Association of maternal scaffolding to maternal education and cognition in toddlers born preterm and full term

Abstract

Aim: Parental behaviour described as 'scaffolding' has been shown to influence outcomes in at-risk children. The purpose of this study was to compare maternal verbal scaffolding in toddlers born preterm and full term.

Methods: The scaffolding behaviour of mothers of toddlers born preterm and healthy full term was compared during a 5-min videotaped free play session with standardized toys. We compared two types of scaffolding and their associations with socio-demographic, neonatal medical factors and cognition.

Results: The mothers of toddlers born full term used more complex scaffolding. Maternal education was associated with complex scaffolding scores for the preterm children only. Specifically, the preterm children who were sicker in the neonatal period, and whose mothers had higher education, used more complex scaffolding. In addition, children born preterm, who had less days of ventilation, had higher cognitive scores when their mothers used more complex scaffolding. Similarly, cognitive and scaffolding scores were higher for children born full term.

Conclusion: Our findings highlight early differences in mother-child interactive styles of toddlers born preterm compared with full term. Teaching parents play methods that support early problem-solving skills may support a child's method of exploration and simultaneously their language development.

Figure 1

Plot of complex scaffolding vs. maternal education level conditional on ventilation days for preterm children. Panel A shows those children with low number of days on ventilation did not have an association between maternal education and complex scaffolding score. Panel B shows those children with high number of days on ventilation had a significant association between maternal education and complex scaffolding score (p=0.02). The lines in the panels are simple least squares fits to the data. Due to numerous tied values points were ‘jittered’ by adding a small amount of random noise to see the actual numbers of points; p values and summary scores were all calculated on original data.

Figure 2

Plot of combined scaffolding vs. cognitive score conditional on ventilation days for preterm children. Panel A shows those children with low number of days on ventilation had a significant association (as measured by Spearman correlation) between cognitive score and combined scaffolding score (p=0.04). Panel B shows those children with high number of days on ventilation had no association between cognitive score and combined scaffolding score. The lines in the panels are simple least squares fits to the data. Due to numerous tied values points were ‘jittered’ by adding a small amount of random noise to see the actual numbers of points; p values and summary scores were all calculated on original data.