Knowledge and Skills Framework: Relationship/attunement
Early intervention providers must know the processes which facilitate the development of parent-infant attunement and relationship.
This page summarises the knowledge base for early intervention providers to support the development of the parent-infant relationship.
Knowledge required
1. Early intervention providers should understand the developing parent-infant relationship and specifically
- the roles played by parents (and family members) and their importance in the early social-emotional development of the infant
- the development of parent-infant attunement (and ultimately attachment) as an ongoing shared process between parents and infant
- the development of responsive and synchronous interactions between parents and infants, including their importance in relation to later developmental outcomes
- the development of communication through the late gestation/early postnatal period and how this is impacted by the neonatal environment
- the influence of neonatal hospitalisation on the establishment of the parent-infant relationship
- the importance for parents to learn to accurately observe, interpret, and respond to their infant’s unique cues
- the importance of parents supporting the development of their infant’s communication skills during the first 12 months
2. Early intervention providers should recognise the potential strengths and vulnerabilities in the family system, in particular
- the family structure, including occupational roles, cultural identification, beliefs, values, and practices
- sources and allocation of family resources (e.g., time, money, energy, social–emotional support)
- the process of family adaptation: adjustment to adding a new family member, adjustment to stressful situations
- needs, culture, and roles of family members, including siblings (Vergara, 2006)
- the impact of parent experience on their developing relationship with their infant. These may include but are not limited to internal working models of parenting, available social-emotional support networks, and specific vulnerabilities (e.g. domestic violence, substance misuse, parent mental/physical well-being)
3. Early intervention providers should understand adult learning styles to recognise
- individual differences in learning
- relationship between emotional state and learning capacities
- changes in parental focus during hospitalisation, and early intervention provision (Vergara, 2006)
Skills required
Early intervention providers working with families of high-risk infants should be able to
- use appropriate clinical tools/approaches to support family members to observe and interpret their infant’s behaviours (e.g. Newborn Behavioural Observations, Video Interactive Guidance).
- illuminate the infant’s capabilities and efforts to interact with and form a relationship with their primary caregivers
- validate the skills and intuition of parents in reading their infant’s communicative efforts and contingent responses
- identify appropriate caregiving strategies that continue to support the developing parent-infant relationship while acknowledging an infant’s vulnerabilities in the sensory, motor or regulation domain
- foster successful parent–infant interactions via mutual problem solving, anticipatory guidance, and modelling of responsive behaviours
- provide appropriate education to parents (both informational and experiential) that supports their development of sensitive, contingent caregiving behaviours and promotes the parent-infant relationship
- support parents to modify the infant’s environment as necessary to support parent-infant interaction and maximise opportunities for development of early communication
- identify and support the hopes, expectations, beliefs, priorities, knowledge and strengths of each family to promote the delivery of a family-centred approach
- adapt intervention approaches as necessary in accordance with changing emotions, needs, and resources that may be influenced by the infant’s developmental progress or other circumstances
References
Vergara, E. (2006). Specialized Knowledge and Skills for Occupational Therapy Practice in the Neonatal Intensive Care Unit. American Journal of Occupational Therapy, 60(6), pp.659-668.