Trajectories of Cognitive Stimulation Among Young Low-Income Mothers of Infants and Toddlers

Background/Purpose: Evidence shows that stimulating, language-rich interactions between parents and young children promote child cognitive and language development. Mothers struggling with the many challenges associated with poverty typically engage their young children in less stimulating interactions than do more advantaged mothers. Although maternal stimulation and its associations with demographic/contextual factors and child developmental outcomes have been examined extensively, stimulation is often treated as a static mother characteristic rather than one that may change over time. This study uses person-oriented group-based trajectory analysis to examine trajectories of maternal stimulation from infancy to toddlerhood, and maternal/infant characteristics associated with these trajectories.

Methods: Data were drawn from a sample of 271 young (M=18.4yrs), low-income mothers (49.5% African American, 40.5% Latina, 10.0% White/other) who completed interviews and video-recorded interactions with their young children at 3-weeks, 3-months, 13-months, and 30-months postpartum. Maternal stimulation (e.g. labeling and describing objects, playing social games, encouraging exploration, verbal exchanges) was rated by trained, blinded coders on 4-point scales at each wave. Group-based trajectory analysis with censored normal distribution was used to identify trajectories of stimulation over time. Models with two to five trajectories were estimated. Conceptual interpretability and larger Bayesian Information Criterion (BIC) were considered in deciding the number of trajectories. Associations between stimulation trajectories and baseline maternal characteristics such as age, race/ethnicity, education, depressive symptoms, intervention status and infant sex were evaluated in a weighted multinomial logistic regression. Associations between trajectories and postpartum maternal depressive symptoms and beliefs/knowledge of infant development were explored using t-tests and chi-square tests.

Results: A three-trajectory solution was chosen. One trajectory remained moderately low over time (low-moderate; 63.1%), a second trajectory started with a similarly low level at 3-weeks but increased sharply through 13-months and then remained highest (sharp-increase; 15.1%). A third trajectory began high and steadily decreased through 30-months (high-decreasing; 21.8%). Latina mothers were more likely to be classified in the sharp-increase trajectory relative to the high-decreasing trajectory, when compared to African American or White/other mothers. Mothers with a high school diploma/GED were more likely to be in the sharp-increase trajectory relative to the low-moderate trajectory. Mothers of boys were more likely to be in the low-moderate trajectory. Analyses of postpartum variables showed that mothers in the sharp-increase trajectory believed that their newborns had fewer cognitive capabilities than mothers in the high-decreasing trajectory at 3-weeks, but they had higher scores on knowledge of infant development at 13-months compared to mothers in the low-moderate trajectory.

Conclusions/Implications: This study empirically demonstrates that maternal stimulation in infancy/toddlerhood is a changing and heterogeneous process that is partly shaped by culture, infant sex, maternal education, and understanding of child development. It is important for social workers to consider family cultural values, practices and mother beliefs about infant capabilities when designing and implementing interventions aimed to promote positive parenting. Additional research should examine associations between these stimulation trajectories and later child development, and qualitative studies should further explore the mechanisms in which mother beliefs about parenting shape maternal stimulation and infant development.