0-3 Center for the at-Risk Infant

Description

The scientific activity of the 0-3 Centre is focused on research projects in the developmental and psycho-biological field with particular attention on the impact that clinical conditions, adverse experiences and relational environment can have on the socio-emotional development of the infant. Specifically, the main focus and interest of the research projects are the interactions between genetic, epigenetic, physiological, behavioral and relational domains of young infants with neurodevelopmental risk.

Perspective on typical and at-risk development

The first years of life profoundly influence the later socio-emotional development and quality of life of a child. This phase represents a “sensitive period” from a neurodevelopment point of view during which the environment significantly influences brain plasticity – neural modifications which mold the functional organization of the infant’s brain. In this period, a combination of factors such as the infant's individual characteristics (for example; temperament characteristics, social and communicative skills and the ability to regulate behavioral and emotional states), and environmental ones (for example, the quality of the relationships formed with the parents, early stress conditions) reciprocally influence themselves and contribute to the psychological and relational growth of the individual. Clinical conditions such as prematurity, neuro-developmental disorders, and syndromic cases have an important impact on cognitive and socio-emotional development, with different degrees of impairment of overall functioning. In these circumstances, the quality of the infant's early relationships with his main caregivers represents both a protection and promotion factor for the development of the child's abilities.

The scientific research activity is one of the main means to expand clinical knowledge and to develop evaluation and intervention protocols that are more and more able to respond in an individualized way to the demands and needs of our little patients and their parents. The main areas of investigation are:

• The study of early mother-infant relationship and the neuro-behavioral profile, communication abilities and regulation of the at-risk infant (e.g. premature infants);
• The study of the short and long-term impact of the quality of care in neonatal intensive care units on the socio-emotional development of the infant and parental wellbeing;
• The study of the epigenetic changes linked to environmental risk factors (for example, early exposure of hospitalization and stress exposure) and protective factors (for example, the quality of parenting support and maternal sensitivity) and of their interaction with the behavioral, cognitive and socio-emotional development of the infant;
• The study of the impact of the presence of a rare disease on parental wellbeing and infant functioning:
• The study of neural correlates (e.g. EEG-Mu rhythm) of the mirror neuron system in association with imitative evaluation tasks abilities in children with typical and atypical development;
• The study of the efficacy of parenting support interventions in parents with infants with neurodevelopmental disorders;
• The study and use of new technologies for the evaluation and the support of early interaction between parent and infant with neurodevelopmental disorders.

Selected publications

2018

• Provenzi L (2018) Early Career Investigator Highlight – June. Pediatric Research, in press.
• Longoni L, Provenzi L, Cavallini A, Sacchi D, Scotto di Minico G, Borgatti R (2018) Predictors and outcomes of the Neonatal Oral Motor Assessment Scale (NOMAS) performance: A systematic review. European Journal of Pediatrics, in press.
• Provenzi L, Broso S, Montirosso R (2018). Do mothers sound good? A systematic review of the effects of maternal voice exposure on preterm infants development. Neuroscience & Biobehavioral Reviews, in press.
• Provenzi L, Scotto di Minico, G., Giusti L, Guida E, Müller, M (2018). Disentangling the dyadic dance: Theoretical, methodological and outcomes systematic review of mother-infant dyadic processes. Frontiers in Psychology, in press.
• Provenzi L, Olson K, Giusti L, Montirosso R, DeSantis A, Tronick E (2018). NICU Network Neurobehavioral Scale: 1-month normative data and variation from birth to 1 month. Pediatric Research, in press.
• Provenzi L, Giorda R, Fumagalli M, Pozzoli U, Morandi F, Scotto di Minico G, Mosca F, Borgatti R, Montirosso R (2018). Pain exposure associates with telomere length erosion in very preterm infants. Psychoneuroendocrinology, 89, 113-119.
• Fumagalli M, Provenzi L, De Carli P, Dessimone F, Sirgiovanni I, Giorda R, Cinnante C, Squarcina L, Pozzoli U, Triulzi F, Brambilla P, Borgatti R, Mosca F, Montirosso R (2018). From early stress to 12-month development in very preterm infants: Preliminary findings on epigenetic mechanisms and brain growth. PLoS One 13(1), e0190602.
• Cassiano RGM, Provenzi L, Linhares MBM, Gaspardo CM, Montirosso R (2018). Maternal sociodemographic factors differentially affect the risk of behavioral problems in Brazilian and Italian preterm toddlers. Infant Behavior & Development, 50, 165-173.
• Provenzi L, Guida E, Montirosso R (2018). Preterm Behavioral Epigenetics: A systematic review. Neuroscience & Biobehavioral Reviews, 84, 262-271.

2017

• Cavallini A, Provenzi L, Sacchi D, Longoni L, Borgatti R (2017). The Functional Evaluation of Eating Difficulties Scale (FEEDS): Study protocol and validation in infants with neurodevelopmental impairments and disabilities. Frontiers in Pediatrics, 5, 273.
• Barello S, Graffigna G, Pitacco G et al. (2017). An educational intervention to train professional nurses in promoting patient engagement: A pilot feasibility study. Frontiers in Psychology, 7, 2020.
• Giusti L, Provenzi L, Tavian D et al. (2017). The BDNFval66met polymorphism and individual differences in temperament in 4-month-old infants: A pilot study. Infant Behavior and Development, 47, 22-26.
• Graffigna G, Barello S, Riva G et al. (2017). Fertilizing a patient engagement ecosystem to innovate healthcare: toward the first Italian consensus conference on patient engagement. Frontiers in Psychology, 8(812).
• Montirosso R, Arrigoni F, Casini E et al. (2017). Greater brain response to emotional expressions of their own children in mothers of preterm infants: An fMRI study. Journal of Perinatology, 37(6), 716-722.
• Montirosso R, Tronick E, Borgatti R (2017). Promoting Neuroprotective Care in Neonatal Intensive Care Units and Preterm Infant Development: Insights From the Neonatal Adequate Care for Quality of Life Study. Child Development Perspectives, 11(1), 9-15.
• Provenzi L, Barello S, Saettini F et al. (2017). Paediatricians should encourage the parents of children with special healthcare needs to disclose their use of complementary and alternative medicine. Acta Paediatrica, 106(11), 1883-1884.
• Provenzi L, Borgatti R, Montirosso R (2017). Why are prospective longitudinal studies needed in preterm behavioral epigenetic research? JAMA Pediatrics, 171, 92.
• Provenzi L, Cassiano RGM, Scotto di Minico G et al. (2017). Study protocol for the Preschooler Assessment of Emotional Stress (PRES) procedure. Frontiers in Psychology, 8(1653).
• Provenzi L, Fumagalli M, Giorda R et al. (2017). Maternal sensitivity buffers the assocaition between SLC6A4 methylation and socio-emotional stress response in 3-month-old full-term but not very preterm infants. Frontiers in Psychiatry, 8(171).
• Provenzi L, Guida E, Montirosso R (2017). Preterm Behavioral Epigenetics: A systematic review. Neuroscience & Biobehavioral Reviews, in press.
• Provenzi L, Menichetti J, Coin R et al. (2017). Psychological assessment as an intervention: application of collaborative techniques in clinical practice. Professional Psychology: Research & Practice, 48(2), 90-97.
• Provenzi L, Scotto di Minico G, Giorda R et al. (2017). Telomere length in preterm infants: A promising biomarker of early adversity and care in the neonatal Intensive Care Unit? Frontiers in Endocrinology, 8, 295.

2016

• Montirosso R, Casini E, Borgatti R et al. (2016). Neonatal developmental care in infant pain management and internalizing behaviours at 18 months in prematurely born children. European Journal of Pain, 20(6), 1010-1021.
• Montirosso R, Giusti L, Del Prete A et al. (2016). Does quality of developmental care in NICUs affect health-related quality of life in 5-y-old children born preterm? Pediatric Research, 80(6), 824-828.
• Montirosso R, Provenzi L, Fumagalli M et al. (2016). Serotonin transporter gene (SLC6A4) methylation associates with NICU stay and 3-month-old temperament in preterm infants. Child Development, 87, 38-48.
• Montirosso R, Provenzi L, Giorda R et al. (2016). SLC6A4 promoter region methylation and socio-emotional stress response in very preterm and full-term infants. Epigenomics, 8, 895-907.
• Montirosso R, Provenzi L, Tavian D et al. (2016). COMTval158met polymorphism is associated with stress reactivity in 4-month-old infants. Infant Behavior and Development, 45, 71-82.
• Mussa A, Di Candia S, Russo S et al. (2016). Recommendations of the Scientific Committee of the Italian Beckwith-Wiedemann Syndrome Association on the diagnosis, Management and follow-up of the syndrome. European Journal of Medical Genetics, 59(1), 52-64.
• Provenzi L, Barello S, Graffigna G et al. (2016). A Comparison of maternal and paternal experiences of becoming parents of a very preterm infant. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 45, 528-541.
• Provenzi L, Fumagalli M, Casini E et al. (2016). Very preterm and full-term infants’ response to socio-emotional stress: The role of post-natal maternal bonding. Infancy, 22, 695-712.
• Provenzi L, Giorda R, Beri S et al. (2016). SLC6A4 methylation as an epigenetic marker of life adversity exposures in humans: A systematic review of literature. Neuroscience & Biobehavioral Reviews, 71, 7-20.
• Provenzi L, Giusti L, Fumagalli M et al. (2016). Pain-related stress in the Neonatal Intensive Care Unit and salivary cortisol reactivity to socio-emotional stress in 3-month-old very preterm infants. Psychoneuroendocrinology, 72, 161-165.
• Provenzi L, Giusti L, Montirosso R (2016). Do infants exhibit significant cortisol reactivity to the Face-to-Face Still-Face procedure? A narrative review and meta-analysis. Developmental Review, 42, 34-55.
• Provenzi L, Olson Kl, Montirosso R et al. (2016). Infants, mothers, and dyadic contributions to stability and prediction of social stress response at 6 months. Developmental Psychology, 52, 1-8.
• Provenzi L, Saettini F, Barello S et al. (2016). Complementary and alternative medicine (CAM) for children with special health care needs: A comparative usage study in Italy. European Journal of Integrative Medicine, 8(2), 115-121.

2015

• Brenna V, Nava E, Turati C et al. (2015). Intersensory redundancy promotes visual rhythm discrimination in visually impaired infants. Infant Behavior and Development, 39, 92-97.
• Montirosso R (2015). XI. Relationship between feeding and early stress in premature infant: The role of epigenetic factors. Journal of Pediatric Gastroenterology and Nutrition, 61, S15-S16.
• Montirosso R, Casini E, Provenzi L et al. (2015). A categorical approach to infants' individual differences during the Still-Face paradigm. Infant Behavior and Development, 38, 67-76.
• Montirosso R, Provenzi L (2015). Implications of Epigenetics and Stress Regulation on Research and Developmental Care of Preterm Infants. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 44, 174-182.
• Montirosso R, Provenzi L, Tavian D et al. (2015). Social stress regulation in 4-month-old infants: Contribution of maternal social engagement and infants' 5-HTTLPR genotype. Early Human Development, 91, 173-179.
• Provenzi L, Barello S (2015). Behavioral Epigenetics of Family-Centered Care in the Neonatal Intensive Care Unit. JAMA Pediatrics, 169, 697-698.
• Provenzi L, Borgatti R, Menozzi G et al. (2015). A dynamic system analysis of dyadic flexibility and stability across the Face-to-Face Still-Face procedure: application of the State Space Grid. Infant Behavior and Development, 38, 1-10.
• Provenzi L, Casini E, De Simone P et al. (2015). Mother-infant dyadic reparation and individual differences in vagal tone affect 4-month-old infants' social stress regulation. Journal of Experimental Child Psychology, 140, 158-170.
• Provenzi L, Fumagalli M, Sirgiovanni I et al. (2015). Pain-related stress during the Neonatal Intensive Care Unit stay and SLC6A4 methylation in very preterm infants. Frontiers in Behavioral Neuroscience, 9, 1-9.
• Provenzi L, Montirosso R (2015). "Epigenethics" in the neonatal intensive care unit: Conveying complexity in health care for preterm children. JAMA Pediatrics, 169, 617-618.
• Provenzi L, Santoro E (2015). The lived experience of fathers of preterm infants in the Neonatal Intensive Care Unit: a systematic review of qualitative studies. Journal of Clinical Nursing, 24, 1784-1794.

2011-2014

• Montirosso R, Fedeli C, Del Prete A et al. (2014). Maternal stress and depressive symptoms associated with quality of developmental care in 25 Italian Neonatal Intensive Care Units: A cross sectional observational study. International Journal of Nursing Studies, 51(7), 994-1002.
• Montirosso R, Provenzi L, Tronick E et al. (2014). Vagal tone as a biomarker of long-term memory for a stressful social event at 4 months. Developmental Psychobiology, 56, 1564-1574.
• Cozzi P, Putnam, SP, Menesini E et al. (2013). Studying cross-cultural differences in temperament in toddlerhood: United States of America (US) and Italy. Infant Behavior and Development, 36(3), 480-483.
• Matricardi S, Agostino R, Fedeli C et al. (2013). Mothers are not fathers: Differences between parents in the reduction of stress levels after a parental intervention in a NICU. Acta PAediatrica, 102(1), 8-14.
• Montirosso R, Tronick E, Morandi F et al. (2013). Four-month-old infants' long-term memory for a stressful social event. Plos One, 8(12), e82277.
• Montirosso R, Cozzi P, Tronick E et al. (2012). Differential distribution and lateralization of infant gestures and their relation to maternal gestures in the Face-to-Face Still-Face paradigm. Infant Behavior and Development, 35(4), 819-828.
• Montirosso R, Fedeli C, Murray L et al. (2012). The role of negative maternal affective states and infant temperament in early interactions between infants with cleft lip and their mothers. Journal of Pediatric Psychology, 37(2), 241-250.
• Montirosso R, Provenzi L, Calciolari G et al. (2012). Measuring maternal stress and perceived support in 25 Italian NICUs. Acta Paediatrica, 101, 136-142.
• Rescorla LA, Achenbach TM, Ivanova MY et al. (2012). Behavioral/Emotional Problems of Preschoolers: Caregiver/Teacher Reports From 15 Societies. Journal of Emotional and Behavioral Disorders, 20(2), 68-81.
• Rescorla LA, Achenbach TM, Ivanova MY et al. (2011). International comparisons of behavioral and emotional problems in preschool children: Parents' reports from 24 societies. Journal of Clinical Child and Adolescent Psychology, 40(3), 456-467.
• Turati C, Montirosso R, Brenna V et al. (2011). A Smile Enhances 3-Month-Olds' Recognition of an Individual Face. Infancy, 16(3), 306-317.

Partnership

Research activity has collaborations on a national level, among which:

• the neonatal pathology ward in the Hospital Maggiore Fondazione Ca’ Granda Policlinico Mangiagalli and Regina Elena in Milan;
• the neonatology ward, NICU, maternal infant department of the Manzoni Hospital in Lecco;
• the Pediatric Unit in the Hospital Sacra Famiglia in Erba (CO)
• the psychology department in the University Bicocca in Milano
• the psychology department in the University Cattolica in Milano
• Study group on Developmental Care, Italian Neonatology Society (Società Italiana di Neonatologia; SIN)

And on an international level with:

• Prof. Ed Tronick, department of Psychology, University of Massachusetts, Boston (USA);
• Prof. Lynne Murray, head of the Winnicott Research Unit, School of Psychology, Reading University (UK);
• Prof. Samuel Putnam, Psychology Department, Bowdoin College of Brunswick (USA);
• Prof. Maria Gartstein from the Department of Psychology, Washington State University (USA);
• Prof. Bjorn Westrup, Karolinska Institute (Stockholm, Sweden);
• Prof. Liisa Lehtonen, Prof. Anna Axelin, NICU, Turku University (Finland);
• Prof. Uwe Ewald, Prof. Erik Normann, NICU, Uppsala University (Sweden);
• Prof. Beatriz Linhares, Ribeirao Preto University, Sao Paulo (Brazil);
• Prof. Amy D’Agata, NICU, University of Rhode Island (USA)
• The Separation and Closeness Experiences in the Neonatal Environment (SCENE) Group;
• The European Foundation for the Care of Newborn Infants (EFCNI).