Centro 0-3 per il bambino a rischio evolutivo

Il Centro 0-3 per il bambino a rischio evolutivo (da qui in avanti Centro 0-3) offre un servizio di psicologia clinica e svolge attività di ricerca scientifica con uno specifico focus sui primi tre anni di vita occupandosi di bambini che presentino una disabilità neuroevolutiva o/e un ritardo dello sviluppo psicomotorio.

Descrizione

I primi anni di vita condizionano in maniera decisiva il successivo sviluppo socio-emozionale e la qualità della vita di un bambino. Questa fase infatti costituisce un “periodo sensibile” dal punto di vista neuromaturativo nel corso del quale l’ambiente influenza in modo significativo la cosiddetta plasticità cerebrale, cioè le modificazioni neuronali che plasmano l’organizzazione funzionale del cervello del bambino. In questo periodo un insieme di fattori individuali (ad esempio, le caratteristiche temperamentali, le competenze sociali e comunicative e la capacità di regolare gli stati comportamentali ed emozionali) e di fattori ambientali (ad esempio, qualità della relazione instaurata con i genitori, condizioni di stress precoce) si influenzano reciprocamente e contribuiscono alla crescita psicologica e relazionale dell’individuo. Condizioni cliniche come la prematurità, disturbi del neuro-sviluppo, quadri sindromici hanno un significativo impatto sullo sviluppo cognitivo e socio-emozionale, con diversi gradi di compromissione del quadro funzionale. In queste circostanze, la qualità delle relazioni precoci del bambino con le figure primarie di riferimento costituisce sia uno dei fattori di protezione che di promozione dello sviluppo delle competenze del bambino.

All’interno di questo contesto l’attività ricerca scientifica è uno dei principali mezzi per accrescere la nostra conoscenza clinica e per sviluppare protocolli di valutazione e di intervento sempre più efficaci e capaci di rispondere in modo individualizzato alle esigenze e ai bisogni dei nostri piccoli pazienti e dei loro genitori. Le principali aree di indagine riguardano:

• lo studio della relazione precoce madre-bambino e del profilo neuro-comportamentale, delle capacità comunicative e della regolazione del bambino a rischio evolutivo (es. nati prematuri);
• lo studio dell’impatto a breve e lungo termine della qualità delle cure in terapia intensiva neonatale sullo sviluppo socio-emozionale del bambino e sul benessere genitoriale;
• lo studio delle modificazioni epigenetiche connesse a fattori di rischio ambientali (ad esempio, precoci esperienze di ricovero ed esposizione a stress) e a fattori di protezione (ad esempio, la qualità del supporto genitoriale e della sensibilità materna) e della loro interazione con lo sviluppo comportamentale, cognitivo e socio-emozionale del bambino;
• lo studio dell’impatto che la presenza di una malattia rara ha sul benessere genitoriale e sul funzionamento del bambino;
• lo studio dei correlati neurali (es. ritmo EEG-Mu) del sistema dei neuroni specchio in associazione a compiti di valutazione delle competenze imitative in bambini a sviluppo tipico e atipico;
• lo studio dell’efficacia di interventi di supporto alla genitorialità in genitori di bambini con disturbo neuro-evolutivo;
• lo sviluppo e l’utilizzo di nuove tecnologie per la valutazione e il supporto dell’interazione precoce genitore-bambino con disturbo neuro-evolutivo.

Il Centro 0-3 fornisce consulenza alle ricerche cliniche su problematiche neurologiche /comportamentali (ad esempio disturbi dell’alimentazione e della deglutizione, disturbi del sonno) associate a quadri di disturbo del neurosviluppo.

Pubblicazioni principali

2019

• Cavallini A, Provenzi L, Scotto di Minico G, Sacchi D, Gavazzi L, Amorelli V, Borgatti R (2019) Functional Evaluation of Eating Difficulties Scale (FEEDS) to predict oral motor skills in infants with neurodevelopmental disorders: A longitudinal study. Developmental Medicine & Child Neurology, in press.
• Provenzi L, Giorda R, Fumagalli M, Brambilla M, Mosca F, Borgatti R, Montirosso R (2019) Telomere length and salivary cortisol stress reactivity in very preterm infants. Early Human Development, 129, 1-4.
• Provenzi L, Giusti L, Fumagalli M, Frigerio S, Morandi F, Borgatti R, Mosca F, Montirosso R (2019) The dual nature of hypothalamic-pituitary-adrenal axis regulation in dyads of very preterm infants and their mothers. Psychoneuroendocrinology, 100, 172-179.

2018

• Provenzi L, Brambilla M, Borgatti R, Montirosso R (2018) Methodological challenges in developmental human behavioral epigenetics: Insights into study design. Frontiers in Behavioral Neuroscience, 12, 286.
• Provenzi L, De Carli P, Fumagalli M, Giorda R, Casavant S, Beri S, Citterio A, Morandi F, Mosca F, Borgatti R, Montirosso R (2018) Very preterm birth is associated with PLAGL1 gene hypo-methylation at birth and discharge. Epigenomics, 10(8), 1121-1130.
• Provenzi L (2018) Early Career Investigator Highlight – June. Pediatric Research, 83, 1086.
• 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, 83, 1104-1109.
• Giusti L, Provenzi L, Montirosso R (2018) The face-to-face still-face (FFSF) paradigm in clinical settings: Socio-emotional regulation assessment and parenta support with infants with neurodevelopmental disabilities. Frontiers in Psychology, 9, 789.
• 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.

Collaborazioni

L’attività di ricerca si avvale di collaborazioni a livello nazionale, tra cui:

• Unità Operativa di Patologia Neonatale dell’Ospedale Maggiore Fondazione Ca’ Granda Policlinico Mangiagalli e Regina Elena di Milano;
• Unità Operativa di Neonatologia e Terapia Intensiva Neonatale, Dipartimento Materno Infantile, Ospedale Manzoni di Lecco;
• Unità Operativa di Pediatria dell’Ospedale Sacra Famiglia di Erba (CO);
• Dipartimento di Psicologia dell’Università Bicocca di Milano;
• Dipartimento di Psicologia dell’Università Cattolica di Milano;
• Gruppo di Studio sulla Developmental Care, Società Italiana di Neonatologia (SIN).

E a livello internazionale, tra cui:

• Prof. Ed Tronick, Dipartimento di Psicologia, University of Massachusetts, Boston (USA);
• Prof.ssa Lynne Murray, Winnicott Research Unit, School of Psychology, Reading University (UK);
• Prof. Samuel Putnam, Dipartimento di Psicologia, Bowdoin College di Brunswick (USA);
• Prof.ssa Maria Gartstein, Dipartimento di Psicologia, Washington State University (USA);
• Prof. Bjorn Westrup, Karolinska Institute (Stoccolma, Svezia);
• Prof.ssa Liisa Lehtonen, Prof.ssa Anna Axelin, Terapia Intensiva Neonatale, Turku University (Finlandia);
• Prof. Uwe Ewald, Prof. Erik Normann, Terapia Intensiva Neonatale, Uppsala University (Svezia);
• Prof. Beatriz Linhares, Ribeirao Preto University, Sao Paulo (Brasile);
• Prof. Amy D’Agata, Terapia Intensiva Neonatale, University of Rhode Island (USA)
• Separation and Closeness Experiences in the Neonatal Environment (SCENE) Group;
• European Foundation for the Care of Newborn Infants (EFCNI).