The psychology of the neonate: Analysis of sequential-temporal patterns in neonatal behaviour

Lead Research Organisation: University of Dundee
Department Name: Psychology

Abstract

Although human development is a continuous process of growth from conception to death, distinct developmental stages, such as infancy, childhood and adolescence, are recognised.
This stage view of development has had a practical impact on the organisation of social, educational, mental health and medical services. However, the stage for neonates (infants in the first four weeks of life) is absent from the field of psychology. Unlike psychologists, medical professionals demarcated this stage in the mid-twentieth century, although they considered newborns as being reactive, not responsive, social beings. Whether or not newborns are 'social' continues to be debated and the debates might prevent the field from recognising the stage of neonatal, and from exploring the behaviour of the neonate.
The proposed project uses the databases of two previously completed projects for secondary analysis. ESRC RES-000-22-1887 investigated imitation in 133 newborn infants, while ESRC RES-062-23-1779 investigated responses to the still face paradigm in 322 neonates. Both projects used a block-designed, statistical approach to analyse the behavioural changes in groups of newborns. However, a temporally sensitive approach is needed to address the current debates on 'intentionality' and 'sociality'. The temporal relationship between the behavioural elements and events are ignored in such block-designed analysis, therefore it is not known how individual responses evolve over time, how they appear in the context of the behaviour of the experimenter and the other responses of the neonate. Such temporal analyses of the behaviour of newborns have not been performed before because of the issues regarding access to a large number of newborns, the experimental-statistical difficulties of the descriptive analytic methods, the conflict between a large sample and the need of individual descriptive analysis, and the expertise that state-of-art time-series work requires.
The secondary analysis of data from these already collected datasets-which represent probably the largest neonatal behavioural database to date-provides a unique opportunity to explore the temporal and structural patterns and sequencing rules of the newborns' behaviours.
The project aims to analyse video and, in part, heart rate recordings from 205 newborns. Stage 1 of the project employs descriptive, frame-by-frame behavioural analysis of the arm, finger, facial, mouth, eye movements, postural positions and the states of the newborn (n=40), then visualizes the changes of these behaviours and interprets the emerging patterns. Stages 2 and 3 involve learning and employing lag-sequential analytic techniques in 75 newborns using the Observer and the Theme systems (Noldus, 2009; Magnusson, 2000) and the General Sequential Querier (GSEQ) programs (Bakeman & Quera,1995). Computerized algorithms will help detect patterns in the behaviour that are repeated sets of events that occur repeatedly in the same order and in which the temporal distance between the consecutive parts is similar over the repetitions. Stage 4 co-analyses the behavioural and the psychophysiological changes, displaying the psychophysiological data along the behavioural responses to the still face (n=30), the imitation (n=30) paradigms and a control condition (n=30). Such analysis could also address the possible role of 'arousal' mechanisms in the responses of the neonates to social situations. Stage 5 involves integrating the quantitative, qualitative, behavioural and psychophysiological results and evaluating them using multiple frameworks. The resulting wealth of data and the emerging patterns could transform our understanding of the neonate and the neonatal stage of development and have a significant effect on how we treat newborns and how we advise the parents of newborns. The knowledge on patterns of neonatal behaviour and responses might facilitate the emergence of a 'neonatal psychology' with a sound empirical foundation.

Planned Impact

The interdisciplinary nature of the project has the potential to bring benefit across a broad range of settings.
1. The scientific community would gain from the wealth of data on neonatal behaviour, including how very young newborn infants respond to social situations and whether or not they engage in reciprocal dialogues from birth. Given the renewed debate regarding the existence and validity of neonatal imitation and inborn intersubjectivity, the work hopes to substantially advance knowledge in the field. Academic beneficiaries are researchers investigating neonatal, infant imitation and using imitation in applied areas, such as understanding learning processes, or researchers using it as a tool such as in intensive interaction.
2. Psychologists and researchers in the fields of cognitive, developmental, comparative, language and motor-perception areas will also find the data useful. Potentially, the data on the motor, social and communicative competence of newborns could influence the views about the neonate held by neonatologists, paediatricians, obstetricians, mental health professionals and infant mental health professionals. The data will also will be of interest to neuroscientists.
3. Methodological impact on academic research and teaching: Advanced methods for behavioural analysis will hopefully gain popularity and revive observational research in psychology and related disciplines. The combination and the integration of behavioural and psychophysiological, heart rate data from Stage 4 will further benefit the field.
4. Research students, undergraduates, graduates and postgraduates will benefit from the data and the techniques. Methodologies for complex behavioural analysis will be taught to undergraduate and postgraduate students enrolled in advanced modules as well as those taking part in research projects.
5. The research project might also have a longer term impact through the career pathways of the research assistants and the undergraduate, postgraduate and research students who will be learning from the project.
6. Mental health professionals would benefit by gaining a deeper understanding of the interpersonal abilities of neonates. These results could underline the importance of sensitive parenting, not only in later infancy but from the very first moments of life. Psychodynamically-oriented psychotherapists will find the data and its implications particularly useful.
7. The result of dissemination of knowledge about the earliest developmental stage in life could inform policy makers and could be used when planning changes in early years development and healthcare as well as policies related to improving parent-infant mental health. Organizations and foundations involved in improving early years communication could also benefit from and use the knowledge gained from the project.
8. Support groups and parents would gain from the research by learning about the socio-emotional responses of their newborns. They will be able to see cases that demonstrate these responses and that analyse the first interactions in detail. Therefore, the results could enhance parental competence, facilitate and reinforce the earliest interactions, and help in securing early attachment.
9. The research could lead to further research towards primary and secondary prevention studies. Furthermore, in collaboration with practicing midwives and physicians, training programs for professionals and parents could be developed that focus on understanding newborn behaviour and newborns' typical and atypical behavioural responses to social stimuli, which could also enhance the efficiency of intervention programs. These programs could even be extended to high risk and ill neonates. The knowledge about neonatal behaviour and responsivity could inform and educate professionals and parents, could improve infant feeding, decrease maternal anxiety, improve perinatal mental health and result in better later quality of life.

Publications

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Bard, K.A., Nagy, E. (2016) Cambridge Encyclopedia of Child Development.

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Farkas, T (2013) Imitation and social engagement in children with and without autism. in Conference of the British Psychological Society, Developmental and Cognitive Section, Reading

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Nagy, E (2013) Imitation and Communication in Human Neonates: Possible Mechanisms in Conference of the British Psychological Society, Developmental and Cognitive Section, Reading

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Nagy, E (2014) The Psychology of the Neonate in APCP and OT Neonatal Groups Study Day : Infant Mental Health

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Nagy, E (2014) Homo Provocans: Communication with human neonates. in World Association for Infant Mental Health Congress

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Nagy, E (2014) Challenges when studying the behaviour of the human neonate. in The Psychology of the Neonate - Workshop, Dundee, Scotland, 2014.

 
Description The main aim of the Fellowship was to investigate if the behaviour of the neonates is intentional and they are socially responsive, and if so, the characteristic patterns of their responses. In broader terms, the aim is to map the socio-emotional characteristics of the neonatal period. Given that the project addresses newborns only hours old, the broader context of the research is to reflect on human sociality, through interaction with neonates. The goal was to learn advanced methodologies in behavioural and statistical analysis that enable the Fellow to explore the complex nature, temporal, structural patterns, and rules of newborn behaviour. The main achievement of the project was to to facilitate the emergence of "neonatal psychology".
1. Although only the analysis of 75 videos were planned originally, the grant over-achieved the original plans for methodological reasons. With secondary analysis we re-analyzed 4 projects (1. imitation of finger movements (n=50 newborns), 2. imitation of tongue movements (n=40 newborns), 3. still face responses (n=60 newborns) and 4. imitation of four consecutive gestures, n=35 newborns) with frame-by-frame coding. This involved coding and recoding 195 videorecords over the period of the funding. We also have added additional codes to harmonize the codings among the projects and to refine the level of the coding using additional codes that have been added at this stage. We then visualized the coded data and analysed the patterns by visual inspection and case-by-case descriptions.
2. After the exploratory phase, the PI learnt two methodologies: Lag/sequential analysis with the use of the Observer and the Theme systems (Noldus, 2009, Magnusson, 2000) and the General Sequential Querier (GSEQ) computer program developed by Bakeman and Quera (1995). She visited both laboratories and worked together with Professors Magnusson and Bakeman using the two different approaches to analyse her data.
3. A high impact and very inspirational visit has been made to the Brazelton Institute at Harvard's Boston Children's Hospital where the PI was asked to give a talk. World-leading scientists in the field of neonatal and infant psychology and mental health (including Professor Berry Brazelton) engaged in the interaction. Further collaborations and talk invitations emerged from this meeting.
4. A large impact International Workshop on the Psychology of the Newborn has been organized and held at the end of the Award, as planned. As a result an active network of researchers and professionals working with the newborn infant has been created and there is a strong need to continue the meetings as a forum for researchers in the area. If it will continue the Project has set off the field and the network.
Overall The new behavioural analysis methods that the Fellow learnt during the Fellowship will help her describe neonates' behaviour, and how social responses evolve over time. Such approach will mean a major advancement in understanding the behavioural data from neonates and young infants.
Exploitation Route As a result of this work, it will be possible to identify the characteristic temporal sequential patterns of the neonates' intentional behaviour. In broader terms, the aim is to map the socio-emotional behavioural characteristics of the neonate. More refined cases will be published from experimental research that will in turn aid the design of future experimental work.
The fine-grained description of the patterns of neonatal behaviour will hopefully transform our understanding of the neonate and the neonatal stage of development and will be applied to research with foeti as well to investigate the transition from the foetus to the newborn. A PhD project in this area has just started in 2014 under the PI supervision.
The field of 'neonatal psychology' will further develop. The results, the new methodologies, the large neonatal database, the Workshop continues to bring together researchers from the field. These results will facilitate further interdisciplinary efforts towards training and prevention programs and increase awareness towards sensitive parenting from as early on as the birth of a child.
Additionally, the research could lead to further research towards primary and secondary prevention studies, and towards improved perinatal mental health and better later quality of life.
Sectors Communities and Social Services/Policy,Education,Healthcare

 
Description 1. Given the nature of the research, the difficult-to-access population, the interdisciplinary expertise required, and the amount and quality of the collected data, the scientific community gained by the reanalysis of this large amount of unique data. From early dissemination it looks that psychologists, researchers in the fields of cognitive, developmental, comparative, language and motor-perception areas, paediatricians, obstetricians, neonatologists, infant mental health professionals, and neuroscientists alike find the data useful. 2. Research students, undergraduates, graduates and postgraduates already benefited from the gained expertise. Victoria Stillwell, received her MSc degree during the project, received training in the methodologies and used it in applied setting. Viola Marx undergraduate student wrote a dissertation and received the Sir James Black Award for the best undergraduate dissertation - also she secured a PhD studentship under the PI's supervision. In 2014-2015 the work inspired 3 further dissertation projects; Veronika Kastori, Emily Moore and Anna Labno completed separate dissertation projects on the psychology of the neonate. Veronika Kastori and Emily Moore presented their findings at the Scottish Undergraduate Dissertation conference, and Emily Moore has also submitted her work for presentation at the British Psychological Society's Developmental and Social Psychology Section in 2015, Manchester. Emily Moore worked as a research assistant on the grant. The training she received led to the further projects and she is planning to continue her research in this area with the PI on postgraduate level in the next academic year. 3. There has been an International Workshop on the Psychology of the Newborn funded by the ESRC on the course of this grant. It brought together prominent international professionals from the field; Professors Mikael Heimann (Linkoping, Sweden), Giannis Kugiumutzakis (Crete, Greece), Colwyn Trevarthen (Edinburgh, Scotland), Kim Bard (Portsmouth, UK), Jacqueline Nadel (Paris, France), Pier Ferrari (Parma, Italy), Jonathan Delafield-Butt (Glasgow, Scotland), Hilary Kennedy (London, UK) as well as professional, academic, practitioner and public audience from all around the UK, and interest to the workshop from all around Europe. The 'psychology of the neonate' attracted a great international interest as well as media coverage. This field is getting more and more attention as a result with request for edited books, issues and chapters to be written. The workshop has been the first of hopefully regular meetings to discuss the psychological aspects of the neonatal stage. The project has been able to set this topic and interest off. 4. There has been an International Workshop on the Psychology of the Newborn funded by the ESRC on the course of this grant. It brought together prominent international professionals from the field; Professors Mikael Heimann (Linkoping, Sweden), Giannis Kugiumutzakis (Crete, Greece), Colwyn Trevarthen (Edinburgh, Scotland), Kim Bard (Portsmouth, UK), Jacqueline Nadel (Paris, France), Pier Ferrari (Parma, Italy), Jonathan Delafield-Butt (Glasgow, Scotland), Hilary Kennedy (London, UK) as well as professional, academic, practitioner and public audience from all around the UK, and interest to the workshop from all around Europe. The 'psychology of the neonate' attracted a great international interest as well as media coverage. This field is getting more and more attention as a result with request for edited books, issues and chapters to be written. Future workshops are planned by the group and collaborations started after the workshop. The PI is writing a chapter with Kim Bard on the psychology of the neonate, has discussed international collaborations with Pier Ferrari, Parma, Italy. 5. Besides the conference presentations, invited talks and other forms of dissemination, several scientific publications are underway. The PI organized a symposium at the British Psychological Society's Developmental and Social section in Manchester, 2015 titled 'Emotional expressions, intersubjectivity : comparative, developmental approaches from fetus to infant' as well as 5 individual presentations. 6. Impact in Practice in Infant Mental Health: The notion and the importance of 'neonatal psychology' is getting more and more widespread with increasing impact in various fields. The PI has been invited to talk to infant mental health practitioners in 2015. Among others, Brazelton Practitioners are interested in the application of the PI's work. Additionally, her two invited talks at the World Association for Infant Mental Health Congress in 2014 attracted not only interest of practitioners but also potential collaborations with psychotherapists in the education of trainees. 7. Centre for Neonatal Psychology: Meanwhile in the past months at the University of Dundee, the Centre for Fetal-and-Neonatal Psychology have been established, with website and facebook pages. The centre will serve the public with neonatal testing, undergraduate and postgraduate research students with training of methodologies that are not part of the curriculum. Students on our degree 'MSc in Mental Health' are particularly interested in gaining experience from the centre. In addition, future research projects on fetal-neonatal behaviour are planned. 8. Medical and health professionals: Potentially, data from newborns' motor, social and communicative competence will change the view of neonatologists, paediatricians and obstetricians. Furthermore, it will enrich the knowledge of mental health- and infant mental health professionals, and will pose challenging questions for neuroscientists. Mental health professionals benefit by gaining a deeper understanding into neonates' interpersonal abilities, how biologically and socially predisposed, prepared and motivated they are for interpersonal communication. These results underline the importance of sensitive parenting not only in later infancy, but from the very first moments of life. Psychodynamically oriented psychotherapists find the data and its implications particularly useful and contacted the PI already for contribution to training in the Scottish branch. 9. Support groups, education professionals, and parents gain from the research by learning about the socio-emotional availability of their newborns for interaction from the first moments, thus potentially enhancing parental competence, facilitating and reinforcing the earliest interactions, and securing early attachment. 10. The research could lead to further research towards primary and secondary prevention studies. At the moment we are working on the first small scale follow up research and prepare future research projects to explore how perinatal social skills are related to later development and mental health.
First Year Of Impact 2013
Sector Education,Healthcare
Impact Types Cultural,Societal

 
Description 'Perinatal Mental Health. The social newborn in the caretaking environment.' Workshop organization and presentation. ISSR Forum, Dundee, 2018. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Perinatal Mental Health, the origins of existence. The social newborn in the caretaking environment. ISSR Forum, Dundee, 2018.
An interdisciplinary session organized about Mental Health, and also a talk presented with the above title on neonatal psychology and perinatal mental health at the School of Social Sciences, the University of Dundee.
Year(s) Of Engagement Activity 2018
 
Description Connections Matter. Intersubjectivity and the Social World. International Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Connections Matter. Intersubjectivity and the Social World. International Workshop with international and national prominent researchers in the area of intersubjective development.
Year(s) Of Engagement Activity 2017
 
Description Media activity on neonatal behaviour 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact A piece on neonatal behaviour was published in the Conversation and reached a considerable audience: "Is newborn smiling really just a reflex? Research is challenging the textbooks"
Year(s) Of Engagement Activity 2018
URL https://theconversation.com/is-newborn-smiling-really-just-a-reflex-research-is-challenging-the-text...
 
Description Public engagement of published paper The Conversation Entry 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Newborn baby development has been vastly underestimated, our study shows. A summary of our recent paper in PLOS-One (Nagy et al., 2017)
Year(s) Of Engagement Activity 2017
URL https://theconversation.com/newborn-baby-development-has-been-vastly-underestimated-our-study-shows-...
 
Description Radio Tay: The Psychology of the Neonate. Coverage for the International Workshop. 2014 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact This interview was to cover the International Workshop on the Psychology of the Newborn Infant that was presented with the support of the ESRC with renown international experts invited.

To disseminate the research activity to the public.
Year(s) Of Engagement Activity 2014
 
Description Second International Workshop on the Psychology of the Neonate 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A group of international experts gathered for a 3-day-long workshop, that was a continuation of the first such workshop that was directly funded by this grant. Associated professionals and members of public also attended the event, participated in the discussions. Further links with other universities have been established via this workshop.
Year(s) Of Engagement Activity 2018
 
Description Talk at the Brazelton Institute, Harvard Boston's Children's Hospital, 2014 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Gave an invited talk at the Brazelton Institute at Harvard's Boston Children's Hospital. It was the most stimulating meeting with the leading research institute for the NBAS method. It reached leading professionals, pediatricians and researchers and resulted in stimulating collaborations.

The results from the research supported by the ESRC was communicated with professionals working with the newborns and the Brazelton Institute expressed a great interest in the research results. There have been requests for further talks and information exchange.
Year(s) Of Engagement Activity 2014
 
Description Talks at the APCP and OT Neonatal Groups Study Day on Infant Mental Health, 2014 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Practitioners working with the newborn infant come for training on the recent advances in research and learn about the abilities of the newborn. It changes views and consequently changes the ways professionals and the public sees the very first relationship between the newborn and the family.

Change the views of practitioners working with the newborn infant
Year(s) Of Engagement Activity 2014
 
Description Talks to parents - ongoing 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Participants in your research and patient groups
Results and Impact Parents attended at information sessions on the research. It informed their decisions whether to take part in the study and most expressed their interest in the abilities of the newborn infant.

Participation in the experiments and changing views.
Year(s) Of Engagement Activity 2006,2007,2008,2009
 
Description Talks to pediatricians 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Regular discussions on the psychology of the newborns with pediatricians in the neonatal ward and the clinic

Changing perceptions of the newborn, increased interest to support the projects
Year(s) Of Engagement Activity 2006,2007,2008,2009,2010,2011,2012,2013,2014
 
Description Talks to postgraduate MSc students 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact A presentation to postgraduate masters students about my recent research results.

Stimulate research ideas, disseminate information and to involve students into research as assistants or practicum students.
Year(s) Of Engagement Activity 2008,2009,2010,2011,2012,2013,2014
 
Description Twitter page for the projects on neonates 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A twitter page has been set up recently to share information about the laboratory, results, publications. It is at its early stages yet but with my students we plan to maintain, popularize and develop.

To reach professional and public audience, disseminate results and achievements.
Year(s) Of Engagement Activity 2014
URL https://twitter.com/NewbornPsychLab