Maternal play behaviors, child negativity, and preterm or low birthweight toddlers’ visual–spatial outcomes: Testing a differential susceptibility hypothesis

ObjectiveWe examined the joint roles of child negative emotionality and parenting in the visual–spatial development of toddlers born preterm or with low birthweights (PTLBW).MethodNeonatal risk data were collected at hospital discharge, observer- and parent-rated child negative emotionality was assessed at 9-months postterm, and mother-initiated task changes and flexibility during play were observed during a dyadic play interaction at 16-months postterm. Abbreviated IQ scores, and verbal/nonverbal and visual–spatial processing data were collected at 24-months postterm.ResultsHierarchical regression analyses did not support our hypothesis that the visual–spatial processing of PTLBW toddlers with higher negative emotionality would be differentially susceptible to parenting behaviors during play. Instead, observer-rated distress and a negativity composite score were associated with less optimal visual–spatial processing when mothers were more flexible during the 16-month play interaction. Mother-initiated task changes did not interact with any of the negative emotionality variables to predict any of the 24-month neurocognitive outcomes, nor did maternal flexibility interact with mother-rated difficult temperament to predict the visual–spatial processing outcomes.

► We examined child negativity, maternal play and PTLBW toddlers’ VSP.
► Flexible play positively related to verbal VSP when child negativity was high.
► Flexible play negatively related to nonverbal VSP when child negativity was low.
► Differential susceptibility in PTLBW toddlers may be limited to development of behavior problems.