Exploring associations between maternal smartphone use and mother-infant synchrony from a dynamic systems perspective

Abstract

Dyadic behavioural synchrony is one of a number of complex bidirectional processes that take place within interactions between a mother and her infant. In the first year of life, when an infant is still prelinguistic, processes such as dyadic synchrony are used to enable the dyad to communicate with each other through shared behaviour and affect, including mutual gaze and touch, facial affect, and vocal intonations. Dyadic synchrony has been observed to emerge in infants as young as 3 months old, typically developing further between 3–9 months old. Dyadic synchrony is a bidirectional process, requiring reciprocal communication from both partners. As such, breakdowns in synchrony, from either infant or mother, can have implications for the development of a positive relationship.

Such breakdowns have been suggested to occur when mothers habitually use their smartphones in the presence of their child. Studies have found that mothers with children aged 0–5 years old who frequently use their phones, may demonstrate less maternal sensitivity and are less likely to respond to their child’s bids for attention than mothers who use their phones less often. This phenomenon of unresponsiveness to proximal relationships has been termed ‘technoference’ a concept describing interruptions to everyday interactions due to the use of digital technology. Crucially, while some recent quantitative research has shown that caregiver smartphone use may have an impact on both infants’ cognitive and social-emotional development, very little evidence is currently available regarding the impacts of parental smartphone use on infants under 12 months old.

This thesis explores the impacts of maternal smartphone use on mother-infant dyadic synchrony when the infant is aged between 3–9 months old. Specifically, the objectives of this thesis are to i) synthesise known risk and protective factors that may influence dyadic synchrony in this age range; ii) evaluate the potential additional risk posed by maternal smartphone use on mother-infant interaction processes; and iii) explore the impact maternal smartphone use has on dyadic synchrony within the mother-infant dyad. To fulfil the thesis objectives, three studies were undertaken.

The first study was a systematic review synthesising risk and protective factors for dyadic synchrony in mother-infant dyads where the infant was aged between 3–9 months old. In total, 28 studies were included in the review. Systematic evaluation highlighted four main areas of influence on dyadic synchrony: i) infant demographics; ii) physiological factors; iii) maternal mental health; and iv) miscellaneous factors such as the immigrant experience, maternal playful singing, and the mother’s perception of being parented herself. Results suggest that social determinants of health, underpinned by biological factors, are likely to influence the development of dyadic behavioural synchrony in mothers and their infants aged 3–9 months old.

The second study explored associations between risk and protective factors for dyadic synchrony in mothers and their infants aged 3–9 months old, as well as the addition of maternal smartphone use as a potential additional risk factor. A cross-sectional survey design was employed, recruiting 450 mothers from across the UK. As dyadic synchrony is a complex behavioural process and difficult to capture through static self-report measures, an outcome variable of mother-infant responsiveness was used to proxy behavioural synchrony within the dyad. Data from this cross-sectional survey was used in two forms of analysis, as outlined below.

Analysis 1 employed hierarchical multiple linear regression to explore the interactions between predictor and outcome variables. The results of this analysis suggested that the likelihood of the mother using her smartphone in the presence of her infant was negatively associated with mother-infant responsiveness. This association, however, was observed only in specific parenting domains, specifically during daily hygiene practices such as getting the baby ready for the day, bathtime, or nappy changes. Due to the cross-sectional nature of the study, no directionality can be assumed, however a relationship between lower mother-infant responsiveness and likelihood of using a smartphone during sensitive parenting practices suggests that maternal support, including education focusing on navigating infant care and smartphone use is needed in the perinatal stage.

Analysis 2 used a person-centered cluster analysis to explore the psychological risk profiles of mother-infant dyads to further understand their support needs. The results of this analysis identified three clusters of mothers with unique psychological profiles.

Cluster 1 comprised mothers who self-reported high infant social emotional development concerns, high likelihood of maternal smartphone use, and low mother-infant responsiveness. Cluster 2 comprised mothers who self-reported high maternal depressive, anxiety, and stress symptoms, low social support, high likelihood of maternal smartphone use, and low mother-infant responsiveness. Importantly, no significant differences were found in the self-reports of mothers in Cluster 1 and 2 in their levels of perceived mother-infant responsiveness, nor in their likelihood of using their device in the presence of their infant. Cluster 3 represented almost 50% of the sample and displayed a low risk profile, with mothers self-reporting high levels of mother-infant responsiveness, low likelihood of smartphone use, high maternal wellbeing and social support, low depressive, anxiety, and stress symptoms, and low levels of perceived infant social emotional difficulties. Cluster 1 and 2 both reported significantly higher smartphone use and significantly lower mother-infant responsiveness than the low-risk Cluster 3. As the risk profiles of Clusters 1 and 2 were uniquely different, this suggests that both perceived infant social emotional developmental issues (as seen in Cluster 1) as well as poor maternal mental health (as seen in Cluster 2), are associated with a higher likelihood of smartphone use, as well as lower mother-infant responsiveness. These results, taken as a whole, suggest that mother-infant dyads whose risk profiles contain either maternal or infant mental health difficulties are at heightened risk for problematic smartphone use and support should be tailored to individual dyads’ mental health needs.

The final study of this thesis utilised a modified experimental paradigm called the Still-Face Paradigm (SFP) to explore how maternal smartphone use may impact mother-infant dyadic synchrony in infants aged between 3–6 months old. Experimental conditions during the modified still face (SF) phases comprised of the mother using the smartphone for both i) audio call and ii) text conversation, while not interacting with her infant. Both mother and infant’s affective behaviours were coded in the initial free play (FP) phase as well as reunion (RU) phases following the period of smartphone use. A dynamic systems approach to measurement was employed to capture both mother and infant’s behaviour, as well as the behaviour of the dyad as a single system. Two outcome variables were reported comprising i) flexibility and ii) synchronous negative affect. The results of this study suggest that flexibility within the dyad was significantly higher in RU phases compared to the FP phase, indicating that the mother and infant recognised the interruption caused by the smartphone use as a stressful event and therefore needed to employ a wider range of behavioural strategies to co-regulate their proceeding interaction. In terms of synchronous negative affect, a significant difference was observed between all three conditions, with both RU phases reporting higher synchronous negative affect than the FP phase, and further RU after texting reporting higher synchronous negative affect than RU after audio call. These results suggest that both mother and infant were significantly more likely to employ negative behavioural affective strategies simultaneously after an interruption of smartphone use, with even more instances of synchronous negative affect after the mother used the phone to text compared to taking an audio phone call. Such synchronous negative affect may be the result of the mother using co-regulation strategies to join the baby in their distress, validating their response to the stressful event. It may also signify that after texting, co-regulation becomes more difficult, with mothers potentially finding it harder to join the baby and becoming emotionally overstimulated themselves by the increase in negative affect within the dyad.

Across the thesis’ studies, social determinants of health, coupled with biological factors, were identified as risk factors for both development of dyadic synchrony as well as for heightened problematic smartphone use. Further, the modality of maternal smartphone use may have implications for the development of interactions within the dyad. The key findings in this study point to the need for increased education support, at a population level, and during the perinatal period to enhance mothers’ understanding of smartphone use as a potential risk to the developing relationship with their infant. Future research should be directed towards more naturalistic empirical studies, capturing how and why mothers use their phones in their daily life. Further, longitudinal studies should be employed to understand the long-term influences that maternal smartphone use may have on the development of relational processes between mother and infant. In addition to widened quantitative studies, qualitative research working in partnership with mothers should be carried out to understand the education and support needs of mothers with young infants in this age range.