Intracranial hemorrhage (ICH), a complication of prematurity, has been shown to be a significant risk factor for later cognitive disabilities. However, little attention has been paid to the effects of ICH on subsequent social and emotional development. Data from hemispheric lateralization studies suggest that infants with right hemisphere bleeds would be particularly vulnerable to deficits in emotional functioning, since there is extensive evidence that the right-hemisphere of the brain is specialized for the perception and expression of emotion in children and adults. The proposed study, therefore, will assess mother-infant interaction in premature infants with different types of bleeds. Fifteen infants with bilateral bleeds, 15 with unilateral RH bleeds, and 15 with unilateral LH bleeds will be compared to 15 premature infants without bleeds. Groups will be matched on relevant demographic and infant variables. At 3 months corrected age, infants' cognitive development will be measured, and mother-infant interaction will be assessed in a face-to-face paradigm, followed by a """"""""still-face"""""""" procedure. Interactional data will be coded using both microanalytic and global rating strategies. It is hypothesized that the interaction pattern of infants with ICH and their mothers will be characterized by increased maternal efforts to elicit the infant and decreased infant responsivity, compared to infants without ICH and their mothers. In addition, it is expected that infants with RH bleeds will be less responsive and less expressive than those with LH bleeds. The results will provide information on the effects of cerebral hemorrhage on mother-infant interaction, and will elucidate the role of hemispheric specialization in infancy. Since the quality of mother-infant interaction predicts later social competence, these data also will allow us to determine if infants with bleeds are at risk for later social difficulties. If so, the next goal of this research will be to conduct a longitudinal study of social development in infants with cerebral hemorrhages.
