Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Sunday, May 1, 2016

Baby Looks at Toys More Than At You? Probably Not a Problem

If you’re a parent of a young child and feel scared about autism, you probably are aware of “red flags” that might warn you of an infant’s future autism diagnosis. The most popular of these has to do with gaze at faces and especially mutual gaze or “eye contact”. Young parents watch to see whether their baby looks toward their faces and gives prolonged examination to their eyes. Not only the many “red flag” lists, but advertisements (usually showing mothers and babies) suggest that long periods of shared gaze are normally frequent events in the lives of parents and infants. Some parents get the idea that these periods of gazing are not only frequent but should be present practically from birth. Others become more concerned about the role of mutual gaze in joint attention after about 9 months and expect those shared gazes to last a long time. 

‘Tain’t so, however, as I’ve commented before on this blog. What is “so”, then? To know this, we have to turn to some very careful, detailed work of microanalysis on video records of infant-adult activity.

In a recent article (De Barbaro, Johnson, Forster,and Deak, [2016]. Sensorimotor decoupling contributes to triadic attention: A longitudinal investigation of mother-infant-object interactions. Child Development, 87, 494-512), the researchers looked at babies as they developed from four months of age to 12 months. They made videos of each baby playing with his or her mother when objects were available to handle or look at. Both partners’ hand movements and gazes were recorded as they sat with interesting toys between them. Both mothers and babies could and did pick up toys and look at them, or look at them without picking them up, or pick them up and not look at them. Each could also watch what the other was doing. The very large number of recorded events were assessed by trained observers with respect to what the individual was touching and where he or she was looking. (The frame-by-frame analysis contained 610,000 behavioral events, which should show readers what it actually takes to understand developmental changes.)

As the babies got older, they spent more time touching the toys, and less time looking at them, but about the same (relatively low) amount of time both looking and touching. The mothers changed what they did as the babies got older, too--  as the babies touched more, the mothers touched less. With increasing age, the babies also increasingly “decoupled” their actions--  that is, they became more likely to look at something without touching it, or to touch it without looking at it. In addition, they became less locked into having their two hands do the same thing, and increased their tendency to do one thing with the right hand and another with the left (an important ability that lets them hold an object in one hand and poke it with the other, or, later on, tie their shoelaces).

For parents who are concerned that their four-month-olds do not make enough eye contact, I want to point to the findings of De Barbaro and her colleagues that four-month-olds actually showed more “joint attention” by looking at objects the mothers were attending to than they did when they were older. The four-month-olds spent more than 40% of their session time touching objects, and 75% looking at them, even though they  were face-to-face with their mothers and could easily have spent more time looking at faces. These authors cited an earlier study as showing that “3-to-5-mont-old infants were approximately 5 times more likely to look at objects manipulated by their parents than at their parents’ faces”.  In addition, when the babies began to spend less time looking at the toys, they did not look more at the mothers’ faces; “rather, infants increasingly looked at other features of their environment (e.g., tray, floor, and furniture)”. 

DeBarbaro and her colleagues also noted that “decoupling”—changing the tendency to link looking and touching, or to link left hand and right hand movements—“allows infants to watch their mothers’ object activity while maintaining contact with their own objects. This sets the stage for activities like taking turns using toys or attempting to imitate the mother’s actions.”

I don’t at all mean to ridicule young parents’ concerns about autism or about problems of attachment. I just want to point out that babies in their first year have a lot of developmental tasks to do in addition to social interactions and the foundations of attitudes toward the self and others. Sighted human beings use gaze in communication in very significant ways, but they use gaze for a great many other things they learn and do. As a highly visual species, we take in most of our information with our eyes. Looking at just one thing we do with our eyes as infants is a mistake, because we need to be considering all the many ways a child interacts with the world.



I also want to point out that the article by De Barbaro and her colleagues is an excellent example of what it takes to understand development at a detailed level. Rather than just doing things more and more or better and better over the first year, babies do some things more and some things less over time. As is the case for crawling and walking, they may abandon an action they do very well and take up one that is quite challenging at the time. The whole picture of development can’t be reduced to “red flags.”  

6 comments:

  1. This is really cool.

    610,000 behavioural acts/exchanges recorded and coded.

    And it's great to read about the role of decoupling in infant development.

    "Two hands all the time" - what happens if the baby has cerebral palsy?

    "They use gaze for a great many other things they learn and do".

    "Looking at just one thing we do with our eyes as infants is a mistake, because we need to be considering all the many ways a child interacts with the world."

    "Rather than just doing things more and more or better and better over the first year, babies do some things more and some things less over time. As is the case for crawling and walking, they may abandon an action they do very well and take up one that is quite challenging at the time."

    And it is that dynamism which really makes human development.

    I think these days people read about decoupling and see that it is a thing that computers do, not a thing that people and babies do.

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  2. PS:

    Here is an earlier paper by the de Barbaro team [2013 CHILD DEVELOPMENT]:

    Social Revolution

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  3. Hello,
    I have really enjoyed reading your blogs. I am a teacher and since the day I found out I was pregnant I have been worried about my child having Autism, as I want the best for my child. He has always been a fairly happy and easy baby. I thought this was amazing, however, after reading articles, I see that this could be an indicator of an autistic child because they don't know to communicate or get upset. These are things I see my baby doing, (he just turned 6 months)
    - He will smile and laugh at us. Some days it takes more work than others. He does belly laugh and smile when smiled at, just not all the time.
    -He can roll from his back to his stomach, but can't roll from his stomach to his back, is this normal?
    -He makes eye contact, but doesn't hold it for periods of times.
    -when I leave the room he will follow my movements, when my husband walks by he will follow his movements
    -he loves to play with toys and uses both hands, he follows toys and can grab them when they are far away.
    -he is sitting independently, but isn't showing signs to start crawling yet.
    -he babbles, somedays more than others, squeals when happy and grunts when he isn't happy
    -he is making a lot of scream and sounds, but doesn't make a lot of double sounds like mama dada
    -he smiles when playing peek a boo, but I don't think he gets the game yet.

    These are things I am worried about;
    -he isn't making long periods of eye contact with me or strangers like other babies we play with. Some of my friends babies stare at their parents and strangers.
    -he will smile at strangers but then quickly look away
    -he doesn't look at me when he feeds, he will come off and look at me and smile, but will not make eye contact during his feeds
    -when he is doing tummy time he moves his arms like he is swimming he hasn't learned to put his hands down and push up... only does this when he is following a toy I move from side to side
    -sometimes he will wake up and coo and cry for me but most times he will play with his stuffed animal for a 10 minutes before calling out
    - he doesn't always look when his name is being called.
    -He makes a lot of eye contact when he is on his back and playing with toys, but doesn't when he is on his belly or sitting (he just learned how to do this)
    -He doesn't like making eye contact when his face is right infront of mine.
    -He likes to look around the room consistantly

    I am mainly worried about his eye contact. All the babies in our groups seem to have more eye contact than him. Some tend to babble more than him as well. Could that be personality or red flag to autism?

    Thank you for your input, I have tried to talked to my doctor but he doesn't seemed concerned, however, I can't stop worrying.

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  4. Dear lansann-- it sounds to me as if your baby is not just okay, but doing extremely well for his age! You really can't assess a baby's eye contact or anything else by making comparisons to other babies you know. They all have different personalities and slightly different patterns of development.

    I assume that your baby sleeps on his back, as parents are usually advised nowadays? That would be the reason that he has better movement control in the supine than in the prone position. Back-sleeping babies take longer to master the "tummy" skills like pushing up with their arms or rolling over. If you do more "tummy time" with him, it will help him move along, but it's not terribly important because he will catch up eventually.

    I am more concerned about your anxiety about this and how long it's gone on. Mothers are often not aware that perinatal mood disorders ("Postpartum depression") can show up as excessive worry rather than sadness. Perhaps your doctor can recommend someone for you to talk to about your feelings and concerns. If you will look at this blog again later today, I am going to post a letter from another mother that you may find helpful to read.

    Good luck!

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  5. It is, also, worth noting that many autistic children can make eye contact just fine. In addition, girls present differently than boys, and researchers are just now starting to really weed through those differences. One way in which girls are suspected to be different than boys, especially in the milder forms of Autism, is that girls tend to want to be more social than boys. They appear to care more about it than boys, and to some extent, that might be due to societal gender roles. Girls, in general, are expected to be more social and nurturing.

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