!?(/!)$0! /!10(#/# %' !)$0!/%$0!"<&($)()1"!' ($%#02()1%4$ !2!"&%"/(1! '%%@4($&($!0( %"#2!1&1(''$(#@%"! $($%(#(/!)($%"%&/($!"('#$"*1$*"4 :"!'($ !$%#1(&&%')4;()&($1%4$ !2!"& %"/(1! R r!"rnr#nrn#rr nrn "%('$0!'!(#$#$*)!)1%1!2$(#(#$()<(' %!/($!"('%<$"*# !!### !3*(''/2%"$($70! !74$0!70%'!%&$0!)( )1"!'($%#02()2%$!$('&'*!1! %1%4$ !)! !'%2/!$$$(10/!$$0!%"#$#02% $0!#A!$0($!?2'%"($%"!0( %"# #0%*')!"!'($!)$%1%4$ !)! !'%2/!$2$/(' #!#$ $()#$"*1$*"4(''%7( &($$%&!!'1%/&%"$('!()!?2'%"!$0!! "%/ !$($((22"%2"($!'10(''!44'! !' %##$!$7$0$0#$0!/!"1(1()!/%&!)( $"1#!/20(#A!#$0!!!)&%" *#$"*1$*"!)$/!7$0%*$!4(4!/!$&"%/2("!$#$ %2"%/%$!2"%2!"#%1('()1%4$ )! !'%2/!$:#!"4+,,5;1())!M(/#
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+. r ($!"('$"*1$*"4B%<$"*# !!##()('! 2!"1!$'!"(@ C,GF :-D+; C--9bC<++, ",",#-"# .!++$'."#)#""## .$n+'""%+%!" '$0%*40$0!"!'($%#02!$7!!#2!1&1/($!"(' !0( %"#()&*$*"!1%4$ )! !'%2/!$#&("'7!''!#$('#0!)3*!#$%## $''("#!(#$%70!$0!"$0!"!#!("10# 2"% )4(()!3*($!21$*"!%&$0!)"!1$&'*! 1!%&/($!"('!0( %"#%&($ )! !'%2/!$0!"!0( !!!&!7#$*)!#$%!?(/! $0!&'*!1!%&/($!"('!0( %"# #2!1&1(''#!#$ $#$"*1$*"4()%<$" *# !!##%$0!)! !'%2/!$%&1%4$ &*1$%4:##!'()"7(@/$0M$!!'/( +,,9>()"''!"<%1("/$0 M7(@+,,+;&$0!#$*)!#$0($0( !!?(/!)$ 0!&'*!1!%&/($!"('!0( %"#% $0!"%()1%1!2$%&1%4$ !#@''#$0!/(I%"$ 0( !!?(/!)$0!#%1('
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

PAGE 39

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PAGE 40

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PAGE 42

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