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Centre for the study of social emotional development of at risk infant


Clinical practice and research activity are largely based on reliable, well validated procedures and tools, which could provide operational guidance to support child’s social emotional development and mother-child interaction. The largely used instruments are:

  • The scale for the assessment of the newborn neurobehavioral profile NICU Network Neurobehavioral Scale (NNNS). The scale, developed by Barry Lester and Edward Tronick in 2004, is a comprehensive assessment of the newborn that allows the clinician and the researcher to draw a profile of neurobehavioral skills of high-risk children, providing also information concerning the presence of signs of stress. As recently documented, furthermore, the scale is able to predict cognitive and behavioral problems detected at the age of four years (Pediatrics, 2009). Within the IRCCS operates the Medea Centre for the neurobehavioral assessment of infant - NNNS Italian program of research and training, which is the only Italian centre certified to provide NNNS training and the related certification. In accordance with the guidelines and under the supervision of the authors, the training course is conducted periodically by teachers credited to the use of scale, based on lectures, video, demonstrations of administration of the scale with term and preterm infants, and practices. After the training, participants have to take an examination to receive NNNS certification;

  • The Still-Face paradigm, introduced by Tronick and colleagues in the late seventies. The procedure allows to assess infant social skills, emotional adjustment and coping. It also allows to observe the quality of emotional interaction between mother and child. The paradigm includes a temporary interruption of communication by the mother during face-to-face interaction with their child and lets you see the strategies adopted by the child to cope with the subsequent stress. The application of the paradigm at the Center is based on years of experience with infants at risk and not, under the constant supervision of Prof. Tronick, creator of the procedure and director of the Child Development Unit, Harvard Medical School in Boston, with which the Center is a partner since its foundation;

  • The coding system of mother-infant interaction Global Rating Scale, developed by Prof. Murray and colleagues. The system allows to assess the quality of early mother-infant relationship through the coding of behaviors exhibited during a face-to-face interaction videotaped during the first months of life of the infant. The supervision of Prof. Murray and a specific training in the use of the coding system acquired by the operators of the Center are the basis of a research activity developed in collaboration with the Winnicott Research Unit, University of Reading.

In addition, several self-report tools addressed to parents and educators/teachers are utilized. The Center has translated and adapted the Italian versions of some of these, as in the following cases:

  • The questionnaire Social Competence and Behavior Evaluation (SCBE) introduced by LaFreniere and Dumas for the assessment of social competence, emotional expression and adaptive difficulties in children between 30 and 78 months;

  • The questionnaires TAPQOL and TACQOL, developed by the Leiden Center for Child Health and Pediatrics LUMC-TNO, aimed at assessing the health-related quality of life in n children;

  • The questionnaires Parental Stressor Scale : Neonatal Intensive Care Unit e Nurse Parent Support Tool, developed by Margaret Miles and designed to asses the levels of parental stress and the perception of support received from the NICU staff during the hospitalisation in neonatal intensive care units;

  • The Infant Behavior Questionnaire-Revised, developed by Mary Rothbart & Maria Gartstein (2000) developed for the analysis of infant temperament in the first year of life.

17-Gen-2013 - © I.R.C.C.S. Medea