Profiles of Infant Regulation: Associations with Child Mental Health in a Large, Prospective, Community Cohort

• In Event: 2-036 - Short-Term and Long-Term Outcomes After Infant Crying, Sleeping and Feeding Problems

Integrative Statement

Introduction. Infant sleeping and crying problems are associated with poorer childhood emotional and behavioral outcomes (Hemmi et al, 2011; Williams et al, 2016), however, few studies have considered other facets of infant regulation such as feeding problems, tantrums, mood swings and temperament. Hypotheses. First, we aim to identify unique profiles of infant regulatory behaviors. Second, we will examine whether socio-demographic factors predict profile membership. We hypothesize that regulatory profile membership predicts mental health difficulties at 5 and 11 years of age.
Study population. Data were drawn from a longitudinal, community cohort study carried out in Melbourne, Australia (the Early Language in Victoria Study). Mothers (n=1910) of 8-10 month old infants were invited to take part during scheduled universal well-child health visits.
Methods. Sociodemographic data were gathered from mothers at infant age 8-10 months (wave 1, n=1910), data on infant regulation (sleeping, crying, feeding, temper tantrums, mood swings and global temperament) and maternal mental health were gathered at infant age 12 months (wave 2, n=1759) and mothers completed the Strengths and Difficulties Questionnaire (SDQ) at child age 5 (wave 6, n=1002) and 11 years (wave 10, n=871).
Results. Analyses identified five profiles, including infants who were mostly settled (36.8%), those with mostly mild sleep problems (25.4%), those with mostly isolated mild to moderate tantrums (21.3%), those with multiple mild to moderate regulatory difficulties (13.2%), and those with the most complex and severe regulatory difficulties (3.4%). Maternal factors associated with more complex and severe infant dysregulation, included younger maternal age (years of age: M=31.27, SD=4.98 vs. M=32.39, SD=4.02 in the settled profile), being born outside Australia (71.2% vs. 84.8% in the settled profile), non-English speaking background (13.6% vs. 5.4% in the settled profile), incomplete secondary education (63.2% vs. 78.8% in the settled profile), less socioeconomic advantage (M=1014.95, SD=81.47 vs. 1042.42, SD= 54.20 in the settled profile), and greater maternal distress (27.1% vs. 5.0% in the settled profile). Additional analyses revealed that mothers of severely unsettled infants, compared to settled infants, were more likely to report poorer quality interactions with their infant (OR 6.7, 95%CI 3.4, 13.4, p<.001). Compared to the settled profile, children in the moderately unsettled profile were more likely to score in the clinical range for mental health concerns at 11 years of age (OR 2.85, 95% CI 1.28 to 6.36, p<.01), and children in the severely unsettled profile were more likely to score in the clinical range at 5 (OR 9.35, 95% CI 2.49 to 35.11, p<.01) and 11 years of age (OR 10.37, 95% CI 3.74 to 28.70, p<.01).
Conclusions. The presence of multiple severe infant regulatory problems seems to indicate the beginning of a trajectory toward poor child mental health. Clinicians must enquire about the extent, complexity, and severity of infant regulatory problems, to identify those in most urgent need of intervention and support.

Authors

• Fallon Cook, Murdoch Children’s Research Institute, Melbourne
  Presenting Author

• Rebecca Giallo, Murdoch Children’s Research Institute, Melbourne
  Non-Presenting Author

• Harriet Hiscock, Murdoch Children’s Research Institute, Melbourne
  Non-Presenting Author

• Fiona Mensah, Murdoch Children’s Research Institute, Melbourne
  Non-Presenting Author

• Katherine Sanchez, Murdoch Children’s Research Institute, Melbourne
  Non-Presenting Author

• Sheena Reilly, Murdoch Children’s Research Institute, Melbourne
  Non-Presenting Author