Mother-Preterm Infant Contingent Interactions During Supported Infant-Directed Singing in the NICU-A Feasibility Study.

Background: Supported infant-directed singing (IDS) for parents and their preterm infants has proven beneficial for parents and preterm infants' health and relationship building. Studying parent-infant contingent interactions through behavioral observations is an established method for assessing the quality of interactions. Very few studies have measured contingency between parent and preterm infants in the neonatal period during supported IDS.

Methods: We conducted a feasibility study to assess the possibility of analyzing parent-very preterm infant dyads' contingency during supported IDS in the NICU. We recruited four mother-infant dyads and video-recorded a single music therapy (MT) session before their discharge from the hospital. Two independent researchers coded three selected segments (beginning, middle, and end) from each video, according to adapted behavioral scales with inter-rater agreement analysis. Contingency between infant and maternal behaviors was analyzed.

Results: Twelve video segments were coded. High inter-rater agreements (Cohen's kappa) were found for infant eye-opening (0.93), hand positions (0.79), and head orientation (0.94), as well as maternal head orientation (0.95) and vocalizations (0.95). During supported IDS, increased infant head orientation toward the mother, eyes closed, as well as maternal head orientation toward the infant (all p < 0.001), were recorded compared to no IDS. Direction of the maternal head toward her infant was contingent on the infant's closed eyes, extended hands, and head not toward mother.

Conclusions: This feasibility study demonstrates contingency between mothers and their preterm infants' specific behaviors during IDS. These interactions can be analyzed through video segments with high inter-rater agreement. The method described might help in evaluating other modalities that might be related to contingency. Recent advances in AI can make this tool easier to accomplish, with further studies to evaluate the importance of contingency for child development. The findings suggest that supported IDS influences infant attention and regulation.