THE ROLE OF THE MOTHER-CHILD RELATIONSHIP IN DEVELOPMENTAL OUTCOMES OF INFANTS AND YOUNG CHILDREN WITH AND WITHOUT PRENATAL ALCOHOL EXPOSURE

Background Prenatal alcohol exposure has been associated with deficits in many developmental areas. Effects on developmental outcomes can be exacerbated by cumulative risk across the pre-and postnatal environments. Given that the parent-infant relationship provides the primary context for healthy child development, it is possible that maternal caregiving may play a substantial role in mitigating these effects. Objectives To clarify the role of the quality of the mother-child relationship in the relation between cumulative risk and neurodevelopmental outcomes. Methods Participants were 40 infants/children and their mothers with substance-use problems who were taking part in an early mental health intervention program. Cumulative risk, across the pre-and postnatal period was measured, and quality of the mother-child relationship was rated based on clinical file reviews and observation of mother-child interactions. Outcome measures were infant/child IQ, and neurobehavioral functioning rated across several developmental domains. Results The quality of the mother-child relationship mediated the direct relation between cumulative risk and neurobehavioral functioning, and cumulative risk was related with IQ indirectly through the mother-child relationship. Conclusions These findings indicate an important role for quality of the mother-child relationship in determining outcomes for infants and young children of substance-using women, and emphasize the need to consider both the larger context of risk, as well as the mother-child relationship for best intervention outcomes.