A PhD which examines, within the Froebelian framework, the effect of maternal postnatal depression on infants’ verbal and non-verbal communication skills during three crucial activities in child development - play, mother singing and face-to-face interaction.
Postnatal depression (PND) is the most common complication observed in women following delivery, affecting approximately 17% of mothers. Research shows that mothers with PND are less involved in enriching and educational interactions with their infants, such as play, singing songs, face-to-face contacts and smiling. These differences in mother-child interactions in the case of PND have been found to negatively affect the child’s development of verbal and non-verbal communication skills. Hence, children of mothers with PND are at increased risk of poor developmental outcomes, such as emotional difficulties and poor cognitive capacities, language outcomes and academic attainment. However, there is limited research focused on infants’ verbal and non-verbal communication skills during interactive activities with mothers with PND, and especially in the context of an inpatient Mother- Baby Unit (MBU). The novel aspect of this study is that it focused on a negligible population, namely infants and their mothers who suffered from PND enough to warrant hospitalization in a MBU.
Ultimately, this study, embracing the Froebelian principle that every child deserves equal opportunities to lead a healthy and fulfilling life aims at producing suggestions for improvement in the existing policies for early intervention. It is driven by the assumption that helping children from the very first years of their life is the most effective way to give them the opportunity for personal fulfilment and individual growth, a value highly endorsed by Froebel’s theory.
For the purpose of this study, pre-existing videos from the largest MBU in the UK, that contain footages of mothers with PND interacting with their babies were used. A comparison group of mothers without PND interacting with their infants were video-recorded to illustrate the differences in the interaction between mothers with PND and their infants. Overall, this study provided a detailed examination of the use of verbal and non-verbal communication (NVC) skills in infants during play with their mothers in this population.
Five of the most important research conclusions are as follows:
1) While mothers without PND predominantly engaged in play activities with their infant that were organised around the use of toy-objects, mothers with PND were mainly playing with their infants without the use of toy. The fact that dyads from the clinical group usually play without the use of toy is a novel and encouraging finding indicating the maternal ability to engage into a play interaction through different ways in the case of PND. However, this play pattern could compromise the educational and developmental benefits that infants could get from the play activities with toys.
2) The infants of mothers with PND (vs infants of mothers without PND) showed more immature and passive way of playing. In particular, the findings indicated that infants of mothers with PND were less likely to engage in play activities with their mothers and display a decreased level of curiosity for and interest in objects during playtime. Taking into account that the use of toys in playtime creates a space in which infants engage with the toys not only to discover the world but also to manage their emotions and soothe themselves, the findings of this research project highlighted that that infants of PND mother could be at an increased risk poor developmental outcomes.
3) A negative association was found between the absence of toy manipulation in infants and their self-regulatory skills in both groups (i.e., clinical and comparison group). This finding is of fundamental importance pointing to the emotional function of object play in infants’ well-being that contributes to children’s emotional expressiveness, self-regulation and self-awareness, as suggested by Froebel.
4) Mothers with PND were found to sing and talk less to their infants while the quality of the content of their speech showed deficits when compared to mothers without PND. Given the evidence that reduced quality of maternal vocal behaviour, including the way of speaking and singing, could lead to poorer language outcomes and cognitive capacities as well as to emotional difficulties in children (Alhusen et al., 2013; Music, 2011; Sohr-Preston & Scaramella, 2006; Kawai et al., 2017; Kaplan et al., 2012; 2014; Zajicek-Farber, 2009; Paulson et al., 2009), the findings of the present study are of fundamental importance, showing that the infants of mothers with severe PND are a population at risk for adverse developmental outcomes.
5) Overall, differences were found in infants’ verbal and NVC skills between the clinical and the comparison group. Infants from the clinical group (vs. infants from the comparison group) displayed more passive non-verbal communication patterns while they were more vocally active, insofar that this could be a sign of distress. These findings regarding the high level of vocalizations in infants of mothers with PND are important, given that there is an association between a higher infant vocalization frequency and later child psychopathology.
A link to the e-thesis for this project will be added to this page as soon as it becomes available.