To this point we have dealt with attainment of maternal role during pregnancy and the first year of life. Mercer's (1985,1986) work embraces the first year of the child's life, yet it deals primarily with the mother's own perception of her role, how well she fulfills it, and how satisfying it is to her. The next step is to explore what it is that mothers actually do with children. We focus on mothers because in our experience, we have found that, in the vast majority of cultures around the world, the mother remains the primary caregiver of the young child. It is true in many cultures that the extended female family members such as mothers, mothers-in-law, sisters, and aunts are integrated into the caring role, either directly caring for the children or indirectly by caring for the mother and her household responsibilities. Stern and Bruschweiler-Stern (1998) described the psychological support women seek from other women after the birth of their baby. They described it in the same terms as those Winnicott (1990) used to describe the character of the environment needed by infants: a holding environment.
Winnicott (1990, p. 49) described the mothering role to be one of "holding." He defined holding for infants as involving (1) protection from physiological insult; (2) taking account of the infant's skin sensitivity, temperature, auditory sensitivity, visual sensitivity, sensitivity to failing, and lack of knowledge of existence of anything other than the self; (3) a routine of care through the entire day and following to the minute the day-to-day changes belonging to the infant's growth and development, both physical and psychological; and (4) physical holding of the infant, which is a form of love.
Taken in its totality, providing a holding environment for a child is a very demanding undertaking. Winnicott's (1990) formulation can be applied to any age; characteristics of the child form the changing nature of the child's needs for a holding environment. Providing a holding environment requires that the caregiver have the physical and psychological resources to be on alert to the child and respond in a manner that satisfies not only the child's need but also in a way that facilitates the child's ongoing development.
There are three aspects of the mothering role embedded in Winnicott's (1990) notation of the holding environment that are important to examine in relation to actual behavioral observation of maternal role performance. These aspects are (1) the monitoring-surveillance function, (2) expectant nurturing, and (3) responsive caregiving.
When talking with a mother of a young infant, one soon becomes aware that the mother's attention is riveted to the infant. Even though she may be engaged in a social exchange with other persons, she visually checks in on the infant's well-being approximately every 20 seconds. In our experience, mothers have reported that they develop a special sense for the infant's breathing and movement patterns that they monitor during the infant's sleep and that they arouse from their own sleep if they detect an unusual change in those patterns. Winnicott (1988) called this "maternal preoccupation" with the infant.
Infants are beginning to develop the ability to control their behavior, or self-regulate, through their sleeping, feeding, and responses to stress in their environments. This process begins shortly after birth. Part of the mothering role is to support and assist the infant in developing self-regulatory behavior. In observing parenting practices in relation to sleep, it has been established that in the first three months most infants are not put down to sleep until they are already fully asleep, reflecting the belief that infants need help in getting to sleep (Johnson, 1991). By 3 months of age, infants are put down for sleep by their parents while they are still awake, giving the infant a chance to regulate this basic process of self-soothing and putting one's self to sleep. Infants provided with the opportunity to self-soothe learn to get to sleep and stay asleep versus infants who are always put to sleep by their parents. Infants who are put to bed awake also are encouraged by parents to use transitional objects such as pacifiers and blanket ends to soothe or regulate their distress or arousal.
Infancy is a period of development when intensive monitoring is justified, relative to the infant's lack of physiological homeostasis and general helplessness (Bornstein, in Vol. 1 of this Handbook). Even after this period, however, the monitoring of the child's behavior and development is a vital role for the parent. There is evidence of this function in most homes. For example, parents often keep charts on which the infant's weight and length have been recorded, records of sleep and feeding patterns, marks on the kitchen doorframe indicating the height of each child, videotapes, and albums of pictures. As the child matures, the monitoring extends beyond the family when the child plays with peers. Mothers speculate how their child is doing in relation to others. As a child matures, the child can manage more and more behavior; knowing the child's capacity for self-regulation is the dynamic part of maternal surveillance. For the school-age child, the monitoring of the child's whereabouts is extremely important in controlling the situations appropriate for the child's decisionmaking competencies and supporting healthy social development (Collins, Madsen, and Susman-Stillman, in Vol. 1 of this Handbook). With adolescence there is the continuing need for structure and rules to help the teenager maintain a controllable environment (Steinberg and Silk, in Vol. 1 of this Handbook). In other words, teenagers need parameters within which they can make most of their own decisions.
Parental monitoring becomes less intense as children grow older. An ongoing challenge to mothers is how much freedom should they give their children to investigate their environment. Too close monitoring may stifle growing independence, whereas too little monitoring or supervision may lead to childhood behavior problems. One mother shared a clever example of how she negotiated the transition of her preteen son. She admitted she was not sure when she was being "too motherly," acknowledging his increasing need for freedom and independence. They agreed to come up with a code word that he could say to cue her to withdraw a little—he chose the words "Kelsey Grammer." This plan between mother and son helped to ease the tensions between them and to allow for a more supportive transition to increased independence for the child and decreased mothering for the mother.
Expectant nurturing functions include caregiving behaviors such as providing nutrition for the growing child, maintaining an environment that provides for the basic needs of health care, appropriate environmental temperature control, safe housing, maintainance of appropriate physical safety, and the meeting of general dependency needs. Expectant nurturing are those acts that are expected to be performed by the mother or a responsible caregiver to ensure the physical survival of the child. Only in the extreme circumstances are these basic human needs not met; when they are not provided this is labeled as neglect. Most cases of reported child abuse contain elements of chronic neglect. Neglect can have devastating effects on the developing child, especially when the neglect of basic needs is coupled with the neglect for psychological or social needs. Interestingly, there is less agreement on the expectant nurturing for psychological or social needs.
The primary focus of parenting in the early months of an infant's life is to establish routines, patterns of interaction, and patterns of communication (Bornstein, in Vol. 1 of this Handbook). Theories that attempt to explain the consolidation of the mother-infant relationship over time often reflect even larger endeavors to explain all of human relationships. A commonly held view, and basic tenet of "general systems theory," is that parents and children mutually influence and provide feedback to one another.
Especially for the infant there is a degree of dependency that makes survival questionable without the commitment of a caregiver. Infants cannot nourish themselves with food, nor can young infants manage to make the environment change or be predictable. Infants require adults for bringing objects into reach, to both provide and eliminate auditory stimulation, and to maintain the safety of the environment. Papousek and Bornstein (1992) described two different forms of caregiving, responsive and didactic, which in turn have been related to different child outcomes. Responsive caregiving involves the social interaction between the partners, whereas didactic caregiving involves the transmission of information between mother and child. Mothers who engaged in more social interaction had infants doing more social orienting, whereas mothers who concentrated more on orienting the infant to the environment had infants who explored objects more and who later had higher verbal intelligence. As the infant develops, the adult is mediating the environment for the child. Only when the child begins to locomote and finally walks and talks does the child begin to have more control over how much stimulation she or he gets and what activities she or he engages in. Scarr and McCartney (1983) stated that it is before the child is 3 years old that the environment the child is provided has the most influences on the child's development. After the age of 3 years, the child has the ability to seek environments and activities independently. In studies of children coming from high-risk environments, we have discovered that the amount of caregiving and stimulation increases for children after the onset of walking and talking.
Because the infant has a limited capacity to accommodate, the quality of the socioemotional environment in the early infancy period is highly dependent on the social competence of the mother. Goldberg (1977) highlighted three areas of infant social competence that contribute optimally to infants' interactions with their caregivers: predictability of behavior (which includes regularity of biological rhythms), social responsiveness, and readability of cues. High-risk infants or infants with handicaps may be compromised in these areas of social competence. These infants may be frequently irritable, be difficult to soothe, be difficult to feed, reject holding or cuddling, and be unresponsive. The ability of the mother to interpret infant behavior and to respond contingently, as well as the infant's ability to give clear behavioral cues, influence the quality of mother-infant interactions.
Critical to the success of any interaction is the ability of the mother and the child to adapt to one another. Sander (1962, 1964) suggested that initial mother-infant adaptation involves the fitting together of the "active tendencies" of each partner. Parent-infant synchrony is facilitated by a sense of rhythmicity, which is proposed to be in underlying pattern in the flow of interactive behavior (Censullo, Bowler, Lester, and Brazelton, 1987; Censullo, Lester, and Hoffman, 1985; Lester, Hoffman, and Brazelton, 1985). When partners in an interaction are only passively involved, the interaction becomes less adaptive, less positive.
In any social interaction there is an exchange. In most partnerships this exchange is an equal one. Exchanged are feelings, emotions, and information. In the mother-child interaction, the roles are altered slightly in that the mother takes on more responsibility for the social exchange, depending on the child's capacity or developmental level. In parent-child exchanges, the parent or mother provides more feedback of an instructional nature during the exchange. Bornstein (1989) labeled this type of instructional feedback as didactic exchanges.
In a responsive caregiver-child interaction, there are certain behaviors that are cardinal to fulfilling the role. A fundamental aspect of responsiveness is contingency. The ability to monitor, interpret, and respond to the child's behavior in an immediate and appropriate manner is key to the child's developing a sense of the trustworthiness of his or her environment and that his or her behavior has an influence on others. The temporal nature of contingency is important. Often in situations in which the mother is preoccupied, the ability to be contingent is compromised. She may respond to the child but with a latency that does not allow the child to connect her behavior with the mother's response. It is in the response of others that the child develops meaning of her or his behavior. When the response is absent or inconsistent, it is more difficult for the child to assign meaning to her or his behavior. Often in families with high degrees of stress, it is observed that mothers are not responsive to the immediate behavior of the child. The lack of concordance between behavior and mother's response makes it difficult for the child to detect cause-effect relations. Successful child behavior management programs aim to help parents improve the concordance between the child's behavior and its consequences (Webster-Stratton, 1992).
Barnard, Hammond, Booth, Mitchell, and Spieker (1989) described the mother-infant interaction system as a dialogue or a mutually adaptive "waltz" between partners. For the waltz to flow smoothly, and for the infant to receive the quantity and quality of stimulation needed for optimum development, both the dance partners and the dialogue must have certain features:
(1) The partners in the dialogue must have a sufficient repertoire of behaviors so that interlocking sequences are possible and a smooth-flowing interactive system develops. Low-education mothers and preterm infants who are typically less responsive than term infants are both examples of partners with diminished interactive behaviors (Barnard, 1994; Morisset, 1994).
(2) The partners' responses must be contingent on one another; as the child matures, the mother must remain both consistent and contingent in responding to the child. Low-education mothers have been found to be less contingent (Barnard, 1994; Morrisett, 1994).
(3) Interactive content must be rich in terms of positive affect, verbal stimulation, and range of play materials provided.
(4) The adaptive patterns between mother and child must change over time relative to the emerging developmental capacities of the child.
Others have described the mutual mother-infant "dance" with terms such as contingency (Greenspan and Lieberman, 1980), attunement (Stern, 1985), emotional availability, reciprocity, or mutuality (Brazelton, Tronick, Adamson, Als, and Wise, 1975), and synchrony (Censullo et al., 1987).
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