Prediction of Behavioral Problems Based on Attachment Styles and Sensory Processing in Children with a History of Prematurity at Birth

Document Type : Original Article

Authors

1 Department of Basic Sciences, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Occupational Therapy, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Islamic Azad University, Tehran, Iran

10.22038/ijn.2024.76387.2476

Abstract

Background: Despite significant advancements in the care of premature infants, it must be acknowledged that premature infants, especially low birth weight infants, are prone to problems such as sensory, cognitive, neuro-motor, visual, and hearing problems. Their objective future difficulties are behavioral abnormalities, socio-emotional difficulties, and impaired school performance.
Methods: This research aimed to predict behavioral problems based on attachment styles and sensory processing in children with a history of prematurity at birth. The research method was a descriptive cross-sectional study. The study population consisted of all 5 to 12-year-old children in Tehran in the year 2022; among them, 154 children aged 5 to 12 years old with a history of prematurity at birth were selected by the convenience sampling methods. Data were collected using the Sensory profile2-child, Kinship Center Attachment Questionnaire, and Strengths and Difficulties Questionnaire. Data were analyzed using the Pearson correlation coefficient and regression analysis.Results: The findings demonstrated a significant negative correlation between adaptive development and children's behavioral problems (r=-0.65, p<0.05). Moreover, a significant positive relationship was found between attachment styles and emotional reactivity (r=0.64, p<0.05), negative behaviors, and avoidance of attachment figure support (r=0.67, p<0.05), as well as sensory processing and behavioral problems in children with a history of prematurity at birth (r=0.67, p<0.05). Additionally, motor processing (β=0.22, p<0.05), emotional reaction (β=0.17, p<0.05), and avoidance of attachment figure support (β=0.17, p<0.29) were capable of predicting behavioral problems in children with a history of prematurity at birth.
Conclusion: It was concluded that as the levels of attachment styles, emotional reactions, negative behaviors, and avoidance of attachment increase in children with a history of prematurity, their behavioral problems increase as well. Conversely, increased positive adaptive development is associated with decreased behavioral problems.
 

Keywords


  1. Vogel JP, Chawanpaiboon S, Moller AB, Watananirun K, Bonet M, Lumbiganon P. The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol. 2018;52:3-12.
  2. Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: A systematic review and modelling analysis. Lancet Glob Health. 2019;7(1):e37-e46.
  3. Shafaghatian N, Bordbar A, Maroufizadeh S, Mirzakhani N, Amini M. The predictive effect of individual and environmental factors on motor performance of low birth weight infants. Iran Rehabil J. 2022;20(3):355-362.
  4. Farhat A, Saeidi R, Zegheibizadeh F, Golhasani F, Mohammadzadeh A. Causes of Death and the Mortality Rate of Newborns in NICU in Mashhad for Five Years. Iran J Neonatol. 2022;13(3).
  5. Darbandi M, Rezaeian S, Dianatinasab M, Yaghoobi H, Soltani M, Etemad K, et al. Prevalence of gestational diabetes and its association with stillbirth, preterm birth, macrosomia, abortion and cesarean delivery: A national prevalence study of 11 provinces in Iran. J Prev Med Hyg. 2022;62(4):E885-E891.
  6. Amini M, Aliabadi F, Alizade M, Kalani M, Qorbani M. The Relationship between Motor Function and Behavioral Function in Infants with Low Birth Weight. Iran J Child Neurol. 2016;10(4):49-55.
  7. Urfer A, Turpin H, Dimitrova N, Borghini A, Plessen KJ, Morisod Harari M, et al. Consequences of prematurity on cortisol regulation and adjustment difficulties: A 9-year longitudinal study. Children (Basel). 2021;9(1):9. 
  8. Machado ACCP, Oliveira SR, Magalhães LC, Miranda DM, Bouzada MCF. Sensory processing during childhood in preterm infants: A systematic review. Rev Paul Pediatr. 2017;35(1):92-101.
  9. Rodrigues C, Zeitlin J, Carvalho AR, Gonzaga D, Barros H. Portuguese EPICE (Effective Perinatal Intensive Care in Europe) Network. Behavioral and emotional outcomes at preschool age in children born very preterm: The role of breast milk feeding practices. Early Hum Dev. 2022;165:105535.
  10. Ross GS, Perlman JM. Relationship of withdrawn, anxious/depressed and attention problems to cognitive performance in preterm children at 18 months and 36 months of age. Infant Behav Dev. 2022;66:101660. 
  11. Khoramirad A, Taheri L, Eskandari N, Abedini Z. Effect of mindfulness-based neurodevelopmental care on infant outcomes in NICU. J Neonatal Nurs. 2024; 30(3):237-242
  12. Chen YC, Tsai WH, Ho CH, Wang HW, Wang LW, Wang LY, et al. Atypical sensory processing and its correlation with behavioral problems in late preterm children at age two. Int J Environ Res Public Health. 2021;18(12):6438.
  13. Gunning MD, Waugh H, Robertson F, Holmes B. Emotional intelligence, attachment and bonding and communication. Community Pract. 2011;84(3):
    27-31.
  14. Shahbazi M, Mirzakhany N, Alizadeh Zarei M, Zayeri F, Daryabor A. Translation and cultural adaptation of the Sensory Profile 2 to the Persian language. Br J Occup Ther. 2021;84(12):794-805.
  15. Soleimani H, Bashash l, Latifiyan M. Psychometric properties of the kinship center attachment questionnaire (KCAQ) of latency-aged for children. 2014:41-63.
  16. Ghanizadeh A, Izadpanah A. Scale validation of the strengths and difficulties questionnaire in Iranian children. Iran J Psychiatry. 2007;2(2):65-71.
  17. Dagan O, Schuengel C, Verhage ML, van IJzendoorn MH, Sagi-Schwartz A, Madigan S, et al. Collaboration on attachment to multiple parents and outcomes synthesis. configurations of mother-child and father-child attachment as predictors of internalizing and externalizing behavioral problems: An individual participant data (IPD) meta-analysis. New Dir Child Adolesc Dev. 2021;2021(180):67-94. 
  18. Esmaeili F, Tahmsebi S, Mohammadi Arya A, Soltani PR. The Relationship between Parenting Styles and Moral Development of Preschool Children Mediated by Children’s Attachment. J rehab 2021;22(3):362-377.
  19. Reisz S, Duschinsky R, Siegel DJ. Disorganized attachment and defense: exploring John Bowlby's unpublished reflections. Attach Hum Dev. 2018;20(2):107-134.
  20. Saeidi R, Asnaashari Z, Amirnejad M, Esmaeili H, Robatsangi MG. Use of "kangaroo care" to alleviate the intensity of vaccination pain in newborns. Iran J Pediatr. 2011;21(1):99-102.
  21. Winston R, Chicot R. The importance of early bonding on the long-term mental health and resilience of children. London J Prim Care (Abingdon). 2016;8(1):12-14.
  22. Horrevorts EM, van Grieken A, Broeren SM, Bannink R, Bouwmeester-Landweer MB, Hafkamp-de Groen E, et al. Design of a controlled trial to evaluate the effectiveness of supportive parenting ('Stevig Ouderschap'): an intervention to empower parents at increased risk of parenting problems by providing early home visits. BMC Psychol. 2015;3:47
  23. Shreffler KM, Spierling TN, Jespersen JE, Tiemeyer S. Pregnancy intendedness, maternal-fetal bonding, and postnatal maternal-infant bonding. Infant Ment Health J. 2021;42(3):362-373. 
  24. Dunn W. Supporting children to participate successfully in everyday life by using sensory processing knowledge. Infants & Young Children. 2007;20(2):84-101.
  25. Engel-Yeger B, Ziv-On D. The relationship between sensory processing difficulties and leisure activity preference of children with different types of ADHD. Res Dev Disabil. 2011;32(3):1154-1162. 
  26. Carter AS, Ben-Sasson A, Briggs-Gowan MJ. Sensory over-responsivity, psychopathology, and family impairment in school-aged children. J Am Acad Child Adolesc Psychiatry. 2011;50(12):1210-1219. 
  27. Garcia Quiroga M, Hamilton-Giachritsis C. Attachment styles in children living in alternative care: A systematic review of the literature. Child Youth Care Forum. 2016;45:625-653.
  28. Gourley L, Wind C, Henninger EM, Chinitz S. Sensory processing difficulties, behavioral problems, and parental stress in a clinical population of young children. J Child Fam Stud. 2013;22(7):912-921.
  29. Reynolds S, Glennon TJ, Ausderau K, Bendixen RM, Kuhaneck HM, Pfeiffer B, et al. Using a multifaceted approach to working with children who have differences in sensory processing and integration. Am J Occup Ther. 2017;71(2):7102360010p1-7102360010p10.