Protecting the child while preserving the relationship: Using baby’s relational withdrawal to gauge the effect of parental visitation

Alexandra Deprez; Jaqueline Wendland; Line Brotnow; Arno C. Gutleb; Servane Contal; Antoine Guédeney

doi:10.1371/journal.pone.0196685

Abstract

The impact of children’s interactions with parents in the context of out-of-home placements is receiving much-needed cross-disciplinary attention. However, the paucity of instruments that can reliably represent young children’s experiences of such interactions precludes a nuanced evaluation of their impact on wellbeing and development. In response to this empirical gap, the present study investigates children’s relational withdrawal as a clinically salient, easily observable and conceptually valid measure of infants’ and toddlers’ responses to parents. Relational withdrawal, challenging behaviors and salivary cortisol were assessed before, during and after parental visits. Conceptually, the findings suggest that observations of relational withdrawal correlate meaningfully with measure of neurobiological reactivity. Clinically, three profiles of cross-variable responses in children appeared, distinguishing between groups that experience increased, decreased or unchanged levels of stress in response to parental visits. Taken together, the findings lend empirical support to systematic observations of relational withdrawal to bolster evaluations of young children’s experience of parental visitation during out-of-home placements.

Citation: Deprez A, Wendland J, Brotnow L, Gutleb AC, Contal S, Guédeney A (2018) Protecting the child while preserving the relationship: Using baby’s relational withdrawal to gauge the effect of parental visitation. PLoS ONE 13(5): e0196685. https://doi.org/10.1371/journal.pone.0196685

Editor: Jacobus P. van Wouwe, TNO, NETHERLANDS

Received: October 5, 2017; Accepted: April 17, 2018; Published: May 3, 2018

This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Data Availability: Due to legal and ethical concerns, full data cannot be available publicly. The minimal anonymized data necessary to replicate the authors’ study findings have been uploaded as Supporting Information files.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Child welfare services in Europe and North America continue to grapple with the controversies related to establishing and maintaining child-parent relationships when parental care has been temporarily or permanently suspended. Nowhere is this difficulty more pronounced than regarding parental visitation, prompting professionals to assess and balance children’s need for protection with that of preserving a relationship with primary caretakers.

At present, the dearth of developmentally sensitive empirical findings cause these decisions to be swayed by legal and social considerations. Indeed, although parental visitation appears at the epicenter of longstanding clinical and legal debates [1], specific effects on the development and wellbeing of the child, the biological parents and foster parents remain virtually unexplored in research literature [2].

Pursuant to the understanding of the detrimental impact of early toxic stress on long-term neurophysiological development, the importance of early intervention in the context of child abuse or neglect has received broad recognition in recent literature [3] However, the detection of such deleterious effects in young children is complicated by the lack of verbal language, limiting the arsenal of instruments gauging the child’s emotional reactions to observation-based evaluations. Substantial concerns have been raised about the validity of such assessments [4,5,6]. Indeed, most of the extant research is retrospective, relies on carer-reports and fails to account for the effect of factors such as child age and placement conditions [7,8,9]. From a clinical perspective, a majority of the available measures require a level of training and expertise that most childcare professionals in the field of infant and toddler mental health do not possess. In response to these issues, the present study explores the conceptual validity and clinical usefulness of an observational measure quantifying the immediate effects of parental visitation on children aged 6–36 months placed in institutional foster care.

Measuring child responses to parental visitation

Child behavioral distress: In young, and especially pre-verbal children, direct effects of adverse events can be difficult to identify. Indeed, whereas older children and adolescents have cognitive and verbal capacities that can be more easily measured and interpreted, the assessment of infants and toddlers is generally restricted to behavioral responses. Experts in early child development have proposed a range of in-depth, observational instruments for trained professionals to gauge infant and toddler mental health and development. Clinical research instruments such as Brazelton’s Neonatal Behavioral Assessment Scale (NBAS, Brazelton & Nugent, 1995) and the Bayley Scales of Infant Development (BSID, Bayley, 1993) evaluate infant and toddler behavior and development on multiple dimensions, including somatic symptoms, affect and relational factors. However, these and other instruments are generally time-consuming and require specifically trained reporters. Furthermore, they are generally insensitive to changes occurring within the span of a few hours or a day, rendering them unhelpful with regards to detecting acute stressors.

Interactional patterns and relational withdrawal: In terms of young children’s behavioral responses, the concept of relational withdrawal—defined as ‘a turn inward, to retract oneself as to defend, preserve one’s personality"[10]—when persistent and/or intense is considered a relevant early marker of infant psychopathology and of maladaptive parent-child interactions. Relational withdrawal may reflect the baby’s immediate reactions to changing modalities of interaction or denote chronic distress due to mutual difficulties in adaptation over time [11].

On a micro-analytic level, transitory relational withdrawal is an essential and normative mechanism for regulating interactions in early childhood [12,13,14]. When faced with unusual, inadequate or unpleasant stimuli and interactions, babies show their distress by modulating their relational engagement. Thus, avoiding eye contact, not smiling, frowning, diverting attention away from people and toys as well as some self-regulatory and soothing activities can be understood as ways for the young child to communicate relational and/or physical discomfort [15,16,13, 17].

More clinically worrisome is the prolonged relational withdrawal that can be observed in the context of somatic illness, neurological and sensory processing disorders, severe forms of malnutrition, in non-organic failure to thrive, and chronic pain in infancy [18,19]. Such behaviors are also frequently observed in children presenting with separation anxiety, post-traumatic stress disorders, depression and autism spectrum disorders as well as in the context of child neglect [20, 14, 21, 22]. Prolonged relational withdrawal can also be a part of the child’s response to inadequate interactions pursuant to post-partum depression [23] and other parental mental health issues [24] As such, prolonged relational withdrawal can be considered a mutual adaptation disorder, partly resulting from and always affecting the quality of the child-parent interaction [25] Over time, chronic relational withdrawal correlates strongly with insecure attachment [20] and has been identified in conjunction with attachment disorders [26].

Thus, relational withdrawal could—for biological, developmental or relational reasons—be considered a marker of asynchronicity between the baby and its relational environment. Although it can be seen as adaptive when transitory (seconds or minutes), prolonged or systematic withdrawal from interpersonal interactions is a relevant indicator of maladaptation and predictive of future psychopathology [27].

Neurobiological reactivity in the context of child emotional development: Salivary cortisol is a neurobiological stress marker, reliably predictive of blood cortisol levels [28,29]. Given the non-invasive and inexpensive sampling procedure, it is currently one of the most frequently used objective indicators of stress in infants and young children [30, 31, 32, 33] Similarly to adults, the production of cortisol in children follows a predictable circadian rhythm from the age of two months. Under normal circumstances, the rhythm is characterized by peaks of cortisol thirty minutes after waking followed by a slow decline throughout the day [34]. A stressful event can be detected in the salivary cortisol concentration by a peak in concentration twenty to forty minutes after the incident. Such neurophysiologic stress-response can be triggered by social interactions and the development of the Hypothalamic-Pituitary-Adrenal (HPA) axis during the first years of life is lastingly impacted by the quality of early relationships [30]. Indeed, research has shown that HPA-axis abnormalities in early life predict an increased risk for psychopathology across the lifespan [35, 36, 37, 38]. In children exposed to environmental stressors, including disturbed, disrupted or abusive parent-child relationships, HPA-axis deviations range from hyper-activation and increased reactivity to the near-extinction of variability (no morning cortisol peak and a reduced mean concentration throughout the day) [39, 36, 37]. These findings have established the relevance of salivary cortisol in the context of child psychopathology and its psychosocial environment. Conversely, salivary cortisol levels can be used to qualify the effects of therapeutic interventions and this measure is thus broadly apt to inform clinical practices in the field of child psychopathology [40, 41, 42].

The present study

In a sample of children aged 6–36 months temporarily removed from parental care, the present study aims to assess the links between relational withdrawal—conceptualized as a coping strategy and a reaction to the stress induced by caregiver interactions—and other indicators of child distress. More precisely, a decrease in relational withdrawal upon contact with a parent is viewed as a marker of the adequacy of this relational environment (influenced namely by caregiver sensitivity) as compared to the level of withdrawal demonstrated by the child before contact. We hypothesize the presence of distinct profiles of child reactions, present across measures of relational withdrawal, salivary cortisol level, and challenging behaviors.

Method

Participants.

15 children (8 males) aged 6–36 months (M = 17.0, SD = 6.9) living in a residential nursery setting due to temporary termination of parental care were recruited to participate in the study. The children all received regular visits from parents, at least one of whom demonstrated adequate French language fluency. Institutional foster care in France, Belgium and Luxemburg is offered in response to situations requiring the immediate suspension of parental custody. The average frequency of visits was once weekly and the visits occurred following a regular schedule. For this reason, the time elapsed since the last visit would have been approximately similar for each family. The institutions participating in the present study have all benefited from quality improvement schemes based on early childhood and infant development research including an decreased child/caregiver ratio, the presence of team psychologists, numerous staff training opportunities, organized parental visits and dedicated work on parent-child relationship. These units welcome a small number of children and emphasize the establishment of stable routines of care (including a dedicated reference person). The current study was conducted in one institution in Belgium and one in Luxemburg, both using the Loczy approach for the care of children [43].

Procedure.

Children removed from parental care represent a vulnerable and difficult-to-access population. Accordingly, a cautious and careful recruitment process was established to protect of children, parents and carers. To this end, the study obtained unanimous, twice-renewed approval from the National Ethics Research Center in Luxembourg (CNR) and the Childhood National Ethics center in Belgium (ONE). Written informed consent from one or both parents and the appointed legal guardian were obtained in a multi-step process, allowing ample time and opportunity to withdraw from the study.

Children were observed in their care institution on multiple occasions before, during, and after a planned visit from parents. Nurses completed questionnaires evaluating infants’ challenging behaviors on 4 occasions, at the end of both night and day shifts. Furthermore, infants’ interactions with nurses and parents were video recorded at 5 time points and coded by blinded evaluators with regards to establishing their level of relational withdrawal before, during and after the visit (see Fig 1). Salivary cortisol was collected at 8 time points. In order to ensure reliability, evaluations were conducted when the child had been fed and interrupted if the child showed signs of fatigue, discomfort or illness.

Download:

Fig 1. Data collection scheme.

https://doi.org/10.1371/journal.pone.0196685.g001

Measures.

A multi-method approach was used to evaluate three dimensions of child reactions to parental visitation: child distress behaviors (day and night), relational withdrawal, and neurophysiological reactivity (salivary cortisol).

Relational withdrawal.

The Alarm-Distress Scale (ADBB) [11] consists of eight items rated on a 5-point Likert scale ranging from 0 (normal behavior) to 4 (massively atypical behavior) and yielding a range of scores between 0–32. The eight items include facial expression, eye contact, activity level, self-stimulation gestures, vocalizations, delay in response to stimulation, relational quality, and attractiveness. The clinical cutoff score of 5 correlates with higher risk of developmental and psychopathological problems in the short and medium term [11, 14, 44, 45]. The ADBB scale has demonstrated adequate psychometric properties across cultural contexts [14] with regards to inter-rater correlations (r = 0.84), specificity (r = 0.78), and sensitivity (r = 0.82). A two-point difference in the overall ADBB score is considered clinically significant (Personal communication, Guedeney, 2010).

Salivary cortisol.

Saliva samples were obtained using the Salimetrics Kit 8 times over the course of 24 hours. Concentrations were measured in micrograms per deciliter (ug/DL). In order to determine the baseline circadian production of cortisol, cortisol was measured on 3 occasions: 30 minutes after waking up and 30 minute before bed time the day of the visitation and 30 minutes after waking up on the day following the visitation. To establish the effect of the visit, cortisol was further measured on five occasions, immediately following each video-recorded interaction.

In order to obtain the samples, the child sucked or chewed on an absorbent cotton swab for 30–60 seconds. The child did not eat, drink or have their teeth brushed in the minutes preceding the sample. No salivation stimulator was used. The absorbent cotton was then stored in a sterile test tube provided for this purpose before being place in a freezer at -18 °C and preserved until they were transported to the laboratory for analysis.

Child distress behaviors.

A systematic review of current literature did not identify a validated instrument evaluating challenging child behaviors that can be used in a 24 hour test-retest situation and that takes into account the child’s behavior during the day and at night. A behavior inventory was therefore constructed for the present study, based on items from the Symptom Checklist [46]. The behavioral inventory was created to take account of even slight changes in child nonverbal behavior over the course of a few hours. In addition to being conceptually rooted in the literature on normal and pathological child response to stressful events, this measure takes into account key aspects of babies’ life such as feeding, sleeping, somatic functioning, and non-verbal behavior. Furthermore, it was constructed to be user friendly, require no specific prior training, and be completed quickly (5–10 minutes).

Each item was rated in terms of absence/presence of the described behavior. Nurses who completed the inventory were those in charge of the child during the entire period of observation. They were instructed to interact with and observe the child as they ordinarily would and to rate the observed behavior at the end of their shift. Evaluating the child in their everyday context and integrating the assessment into nurses’ existing work responsibility was intended to increase the study’s ecological validity.

Data analytic strategy.

The aim of the present study was to investigate the clinical value of relational withdrawal in terms of its ability to detect effects of parental visitation on young children. Based on videotaped interactions, subgroups of children were first identified based on the change in relational withdrawal observed upon initial contact with a parent. Then, the groups were compared with regards to salivary cortisol and challenging behaviors. Given the wide range of child age and duration of institutional placement, these variables were included as covariates. Analyses were performed using SPSS version 22.

Results

Relational withdrawal.

Based on changes in scores of relational withdrawal before and after parental visitation, three groups of children were identified: one showing decrease in relational withdrawal of 2 points or more on the ADBB upon contact with the parent (n = 4), another with a corresponding increase in relational withdrawal (n = 6), and a final group of children with no change in relational withdrawal (n = 5). See Table 1 for demographic information describing each group.

Download:

Table 1. Demographic information by reaction profile.

https://doi.org/10.1371/journal.pone.0196685.t001

In order to examine differences in trajectories of relational withdrawal beyond the initial response to the parent(s), data were further analyzed using a mixed analysis of variance (ANOVA) with reaction profile as the between-subjects factor (decrease, increase or stagnation of relational withdrawal upon meeting parents) and the repeated measurement of ADBB as the within-subjects factor (5 time points). (See Fig 2).

Download:

Fig 2. Estimated marginal means (logarithmic) for reaction profiles and repeated measures ADBB scores including age and duration of placement as covariates.

https://doi.org/10.1371/journal.pone.0196685.g002

To meet the assumption of variance homogeneity, data were transformed to logarithms, which satisfactorily normalized the distribution. Because Mauchly’s test indicated that the assumption of sphericity had been violated (X²₍₉₎ = 20.97, p = .014), degrees of freedom were corrected using Huynh-Feldt estimates of sphericity (ε = .931).

The analysis revealed a significant and robust main effect of time (F_{(3.73, 44.67)} = 3.73, p = .001, η_p² = .346, f = .56) but not of group (F_{(2, 12)} = 1.49, p = .265, η_p² = 198, f = .5). However, a significant and similarly robust interaction effect was observed (F_{(7.44, 44.67)} = 4.05, p = .001, η_p² = .403, f = .66) suggesting that the three groups display different trajectories of relational withdrawal as a function of time. Thus, in addition to the difference observed during the child’s interaction with the parent(s), the groups distinguish themselves with regards to the trajectory of return to baseline levels of relational withdrawal. Importantly, these results remain significant after controlling for duration of placement and child age at evaluation and the effects remain in the large to very large range (f = .44-.74). Taken together, these findings suggest the presence of underlying profiles of relational withdrawal that can be meaningfully gleaned from the initial behavioral response to the parent, quantified by the ADBB scale.

Salivary cortisol.

Following the initial empirical validation of the group categorization, salivary cortisol data were analyzed using a mixed-design ANOVA with reaction profile as the between-subjects factor (decrease, increase or stagnation of relational withdrawal upon meeting parents) and the repeated measurement of cortisol as the within-subjects factor (8 time points). To meet the assumption of variance homogeneity, outliers were Windsorized and missing data replaced with the mean sample score for the relevant time point. Less than 5% of data were missing in total and each child had a maximum of one altered score.

Because Mauchly’s test indicated a violation of the assumption of sphericity (X²₍₂₇₎ = 52.44, p = .004), degrees of freedom were corrected using Huynh-Feldt estimates of sphericity (ε = .853).

In line with previous findings, the analysis revealed a significant main effect of time (F_{(5.97, 71.69)} = 6.06, p < .000, η_p² = .336, f = .54), indicating that, for the sample as a whole, mean levels of salivary cortisol differ during the course of a day. This remains true after controlling for duration of placement (F_{(6.15, 67.64)} = 2.34, p < .036, η_p² = .179, f = .39) but not when age at evaluation is included as a covariate (F_{(5.99, 65.89)} = 1.88, p < .097, η_p² = .146, f = .35).

In line with hypotheses theorizing that relational withdrawal would be associated with neurophysiological reactivity, the analysis revealed a main effect of the reaction profile (F_{(2, 12)} = 7.22, p = .009, η_p² = .546, f = .98). The mean salivary cortisol level across all time points differed significantly between the three groups. Importantly, this pattern remained after controlling for both duration of placement (F_{(2, 11)} = 6.71, p = .012, η_p² = .550, f = .74) and child age (F_{(2, 11)} = 5.62, p = .021, η_p² = .505, f = .71). Specifically, post hoc analysis revealed that the group demonstrating increased relational withdrawal during the visit has statistically significantly higher mean levels of salivary cortisol than the stagnation group after controlling for multiple comparisons (Tukey HSD, p = .007). (See Fig 3).

Download:

Fig 3. Estimated marginal means of salivary cortisol by group of relational withdrawal.

https://doi.org/10.1371/journal.pone.0196685.g003

No statistically significant interaction between reaction profile and cortisol levels was revealed (F_{(11.95, 71.67)} = 1.22, p = .290, η_p² = .168, f = .34). However, given the likely impact of the sample size sample on the statistical power associated with this analysis (as indicated by the presence of a medium sized, yet not statistically significant effect) and for the sake of future replication efforts, the below graph is included to show the trends observed in the present sample (see Fig 4).

Download:

Fig 4. Estimated marginal means of salivary cortisol as a function of reaction profile (interaction).

https://doi.org/10.1371/journal.pone.0196685.g004

Overall, the different profiles previously observed in terms of relational withdrawal thus also appear to be distinguishable in terms of HPA axis reactivity.

Child distress behavior index.

Due to the high number of zero observations, data could not be normalized. A Kruskal-Wallis H-test showed no statistically significant baseline differences in challenging behaviors between the three groups at any of the four time points.

Discussion

The present study used the ADBB scale of relational withdrawal to gauge the effects of parental visit on babies temporarily placed out-of-home. Three distinct profiles appeared based on observed variation of relational withdrawal upon initial parental contact. These groups were found to differ significantly in relational withdrawal over the course of 24 hours and also in terms of salivary cortisol. Overall, the results indicate that relational withdrawal can meaningfully be used to identify babies’ experience of parental contact in the context of temporary suspension of custody.

The decrease group showed a reduction of relational withdrawal level upon contact with parents. These babies seemed to heighten their social engagement during the visit as compared with baseline levels. Upon returning from the visit, data showed an increase of relational withdrawal followed by steady improvement (reduction) over the following 24h. Children in this group demonstrated an increase in cortisol levels but only at the time of separation from their parents. Taken together, these results suggest a positive impact of contact with parents, which remained beyond the initial reaction of protest upon separation. For these children, the separation may thus constitute a more substantial stressor than the interaction with their parents in itself. Pending replication of the present findings, it may be necessary to adopt practices helping these children cope with the stress of the separation.

The increase group showed an elevation of relational withdrawal level upon contact with parents. Generally, children in this group had a baseline level of relational withdrawal below the clinical threshold and lower than the other two groups prior to the visit and they withdrew strongly upon contact with parents. After the visit, relational withdrawal scores returned to baseline, suggesting an absence of distress linked to the separation itself. Overall, this group showed higher average cortisol levels at all time-points than the two other groups, which may be suggestive of a more stressful early environment or a more reactive neurophysiological profile. Importantly, no decrease in salivary cortisol was observed during contact with parents, highlighting the absence of a soothing effect of the interaction. Taken together, these findings seem to indicate that, as least for some children, contact with parents can be a stressful event that would need to be understood, acknowledged and taken into consideration when planning visits so that babies can receive enough support to offset the impact of relational stress [2]. A number of factors related to the developmental history of the child (e.g. premature relational disruptions, absence of attachment relationships) and of the psychosocial environment (parent/caretaker conflict, stressful life experiences) may be relevant to understand this stress response. Future research should consider such factors specifically.

The last group showed no visible reaction to visitation in terms of relational withdrawal. On average, these children demonstrated more severe levels of relational withdrawal than the other two groups at all four time-points and showed very limited variation in relational withdrawal behavior over the course of 24 hours. Children in this group also had lower average salivary cortisol level at all time-points than the two other groups. These results could be indicative of HPA axis inhibition, resulting in lower reactivity [39, 36, 37, 47]. Indeed, the absence of any emotional reaction to contact with parents could be a sign of overall heightened distress for the baby and thus indicate elevated risk of future psychopathology [47, 27]. This finding is all the more worrying as this group is “emotionally silent”. Indeed, these babies are not difficult to deal with; they don’t protest (anymore) and overlooking their despair is likely even though they may be more in need of help than the other groups.

Taken together, these sometimes counterintuitive findings highlight the potential for misinterpreting babies’ behaviors in the context of parental visits and thus for misunderstanding the kind of support and protection that could be needed to foster healthy development. The present study also highlights the need for more research to understand witch factors are affecting babies’ reaction to contact with parents. For example, the improvement in relational withdrawal during the visit coupled with the spike in cortisol during separation for the decrease group indicates a potential risk to social and emotional development not from the visitation but from recurring separations. Contrastingly, for the increase group, the visit with the parent seems to be the stressor and the lack of meaningful observable reaction at separation lends empirical support to this interpretation. Finally, the stagnation group appears unbothered although, in reality, may present with the most substantial need for support and protection considering they display higher level of sustained relational withdrawal overall.

The findings reported in the present study should be interpreted with a number of limitations in mind. First of all, the size of the sample severely limits statistical power and thus the complexity of the analyses that can be carried out. More complex, multilevel modeling will be needed to further elucidate and corroborate the present findings. Another limitation concerns the challenging behavior inventory. Although it is closely associated with the Symptom Checklist [46] the measure was created for the purposes of the study and had not been the subject to independent empirical validation. It is possible that such tool, to be effective, would require substantially more training. Furthermore, previous literature has indicated that the ADBB partly reflects child temperament[48], which could not be verified in the present study. Further studies should therefore include measures of both child temperament and mood. Finally, although the specific context of the present study—institutional foster care—allows for a more controlled environment, it has specific characteristics that limit direct comparison with other forms of out-of-home placements. Further studies on children cared for in foster families or in joint-custody contexts are needed to replicate the present findings. As outlined, such designs would however have to resolve the substantial challenges related to standardizing the data collection.

These limitations notwithstanding, the present findings provide initial support for the usefulness of relational withdrawal as a concept to understand babies’ point of view in challenging interpersonal situations, and in distinguishing between possible groups of young children presenting with distinct needs in response to parental visitation. Importantly, the results indicate that emotional responses following parental visitation may be substantially misrepresenting the young child’s experience. This highlights the need for systematic training of professionals to conduct careful observation and assessment of children’s levels of relational withdrawal. Clinically, understanding babies’ responses can help professionals monitor their adaptation to the situation and, if necessary, take very early therapeutic steps to promote sensitive interactions. Further observation-based research is needed to substantiate these findings.

In terms of child welfare services, the present findings provide empirical support in response to the controversies that are currently re-emerging concerning the effect of parental visits on children placed out of home [49, 6, 50, 51, 2]. This study suggests that the question to ask is not whether there is a benefit to parental contact for babies placed away from home, but for which babies the visit is most beneficial. In order to construct sensitive and ecologically feasible interventions to address this issue, future studies are needed to understand the interplay of the specific characteristics of the parent-child interactions, of the placement and of the child. In-depth analysis of the specific parenting skills (sensitivity, reflective function) likely to affect levels of relational withdrawal in the child are particularly susceptible of becoming targets for intervention. Understanding these factors could then contribute to developing decision making models in child protection, guaranteeing the maximum level of contact between babies and parents with minimum adverse effects on the developing child.

Supporting information

S1 Minimal Dataset.

https://doi.org/10.1371/journal.pone.0196685.s001

(XLSX)

References

1. Miron D., Bisaillon C., Jordan B., Bryce G., Gauthier Y., St-André M., & Minnis H. Whose Rights Count? Negotiating Practice, Policy, and Legal Dilemmas Regarding Infant-Parent Contact When Infants are in Out-of-Home Care. Infant Mental Health Journal, 2013, 34(2), 177–188. http://doi.org/10.1002/imhj.21381 pmid:24098062
- View Article
- PubMed/NCBI
- Google Scholar
2. Triseliotis J. Contact between Looked after Children and Their Parents: A Level Playing Field? Adoption & Fostering, 2010, 34(3), 59–66. http://doi.org/10.1177/030857591003400311
- View Article
- Google Scholar
3. Tottenham N. The importance of early experiences for neuro-affective development. In The Neurobiology of Childhood (pp. 109–129). Springer Berlin Heidelberg. 2014
4. Berger M. L'échec de la protection de l’enfance. Paris. Dunod. p.264,2004
5. Barnum R. Understanding Controversies in Visitation. Journal of the American Academy of Child & Adolescent Psychiatry, 1987, 26(5), 788–792.
- View Article
- Google Scholar
6. Humphreys C., & Kiraly M. High-frequency family contact: a road to nowhere for infants. Child & Family Social Work, 2010, 16(1), 1–11. http://doi.org/10.1111/j.1365-2206.2010.00699.x
- View Article
- Google Scholar
7. Quinton D., Rushton A., Dance C., & Mayes D. Contact between children placed away from home and their birth parents: Research issues and evidence. Clinical Child Psychology and Psychiatry, 1997, 2(3), 393–413.
- View Article
- Google Scholar
8. Quinton D., Selwyn J., Rushton A., & Dance C. Contact between Children Placed Away from Home and their Birth Parents: Ryburn’s ‘Reanalysis’ Analysed. Clinical Child Psychology and Psychiatry, 1999, 4(4), 519–531. http://doi.org/10.1177/1359104599004004008
- View Article
- Google Scholar
9. Ryburn M. Contact between Children Placed Away from Home and their Birth Parents: A Reanalysis of the Evidence in Relation to Permanent Placements. Clinical Child Psychology and Psychiatry, 1999, 4(4), 505–518.
- View Article
- Google Scholar
10. Guedeney A. Petite enfance et psychopathologie: Développement et psychopathologie précoce, évaluation et intervention en périnatalité et petite enfance. Elsevier Masson. 2014
11. Guedeney A., & Fermanian J. (2001) A validity and reliability study of assessment and screening for sustained withdrawal reaction in infancy: The Alarm Distress Baby scale. Infant Mental Health Journal, 2001, 22(5), 559–575. http://doi.org/10.1002/imhj.1018
- View Article
- Google Scholar
12. Brazelton T. B., Koslowski B., & Main M. The origins of reciprocity: The early mother-infant interaction. New-York, Wiley, 1974.
13. Cohn J. F., & Tronick E. Specificity of infants”response to mothers” affective behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 1989, 28(2), 242–248.
- View Article
- Google Scholar
14. Guedeney A., Matthey S., & Puura K. Social withdrawal behavior in infancy: a history of the concept and a review of published studies using the Alarm Distress baby scale. Infant Mental Health Journal, 2013, 34(6), 516–531.
- View Article
- Google Scholar
15. Brazelton TB, Yogman M, Als H, Tronick E. Joint regulation of neonate-parent behavior. In: Tronick E, editor. Social interchange in infancy. Baltimore: University Park Press; p. 7–22. 1979
16. Trevarthen C, Aitken KJ. Infant inter subjectivity: research, theory and clinical applications. J Child Psychol Psychiat; 2001, 42(1):3–48 pmid:11205623
- View Article
- PubMed/NCBI
- Google Scholar
17. Field T., Early interactions between infants and their post partum depressed mothers. Infant Behav Dev 1984;7:532–7.
- View Article
- Google Scholar
18. Gauvain-Piquard A., Rodary C., Rezvani A., & Lemerle J. Pain in children aged 2–6 years: a new observational rating scale elaborated in a pediatric oncology unit—preliminary report. Pain, 1987, 31(2), 177–188. pmid:3501562
- View Article
- PubMed/NCBI
- Google Scholar
19. Gauvain-Piquard A., Rodary C., Rezvani A., & Serbouti S. The development of the DEGRR: a scale to assess pain in young children with cancer. European Journal of Pain, 1999, 3(2), 165–176. pmid:10700346
- View Article
- PubMed/NCBI
- Google Scholar
20. Guedeney A. From early withdrawal reaction to infant depression: A baby alone does exist. Infant Mental Health Journal, 1997, 18(4), 339–349. http://doi.org/10.1002/(SICI)1097-0355(199724)18:4
- View Article
- Google Scholar
21. Scheeringa M. S., & Zeanah C. H. Symptom expression and trauma variables in children under 48 months of age. Infant Mental Health Journal, 1995,16(4), 259–270.
- View Article
- Google Scholar
22. Spitz R. A., & Wolf K. M. Anaclitic depression: an inquiry into the genesis of psychiatric conditions in early childhood, II. The Psychoanalytic Study of the Child, 1946, 2, 313–342
- View Article
- Google Scholar
23. Murray L., & Cooper P. J. Editorial: Postpartum depression and child development. Psychological Medicine, 1997, 27(02), 253–260.
- View Article
- Google Scholar
24. Reder P., & Lucey C. Significant issues in the assessment of parenting. In Assessment of Parenting: Psychiatric and Psychological Contributions, London Routledge, pp 3–21, 1995.
25. Mäntymaa M., Puura K., Luoma I., Kaukonen P., Salmelin R. K., & Tamminen T. Infants’ social withdrawal and parents’ mental health. Infant Behavior and Development, 2008, 31(4), 606–613. http://doi.org/10.1016/j.infbeh.2008.07.005 pmid:18774609
- View Article
- PubMed/NCBI
- Google Scholar
26. Zeanah C. H., Boris N. W., & Bakshi S. Lieberman AF Attachment disorders of infancy. WAIMH Handbook of Infant Mental Health, 2000, 4, 91–122.
27. Milne L., Greenway P., Guedeney A., & Larroque B. Long term developmental impact of social withdrawal in infants. Infant Behavior and Development, 2009 32(2): 159–166.http://doi.org/10.1016/j.infbeh.2008.12.006 pmid:19185351
- View Article
- PubMed/NCBI
- Google Scholar
28. Smyth N., Hucklebridge F., Thorn L., Evans P., & Clow A. Salivary cortisol as a biomarker in social science research. Social and Personality Psychology Compass, 2013, 7(9), 605–625.
- View Article
- Google Scholar
29. Bozovic D., Racic M., & Ivkovic N. Salivary cortisol levels as a biological marker of stress reaction. Medical archives, 2013, 67(5), 374. pmid:24601177
- View Article
- PubMed/NCBI
- Google Scholar
30. Gunnar M. R., & Donzella B. Social regulation of the cortisol levels in early human development. Psychoneuroendocrinology, 2002, 27(1–2), 199–220. pmid:11750779
- View Article
- PubMed/NCBI
- Google Scholar
31. Gunnar, M. R., & Herrera, A. Stress et développement précoce du cerveau. Encyclopédie Sur Le Développement Des Jeunes Enfants. 2009 retrieved from http://www.enfant-encyclopedie.com/sites/default/files/textes-experts/fr/49/stress-et-developpement-precoce-du-cerveau-.pdf
32. Jansen J., Beijers R., Riksen-Walraven M., & de Weerth C. Cortisol reactivity in young infants, Psychoneuroendocrinology,2010, 35(3), 329–338.http://doi.org/10.1016/j.psyneuen.2009.07.008 pmid:19651476
- View Article
- PubMed/NCBI
- Google Scholar
33. Van Andel H. W. H., Jansen L. M. C., Grietens H., Knorth E. J., & van der Gaag R. J. Salivary cortisol: a possible biomarker in evaluating stress and effects of interventions in young foster children? European Child & Adolescent Psychiatry, 2013, 23(1), 3–12. http://doi.org/10.1007/s00787-013-0439-1
- View Article
- Google Scholar
34. Watamura S. E., Donzella B., Kertes D. A., & Gunnar M. R. Developmental changes in baseline cortisol activity in early childhood: Relations with napping and effortful control. Developmental Psychobiology, 2004,45(3), 125–133. pmid:15505801
- View Article
- PubMed/NCBI
- Google Scholar
35. Bernard K., Butzin-Dozier Z., Rittenhouse J., & Dozier M. Cortisol Production Patterns in Young Children Living With Birth Parents vs Children Placed in Foster Care Following Involvement of Child Protective Services. Archives of Pediatrics & Adolescent,Medicine, 2010, 164(5), 438–443. http://doi.org/10.1001/archpediatrics.2010.54
- View Article
- Google Scholar
36. Gunnar M. R., & Quevedo K. M. Early care experiences and HPA axis regulation in children: a mechanism for later trauma vulnerability. Progress in Brain Research, 2008 167, 137–149. http://doi.org/10.1016/S0079-6123(07)67010-1 pmid:18037012
- View Article
- PubMed/NCBI
- Google Scholar
37. Hunter A. L. A., Minnis H. H., & Wilson P. P. Altered stress responses in children exposed to early adversity: a systematic review of salivary cortisol studies. Stress: the International Journal on the Biology of Stress, 2011, 14(6), 614–626. http://doi.org/10.3109/10253890.2011.577848
- View Article
- Google Scholar
38. Tarullo A. R., & Gunnar M. R. Child maltreatment and the developing HPA axis. Hormones and Behavior, 2006, 50(4), 632–639. http://doi.org/10.1016/j.yhbeh.2006.06.010 pmid:16876168
- View Article
- PubMed/NCBI
- Google Scholar
39. Carlson M., & Earls F. Psychological and neuroendocrinological sequelae of early social deprivation in institutionalized children in Romania. Annals of the New York Academy of Sciences, 1997, 807, 419–428. pmid:9071367
- View Article
- PubMed/NCBI
- Google Scholar
40. Davis E. P., & Granger D. A. (2009) Developmental differences in infant salivary alpha-amylase and cortisol responses to stress, Psychoneuroendocrinology, 2009, 34(6), 795–804. http://doi.org/10.1016/j.psyneuen.2009.02.001 pmid:19268476
- View Article
- PubMed/NCBI
- Google Scholar
41. Dozier M., Peloso E., Lewis E., Laurenceau J.-P., & Levine S. Effects of an attachment-based intervention on the cortisol production of infants and toddlers in foster care. Development and Psychopathology, 2008, 20(3), 845–859. http://doi.org/10.1017/S0954579408000400 pmid:18606034
- View Article
- PubMed/NCBI
- Google Scholar
42. Nelson E. M., & Spieker S. J. Intervention Effects on Morning and Stimulated Cortisol Responses among Toddlers in Foster Care. Infant Mental Health Journal, 2013, 34(3), 211–221. http://doi.org/10.1002/imhj.21382
- View Article
- Google Scholar
43. David, M., Appell, G, et Centres d’entraînement aux méthodes d'éducation actives (France). Lóczy ou le maternage insolite. Erès, 1973.
44. Lopes S. C. F., Ricas J., & Mancini M. C. Evaluation of the psychometrics properties of the alarm distress baby scale among 122 Brazilian children. Infant Mental Health Journal, 2008, 29(2), 153–173. http://doi.org/10.1002/imhj.20169 pmid:28636194
- View Article
- PubMed/NCBI
- Google Scholar
45. Milne L., Greenway P., Guedeney A., & Larroque B. Long term developmental impact of social withdrawal in infants. Infant Behavior and Development, 2009, 32(2), 159–166. pmid:19185351
- View Article
- PubMed/NCBI
- Google Scholar
46. Robert-Tissot C., Rusconi-Serpa S., Bachman J.P., Besson G., Cramer B., Knauer D. F. Stern D. N. Le questionnaire « symptom check-list »: évaluation des troubles psycho-fonctionnels de la petite enfance. In Lebovici S., Mazet et P. Visier J.P. (eds.) L’Evaluation des interactions précoces entre le bébé et ses partenaires. Paris: ESHEL. 1989
47. Gunnar M. R., & Vazquez D. M. Low cortisol and a flattening of expected daytime rhythm: Potential indices of risk in human development. Development and psychopathology, 2001,13(03), 515–538.
- View Article
- Google Scholar
48. Costa R., & Figueiredo B. Infants’ behavioral and physiological profile and mother-infant interaction. International Journal of Behavioral Development, 2012,36(3), 205–214. http://doi.org/10.1177/0165025411428248
- View Article
- Google Scholar
49. Biehal N. Reuniting Children with their Families: Reconsidering the Evidence on Timing, Contact and Outcomes. British Journal of Social Work,2006,37(5), 807–823. http://doi.org/10.1093/bjsw/bcl051
- View Article
- Google Scholar
50. Kenrick J. Concurrent Planning: A Retrospective Study of the Continuities and Discontinuities of Care, and Their Impact on the Development of Infants and Young Children Placed for Adoption by the Coram Concurrent Planning Project. Adoption & Fostering, 2009, 33(4), 5–18. http://doi.org/10.1177/030857590903300403
- View Article
- Google Scholar
51. Schofield G., & Simmonds J. Contact for Infants Subject to Care Proceedings. Adoption & Fostering, 2011, 35(4), 70–74. http://doi.org/10.1177/030857591103500408
- View Article
- Google Scholar

[ref1] 1. Miron D., Bisaillon C., Jordan B., Bryce G., Gauthier Y., St-André M., & Minnis H. Whose Rights Count? Negotiating Practice, Policy, and Legal Dilemmas Regarding Infant-Parent Contact When Infants are in Out-of-Home Care. Infant Mental Health Journal, 2013, 34(2), 177–188. http://doi.org/10.1002/imhj.21381 pmid:24098062
View Article
PubMed/NCBI
Google Scholar

[2] View Article

[3] PubMed/NCBI

[4] Google Scholar

[ref2] 2. Triseliotis J. Contact between Looked after Children and Their Parents: A Level Playing Field? Adoption & Fostering, 2010, 34(3), 59–66. http://doi.org/10.1177/030857591003400311
View Article
Google Scholar

[6] View Article

[7] Google Scholar

[ref3] 3. Tottenham N. The importance of early experiences for neuro-affective development. In The Neurobiology of Childhood (pp. 109–129). Springer Berlin Heidelberg. 2014

[ref4] 4. Berger M. L'échec de la protection de l’enfance. Paris. Dunod. p.264,2004

[ref5] 5. Barnum R. Understanding Controversies in Visitation. Journal of the American Academy of Child & Adolescent Psychiatry, 1987, 26(5), 788–792.
View Article
Google Scholar

[11] View Article

[12] Google Scholar

[ref6] 6. Humphreys C., & Kiraly M. High-frequency family contact: a road to nowhere for infants. Child & Family Social Work, 2010, 16(1), 1–11. http://doi.org/10.1111/j.1365-2206.2010.00699.x
View Article
Google Scholar

[14] View Article

[15] Google Scholar

[ref7] 7. Quinton D., Rushton A., Dance C., & Mayes D. Contact between children placed away from home and their birth parents: Research issues and evidence. Clinical Child Psychology and Psychiatry, 1997, 2(3), 393–413.
View Article
Google Scholar

[17] View Article

[18] Google Scholar

[ref8] 8. Quinton D., Selwyn J., Rushton A., & Dance C. Contact between Children Placed Away from Home and their Birth Parents: Ryburn’s ‘Reanalysis’ Analysed. Clinical Child Psychology and Psychiatry, 1999, 4(4), 519–531. http://doi.org/10.1177/1359104599004004008
View Article
Google Scholar

[20] View Article

[21] Google Scholar

[ref9] 9. Ryburn M. Contact between Children Placed Away from Home and their Birth Parents: A Reanalysis of the Evidence in Relation to Permanent Placements. Clinical Child Psychology and Psychiatry, 1999, 4(4), 505–518.
View Article
Google Scholar

[23] View Article

[24] Google Scholar

[ref10] 10. Guedeney A. Petite enfance et psychopathologie: Développement et psychopathologie précoce, évaluation et intervention en périnatalité et petite enfance. Elsevier Masson. 2014

[ref11] 11. Guedeney A., & Fermanian J. (2001) A validity and reliability study of assessment and screening for sustained withdrawal reaction in infancy: The Alarm Distress Baby scale. Infant Mental Health Journal, 2001, 22(5), 559–575. http://doi.org/10.1002/imhj.1018
View Article
Google Scholar

[27] View Article

[28] Google Scholar

[ref12] 12. Brazelton T. B., Koslowski B., & Main M. The origins of reciprocity: The early mother-infant interaction. New-York, Wiley, 1974.

[ref13] 13. Cohn J. F., & Tronick E. Specificity of infants”response to mothers” affective behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 1989, 28(2), 242–248.
View Article
Google Scholar

[31] View Article

[32] Google Scholar

[ref14] 14. Guedeney A., Matthey S., & Puura K. Social withdrawal behavior in infancy: a history of the concept and a review of published studies using the Alarm Distress baby scale. Infant Mental Health Journal, 2013, 34(6), 516–531.
View Article
Google Scholar

[34] View Article

[35] Google Scholar

[ref15] 15. Brazelton TB, Yogman M, Als H, Tronick E. Joint regulation of neonate-parent behavior. In: Tronick E, editor. Social interchange in infancy. Baltimore: University Park Press; p. 7–22. 1979

[ref16] 16. Trevarthen C, Aitken KJ. Infant inter subjectivity: research, theory and clinical applications. J Child Psychol Psychiat; 2001, 42(1):3–48 pmid:11205623
View Article
PubMed/NCBI
Google Scholar

[38] View Article

[39] PubMed/NCBI

[40] Google Scholar

[ref17] 17. Field T., Early interactions between infants and their post partum depressed mothers. Infant Behav Dev 1984;7:532–7.
View Article
Google Scholar

[42] View Article

[43] Google Scholar

[ref18] 18. Gauvain-Piquard A., Rodary C., Rezvani A., & Lemerle J. Pain in children aged 2–6 years: a new observational rating scale elaborated in a pediatric oncology unit—preliminary report. Pain, 1987, 31(2), 177–188. pmid:3501562
View Article
PubMed/NCBI
Google Scholar

[45] View Article

[46] PubMed/NCBI

[47] Google Scholar

[ref19] 19. Gauvain-Piquard A., Rodary C., Rezvani A., & Serbouti S. The development of the DEGRR: a scale to assess pain in young children with cancer. European Journal of Pain, 1999, 3(2), 165–176. pmid:10700346
View Article
PubMed/NCBI
Google Scholar

[49] View Article

[50] PubMed/NCBI

[51] Google Scholar

[ref20] 20. Guedeney A. From early withdrawal reaction to infant depression: A baby alone does exist. Infant Mental Health Journal, 1997, 18(4), 339–349. http://doi.org/10.1002/(SICI)1097-0355(199724)18:4
View Article
Google Scholar

[53] View Article

[54] Google Scholar

[ref21] 21. Scheeringa M. S., & Zeanah C. H. Symptom expression and trauma variables in children under 48 months of age. Infant Mental Health Journal, 1995,16(4), 259–270.
View Article
Google Scholar

[56] View Article

[57] Google Scholar

[ref22] 22. Spitz R. A., & Wolf K. M. Anaclitic depression: an inquiry into the genesis of psychiatric conditions in early childhood, II. The Psychoanalytic Study of the Child, 1946, 2, 313–342
View Article
Google Scholar

[59] View Article

[60] Google Scholar

[ref23] 23. Murray L., & Cooper P. J. Editorial: Postpartum depression and child development. Psychological Medicine, 1997, 27(02), 253–260.
View Article
Google Scholar

[62] View Article

[63] Google Scholar

[ref24] 24. Reder P., & Lucey C. Significant issues in the assessment of parenting. In Assessment of Parenting: Psychiatric and Psychological Contributions, London Routledge, pp 3–21, 1995.

[ref25] 25. Mäntymaa M., Puura K., Luoma I., Kaukonen P., Salmelin R. K., & Tamminen T. Infants’ social withdrawal and parents’ mental health. Infant Behavior and Development, 2008, 31(4), 606–613. http://doi.org/10.1016/j.infbeh.2008.07.005 pmid:18774609
View Article
PubMed/NCBI
Google Scholar

[66] View Article

[67] PubMed/NCBI

[68] Google Scholar

[ref26] 26. Zeanah C. H., Boris N. W., & Bakshi S. Lieberman AF Attachment disorders of infancy. WAIMH Handbook of Infant Mental Health, 2000, 4, 91–122.

[ref27] 27. Milne L., Greenway P., Guedeney A., & Larroque B. Long term developmental impact of social withdrawal in infants. Infant Behavior and Development, 2009 32(2): 159–166.http://doi.org/10.1016/j.infbeh.2008.12.006 pmid:19185351
View Article
PubMed/NCBI
Google Scholar

[71] View Article

[72] PubMed/NCBI

[73] Google Scholar

[ref28] 28. Smyth N., Hucklebridge F., Thorn L., Evans P., & Clow A. Salivary cortisol as a biomarker in social science research. Social and Personality Psychology Compass, 2013, 7(9), 605–625.
View Article
Google Scholar

[75] View Article

[76] Google Scholar

[ref29] 29. Bozovic D., Racic M., & Ivkovic N. Salivary cortisol levels as a biological marker of stress reaction. Medical archives, 2013, 67(5), 374. pmid:24601177
View Article
PubMed/NCBI
Google Scholar

[78] View Article

[79] PubMed/NCBI

[80] Google Scholar

[ref30] 30. Gunnar M. R., & Donzella B. Social regulation of the cortisol levels in early human development. Psychoneuroendocrinology, 2002, 27(1–2), 199–220. pmid:11750779
View Article
PubMed/NCBI
Google Scholar

[82] View Article

[83] PubMed/NCBI

[84] Google Scholar

[ref31] 31. Gunnar, M. R., & Herrera, A. Stress et développement précoce du cerveau. Encyclopédie Sur Le Développement Des Jeunes Enfants. 2009 retrieved from http://www.enfant-encyclopedie.com/sites/default/files/textes-experts/fr/49/stress-et-developpement-precoce-du-cerveau-.pdf

[ref32] 32. Jansen J., Beijers R., Riksen-Walraven M., & de Weerth C. Cortisol reactivity in young infants, Psychoneuroendocrinology,2010, 35(3), 329–338.http://doi.org/10.1016/j.psyneuen.2009.07.008 pmid:19651476
View Article
PubMed/NCBI
Google Scholar

[87] View Article

[88] PubMed/NCBI

[89] Google Scholar

[ref33] 33. Van Andel H. W. H., Jansen L. M. C., Grietens H., Knorth E. J., & van der Gaag R. J. Salivary cortisol: a possible biomarker in evaluating stress and effects of interventions in young foster children? European Child & Adolescent Psychiatry, 2013, 23(1), 3–12. http://doi.org/10.1007/s00787-013-0439-1
View Article
Google Scholar

[91] View Article

[92] Google Scholar

[ref34] 34. Watamura S. E., Donzella B., Kertes D. A., & Gunnar M. R. Developmental changes in baseline cortisol activity in early childhood: Relations with napping and effortful control. Developmental Psychobiology, 2004,45(3), 125–133. pmid:15505801
View Article
PubMed/NCBI
Google Scholar

[94] View Article

[95] PubMed/NCBI

[96] Google Scholar

[ref35] 35. Bernard K., Butzin-Dozier Z., Rittenhouse J., & Dozier M. Cortisol Production Patterns in Young Children Living With Birth Parents vs Children Placed in Foster Care Following Involvement of Child Protective Services. Archives of Pediatrics & Adolescent,Medicine, 2010, 164(5), 438–443. http://doi.org/10.1001/archpediatrics.2010.54
View Article
Google Scholar

[98] View Article

[99] Google Scholar

[ref36] 36. Gunnar M. R., & Quevedo K. M. Early care experiences and HPA axis regulation in children: a mechanism for later trauma vulnerability. Progress in Brain Research, 2008 167, 137–149. http://doi.org/10.1016/S0079-6123(07)67010-1 pmid:18037012
View Article
PubMed/NCBI
Google Scholar

[101] View Article

[102] PubMed/NCBI

[103] Google Scholar

[ref37] 37. Hunter A. L. A., Minnis H. H., & Wilson P. P. Altered stress responses in children exposed to early adversity: a systematic review of salivary cortisol studies. Stress: the International Journal on the Biology of Stress, 2011, 14(6), 614–626. http://doi.org/10.3109/10253890.2011.577848
View Article
Google Scholar

[105] View Article

[106] Google Scholar

[ref38] 38. Tarullo A. R., & Gunnar M. R. Child maltreatment and the developing HPA axis. Hormones and Behavior, 2006, 50(4), 632–639. http://doi.org/10.1016/j.yhbeh.2006.06.010 pmid:16876168
View Article
PubMed/NCBI
Google Scholar

[108] View Article

[109] PubMed/NCBI

[110] Google Scholar

[ref39] 39. Carlson M., & Earls F. Psychological and neuroendocrinological sequelae of early social deprivation in institutionalized children in Romania. Annals of the New York Academy of Sciences, 1997, 807, 419–428. pmid:9071367
View Article
PubMed/NCBI
Google Scholar

[112] View Article

[113] PubMed/NCBI

[114] Google Scholar

[ref40] 40. Davis E. P., & Granger D. A. (2009) Developmental differences in infant salivary alpha-amylase and cortisol responses to stress, Psychoneuroendocrinology, 2009, 34(6), 795–804. http://doi.org/10.1016/j.psyneuen.2009.02.001 pmid:19268476
View Article
PubMed/NCBI
Google Scholar

[116] View Article

[117] PubMed/NCBI

[118] Google Scholar

[ref41] 41. Dozier M., Peloso E., Lewis E., Laurenceau J.-P., & Levine S. Effects of an attachment-based intervention on the cortisol production of infants and toddlers in foster care. Development and Psychopathology, 2008, 20(3), 845–859. http://doi.org/10.1017/S0954579408000400 pmid:18606034
View Article
PubMed/NCBI
Google Scholar

[120] View Article

[121] PubMed/NCBI

[122] Google Scholar

[ref42] 42. Nelson E. M., & Spieker S. J. Intervention Effects on Morning and Stimulated Cortisol Responses among Toddlers in Foster Care. Infant Mental Health Journal, 2013, 34(3), 211–221. http://doi.org/10.1002/imhj.21382
View Article
Google Scholar

[124] View Article

[125] Google Scholar

[ref43] 43. David, M., Appell, G, et Centres d’entraînement aux méthodes d'éducation actives (France). Lóczy ou le maternage insolite. Erès, 1973.

[ref44] 44. Lopes S. C. F., Ricas J., & Mancini M. C. Evaluation of the psychometrics properties of the alarm distress baby scale among 122 Brazilian children. Infant Mental Health Journal, 2008, 29(2), 153–173. http://doi.org/10.1002/imhj.20169 pmid:28636194
View Article
PubMed/NCBI
Google Scholar

[128] View Article

[129] PubMed/NCBI

[130] Google Scholar

[ref45] 45. Milne L., Greenway P., Guedeney A., & Larroque B. Long term developmental impact of social withdrawal in infants. Infant Behavior and Development, 2009, 32(2), 159–166. pmid:19185351
View Article
PubMed/NCBI
Google Scholar

[132] View Article

[133] PubMed/NCBI

[134] Google Scholar

[ref46] 46. Robert-Tissot C., Rusconi-Serpa S., Bachman J.P., Besson G., Cramer B., Knauer D. F. Stern D. N. Le questionnaire « symptom check-list »: évaluation des troubles psycho-fonctionnels de la petite enfance. In Lebovici S., Mazet et P. Visier J.P. (eds.) L’Evaluation des interactions précoces entre le bébé et ses partenaires. Paris: ESHEL. 1989

[ref47] 47. Gunnar M. R., & Vazquez D. M. Low cortisol and a flattening of expected daytime rhythm: Potential indices of risk in human development. Development and psychopathology, 2001,13(03), 515–538.
View Article
Google Scholar

[137] View Article

[138] Google Scholar

[ref48] 48. Costa R., & Figueiredo B. Infants’ behavioral and physiological profile and mother-infant interaction. International Journal of Behavioral Development, 2012,36(3), 205–214. http://doi.org/10.1177/0165025411428248
View Article
Google Scholar

[140] View Article

[141] Google Scholar

[ref49] 49. Biehal N. Reuniting Children with their Families: Reconsidering the Evidence on Timing, Contact and Outcomes. British Journal of Social Work,2006,37(5), 807–823. http://doi.org/10.1093/bjsw/bcl051
View Article
Google Scholar

[143] View Article

[144] Google Scholar

[ref50] 50. Kenrick J. Concurrent Planning: A Retrospective Study of the Continuities and Discontinuities of Care, and Their Impact on the Development of Infants and Young Children Placed for Adoption by the Coram Concurrent Planning Project. Adoption & Fostering, 2009, 33(4), 5–18. http://doi.org/10.1177/030857590903300403
View Article
Google Scholar

[146] View Article

[147] Google Scholar

[ref51] 51. Schofield G., & Simmonds J. Contact for Infants Subject to Care Proceedings. Adoption & Fostering, 2011, 35(4), 70–74. http://doi.org/10.1177/030857591103500408
View Article
Google Scholar

[149] View Article

[150] Google Scholar

Figures

Abstract

Introduction

Measuring child responses to parental visitation

The present study

Method

Participants.

Procedure.

Measures.

Relational withdrawal.

Salivary cortisol.

Child distress behaviors.

Data analytic strategy.

Results

Relational withdrawal.

Salivary cortisol.

Child distress behavior index.

Discussion

Supporting information

S1 Minimal Dataset.

References