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Emotional Expression in Social Interactions of Infants with And Emotional Expression in Social Interactions of Infants with and without Down Syndrome by Kate Thorsteinsson Department of Psychology University of Portsmouth United Kingdom Submitted: April 2011 Funded by FEELIX GROWING, an EU collaborative grant 1 Declaration Whilst registered as a candidate for the above degree, I have not been registered for any other research award. The results and conclusions embodied in this thesis are the work of the named candidate and have not been submitted for any other academic award. 2 Acknowledgements I would like to thank the following people: Professor Kim Bard, my Director of Studies, who has offered me her knowledge, guidance and unstinting support throughout. Thank you for your patience. Professor Sue Buckley, my supervisor, of the Down Syndrome Education International Trust, for her support and comments, and who enabled me the opportunity to work with families and their young infants with Down syndrome. Also to Dr Anne Hillstrom, my supervisor, for her valuable input and feedback Dr Sherria Hoskins and Mr John Oates for their time and support in reviewing the thesis and for their valuable comments. All the staff at the Down Syndrome Education Trust, for their help in recruiting and for finding me space at the centre to conduct my studies. All those involved in the Feelix Growing project, and in particular to the grant leaders, who secured funding for my PhD from the EU. The lab technicians for solving all those technical hiccups. My husband Ian, who has invested so much to keep me smiling throughout, and to my mother, Maureen, who has given her support in so many ways, not least as emergency babysitter and budget manager. Finally, to my children, Harry and Freyja, who have had to endure prolonged periods of maternal disengagement: for their support, understanding and cups of tea. 3 Dissemination The studies that comprise this thesis have been disseminated in the following ways: 1. The rationales for studies 1, 2 and 3 were orally presented at the Down Syndrome Education International Trust Forum in October 2008 2. Oral presentation of a collection of findings from studies 1 and 2. Thorsteinsson, K. (2009). Emotion, interaction and expression in the early development of infants with Down syndrome. Presented at the Down Syndrome International Trust Forum. October 2009 3. Elements of the thesis have been disseminated as contribution to projects to come out of the FEELIX GROWING Grant. 4. Oral presentation of emotional development in early infancy. Collections of findings from Study 2 presented at the Surestart Forum, 26 Nov. 2010. 4 Abstract In this thesis I report on investigations of the early socioemotional development of 4- month-old infants with Down syndrome (DS) in dyadic and triadic interactions, and comparisons of aspects of socioemotional behaviour of infants with DS with those of typically developing (TD) infants. The thesis incorporates theories relating to positive emotion, early infancy and Down syndrome research. I investigate 3 main debates: when compared to typically developing infants 1) infants with DS may have differences in emotionality, and perhaps social and emotional strengths 2) that infants with DS may have may different patterns of attention, perhaps preferring attending to a social partner over object 3) that the environment within which the infant with DS is raised is somehow different. I investigate these debates with consideration that all may relate to each other. I compare typically developing infants and infants with DS on measures of attention, emotion and sociocommunicative behaviour alongside measuring aspects of their environment. I analyse the behaviour of groups of infants in dyadic (TD: n=11, DS: n=10) and triadic social, and less social, situations (TD: n=10, DS: n=10). I investigate aspects of infant emotion and sociocommunicative behaviours and discuss how they may, or may not, be indicative of abilities in for example, social expectancy, person permanence and early joint attention. I also question whether different play partners relate to infant enjoyment. I report on data relating to infant temperament, and aspects of the very young infant’s environment (maternal caregiving preferences, optimism and demographics) in order to consider the relation of these variables to group and individual differences. I integrate findings from all studies and discuss individual differences. Key findings from the thesis were that DS infants were less fussy overall than TD infants, equally as positive and communicative, and demonstrated an ability to maintain longer social interactions compared to TD infants. DS infants had less interest in an object than TD infants, 5 and more interest in the social partner. This was not due to infants with TD being unable to shift gaze, as infants from both groups shifted gaze comparably. TD infants were able to follow gaze to some extent, and demonstrated sensitivity to the timing and structure of the game of peekaboo. This suggests that at 4 months of age, TD infants may have some level of social expectancy regarding the rules and structure of social exchange, and have emerging joint attentional skills. DS infants did not follow gaze as successfully (although some did) and did not demonstrate such sensitivity to the timing and structure of the peekaboo game (although some did, and some TD infants did not) however enjoyed the game as much as TD infants. TD infant and mother pairs played the game of peekaboo differently to TD infant and experimenter pairs. In the main, infants with DS and mothers played similarly, and infants enjoyed the game as much, as DS-experimenter pairs; and this was comparable to how TD infants and experimenters played and enjoyed the game. No differences emerged between groups on measures of temperament, nor in relation to maternal factors such as parenting system preference or optimism. Neither did any of these measures relate to levels of infant positive emotion during positive, dyadic play. It was concluded that the ability for infants with DS to maintain prolonged social interactions with another at 4-months of age could be interpreted as a strength, perhaps due to an increased focus on the building blocks of later emerging social and emotional skills, that occur during face-to-face interaction. My thesis emphasises the importance in recognising strengths for those with DS, and acknowledging similarities rather than differences with the typical population. The value of this cannot be underestimated for those families (and educators, health professionals and carers) involved with DS. Recognition of sameness promotes an inclusive attitude to enable those with DS to integrate and to develop within a positive environment. 6 Table of Contents Acknowledgements 3 Dissemination 4 Abstract 5 Chapter One: Introduction 9 Thesis structure 16 Ethics Considerations 22 Why 4-month-olds? 30 Participants 35 Methodological design and statistical decisions 37 Progression of studies 44 Key thesis aim 45 Chapter Two: Peekaboo! Face-to-face play and emotionality of 46 4-month-old infants with Down syndrome and infants with typical development Abstract 46 Introduction 47 Method 73 Results 84 Discussion 98 Conclusion 118 Chapter Three: Social triangular joint attentional abilities 120 of 4-month-old typically developing infants and infants with Down syndrome Abstract 120 7 Introduction 121 Method 142 Results 153 Discussion 172 Conclusion 190 Chapter Four: Maternal and infant characteristics and individual 192 differences in Down syndrome and typical development Abstract 192 Introduction 193 Method 211 Results 218 Discussion 229 Chapter Five: General Discussion 241 References 267 Appendix A 278 Peekaboo draft coding scheme 8 Chapter One: Introduction In this thesis I examine the socioemotional functioning of 4-month-old infants with Down syndrome and compare this to typically developing infants. I focus on the role that positive emotion plays in very young infant development, drawing on the emerging understanding of the importance of positive emotion, not only with regard to personal wellbeing (Carver & Gaines, 1987; Seligman & Csikszentmihalyi, 2000; Fredrickson, 1998; 2001; 2003; Huppert, Bayliss & Keverne, 2005), but also in how increased positive emotionality may relate to infants reaching better developmental outcomes ( e.g. Fredrickson, 2003; Nadel & Muir, 2005; Baker, Blacher & Olsson, 2005). The thesis is novel in its approach as it incorporates theories of the adaptive role of positive emotion with early infancy research. I discuss how positive emotion may, even in the early months, be shaping and optimising how young infants, both with and without Down syndrome, interact and thrive within their environment. I study Down syndrome firstly for the clear benefits to contributing to research that may improve the developmental outcomes of those with Down syndrome. I also study Down syndrome due to my interest in socioemotional functioning, and how the development of this can be influenced through the developmental process. Down syndrome is almost always diagnosed at birth (Cicchetti & Beeghly, 1990). The developmental implications of the disorder can therefore be studied in the neonate and onwards. For the infancy and emotions researcher, the benefit of analysing potential atypical patterns of emotional development before cognition, language and motor delay interact too greatly is important to understand the flexibility and complexities of the early socioemotional system (see Cicchetti & Beeghly, 1990; Carvajel &
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