Fetal Alcohol and Drug Unit

Baby/Mom Study: A Pilot Infant Mental Health Intervention with Drug-Endangered Children and Their Mothers

Principal Investigator: Therese Grant, Ph.D.

Funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Prevention (2006 – 2013)

 

Project Description

The Baby/Mom Study was conducted within the framework of the Washington State Parent Child Assistance Program (PCAP) to enhance the parent-child relationship of mothers and babies enrolled in the program. This project directed infant mental health resources to mothers who used methamphetamines during pregnancy whose children were at risk for compromised developmental and social-emotional outcomes. In this study, we supplemented standard 3-year PCAP intervention with a nested 12-month infant/mother mental health intervention delivered in the home by supervised infant mental health therapists. We compared outcomes from the enhanced infant/mother intervention group (N=40 infant/mother pairs) with data from a matched comparison group (N=40 infant/mother pairs) that received standard PCAP intervention alone. We hypothesized that mothers in the intervention group would demonstrate improved responsiveness to their children and greater improvement in the quality of infant/mother interaction, and that these indicators of improved relationship would be associated with: 1) fewer age-specific mental and motor development problems in the children and greater functional social-emotional competence; 2) reduced rates of maternal drug/alcohol use; 3) higher rates of permanent maternal child custody placement; and 4) fewer additional methamphetamine and other substance-exposed pregnancies.

Preliminary analysis of the videotaped infant-mother play interactions indicated that almost all the intervention mother-baby dyads evidenced troubled and maladaptive interactions. Common areas of improvement due to the intervention included the mothers’ increasing capacity to think about their baby’s experience (to “keep the baby in mind”) and to engage with their child in a developmentally-sensitive manner. There were few differences between groups with respect to maternal rates of drug/alcohol use or child development and social–emotional problems (based on screening assessment using the Ages and Stages Questionnaires). At intervention exit, more women in the comparison group had lost custody (either permanently or temporarily) during the study compared to mothers in the intervention group (15% vs. 10%). Women in the intervention group had a higher rate of subsequent births compared to comparison group mothers (24% vs. 14%). None of the women reported using methamphetamine during the pregnancy, so none of the subsequent births were prenatally exposed to methamphetamine.

In 2009 this project received supplemental funding to conduct a year-long community-based infant mental health training program with masters’ level professionals interested in working with high-risk mothers and their infants/toddlers. The training was conducted in collaboration with the Michigan Association for Infant Mental Health (MI-AIMH) and was designed to help prepare participants for application to MI-AIMH as Level 3 Infant Mental Health Specialists.