Table Of ContentPatrícia Alvarenga
M. Ángeles Cerezo
Yana Kuchirko
The Maternal
Sensitivity
Program
A Model for Promoting Infant
Development in Challenging Contexts
The Maternal Sensitivity Program
Patrícia Alvarenga • M. Ángeles Cerezo
Yana Kuchirko
The Maternal Sensitivity
Program
A Model for Promoting Infant Development
in Challenging Contexts
Patrícia Alvarenga M. Ángeles Cerezo
Institute of Psychology Department of Psychology
Federal University of Bahia University of Valencia
Salvador, Bahia, Brazil Valencia, Valencia, Spain
Yana Kuchirko
Department of Psychology
Brooklyn College
New York, NY, USA
ISBN 978-3-030-84211-6 ISBN 978-3-030-84212-3 (eBook)
https://doi.org/10.1007/978-3-030-84212-3
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Foreword: Being Sensitive to the Next Steps
in the Area of Maternal Sensitivity
As a part of my doctoral training over 30 years ago, under my esteemed mentor
Marc Bornstein, I visited homes of families in NYC to observe mother-infant inter-
actions. At the time, we wanted to document developmental shifts in face-to-face
“dyadic” engagements and mother-infant-object “extra-dyadic or triadic engage-
ments” when infants were 2 and 5 months old. During home visits, I noticed intrigu-
ing and salient temporal connections between what infants did and how mothers
responded: babies would look to a rattle, and mothers promptly named the rattle or
suggested what to do with it (“You like your monkey rattle! Shake, shake, shake”).
I wondered whether such timely adaptations might promote infant word learning. In
fact, I speculated that contingent responsiveness would be especially critical during
the early emergence of language, when infants require a lot of support to map word
meaning to world referents. And so, I officially embarked on the study of contingent
responsiveness, spending the next three decades of my career describing the nature
of the phenomenon and showing how individual differences among mothers in con-
tingent responsiveness (and sensitivity more broadly) predicted differences among
infants in language learning and other domains of development.
Perhaps the most rewarding part of my personal trajectory has been witnessing
the surge in interest in parental contingent responsiveness and sensitivity (with the
latter and broader construct encompassing a range of behaviors, including parental
warmth, stimulation, and contingent responding). Researchers from many labs
across the globe, studying different populations, using different tasks (e.g., struc-
tured play interactions; naturalistic home interactions), and presenting dyads with
different materials and activities, have consistently documented robust and moder-
ate to large associations between contingent responsiveness and infant develop-
ment—in domains spanning language development, cognition, emotional
understanding, regulation, and so on. Indeed, if replication is key to scientific integ-
rity, the developmental significance of parental contingent responsiveness and sen-
sitivity passes the litmus test with flying colors.
Happily, science marches forward, with each new study shedding fresh light on
the phenomenon of interest. Research on parenting is no different. The study of
maternal responsiveness (and sensitivity) has expanded in exciting new directions
v
vi Foreword: Being Sensitive to the Next Steps in the Area of Maternal Sensitivity
since I began to pursue research on the role of parental responsiveness in infant
learning. Indeed, researchers and clinicians have made great strides in three critical
ways by advancing on: (1) Scientific translation: researchers have translated the
premises of basic science on contingent responsiveness and sensitivity to real-world
application; (2) Global extension: researchers have expanded the study and applica-
tion of contingent responsiveness and sensitivity to understudied (and under-
resourced) samples; and (3) Scientific transparency: researchers have aimed to
widely disseminate and share their know-how through full and readily interpretable
documentation of their methods, procedures, measures, and so on—whether sharing
information on research protocols, data, and findings or successful intervention
approaches.
And so, this brings me to the reason that I welcomed the opportunity to write a
foreword for the current book: The Maternal Sensitivity Program: A Model for
Promoting Infant Development in Challenging Contexts. At the most basic level, the
book is a pleasure to read. The authors avoid jargon and write clearly, and the solid
book coverage is grounded in relevant literature. But beyond these important stylis-
tic features, the book exemplifies the three critical directions of scientific transla-
tion, global extension, and scientific transparency. In this regard, it beautifully
integrates the history of developmental research—as rooted in the tradition of sys-
tematic inquiry into the role of parents in infant development— with the future of
scientific and clinical advances.
On Scientific Translation
Developmental science is ultimately about giving back. Researchers study parents
and children to both understand developmental processes and to apply what they
have learned to bettering the lives of children and families. The idea of a critical
need for basic-applied connections is well described in the book Pasteur’s Quadrant:
Basic Science and Technological Innovation by Donald Stokes, which spotlights the
importance of research that advances a fundamental understanding of scientific
problems while serving the immediate needs of a society. That is, Pasteur’s study of
bacteria and diseases in livestock led to his understanding of how microorganisms
cause disease. Ultimately, it led him to the discovery of how to engineer vaccines
from microbes.
Of course, not all scientific topics should or do fall into Pasteur’s quadrant. But
those that bridge the connection between basic knowledge and application are par-
ticularly noteworthy. In this regard, the authors bring together their complementary
areas of expertise in research on parental sensitivity and contingent responsiveness,
infant learning, and intervention science to the task of designing, evaluating, and
disseminating an intervention aimed to promote maternal sensitivity. Notably, the
authors take several critical steps to ensure confidence in the program’s efficacy and
thus convince stakeholders of the merits of the proposed interventions. As a start,
the book’s clear organization walks the reader through fundamental issues around
Foreword: Being Sensitive to the Next Steps in the Area of Maternal Sensitivity vii
theory, research, implementation, and evaluation. Specifically, the authors begin by
establishing the theoretical and empirical foundations on maternal sensitivity
broadly defined (such as discussion of sensitivity and attachment theory and longi-
tudinal and meta-analyses of research, Chap. 1), followed by systematic review of
how more fine-grained, behavioral measures of contingent responsiveness relate to
language learning specifically (Chap. 2). They then provide a broad overview of the
program (Chaps. 3, 4, and 5) that includes detailed information about program eval-
uation and effectiveness. Each of these introductory steps reinforces the importance
and benefits of the program as described in the sections that follow. Indeed, clini-
cians and researchers who seek to implement the program can be confident of its
grounding in expert knowledge.
On Global Extension
Developmental and intervention science has historically been narrowed in scope
and reach. Much of what we know about parenting and child development draws
from samples of middle-income families in North America, Europe, and parts of
Asia (though even studies on Asian populations are uncommon). In this regard, the
book’s cultural emphasis is timely and appreciated, and the authors apply a cultural
lens in two fundamental ways. First, opening chapters contain thorough cultural
coverage of research on parental sensitivity and contingent responsiveness (where
available). For example, dedicated sections within chapters review the impact of
maternal sensitivity and contingent responsiveness on child development across dif-
ferent cultural communities, a focus that underscores the robust and generalizable
effects of the key parenting constructs that form the basis of the program. Second,
and most centrally, the program was developed for mothers from very poor house-
holds; implemented in two low-income communities in Salvador, Brazil; and shown
to be effective at changing maternal (and subsequently infant) behaviors under
highly stressful and impoverished conditions. Such evidence suggests that the pro-
gram can readily translate to other poor communities throughout the globe, and that
it is possible to effectively train providers on program components, observe fidelity
to implementation of program components, and impact change for vulnerable
populations.
On Scientific Transparency
Full transparency is critical to scientific advancement. Transparency involves the
complete and open sharing of study/intervention protocols, details on participant
recruitment, information on sample characteristics, coding manuals and methods,
analyses and models, and so on. As a result, the method sections of journal articles
do little justice to the many details of what was done, by whom, when, where, how,
viii Foreword: Being Sensitive to the Next Steps in the Area of Maternal Sensitivity
and why. The authors have published their findings on contingent responsiveness,
sensitivity, and the program itself in several articles, and could have settled for con-
tinued dissemination in such traditional outlets (journals, conferences, workshops,
and so on). Instead, they chose to incur the huge time and energy costs of writing a
book that could give back in full all the needed details for other clinicians and
researchers to successfully replicate their efforts. As you read the Maternal
Sensitivity Program, you will come to appreciate the comprehensive coverage and
know-how the authors offer for every component of the intervention. Eight chapters
(organized by age of infant at each session) in the aptly titled part The Maternal
Sensitivity Program Step by Step walk readers through all aspects of the program
with enormous clarity. Each chapter details the goals of the session; provides
detailed information about video recording and coding; and presents precise instruc-
tions for providers on what to say to parents at each step of the intervention. Such
transparency ensures fidelity to the program goals and procedures while training on
age-appropriate strategies for intervening with parents and infants.
Let me close by saying that I am enormously grateful for the opportunity to learn
from the researchers and clinicians who developed the Maternal Sensitivity
Program. Thankfully, after 30 years, I still have much to learn from the next genera-
tion of experts in our field, and I am sure that is the case for anyone who reads this
book. This book offers a valuable and unprecedented resource for people who work
with families and hope to support mothers and infants at the most critical time in a
child’s development. The authors should be commended for giving back in just the
right way—by bridging the basic-to-applied science gap in their messaging, extend-
ing their reach globally, and providing a fully transparent guide on a rigorous,
evidence- based approach to supporting families.
New York, NY, USA Catherine S. Tamis-LeMonda
August 2021
Reference
Stokes, D. E. (1997). Pasteur’s quadrant – Basic science and technological innova-
tion. Brookings Institution Press.
Acknowledgments
This book resulted from the work and support of many people. The idea of develop-
ing a suitable program to promote infant development in challenging contexts was
first inspired by the notable work done by teams who implemented the PAPMI® and
PCPS® in Spain and Ireland, coordinated by the second author, M. Ángeles Cerezo.
We especially thank Pilar Cibai, who generously facilitated our access to materials
and information about PAPMI®.
When developing and evaluating the Maternal Sensitivity Program (MSP), we
counted on the expertise of outstanding colleagues who contributed to refining
methodological procedures and enabling the production of accurate and reliable
data on MSP effects. We especially thank Cesar Augusto Piccinini, Elizabeth Wiese,
Euclides José de Mendonça Filho, Catherine Tamis-LeMonda, and Roger Bakeman.
The first implementation of the MSP in Brazil was successful thanks to two
extremely devoted psychology undergraduate students: Hevilla Oliveira and Jéssica
Coutinho. These two young students put the program into action and helped adapt
the language to fit the target population’s needs and characteristics.
The results of the first implementation of the MSP were analyzed and discussed
during two visiting professorships of the first author, Patrícia Alvarenga, in the
University of Texas and New York University in 2018 and 2019. The insights fos-
tered by the brilliant work done by Dr. Susan Landry, Dr. Tricia Zucker, and Dr.
Catherine Tamis-LeMonda were invaluable and greatly inspired this book.
We also thank CAPES (Coordination for the Improvement of Higher Education
Personnel, Brazil) and CNPq (National Council for Scientific and Technological
Development, Brazil) for their financial support. Without the scholarships and
research funding provided by these two agencies, it would not be possible to deliver
the results presented here.
Finally, we dedicate this book to the mothers and babies from the communities
of Calabar and Alto das Pombas, in Salvador, Bahia/Brazil, who took part in the first
randomized controlled trial of the MSP between 2013 and 2017. Thank you for the
trust and kindness with which you welcomed us into your homes.
ix
Contents
Part I Foundations of the Maternal Sensitivity Program
1 Theoretical and Empirical Underpinnings of Maternal
Sensitivity: Considerations of Sensitivity Across Cultures
and Socioeconomic Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Conceptual Issues and the Evaluation of Maternal Sensitivity . . . . . . . . 5
Predictors of Maternal Sensitivity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
The Impact of Maternal Sensitivity on Child Development
in Different Cultures and Across Developmental Domains . . . . . . . . . . 11
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2 Impact of Maternal Verbal Responsiveness
on Infant Language Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Maternal Verbal Responsiveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Cultural Variation in Maternal Verbal Responsiveness . . . . . . . . . . . . . . 25
Maternal Verbal Responsiveness in Challenging Contexts . . . . . . . . . . . 25
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Part II T he Maternal Sensitivity Program in a Nutshell
3 Program Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
The Story of the Maternal Sensitivity Program in Brazil . . . . . . . . . . . . 35
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
4 Program Description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Structure of the Sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Video Recording . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Video Coding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Video Feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Live Modeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Themes of the Sessions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
xi
