Location: Children's Nutrition Research Center2017 Annual Report
1a. Objectives (from AD-416):
Objective 1: Collect descriptive data on behaviors used to assess infant temperament at 4-months of age. This will be used to assess the variance in these behaviors at this age. Objective 2: Assess correlations between infant temperament based on direct observation using two protocols measured at 4-months and 6-months of age. Objective 3: Assess correlations between infant temperament based on direct observation using two protocols in each of two settings (laboratory and daycare).
1b. Approach (from AD-416):
Approximately three-quarters of pediatric overweight and obesity cases exhibit overweight and obesity between the ages of 2 to 5 years, indicating that obesity prevention efforts may need to begin in infancy. Infancy offers the earliest point for risk stratification and prediction, meaning that we are more likely to be able to implement interventions that prevent obesity in children, rather than treat an existing condition. To understand the role infant temperament plays in adiposity, good measures of infant temperament are needed. We will develop an efficient and objective measure of infant temperament.
3. Progress Report:
We have devised complete protocols for two measures of infant temperament, based on direct observations, which can be delivered to infants (four months and older) and be assessed in the home and in the laboratory. For the first protocol, we have adapted four episodes from the Laboratory Temperament Assessment Battery (Lab-TAB) measure of infant temperament which is designed for infants six months and up, but is most suitable for infants over eight months. Based on advice from one of the creators of Lab-TAB we initially piloted the Lab-TAB as specified on three four-month old infants. Subsequently, we made several adaptations to the Lab-TAB protocol to accommodate the lower physical capabilities of four-month olds, as compared to six-to-eight-month olds. For example, instead of videoing the child playing with blocks while lying on their stomach (which requires the infant to hold their head off the floor for extended periods), we now video the child lying on their back playing in a jungle gym (which does not require the infant to lift their head). Similarly, instead of using a high chair for the child to sit in and watch a slide show, we now use a car seat. The full four episodes are: 1. Peek-a-boo: We made a large black board with "doors". The infant faces these doors, and a member of the study staff opens a door to reveals the mother – who says "peek-a-boo". This is completed four times, but on the fourth door opening the mother is missing. We observe the infant’s reaction. 2. Puppets: One member of study staff use hand puppets to "talk" to and "tickle" the infant. The infant’s reactions are observed. 3. Jungle Gym: The infant is recorded lying on their back in a commercially available Jungle Gym. 4. Slides: The infant sits in a car seat, surrounded by curtains which form a screen. The infant has an iPad in front of them, which sows a selection of pictures: each picture is on the screen for a progressively longer amount of time. In the second protocol we deliver an observation for three-to-twelve month olds, but we have shortened it to allow infants to complete other measures during their study visit (such as the adapted Lab-TAB protocol outlined above). For this protocol, the infant is observed while being shown four stimuli sequentially: rattle, checkerboard, bell, and ball. The infant is given the ball to play with, and the infant's reactions when the ball is taken away are observed. Five members of our staff have been trained to deliver both these protocols, and have collected data on 26 infants. Coding sheets and operations manuals have been written for both measures of infant temperament. For two out of the four Lab-TAB episodes, our staff have counted all behaviors which form part of the assessment, and the data on these has been entered into an electronic database. For these two episodes the Principle Investigator (who is trained as a biostatistician and in psychometrics) has started to conduct initial assessments of how accurately the individual members of staff rate each behavior assessed by the two episodes. Scripts have been generated to automate the analysis for when the full data are collected. In the next phase of the study we will complete data collection (to reach a total of 30 infants), and complete analyses which allow us to include in the final assessment protocol only those behaviors which can be reliably assessed (or counted) by the staff members. This will ultimately allow us to measure infant temperament in an accurate way for the first time in four-month olds, and so enable an assessment of the extent to which infant temperament associated with adiposity at this young age.