An interview with Judith Nebrig, L.C.S.W., co-author of Enhancing Early Emotional Development: Guiding Parents of Young Children. From the October 2001 Early Childhood newsletter.

• Lack of sensitive, responsive caregiving. Parents who have untreated depression, who suffer from chemical addiction, who are living in a threatening environment, or who were themselves abused or neglected when they were very young may have difficulty providing the sensitive, responsive care that their infant needs.
  
  
• Compromised ability to receive or transmit cues, on the part of the infant. Infants with neurological or sensory perception problems may not be able to feel and respond to the soothing that is offered to reduce their distress; they do not experience the care as sensitive and responsive.
  
  
• Lack of "goodness of fit" between the infant's and parent's temperament. A "slow-to-warm" baby whose parents need clear and immediate feedback in order to feel successful in their interaction with their infant can pose a challenge to the attachment process.
  
  

Q: How can professionals help parents overcome these circumstances?

A: When professionals listen respectfully and supportively to parents, and observe infants' responses carefully, they can identify what circumstances are preventing the formation of healthy attachment, and can respond as comprehensively as appropriate. Parents whose ability to be responsive and sensitive is impaired need treatment and/or support to address their personal and environmental stressors. Concurrently, relationship-based intervention through intensive home visits can enhance the parents' ability to respond with sensitivity to their infant.

The professional needs to partner with parents of babies whose ability to interact is compromised in order to discover ways to woo the babies and to respond to their distress effectively, so that the babies can experience caregiving as responsive and sensitive. When lack of "goodness of fit" is observed, professionals can provide information and support for parents regarding normal temperamental styles of infants and parents. They will need to provide concrete information and skill-building activities over time to help these parents adapt to and modify their baby's temperament.

The bottom line is support. The professional should carefully discern how to provide support for a particular infant and parent in order for the parent to do the same for the infant.


Q: What is the first step a professional needs to take to help build infants' attachment to their parents?

A: An infant's attachment to his or her parents develops during the first year, through many daily interactions in which his or her cues are responded to with sensitivity. In parallel fashion, professionals need to respond with sensitivity to the cues of the infant's parents.

The first step is to listen carefully and observe both the obvious concerns and questions of parents as well as more subtle cues, such as evidence of fatigue, discouragement, resentment, or feelings of inefficacy. Observation is necessary for the professional to learn how to support these particular parents so they can be sensitive and responsive to their infant.


Q: What are the most effective techniques for a home visitor or interventionist to use in guiding parents?

A: HOW professionals use techniques to support infant-parent attachment are as important as WHAT techniques they use. By asking nonjudgmental, open-ended questions about how things are going with the baby, professionals can both identify areas where specific support is needed and acceptable, and can help parents discover for themselves what engages or soothes this baby.

Support can include: highlighting the baby's positive response to a parent's caregiving, amplifying the baby's cues when they may be hard to understand and respond to, and providing information in a format this parent prefers (print, video, parent sharing group). Intervention should offer choices when possible to enhance parents' sense of efficacy and offer regular, nonjudgmental contact to build a supportive relationship. This way, the professional is in a position to offer additional support when it's needed.

Judith Nebrig is a co-author of Enhancing Early Emotional Development: Guiding Parents of Young Children, a book to help professionals who work with families of young children nurture the crucial bonds that children form with their caregivers during their first two years.