“Mommy, Where are You?”: Sleep Interventions and Security of Infant-Mother Attachment

1. “Mommy, Where are You?”:Sleep Interventions and Security of Infant-Mother Attachment presented by Megan Blair Department of Psychology and Social Behavior, The University of California, Irvine May 13, 2006

2. Bedtime for Baby . . .

3. Advice from professionals . . . • Sleep Intervention Methods • Help a young child learn to sleep through the night on his or her own • Range from responsive to very non-responsive • Can be as extreme as leaving child to cry for long periods of time (Owens, France & Wiggs, 1999)

4. More advice from professionals . . . • How to promote a secure attachment • provide sensitive, consistent, appropriate responses to your child’s needs (Bowlby, 1982; Ainsworth, 1982)

5. ? Nighttime sleep intervention: not responsive to child’s signals Child sleeps through the night One might wonder . . . Daytime: consistent, responsive care Secure Attachment

6. Secure Infant Attachment . . . • Benefits of a Secure Attachment • Infant will explore a new environment, confident that the parent will protect him/her if needed. • Securely attached children grow up to be more enthusiastic, goal-oriented, and better able to solve problems, compared to children who were insecurely attached (Carlson et al., 2003).

7. Insecure Infant Attachment . . . • Insecure-Avoidant • When distressed, child does not expect comfort from mother because she typically does not provide it • Child learns to inhibit feelings - especially anger • Child expects mother to be emotionally unavailable when he/she needs care or protection (based on history of maternal caregiving) (Ainsworth et al., 1978; Main, 2000)

8. Insecure Infant Attachment . . . • Insecure-Resistant • Child cries a lot if separated from mother and cannot be soothed easily by mother when she returns • When distressed, child both seeks and resists contact with mother because he/she does not believe in mother’s ability to soothe him/her • Child expects inconsistent, unpredictable care (based on the history of caregiving provided by the mother) (Ainsworth et al., 1978; Main, 2000)

9. The Missing Link! • Is security of infant attachment to the mother associated with the use of sleep intervention methods? Security of Infant- Mother Attachment Sleep Intervention Methods ?

10. The Hypothesis . . . • Infants who were subjected to sleep interventions that involve non-response or insensitive responses to their signals (e.g., crying) will be less likely to have secure attachments than infants who did not experience these methods.

11. Setting: UCI Medical Center; lab playroom and offices in Dr. Curt Sandman’s suite Participants: Recruited from larger study of child sleep location, family well-being, and attachment (Keller, Study of Child Sleep and Maternal and Child Well-Being) Families were also participants in a large longitudinal study of prenatal stress and development (Sandman & Davis, UCI Women and Children’s Health and Well-Being Project) The Setting and Sample . . .

12. 31 toddlers (17-19 months of age) and their mothers 17 boys (52%) and 14 girls (48%) The Toddlers . . .

13. The Mothers . . . • 22 - 40 years of age (M = 31.6) • 94% married; 100% living with child’s father • Employment Status • 38% employed full-time • 27% part-time work/school • 35% not employed • Primarily middle-class families (income ranged from less than $40,000 to more than $180,000; median range = $60,000 - $80,000)

14. Mothers’ Educational Attainment . . . High school diploma (10%) No high school diploma (3%) Some college education (26%) 4-Year college degree or higher (61%)

15. Mothers’ Ethnic Background . . . Other (13%) Hispanic (39%) Caucasian (48%)

16. Methods . . . • Attachment Measure • The Strange Situation Procedure (Ainsworth et al., 1978) • 24 minute lab procedure • Consists of time with mother and stranger, and time alone, in playroom • Child’s actions during separations and reunions videotaped and later coded to determine if infant is securely or insecurely attached to mother

17. Methods . . . • Sleep Intervention Measures • Maternal survey • Did you ever use a “formal sleep training method” to help your child learn to sleep through the night? (yes/no) • How often did you respond to your child’s signals by picking him/her up? (coded 1-5 where 1=never and 5=always) • How often did you remain outside of your child’s room when he/she was crying? (coded 1-5 where 1=never and 5=always)

18. Results . . . • Attachment status • 71% Secure • 29% Insecure • (44% Avoidant) • (56% Resistant) Frequency of Attachment Types

19. Descriptive Results . . . • 55% of children had learned to sleep through the night by 6 months; 100% by 16 months • 90% currently sleeping through the night • Some children began reawakening after previously learning to sleep through the night • 63% of mothers believe that parents have an important role in teaching their children to learn to sleep through the night; however, only 26% of mothers reported using a formal sleep intervention method

20. Results . . . • 90% of mothers reported some crying when their young child learned to sleep through the night. • To get child to sleep, mothers tried . . . • Nursing child • Giving child a bottle/pacifier/toy • Bringing child into parents’ bed • Picking child up to comfort him/her • Letting child cry

21. Test of main hypothesis . . . • Reported use of formal sleep intervention methods not significantly associated with security of infant attachment to mother (2 (1) = .38, ns.)

22. Follow-Up Research Question . . . • Although they may not have reported using a formal sleep intervention method, some mothers have tried letting their child “cry it out” during the night. • I examined whether reported non-responsive behaviors at night (not picking up distressed child; remaining outside child’s room) are associated with infant attachment: • Hypothesis: Mothers of insecurely attached infants will provide less responsive care at night than mothers of securely attached infants

23. Results . . . • Mothers of securely attached infants were significantly more likely to provide responsive care when their children woke at night Frequency of Picking Child Up During the Night (t (28) = 2.386, p < .05)

24. Results . . . • Mothers of Insecure-Avoidant babies were significantly more likely to be non-responsive when their children cried at bedtime Frequency of Remaining Outside of Crying Child’s Room at Bedtime (t (24) = 2.217, p < .05)

25. Conclusions and Implications . . . • Use of a formal sleep intervention method was not significantly associated with security of attachment • Non-responsiveness to child’s signals at bedtime was related to greater likelihood of insecure attachments (especially insecure-avoidant) to mother • Responsive care at night may be an important factor in promoting a secure infant attachment to mother

26. Future Research . . . • Larger sample • Add nighttime component to studies of associations between parental behavior and security of attachment • Longitudinal Design • Study infants over a long period of time as they go through sleep intervention methods to see what effect these have on security of attachment

27. A big “thank you!” to . . . Thanks! • Professor Wendy Goldberg • Professor Valerie Jenness • Ph.D. Candidate Meret Keller • UROP and SURP • Research Assistants • Jenna Kieckhaefer • Rebecca Grover • Stephanie Sullivan • Participating families

28. For more information contact me at: • Megan Blair • mblair@uci.edu • (949) 823 - 9564