Infant Mental Health

Our research has a strong focus on clinical and translational outcomes in paediatric social work and infant mental health.

We focus on understanding the relationship between early life stress because of serious illness and hospital experience or significant family stress and social disadvantage and the health and mental health of infants and young children and their families.

Our projects

Changing the Trajectories of Australia's Most Vulnerable Children - The Early Years Education Program Randomised Controlled Trial

• The University of Melbourne - Changing the Trajectories of Australia's Most Vulnerable Children- The Early Years Education Program Randomised Controlled Trial

Infant and Family Wellbeing after Cardiac Surgery: Life as a Pre-schooler

The aim of this project is to investigate the developmental trajectory and predictors of emotional and behavioural regulation in children who had cardiac surgery early in life. This is a longitudinal, prospective cohort study of a group of pre-schoolers with congenital heart disease (CHD), who had cardiac surgery in the first six months of life. It is examining the relationship between data on markers of early infant distress and co-regulatory support collected when the children were infants. This included:

• Six weeks after discharge from cardiac surgery (time 1) and,
• Emotional and behavioural regulation at pre-school age, 3-4 years old (time 2).

Data being collected includes the use of standardised, clinician-rated observational measures, parent-report measures and a biomarker of stress regulation. This study will also examine if the quality of the parent-child relationship moderates the observed outcomes in pre-schoolers' emotional and behavioural regulation, particularly stress.

Researchers: Tamera Clancy PhD Student, Associate Professor Brigid Jordan, Dr Frank Muscara and Professor Carolina de Weerth (Radboud University Medical Centre, Nijmegen, The Netherlands).

Stress Reactivity in Pre-schoolers with Congenital Heart Disease

This study compared cortisol regulation and reactivity in 3-5-year-old outpatients with congenital heart disease (CHD) who did and did not have cardiac surgery prior to 6 months of age. Children with congenital heart disease (CHD) have poorer neurodevelopmental and psychological outcomes. The mechanisms underlying this remain unclear. One mechanism could be that the stressful experience of cardiac surgery early in life influences long-term hypothalamic–pituitary–adrenal (HPA) axis regulation. Dysregulation of the HPA axis has been linked to poorer neurocognitive and psychological outcomes in other study populations.

This case-control study compared HPA-axis regulation (circadian rhythm)  and reactivity using salivary cortisol. The early surgery group had a flatter diurnal slope secondary to lower mean weekend morning waking cortisol levels than the controls (the children with CHD who did not have surgery in the first 6 months of life). The early surgery group also had an increased stress response to an echocardiogram than the controls.

This is the first study to show that cardiac surgery prior to 6 months of age is associated with a different pattern of HPA-axis regulation at 3-5 years of age.

Researchers: Dr Monical McGauran, A/Prof. Brigid Jordan, Dr Candice Franich Ray, Dr Michael Cheung, Irma Janssen, and Professor Carolina de Weerth and Dr Roseriet Beijers, Radboud University Medical Centre, Nijmegen, The Netherlands.

The development of feeding in infants with oesophageal atresia between birth and nine months of age

Feeding problems have been widely reported in babies with oesophageal atresia (OA) and are usually described in terms of growth or oesophageal functioning. The feeding problems may persist into adulthood. This longitudinal, prospective, mixed-methods study explored the nature of feeding development from a wider perspective, comprising biomedical, psychological and interactional factors relevant during the development of feeding in babies with OA. The study found that although babies fed well, their weight gain was markedly lower than expected in their first nine months. Overall, mothers were sensitive caregivers and babies were responsive interactive partners.  There was an association between the mother’s early stress levels and the baby’s feeding outcomes.

Researchers: Dr Libby Ferguson, PhD, A/Prof. Brigid Jordan, Professor Rod Hunt.

Psychosocial determinants of health in infants & preschool children with CF diagnosed via newborn screening

Cystic fibrosis (CF) is a severe, life-shortening, inherited condition, which imposes a heavy burden of daily treatment, intractable health decline and early mortality on patients and families. The psychosocial morbidity associated with CF across the lifespan is significant. Our cross-sectional study examined the relationships between socio-emotional and mental health in preschool children with CF and clinical outcomes in early life. 

The aims of the study are to:

1. document the mental health of children less than 6 years of age with CF, including markers of increased stress and/or trauma related to CF medical care and,
2. investigate whether a relationship exists between mental health, medical-related stress, and CF health parameters (pulmonary inflammation, infection, structural lung disease, weight, height and Body Mass Index (BMI) in early childhood.  

The study also examines the validity of a five-question screening tool designed by the project lead to screen for CF medical care related to stress/trauma responses. This study is a collaboration with ARREST CF and Princess Margaret Hospital Perth. MCRI researchers A/Prof. B Jordan, Dr Jane Sheehan, Dr Frank Muscara, Dr John Massie, and Ms Ashley Depasquale.

Reflecting on Babies in NICU Study–maternal reflective capacity and infant wellbeing

This is a prospective cohort study investigating the psychosocial profiles of infants and their families admitted to a quaternary neonatal unit, and the role of parental reflective functioning on the infant, parent and parent-infant relationship outcomes. These profiles will be analysed to determine whether there are distinct risk factors or patterns that can be identified which are indicative of emerging psychosocial difficulties arising for any of the infant, the parent, or the parent-infant relationship, with a view to offering a targeted infant mental health assessment and early intervention to treat or circumvent emerging difficulties.

Researchers: Dr Megan Chapman, Dr Julia Gun, A/Prof. Campbell Paul

Featured publications

• Family appraisal of paediatric acquired brain injury: A social work clinical intervention trial.
  Developmental Neurorehabilitation, 2018,1-8. Hickey, L., Anderson, V., Hearps, S., & Jordan, B.  
  
  
• Family forward: A social work clinical trial promoting family adaptation following paediatric acquired brain injury.
  Brain Injury, 201832(7). Hickey, L., Anderson, V., Hearps, S., & Jordan, B.
  
  
• The first twelve months in the Early Years Education Program: An initial assessment of the impact on children and their primary caregivers.
  Changing the Trajectories of Australia's Most Vulnerable Children, Report No. 2 (March 2018). Tseng, Y.P., Jordan, B., Borland, J., Coombs, N., Cotter, K., Hill, A., & Kennedy, A.
  
  
• Long-term alternation of the hypothalamic-pituitary-adrenal axis in children undergoing cardiac surgery in the first 6 months of life.
  The International Journal on the Biology of Stress, 2017,20(5), 505-512. McGauran, M., Jordan, B., Beijers, R., Janssen, I., Franich-Ray, C., de Weerth, C., & Cheung, M.
  
  
• Participants in the Trail of the Early Years Education Program, Changing the Trajectories of Australia’s Most Vulnerable Children
  Report  No. 1. Australian Institute of Applied Economic and Social Research, University of Melbourne, June 2017. Tseng, Y., Jordan, B., Borland, J., Clancy, T., Coombs, N,. Cotter, K., Hill, A., & Kennedy, A.