title: Influence of early regulatory problems in infants on their development at 12 months: a longitudinal study in a high-risk sample.
abstract: BACKGROUND
  This study examined the extent to which regulatory problems in infants at 4 and 6 months influence childhood development at 12 months. The second aim of the study was to examine the influence maternal distress has on 4-month-old children's subsequent development as well as gender differences with regard to regulatory problems and development.
  
  
  METHODS
  153 mother-child dyads enrolled in the family support research project "Nobody slips through the net" constituted the comparison group. These families faced psychosocial risks (e.g. poverty, excessive demands on the mother, and mental health disorders of the mother, measured with the risk screening instrument Heidelberger Belastungsskala - HBS) and maternal stress, determined with the Parental Stress Index (PSI-SF). The children's developmental levels and possible early regulatory problems were evaluated by means of the Ages and Stages Questionnaires (ASQ) and a German questionnaire assessing problems of excessive crying along with sleeping and feeding difficulties (SFS).
  
  
  RESULTS
  A statistically significant but only low, inverse association between excessive crying, whining and sleep problems at 4 and 6 months and the social development of one-year-olds (accounting for 5% and 8% of the variance respectively) was found. Feeding problems had no effect on development. Although regulatory problems in infants were accompanied by increased maternal stress level, these did not serve as a predictor of the child's social development at 12 months. One-year-old girls reached a higher level of development in social and fine motor skills. No gender differences were found with regard to regulatory problems, nor any moderating effect of gender on the relation between regulatory problems and level of development.
  
  
  CONCLUSIONS
  Our results reinforce existing knowledge pertaining to the transactional association between regulatory problems in infants, maternal distress and dysfunctionality of mother-child interactions. They also provide evidence of a slight but distinct negative influence of crying and sleeping problems on children's subsequent social development. Easily accessible support services provided by family health visitors (particularly to the so-called "at-risk families") are strongly recommended to help prevent the broadening of children's early regulatory problems into other areas of behavior.
authors.affiliation: University Clinic Heidelberg, Institute for Psychosomatic Cooperation Research and Family Therapy, Bergheimerstr, 54, 69115 Heidelberg, Germany. anna.sidor@med.uni-heidelberg.de.
authors.forename: Anna
authors.initials: A
authors.lastname: Sidor
authors.forename: Cristina
authors.initials: C
authors.lastname: Fischer
authors.forename: Andreas
authors.initials: A
authors.lastname: Eickhorst
authors.forename: Manfred
authors.initials: M
authors.lastname: Cierpka