Book sharing in the preterm mother-infant dyad


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Book sharing in the preterm mother-infant dyad a descriptive analysis of the social dynamics
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ix, 159 leaves : ; 29 cm.
Aaron, Patricia M
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Instruction and Curriculum thesis, Ph. D   ( lcsh )
Dissertations, Academic -- Instruction and Curriculum -- UF   ( lcsh )
bibliography   ( marcgt )
non-fiction   ( marcgt )


Thesis (Ph. D.)--University of Florida, 1996.
Includes bibliographical references (leaves 147-158).
Statement of Responsibility:
by Patricia M. Aaron.
General Note:
General Note:

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University of Florida
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oclc - 36774285
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Copyright 1996


Patncia Montgomery Aaron

To my family

(in memory of) Daddy, whose loving spirit embraces us,
Patrick, Arnold, and Ernie.


A number of people have contributed to the successful completion of this

research. I would like to express my gratitude to them for their guidance and


First, I would like to acknowledge the members of my committee. I offer my

deepest appreciation to my chairperson, Dr. Linda Leonard Lamme, for sharing

her knowledge and encouraging me to extend my thinking; her emotional

support and guiding hand will forever be cherished. I am grateful to Dr. Patricia

Ashton for the generous time devoted to editing and for her insightful

suggestions; her kindness will not be forgotten. I appreciate Dr. Kristen

Kemple's suggestions and her dedication to assist me during her summer

vacation. I would like to thank Dr. Vivian Correa for serving on my committee

during a very demanding year, and I extend my appreciation to Dr. Lynn Hartle

for her assistance in the completion of this project.

I am indebted to my friend and mentor, Dr Athol Packer, Professor

Emeritus, who helped me to identify the study and to begin this project. I would

like to thank Dr. Michael Resnick and Dr. Jeff Roth for their assistance.

Finally, thanks to my friends: Mark Freeman for his faithful prayers and for

helping me to understand my computer; "Baby" for ears that always listened to

me and for removing obstacles; Ruth Brice for her shoulders to lean on; Cheryl

Danley, Georgia Reid, Kaye Underwood, Jackie Cummings, and Valda

Montgomery for cheering me on I owe a very special thanks to Aaron Green

whose encouragement and support during times of struggle helped me to




ABSTRACT ..... .

. v

S. v iii



Background to the Study .. .... ...
Purpose of the Study ......... .......
Statement of the Problem ... ...
Assumptions and Questions Guiding the Inquiry ....
Design of the Study .... ... ......
The Significance of the Study ...
Definition of Terms .. .. ..
Limitations of the Study .........


Introd auction ................. .. ...
Interaction Patterns of Preterm Mother-Infant Dyads ....
Postpartum Separation and Mother-Infant Attachment
The Effects of Infant Temperament on Rhythm and
Reciprocity in Mother-Infant Interactions .. ......
S um m ary ....... ......... .....
Joint Book Reading in the Mother-Infant Dyad .. .....
Visual Behaviors ......
Tactile Behaviors .. .
Verbal Behaviors .
Affective Behaviors .............. .
Implications from the Survey of Literature ..


Introduction .. ...
Research Perspective ............
The Research Model .........

. 11
.. 11
. 12

. 1 5
. .. 2 1
. . 24
. 3 1
. .. 32
. 32
. .. 32
... 34

........ 37

Description of the Research Site ....... ... 40
Mother-Infant Dyads: Selection Criteria ... 41
The Study Participants .......... ........ 43
Gaining Entry to the Site ........... .. 43
Description of the Book Sharing Setting .... ........ 43
Data Collection ... ..... .... .............. 45
Researcher as Principal Instrument for Observation .. 45
Videotaping: Procedures and Instructions ... ... .......... 47
Unobtrusive Measures ................... .. 47
The Researcher's Notebook ................ ........ 50
Analysis of Data .......................... ....... 50
Transcription of Data ....... ........ ... .. .. .. 51
Conclusion Drawing .................. ..... 51
Validity M measures ...... .... ......... ........ 53
Chapter Sum m ary .. .. ............. ........... 55


Introd auction ... ........ ................ ...... ... 56
The Book Sharing Format .................. ....... 56
Phase I: Organizing the Setting for Book Sharing ............ 59
Phase II: Entraining the Infant in Book Sharing ......... 65
Phase III: Closing Book Sharing .. .. ............. .. .. 88
Pathways to Lera,:) Recurrent Themes in Book Sharing .......... 96
S um m ary .............. ................... 108
Emergent Literacy Development in the Context of Book Sharing 108
Communicative Dyads .. ... .... .. .. 113
Noncommunicative Dyads .... ...... .. ... 115
Marginally-communicatives Dyads ....... ... .. .. ..... 116


Summary of the Study .......... .. ........ .. 118
Summary of the Findings ............ .. .. .. 120
Phase I......... .... ... 121
Phase II .. ... ... 122
P hase III ......... .... .. 122
Models of Books Sharing ....... .. ..... 124
C conclusions ... .... ........ ....... ..... .. .... 125
Implications for the Research and Professional Communities ..... 131
The Research Community ............... ... 131
The Professional Community ...... .......... .. 134
Summary and Integration... ........ 138


R EFERENC ES .... ..................... ... 147

BIOGRAPHICAL SKETCH ............ 159

Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy



Patricia M. Aaron

December 1996

Chairman: Dr. Linda Leonard Lamme
Major Department: Instruction and Curriculum

This study is an analysis of book sharing in a sample of 13 low-SES

mothers and their 6-month-old infants who were born prematurely and high risk

for developmental delays. The purposes were to (a) describe the experience,

(b) draw inferences about how interactions influence emergent literacy

development, and (c) provide a context from which to advise parents how to

effectively involve their baby in book sharing. The episodes were audio-

videotaped in a clinical living room play area. The analysis focused on

participants' responses to the request, "Would you please share a book with

your child?"

Findings revealed that

Book sharing was a teaching-learning event. A three-phase activity

format encompassed the mothers' efforts to introduce their babies to traditions

for interacting with a book.

Two interaction patterns emerged: Task-related exchanges gave the

appearance of sharing ideas (communicating) that referenced the book.

Nontask related exchanges gave the appearance of opposing ideas (not

communicating). Grouped by their dominant patterns, there were four

communicative, three marginally-communicative, and six noncommunicative


Communicative mothers entrained the dyad in a flow of task related

exchanges by responding to their infant's spontaneous behavior as if the child

made an appropriate gesture toward the book. Marginally communicative

mothers had difficulty synchronizing their exchanges. Due to prolonged

negotiation of their roles, the infants withdrew before the dyad could entrain in a

flow of task related exchanges. Noncommunicative mothers failed to

synchronize with their infant's behaviors; consequently, book sharing was out of


The variations in episodes indicated that the mother is primary agent of

information. However, the infant is coconstructor, in that failure to synchronize

with the baby impedes, if not completely prevents, book sharing.

These descriptive data further awareness of how book sharing contributes

to emergent language development and the acquisition of cognitive and

instrumental skills associated with interacting with a book. Findings provide a

basis for recommending models of book sharing that promote interaction styles

presumed to foster optimal teaching-learning outcomes and discouraging

interaction styles that are associated with negative outcomes.


Background to the Study

Research findings derri.-nsTraiing that reading to preschool children

positively contributed to their literacy development encouraged educators and

child development specialists to recommend that parents read to their babies

(e.g., Barton, 1986; Butler, 1980, Dinsmore, 1988; Dzama & Gilstrap, 1983;

Gardephe, 1995; Gutfeld, Sangiorgio, & Rao, 1993; Israeloff, 1995; Kupetz,

1993; Lamme, 1980; Machado, 1990; Trelease, 1982, 1989, 1995; Umansky,

1993; Wahl, 1988). According to Hurst (1996), parents can help their child

become a better reader by reading to him or her from the time of birth. Trelease

(1982) wrote, "You may start the first day home from the hospital, and certainly

you can begin by 6 months of age" (p. 30). Lamme (1980), recognizing infancy

as a time when habits originate, asserted:

If reading becomes a part of their regular, daily routine .... a
foundation has been laid for routine reading during the toddler years when
the child makes more of his/her decisions about what to do. Many basic
skills necessary for reading can be learned before the age of 1. (p. 22)

The persuasiveness of research also influenced publishers and parents.

Bolstered by reports that the '.c'unger ime age at which children

are read to is a strong predictor of their language skills (DeBaryshe, 1993),

parents are inundated by a market of books, kits, and courses on how to teach

babies to read (Zigler & Stevenson, 1993). A new market of books for infants

(Dinsmore, 1988) and "baby lit" books for infants as young as 2 months (Jordan

& Mercier, 1987) emerged, followed by lists of recommended reading (e.g.,

Books for Babes Committee, 1995; Jeffery & Mahoney,1989), and "lapsits"

designed by public librarians to help parents introduce their babies through age

24 months to appropriate literature (Jeffery & Mahoney, 1989; Salem Public

Library, 1996). Today, literature for babies is purchased by parents and

grandparents who are convinced that America's children are learning to read on

their parents' knees. However, despite professional and public enthusiasm for

recommending reading to infants, the nature of the interaction (i.e., what

transpires when parents read to babies) is largely unknown. Hence, the

usefulness of the advice, "Read to your infant," may be limited by our inability to

define the experience in terms of the social behaviors that characterize the


Teale (1984) noted that the interest in parent-child reading swelled from

studies that only indicated a link between reading aloud experiences and

children's subsequent literacy skills. For example, research demonstrated a

positive relationship between preschool children's experiences in hearing stories

read and later fluency in oral and written language (Chomsky, 1972; Irwin,1960).

Story time experiences reputedly stimulated prereaders' interest in literature

(Walker & Kuerbitz, 1979), as well as increased their desire to read for

themselves (Mason & Blanton, 1971). Most common among children who

learned to read prior to formal instruction in school (Bissex, 1980; Briggs &

Elkind, 1977; Clark, 1976; Durkin, 1966; Krippner, 1963; Plessas & Oakes, 1964;

Teale, 1978; Tobin, 1982) and children who were most successful in learning to

read in school (Durkin, 1974-75, Sutton 1964; Walker & Kuerbitz, 1979) was that

a parent or older sibling had frequently read to them during the preschool years.

In these studies, "researchers were concerned primarily with how many times a

parent and child engaged in interactions involving printed material rather than the

particulars of what happened during those interactions" (Teale, 1984, p 111).

Expressing the need for descriptive studies, Teale (1981) stated,

The detailed descriptions of story book reading events are necessary for
they provide sources of information from which we can draw conclusions
about the nature of activity which seems most felicitously to further
children's literacy development. (p. 908)

Purpose of the Study

The purpose of this study was to describe the nature of book sharing in a

sample of 13 mothers whose infants were born prematurely and sick.

Specifically, the study was designed to (a) provide a descriptive analysis of the

social interaction that characterized book sharing, (b) draw inferences about

what and how interactions between mother and baby influence the child's

emergent literacy development, and (c) provide a contextual source from which

professionals who serve the preterm infant population may advise parents on

how to effectively involve their baby in book sharing.

Statement of the Problem

In response to Teale's (1981) call for descriptions of parent-child reading,

researchers noted qualitative differences in the social organization and language

features of reading episodes (Heath, 1983; Lennox, 1995; Pellegrini, Brody, &

Siegel, 1985; Porterfield-Stewart, 1993). Such reports supported Teale's (1984)

notion that reading to children is not a routine that is common to all episodes

Furthermore, there is evidence that the child's language (Kertoy, 1994) and the

child's ability to benefit from the experience (Allison & Watson, 1994) are

influenced by the style of adult-child interactions occurring as books are read.

This evidence supports the idea that children's competence originates in different

interactive styles around the book, thereby lending credence to Teale's (1981)

assertion that descriptions of the social dynamics are necessary to further our

understanding of how the experience contributes to emergent literacy


More than a decade after Teale's (1981) admonishment, studies of parents

reading to infants (children under the age of 2 years) are scarce. The few

published reports have primarily included middle-class mothers reading to babies

who were born full term and healthy; only one study (Resnick et al., 1987) has

included babies who were born prematurely and sick. The dearth of information

specific to reading in the preterm infant-mother dyad presents a significant

problem in the sense that generalizing descriptions of book reading from full to

preterm mother-infant dyads assumes that interactions are the same across

populations; hence, findings are interchangeable. Data do not support this

assumption (Gardner & Karmel, 1983; Rocissano & Yatchmink, 1983). Rather,

literature comparing social interactions in full and preterm mother-infant dyads is

replete with evidence of "less optimal" (Friedman, Jacobs, & Werthmann, 1982)

and "disturbed" (Field, 1979) patterns among mothers and their infants who were

born prematurely and sick. Storybook reading between a mother and her infant is

considered an interactive literacy event. Therefore, the history of atypical social

patterns reported among preterm infant dyads suggests that if the advice, "Read

to your infant" is to benefit babies who were born prematurely and sick, the

practice needs to be described within this population.

Assumptions and Questions Guiding the Inquiry

The focus of the present research was on the practice of joint book reading,

referred to as book sharing hereafter, in the preterm infant-mother dyad. The

research objective was to describe the social dynamics of book sharing in a

sample of preterm infant mother dyads.

The following assumptions undergirded this study:

1. The nature of the social dynamics of book sharing is unknown in the

preterm mother-infant dyad (i.e., we do not know how mothers and their infants,

who were born prematurely and sick, transact the event).

2. Book sharing is a cultural construct, projected through the interactions of

its participants; therefore, it is capable of being understood through the

observable expressions and conduct, wherein the experience derives its


One broad question guided this inquiry process: What features

characterized the social dynamics observed in book sharing episodes of 13

mothers and their 6-month-old infants who were born prematurely and sick? Four

specific questions were addressed:

1. What behaviors did a sample of 13 mothers of preterm infants employ in

response to the request, "Would you please share a book with your child?"

2. How did a sample of 13 mothers of preterm infants format their behaviors

to carry out book sharing with their preterm infant (i.e., what structural

organization characterized book sharing)?

3. What features characterized the verbal and nonverbal expressions and

conduct employed by a sample of 13 mothers to carry out book sharing with their

preterm infant (i.e., how did the mothers mediate book sharing with their infant)?

4. What themes characterized the semantic content of the verbal and

nonverbal expressions and conduct employed by a sample of 13 mothers to carry

out book sharing with their preterm infant (i.e., what topics dominated book


Design of the Study

Qualitative research methods were selected to study book sharing in the

preterm mother-infant dyad. The research focused on verbal and nonverbal

behaviors that participants employed in response to a request to "share a book."

Qualitative methodology was selected because it is appropriate for studying

social interactions and yielding descriptive data on the questions that guided this

inquiry. Episodes of book sharing, captured on audio-videotape, were the

primary source of data. Insight into the problem being studied was gained via

analysis of the participants' behavioral expressions. Procedures used to

accomplish the descriptive analysis of book sharing in this sample of 13

mother-infant dyads were adapted from Spradley's (1980) paradigm of qualitative


The Sgnificance :if ihe Slud,

The present study contributes to the small body of research on reading to

children under the age of 2 years. This inquiry yields information toward

understanding the social dynamics of joint book reading with prelinguistic infants

who were born prematurely and sick. The effectiveness of professionals may be

limited by the lack of relevant information for advising how to effectively involve

this population of babies in book sharing. This study provides a source of

contextually based data needed to sharpen the awareness and skills of

individuals who work with preterm infants and their parents.

In view of the limited information available on joint story book reading in the

preterm population, Goldberg's (1978) remarks summarize the significance of this

investigation for parents:

There are ... countless books and articles in the popular press which
purport to give advice to parents on the rearing of full-term infants.
Statements about what to expect and look for in the development of
full-term-infants can be made with great certainty. .. Similar statements
about preterm infants must be made with more reservations and
qualifications because our data base is far more limited. Parents of preterm
infants, like parents of full-term infants, need information that can provide a
basis for forming realistic expectations for their children and themselves.
(p. 143)

Definition of Terms

The following terminology is defined as applied in the present study.

Preterm infants are babies who were born before 37 weeks completed

intrauterine fetal growth and weighing less than 2,500 grams at birth

High risk preterm infants are babies who were preterm and suffered

perinatal or postnatal complications. Generally, these infants are born earlier,

weigh less, spend more time in the hospital than healthy preterm infants, and are

considered high-risk for subsequent social, intellectual, and motor delays.

Chronological age (CA) is the infant's age calculated from the date of birth.

Adjusted gestational age (AGA) is the infant's age, calculated from date of

birth, minus the period of prematurity (e.g., an infant who is chronologically 3

months old but 4 weeks premature, will have an AGA of 2 months).

Neonatal intensive care unit (NICU) is a specialized hospital unit specifically

designed to provide a full range of health services to newborn infants in need of

intensive medical care.

Clinician refers to a professional--including school psychologist, early

childhood education and child development specialist, speech pathologist, and

physical therapist--who administers developmental evaluations and/or makes

recommendations for the management of preterm infants in neonatal follow-up.

Research site refers to the neonatal developmental follow-up unit that was

the location of the setting in which mother-infant book sharing took place.

Book sharing setting refers to the living-room/play area, within the research

site where the book sharing episodes took place.

Book sharing episode refers to the period of time beginning subsequent to

the request that a mother "share a book" with her infant. An episode ended when

the mother ceased to negotiate interactions with her infant around the book.

Momentary interruptions for caregiving did not constitute the end of an episode.

Book sharing refers to the verbal and nonverbal expressions and actions

that a mother and infant engaged subsequent to the request that a mother "share

a book" with her infant. Behaviors that were unrelated to interacting with the

book (e.g., caregiving functions) were not considered a part of book sharing.

Entrainment in book sharing refers to the mother getting her infant locked

into on-going sequences of mutually reciprocated exchanges, giving the

appearance of a conversation where both participants seem to alternately initiate

and reciprocate ideas or tasks that are related to the book.

Task-related refers to a complementary exchange of behavior that gives the

appearance of agreeing on an idea or mutually reciprocating a task that is related

to the book.

Nontask-related refers to a contrasting exchange of behavior in the sense

that it does not give the appearance of agreeing on an idea or mutually

reciprocating a task that is related to the book.

Limriai.rns of ine Sru'd

Findings from this study are based on audio-video-taped episodes of book

sharing that took place in a clinical setting and might not typify mother-infant book

sharing in all settings. The study participants were selected on the basis of the

infants' premature status and availability for observation. Infants in this study

were born prematurely and sick; mothers' average income was between $4,000

to $8,000 annually. Book sharing in these dyads might not reflect a universal

experience. The findings might apply only to the study participants and similar

mother infant populations, because of the unique characteristics that exist among

these dyads.

Books shared by these parents were provided by the clinic. They consisted

of a variety of readily available grocery story books They did not represent the

best literature available for infants. These mothers' responses to the particular

books may not be representative of their responses to all literature for infants.



Two areas of literature were examined in this review. First, the literature on

mother-infant interaction was reviewed to develop an understanding of the nature

of social behavior within the preterm dyad and to provide a background to

understanding the rationale for this investigation in a preterm sample. Second,

descriptive studies of mothers reading with children up to 24 months were

surveyed to assess what is known about the experience with a prelinguistic child.

Finally, from the synthesis of the literature, implications for the present

n.resilaion are discussed.

Interaction Patterns of Preterm Mother-Infant dyads

Social interactions between preterm infants and their mothers have been

described as "less optimal" (Friedman, Jacobs, & Werthmann, 1982) and

"disturbed" (Field, 1977), particularly if the child suffered perinatal complications.

In their explanations of how the sequelae of premature birth affect mother-infant

social relations, researchers proffer differing notions of the significant dimensions

of interactions, the processes by which interactions influence later development,

and the contributions of the infant to interactions (Beckwith & Cohen, 1989).

Typical explanations for the patterns of aisoranizal,-or have focused on

examining how (a) the practice of postpartum separation and (b)characteristics of

the preterm infant's appearance and temperament adversely affect maternal

bonding and infant attachment behaviors, thereby hindering the establishment of

affective behaviors that lead to optimal social relations.

Postpartum Separation and Mother-infant Attachment

Attachment is significant to the quality of the infant's life. The establishment

of the mother's affectionate tie to her baby (bonding) sets the stage for the

infant's emotional tie to her (attachment), locking them together to ensure an

enduring relationship (Klaus & Kennell, 1976, 1982) that provides the child

emotional shelter, security, and information. Attached dyads will interact often

and try to maintain proximity to each other (Bowlby, 1969). Behaviors such as

stroking, cuddling, kissing, getting into the en-face position (mother's head

aligned so that her eyes fully meet those of her rifarni, and vocalizing to the baby

have been used to measure the degree of mothers' attachment to their baby.

Secure attachment tends to occur when mothers are responsive to their baby's

cues during the first few months and throughout the first year of the child's life

(Ainsworth, Blehar, Waters, & Wall, 1978). Infants begin to form an attachment

when they can discriminate mother from the rest of the world, which occurs at 5

or 6 months (Ainsworth,1973). Mothers begin to form the emotional bond at their

baby's birth.

Behaviors that draw mother and baby together at birth and elicit caretaking

are the precursors and the first stage in the development of attachment

(Ainsworth, 1973). At the birth of their child, parents will often display

engrossment--an intense fascination with and strong desire to touch, hold, and

caress their newborn (Greenberg & Morris, 1974; Peterson, Mehl, & Liederman,

1979). However, when born prematurely and sick, the newborn is whisked from

the delivery room and placed in a heated isolette (a plexiglass enclosure) to

maintain body temperature and guard against infections. The first acquaintance

of mother and child might find the newborn covered with monitoring devices and

specialized equipment (Harris, 1993). Their initial contact through the small

portholes of the isolette does not permit the mother to cuddle and show love

toward her baby in the usual way (Shaffer, 1993).

Studies on the effects of postpartum separation reflect concern for the role

that social interaction plays in the child's subsequent development. Recognizing

atypical mothering behaviors in preterm dyads, Kennell, Trause, and Klaus

(1975) claimed that the first 6 to 12 hours after birth are a "sensitive period"

during which the mother quickly forms a bond with her infant. They advanced the

premise that immediate separation and the physical barriers of an isolette

obstruct the optimal course to emotional attachment; consequently, maladaptive

mothering behaviors in the preterm dyad could be explained as the failure to

establish emotional relations that enhance the child's development. The main

idea was that the quality of the infant's socialization rests within the framework of

mother-infant interaction.

Testing the separation hypothesis was the catalyst for comparing

interactions in full and preterm mother-infant dyads to determine how delayed

contact influenced the mother's behavior toward her infant. Klaus, Kennell,

Plumb, and Zuehlke (1970) compared first contact behaviors of full-term mothers

(early contact group) with preterm mothers (late contact group). The sample

consisted of low-socioeconomic status (SES) black mothers and infants of mixed

birth order. On their first three visits to the nursery, preterm mothers touched

their infants less and spent less time positioned en face. Similar results were

reported in other studies. Leifer, Leiderman, Barnett, and Williams (1972)

compared full and preterm mothers' affective behaviors in a sample of

predominantly white, middle-class mothers with infants of mixed birth order. At 1

month, preterm mothers made less ventral contact with their infants, smiled less,

and displayed less affectionate touching. In a follow-up of the sample at 11 and

15 months, Leiderman and Seashore (1975) found that preterm mothers

continued to smile and touch their infants less than full-term mothers.

Eye contact or gaze coupling is one of the first steps in establishing

interactions that enhance the child's socialization. Klaus and Kennell (1976)

revealed a correlation between the amount of time mothers spent looking at their

babies at 1 month and the infants' IQ at 42 months; mean IQ scores were 99 for

full term and 85 for preterm. Barnard (1975) observed that mothers who looked

more at their infant during the hospital period and early months of the child's life

tended to respond more appropriately to their infant's cues than mothers who

looked less at their infants. Researchers explained that interaction forms the

basis of communication (Honig, 1982) Face-to-face contact (en face position)

during caregiver-infant contact increases the chances for social interaction and

provides the foundation for the development of the infant's communicative skills

(Field, 1977; 1987). Bromwich (1981) noted that interaction is the

channel through which mother and baby communicate; the child is motivated to

develop language as the communications steadily increase in complexity and

sophistication. However, when bonding and attachment have not been

satisfactorily established, the subsequent social behaviors might not lead to the

kind of communicative system that will enhance the infant's development.

The Effects of Infant Temperament on Rhythm and Reciprocity in
Mother-infant Interaction

Separation studies primarily underscored the mothers' behaviors toward her

baby as the .-re.:ripiiatng event in their interaction. A second research interest

was launched in recognition of the infant as a social organism capable of

affecting and being affected by his or her social environment (Bell, 1974). From

this posture, the infant's contribution to his or her own development was viewed

in conjunction with the mother's behavior. Ingrained in this literature is the theory

that the quality of interaction between mother and baby is influenced by the

infant's physiological state (Korner, 1979) which dictates the child's temperament

(e.g., quality of attentiveness, responsiveness, irritability, and ease of consoling).

In turn, the infant's temperament influences the quality of rhythm and reciprocity

in the mother-infant dyad. Rhythm and reciprocity refer to synchronized

interaction in which both partners take turns responding to each other's leads

(Shaffer, 1993). The baby gives behavioral cues to the mother who reads them

and responds with signals that the infant gradually learns to read. The baby

receives social stimulation from the mother's prompt and appropriate response to

his or her signals. Consistent and expectable patterns of exchange provide the

framework for the baby's first experiences in cognitive and social development

(Scholmerich, Leyendecker, & Keller, 1995). Hence, maternal sensitivity to the

baby's characteristics is central to fostering the quality of synchronized rhythm

and reciprocity necessary for the child's optimal development (Brazelton, 1978;

Brazelton & Cramer, 1990).

The development of a self-regulatory capacity requires an early experience

with a regulating primary caregiver (Schore, 1994). Through the evolutionary

process, the healthy neonate is genriecai, endowed to evoke and reciprocate

social stimuli that might lead to a regulating caregiver. However, immature

physiological systems and biological insults associated with prematurity may

undermine evolution to the extent that the baby is hindered from eliciting or

reciprocating social responses. Consequently, mothers of babies who were born

prematurely and sick often take home a poorly organized partner (Schwartz,

Horowitz, & Mitchell, 1985) whose behaviors could annoy and alienate social

companions (Als, Lester, & Brazelton, 1979). Infants born prematurely and sick

are frequently inattentive, unresponsive, and chronically irritable (Goldberg,

1978), which adversely influences the reciprocal nature of social interactions

(Charlesworth, 1992). Whereas term babies tend to take the lead and dominate

the interaction, mothers of preterm babies often find it difficult to follow their child

because they cannot figure out what the child will do next (Lester, Hoffman, &

Brazelton, 1985). If the child cannot get into rhythm with the mother or if the

mother is unresponsive, the baby may withdraw and stop trying.

Evidence suggests that the infant's temperament is central to rhythm and

reciprocity in the mother-infant dyad. To illustrate, Field (1979) reported

interactions in a sample of white, middle-class preterm dyads. The infants

received depressed scores on the Brazelton Neonatal Behavioral Assessment

Scales (NBAS), indicating that they were relatively unresponsive and thus at high

risk for interaction disturbances. Dyads were videotaped in four situations: (a)

during feeding, (b) spontaneous face-to-face interactions, (c) attention

getting--mother trying to keep the infant looking at her, and (d) imitation--the

mother imitated her infant's behavior. Maternal behaviors were coded for talking,

smiling, poking, caretaking, and game playing (e.g., pat-a cake). Infant behaviors

were gaze aversion, vocalizing, fussing or crying, cycling, and squirming.

During feeding, spontaneous play, and attention getting, the infants were

described as unresponsive, fussy, and gaze averting. Their mothers were

described as overly stimulating and controlling. The effect of the mothers'

behavior was counterproductive (i.e., excessive attempts to engage a relatively

unresponsive infant in the activity elicited more inattentiveness from the infant).

Field concluded that the infant's depressed activity evoked the mother's

excessive activity, which in turn elicited more of the same unresponsiveness from

the infant. The mother's hyperactivity may have overloaded her infant's

information processing system, thus requiring the child to take frequent pauses

(gaze averting) to assimilate the information. During imitation, when the mother

used her infant's rhythm to moderate her own activity, the interaction was more

synchronized. Perhaps imitation reduced stimulation; consequently, the child

needed to pause less from the interaction. On measures of affective behaviors,

mothers displayed fewer happy expressions and were more talkative. The infants

continued to avert gaze; they cried often, and required a number of game trials

before laughing. Field (1983) pointed out that infrequent game playing may have


been related to the mother's inability to elicit and sustain positive affect from her

infant, suggesting the bidirectional nature of mother-infant behavior.

Evidence that the child's temperament influences social interactions has

been corroborated in diverse situations and samples using the NBAS as the

measure of the infant's behavioral profile. DiVitto and Goldberg (1979) studied a

white middle-class sample at 4 months and found that mothers with sick infants

(depressed NBAS) held their baby at a farther distance and touched and talked to

their infant less. Similarly, in a sample of low SES, mostly Hispanic dyads, Fox

and Feiring (1985) found that at 3 months infants who were healthy neonates

were more alert, less irritable, and looked longer at their mothers during play than

did sick infants. Mothers used less proximal stimulation with more alert infants.

Longitudinal and follow-up studies of previously discussed samples in this

literature provided evidence that atypical behaviors in the preterm dyad persisted

into the second year. In a 2-year follow-up, Field (1979) compared 4-month

interactions of her sample (Field, 1977) with the child's language at 24 months

and found that early interaction styles persisted and they related to the child's

subsequent language skills. Samples of language for infant and mother were

taken in a clinical setting while the dyad engaged in free play with toys. Mothers

who were less imitative at 4 months used more imperatives in conversation with

their infant at 2 years. Infants who were less attentive at 4 months and whose

mothers were less imitative had shorter lengths of utterances and less developed

vocabularies; their mother's attentiveness to pauses at 4 months related to the

infant's larger mean length of utterance at 2 years.

The trend is that as preterm babies mature, mother-infant interactions

become more appropriate and they resemble their term counterparts. However,

the frequently reported discrepancies, observed when compared with term dyads,

do not altogether fade as preterm infants mature This tendency was observed

by Brown and Bakeman (1980) who followed a sample of term and preterm black,

low SES dyads through the first year. At 3 months, infants who had the lowest

NBAS scores were most difficult to stimulate. Consistent with other reports,

preterm mothers were described as hyperactive while their infants were

hypoactive. During feeding, preterm mothers issued more directives and

commands, thumped, poked, pinched, and rocked their infants more; in return,

their babies rewarded them with less response. Although qualitative differences

remained between term and preterm dyads at 12 months, they were not

significant. The authors concluded that the quality of mother-infant interaction is

influenced by the infant's behavior as well as the mother's adaptation to her

child's behavioral profile. As mothers adapted to their infant's characteristics

they were able to establish a style of interacting that was appropriate for the


In addition to the persistence of qualitative differences, researchers also

found that the preterms' direction toward mature behavior is not an orderly

progression. That is, the quality of preterm mother-infant behavior progresses

and regresses. This discontinuous pattern was noted by Barchfield, Goldberg,

and Soloman (1980) in their follow-up of the DiVitto and Goldberg (1979) sample

Infants who were born prematurely and sick had the longest hospital stay, the

most depressed NBAS, were the least responsive, and the most difficult during

floor play with toys at 8 and 12 months. Their mothers' activity peaked

dramatically at 8 months, giving their child more attention. However, at 12

months term and preterm dyads were similar. The authors pointed out that when

infant maturity was held constant for term and preterm dyads, qualitative

differences continued to appear, especially in infant affective expression and

parent activity level. Therefore, it appeared that the differences could not be

explained as a developmental lag in the preterm group; rather, it was likely that

the development of social interaction in preterm dyads followed a different course

than term groups.

A similar explanation of the preterm's course of development was proffered

by Barnard, Bee, and Hammond (1984) who compared diverse SES groups of

term and preterm dyads on teaching interactions at 4, 8, and 12 months. The

activities were selected from the Bayley Scales of Infant Development and

consisted of one age appropriate (easy task) and one task several months in

advance of the child's age (hard task). At 4 months the hyperactive mother and

hypoactive infant were observed in preterm dyads. Across time, preterm mothers

steadily increased on facilitation measures (e.g., sensitivity, selections of

materials) on both hard and easy tasks; term mothers' facilitation scores

increased on hard tasks only. Observing that the variations between term and

preterm behaviors did not altogether fade at 12 months, the researchers

explained that perhaps differences in the dyads were not as dramatic at 12

months because the preterm infants had caught up in their level of participation.

Although preterm babies matured and resembled term infants, it appeared that

preterm mother-infant dyads passed through a different developmental course in

their progression toward synchronous interactions

Crawford (1982) compared full and preterm dyads at home during daily

routines at 6, 8, 10, and 14 months. Preterm babies vocalized less, were more

fretful, and played significantly less; their mothers spent more time holding them

and engaged in caretaking, until 14 months. Discussing the tendency of preterm

dyads to improve in their social interactions yet remain qualitatively different from

term dyads, Crawford (1982) pointed out that a single infant or maternal

characteristic could not account for the tendency of preterm dyads to resemble

their term counterparts. Rather, changes may be attributable to both the infant's

development, as well as changes in caretaking. As preterm mothers developed

appropriate styles for coping with their infant's developmental level, the child

became more responsive; consequently, a more synchronous pattern of

interaction was established.


In summary, the investigative responses to Klaus and Kennell's (1976)

theory of postpartum separation were seminal to our current knowledge of the

sequelae of prematurity and mother-infant social relations. It is now widely

accepted that preterm mother-infant interaction is a domain in which distinct

patterns, suggesting disturbance, are frequently observed (Selfer, Clark, &

Sameroff, 1991), particularly when the infants were born sick. However, it should

be acknowledged that Klaus and Kennell's (1976) claim that failure to make

contact during the first 6-12 hours (sensitive period) causes irreparable harm to

the mother-infant emotional bond is questionable. In their review of studies on

the effects of delayed contact, Goldberg (1983) and Myers (1984) indicated that

while early contact is pleasurable for the mother and may have some short-term

effects, the long term effects are very small The contemporary view

acknowledges that parents who have an opportunity to spend time with their

newborn become highly involved with their baby if they are permitted to touch,

hold, cuddle, and play with their baby during the first few hours; however,

irreparable damage is not set into motion as the result of delayed contact

(Goldberg, 1983; Palkovitz, 1985).

Credence once given the linear model of developmental outcome was

attenuated by the failure of researchers to unequivocally support the notion that a

single factor, such as postpartum separation or the infant's temperament, is

sufficient to explain the prominence of the passive infant and overly stimulating

mother in preterm interactions Alternatively, the "transactional" (Sameroff &

Chandler, 1975) or bio-social model is now widely accepted in recognition that

the infant's outcome is mediated by the interchange of factors related to

biological constitution (e.g immature neurological systems that affect

*enmperarmeni i, as well as characteristics of the social environment (e.g., practices

for medical management and the quality of interactions in the child's caregiving


Implicit in the literature is that preterm mother-infant interactions need to be

respected as a unique relationship. Longitudinal follow-up studies indicated that

as the preterm baby matured, mother-infant interactions became more

appropriate and they resembled their term counterparts; however, the qualitative

differences did not altogether disappear. Additionally, in preterm dyads the

progression toward reciprocally synchronized interactions was discontinuous

(i.e the dyads progressed and regressed in their advancement toward

synchronized relations). In view of the discontinuous trend, Goldberg (1983)

proposed that an alternative to characterizing preterm mother-infant relations as

stressed (Goldberg, 1978), disturbed (Field, 1979), or less optimal (Friedman,

Jacobs, & Werthmann, 1982) is to view the relationship as a unique style that

represents an appropriate adaptation to the special needs of the preterm infant.

According to Gardner and Karmel (1983), this catching up trend indicated that the

tendency for preterms to resemble term dyads cannot be explained simply as the

result of the infant maturing, thus becoming more like his or her term counterpart.

Rather, premature birth and illness are such that once they occur, the course and

duration of subsequent development are reorganized and redirected.

Consequently, preterm mother-infant dyads follow a different course in their

advancement to synchronous interactions. On this basis, Gardner and Karmel

(1983) concluded that pretermm infants are not just immature full-term infants to

be studied as such. Direct comparisons between preterms at term age and

full-term neonates may not be completely justified" (p 70), suggesting that

preterm dyads need to be studied as a unique population.

Finally, in accord with the transactional model of infant development, the

idea that a good relationship between mother and baby can prevent or ameliorate

the effects of early birth is widely supported. Consequently, the contemporary

focus of infancy researchers is on exploring techniques for enhancing parents'

sensitivity to their infants (Field, 1993). The objective is to attenuate social

interactive dimensions that have a debilitating effect on the child's outcome

Toward this end, strategies are designed to help mothers establish a caregiving

environment that is supportive of the child's bio-social characteristics. For

example, a growing trend is that hospitals provide intervention as soon as infants

are identified as high risk for developmental delays (Bricker, 1986). Although

postpartum separation is often unavoidable when babies are born prematurely

and sick, hospital management includes early touching and cuddling contact to

improve mother-infant relations (Shaffer, 1993). Additionally, interaction

coaching programs to improve communicative strategies (Haney & Klein, 1993),

teaching infant massage, and demonstrating the NBAS for parents (Field, 1993)

are strategies employed to remediate disorganized social interaction that is a

frequently encountered obstacle to the preterm infant's psycho-social outcome

(Seifer, Clark, & Sameroff, 1991).

Joint Book Reading in the Mother-infant Dyad

The few studies'on reading to infants (children less than 24 months) provide

data on the language format and social organization of the activity. These

descriptions provide a background for understanding how mothers carry out the

experience with their prelinguistic infant.

Ninio and Bruner (1978) examined book reading interactions between a

mother and son when the child was between 8 to 18 months. The white, British,

middle-class dyad was video recorded in their home during 12 sessions that

occurred within routine play; no special instructions were given. Observation

of reading interactions were described as a "structured interactional sequence

that has the texture of a dialogue. ... Joint book reading by mother and child

very early and very strongly conforms to the turn-taking structure of

conversation" (p. 6). Typically, interaction was characterized by a standard

format of dialogue cycles in which the mother customarily used adult language,

without distinction in wording or intonation between earlier and later sessions.

Four types of utterances accounted for virtually all of her speech during the

reading cycle; they were attentional vocative, query, labeling, and feedback


Through the process of "scaffolding dialogue," the adult supplied linguistic

forms of what she believed her son intended to express, thus establishing the

child's "turn" in the reading dialogue, illustrated by an example from a session

when the child was 13 months:


Child: (Touches picture)

M: What are those? (QUERY)

C: (Vocalizes and smiles)

M: Yes, they are rabbits. (FEEDBACK AND LABEL)

C: (Vocalizes, smiles and looks up at mother)

M: (Laughs) Yes, rabbit. (FEEDBACK AND LABEL) (p. 6)

The child's ability to participate increased with age and his mother escalated

her performance demands by changing her expectations of the child. The

researchers suggested that the mother's modification of her theory about the

child's development might explain the escalation. Based on her knowledge of his

past exposure to objects, events, and words he previously understood and the

forms of expressions he had achieved, she coaxed the child to "substitute, first, a

vocalization for a non-vocal signal and later a well-formed word or word

approximation for a babbled vocalization, using appropriate turns in the labeling

routine to make her demands" (pp. 11-12). The investigators concluded that this

pattern of book reading behavior was more central than other formats observed

during play to teaching language. Apparently, dialogue preceded the emergence

of labeling; consequently, the ritualized exchanges around a picture book, rather

than imitation, was the mechanism through which the child mastered rules that

govern reciprocal dialogue and thereafter mastered standard use of lexical


Ninio (1980) described the dynamics of vocabulary acquisition in the context

of joint picture-book reading. Participants were 20 middle and 20 low SES, Israeli

mother-infant dyads. Each dyad was audio taped once in their home when the

children were between 17 and 22 months. The analysis of interaction focused on

the ways mothers elicited or provided abehing information. Mothers were asked

to elicit from their child "all the words he knows which are shown in the book" (p.

592). The productive, imitative, and comprehension vocabularies were obtained

and measured by the number of different words the children produced, imitated,

or pointed to.

The mothers displayed interactive cycles consisting of label eliciting, gesture

eliciting, and maternal labeling. Each cycle represented three dyadic styles. The

first format elicited the child's production of labels. Initiated by mothers' "what"


new information is provided in the form of feedback utterances used with
active infants who frequently emit behavioral response, which then might be
shaped by the mother in the manner of operant (p. 589)

The second format elicited gestures. Initiated by "where" questions, the format

represents an interaction style in which the mother preempts most of the
talking and the infant is required merely to indicate comprehension by
pointing ... Feedback tends not to include a label. The label has already
been uttered by the mother in her "Where is X ?" question, and because the
infant tends not to provide a verbal behavior which requires semantic or
phonetic modification. ( p 589)

A third format, maternal labeling only, primarily focused on giving rather than

eliciting information from the child.

The style consists of the tendency to open cycles by a maternal labeling
statement and of the mothers' emitting many labeling utterances in general.
the mother's way of coping with an essentially incompetent non
participatory infant. (p. 589)

The high- and low-SES dyads differed in the format of their interactions.

High-SES mothers tended to employ a particular eliciting style, depending on

their child's vocabulary size and the benefit the mother believed the child would

get from the interaction. In contrast, low-SES mothers did not increase "eliciting

style" behaviors with the child's age. Infant groups did not differ in terms of their

readiness to initiate or participate in book reading and emission of labels in

cycles. However, low-SES infants had a smaller productive vocabulary on all

three measures. Maternal behaviors clustered in the label-eliciting format, that low-SES mothers did not adjust their behavior in response to their

infants. Ninio indicated that

low-SES mothers might be thought of as adequate teachers of vocabulary
for their infants' present level of development, but their teaching style is not
future oriented, not sensitive to changes in the infant's needs and
capabilities, and therefore probably inadequate for the enhancing of rapid
progression to more complex levels of language use. (p. 589)

Wheeler (1983) focused on mothers' speech as children age. Ten

middle-class dyads were videotaped twice while looking at a picture book.

Mothers were asked to look at the book as they normally would. At the first

taping the children were between the ages of 17 and 22 months. They were in

the one word stage of language development, uttering recognizable words; three

children had begun putting words together. At the second taping, the children

were 29 to 34 months; all were speaking in short telegraphic sentences (e.g.,

"Girl fall down"). The functional content of mother's speech differed sgnl,,:arntIl

from the first to the second session. Mothers mostly described pictures to the

younger children; a year later, they asked for more information. Mothers first

talked about single major elements of pictures (e.g., "That's a wagon"); a year

later they spoke of more than one element in a single sentence (e.g., "The boy is

pulling the wagon"). The differences in a mothers' speech were determined to be

related to the child's development. Wheeler indicated that changes in a mother's

speech provided models of book reading that were "fine tuned" to the child's own

verbal abilities, which exposed the child to age appropriate models of speech in a

particular context.

DeLoache (1984) reported findings from two studies of the memory

demands that mothers made of their children while looking at picture books. The

focus was on the questions mothers asked. The participants were all white

middle-class dyads. In the first study, 30 mothers and their 12-, 15-, and

18-month-old children "read" a simple ABC book of one picture for each letter in

the alphabet. In a second study, 15 pairs of 18- to 38-month-old children and

their mothers talked about a farm scene in a children's book.

The frequency and type of questions asked by mothers appeared to be

determined by the mother's perception of the child's ability. With the youngest

children (12 months), mothers tended to be the only active participant and made

almost no demands; her primary role was pointing to and labeling pictures

M (12): Look at the apple. Apple
Teddy bear
And Kitty. (p. 88)

The activity was often formatted as questioning; however, mothers assumed the

roles of both questioner and respondent. They seemed not to expect a verbal

response from the child; instead, they modeled what the child was incapable of


M (12): And that's a kite.
Is that a kite, Josh ?
Isn't that a froggie? (p. 88)

Mothers often asked for information then shortly thereafter proceeded to answer

their own questions.

M(12): That's a doggie.
What does a doggie say?
Arf, arf arf, arf.

M (15): Do you know what that is?
Elephant. (p. 89)

Beginning around 15 months, children were expected to assume a more

active role in reading. Mothers' demands for recall and recognition increased in

frequency and complexity. The children were increasingly expected to retrieve

the labels for objects from memory.

M (15): What's this?
C: Bah.
M: Ball.
M (18): You know what this is?
C: Kite.
M: A Kite. Yeah. (p. 89)

Mothers reduced demands or gave clues if their child was not forthcoming with a


M (13): What do bees make?
C: BEE, bee, bee, bee, bee ....
M: What do bees make?
M: What does Winnie the Pooh eat?
C: Honey.
M: Yeah. Look at these beehives where the honey is made
by the bee. (p. 90)

Another technique used to assist children was to relate something in a picture to

the child's experience.

M (12): Frog. You have a frog, a stuffed one.
M(15): Look at the little mouse.
Just like the one daddy works with. (p. 91)

Mothers often skipped pictures that were unfamiliar to their children. The

decision to omit a picture, label a picture themselves, or ask their children to label

seemed to have been based on the mothers' belief about their children's

knowledge. DeLoache (1984) concluded that the particular techniques employed

by mothers in the process of joint picture book reading, "are primarily dictated by

the necessity of communicating with a limited partner, a partner who is not

capable of playing a fully complementary role in dialogue" (p. 94).

Penfold and Bacharach (1988) investigated the effects of experimentally

manipulated illustrations on the types of comments made by mothers to their

prelinguistic children during book reading to infants between 10 and 14 months.

The study sample consisted of 12 middle-class, high school educated mothers

and their intellectually and physically healthy babies. The dyads were

videotaped reading two books, one minimally illustrated and one highly

illustrated. The frequencies of different types of illustrations were recorded and

analyzed for the proportion of comment types as a function of the degree of

illustration and reading session. The researchers found that illustrations

promoted parental talk and the degree of illustration influenced the amount and

types of comments mothers made to their children. Mothers made twice as many

comments to their children when reading highly illustrated books. The increase

in illustrations also increased the overall frequency of comments made by

mothers, and the frequency of wh-questions. Children vocalized more and

mothers pointed more when reading highly illustrated books. The authors

concluded that the more highly illustrated books promoted parent-child

interactions; and therefore, may be preferred over minimally illustrated books.

Lamme and Packer (1986) focused on infants' verbal and nonverbal

behaviors in response to their mothers' book reading. Thirteen mother-infant

dyads were videotaped reading four books. Infants ranged in age from 3 to 8

months at the beginning of the study and 7 to 12 months at the conclusion.

Nineteen different types of infant behaviors were identified and categorized into

visual, tactile, verbal, and affective domains. The authors combined the

behaviors in the four categories into a profile of infant reading behaviors,

indicating gradual transitions in book reading behaviors as the infant matures.

Visual Behaviors

At 3 months the babies merely stared at the book sometimes focusing on a

picture; however, there did not appear to be a connection between the infant's

gaze and the mother's speech. At 5 months infants followed their mother's

pointing cues or the mother matched language to what her child looked at. After

9 months infants looked at the picture which corresponded with the adult's


Tactile Behaviors

At 3 months infants aimlessly touched the book while randomly moving their

arms; they began scratching the pages of the book at 4 months; by 6 months

scratching was combined with patting, rubbing, hitting, and grabbing at the

pages. Patting and grabbing behavior meshed into page turning by 8 months;

older infants sometimes became absorbed in just turning pages, rather than

looking at the contents of the book. By 12 months, infants whose mothers

pointed frequently during book reading pointed themselves, and the adult

responded by naming the picture.

Verbal Behaviors

Babies were generally silent for the first 6 months unless protesting the

continuation of book reading. Entering 6 months babies responded verbally with

giggles or chuckles as reactions to anticipating or predicting what would happen

next in a familiar book. At 12 months infant behaviors were louder and more

pronounced. Some infants cooed as their mothers read or they reacted verbally

to rituals such as the mother making animal sounds. By 15 months some babies

supplied words in familiar stories or responded, "Dat?" to request the mother to


Affective Behaviors

Affect stood out in all age levels. The youngest babies were more relaxed

and contented while their mothers snuggled and read to them. At 3 months

infants initiated affective behaviors by holding on to their mother's finger; at 5

months by gently stroking or patting her arm; by 6 months infants were able to

turn around and look at their mothers during story reading; and by 12 months

infants hugged their mothers at the finish and begged for another story to be


Resnick et al. (1987) observed mothers reading to prematurely born infants

in 116 dyads at 6 (n=49), 12 (n=42), and 24 months (n=25). The racially mixed

participants were Videotaped in a clinical setting. Mothers were asked to "share"

a book with their children. The researchers did not describe the social dynamics

between mother and infant; rather, they focused on identifying specific maternal

book sharing behaviors.

From their observations of mother-infant reading, 56 maternal book sharing

behaviors were cataloged. Seven of the 56 behaviors were considered negative,

inasmuch as they were not regarded as favorably contributing to the experience:

Pinches, pulls, or pushes child
Restricts child's movements
Resists child turning pages
Interrupts her reading to play with a toy
Becomes absorbed by book and ignores child
Reprimands child
Comments negatively about child's participation (p. 892)

The quality of maternal book reading behaviors was assessed by subtracting the

number of negative behaviors from the mother's cumulative score. Mothers of

12-month-old infants had higher scores than mothers in the 6-month-old group;

however, the difference was not significant. Mothers of 24-month-old infants

scored significantly higher than the 6-month-old and 12-month-old groups. Four

behaviors were observed in more than 75% of the dyads: (a) inspects the face of

the child, (b) points to picture, (c) labels picture, and (d) begins reading from front

of book. Mothers in the 24-month-old dyads displayed more than twice as many

of the high frequency behaviors compared to the 6-month-old dyads, suggesting

that the mothers became more involved with their infants as the children aged.

The researchers concluded that reading to an infant involves a "complex

constellation of behaviors" (p. 893).

Implications from the Survey of Literature

The few studies on joint reading in the mother-infant dyad have focused on

the language format of mother-infant reading (Ninio & Bruner, 1978), the mother's

speech as it relates to the infant's age (Wheeler, 1983), the contribution of the

activity to the child's vocabulary development (Ninio, 1980), the mother's memory

demands of the child (DeLoache, 1984), and the mother's language as a function

of the illustrations (Penfold & Bacharach, 1988). One study has focused

specifically on infants' reactions to being read to at various ages (Lamme &

Packer, 1986), and one has specifically targeted a range of maternal behaviors,

as well as included children who were born prematurely and sick (Resnick et al.,

1987). In view of the small number of studies, the scattered focus of inquiry, and

the small samples that have been studied, our knowledge about book sharing in

the population at large and in diverse populations remains limited.

Patterns of language around the book have been described as

synchronized (DeLoache, 1984; Ninio, 1980; Ninio & Bruner, 1978) and

conforming to the turn taking structure of conversation (Ninio, 1980). However, in

the youngest dyads (3 months) the infants' activity was described as a less

organized pattern that persisted until about 6 months (Lamme & Packer, 1986)

and in preterm dyads the mother's behavior was described as a "complex

constellation" including positive and negative behaviors (Resnick et al., 1987).

Findings of variations in the mothers' and infants' interactive styles indicate that

inquiries concentrating on the impact of specific interactive qualities are needed

in order to draw inferences about the most accommodative practices for particular

mother-infant characteristics.

A common thread in joint reading was that the mother adjusted her requests

for the infant's language based on her perception of the child's ability to take a

verbal or nonverbal role, indicating that the mother's language format may be

explained as a function of her infant's ability to participate (DeLoache, 1984;

Ninio, 1980; Ninio & Bruner, 1978; Wheeler, 1983). Usually, when infants were

not able to take a verbal role, their mother employed the process of scaffolding

dialogue. She provided words that the child could not produce, as if the infant

intended to express her imputations. This behavior was not typical of low SES

mothers in the one study that compared high- and low-SES mothers (Ninio,

1980). Regardless of their infants ability and readiness to participate, low-SES

mothers tended not to adjust their behavior to accommodate their children's

ability. The inference is that sociocultural factors as well as the infant's

developmental characteristics influence the nature of book sharing. On this

basis, in consideration of the difficulties described in mother-infant relations when

infants were born prematurely and sick (e.g., Barchfield, Goldberg, & Soloman,

1980; Barnard, Bee, & Hammond, 1984; Brown & Bakeman, 1980; Crawford,

1982; DiVitto & Goldberg, 1979; Field, 1977, 1979, 1983; Fox & Feiring, 1985;

Schwartz, Horowitz, & Mitchell, 1985), there is reason to assume that book

sharing in the preterm population may not reflect the same experience described

in episodes of reading with healthy babies. Consequently, there is a need to

describe the activity in the preterm infant dyad.

Being born prematurely and sick is a threat to the quality of reciprocal

interactions that normally ensure the child's optimal development (Als, et al.,

1979; Bromwich, 1981; Klaus & Kennell,1976; Shaffer,1993). However, a

negative outcome is not predestined. The positive outcome for these babies is

predicated upon a caregiving environment that is consistent with their bio-social

characteristics, which may not be the same as the healthy term infant. Gardner

and Karmel (1983) pointed out that the preterm mother-infant unit is not simply an

immature model of a full-term counterpart; it follows a different course in physical

and social development. Identifying strategies to help mothers establish

interactive styles that support their babies' needs is central to the prematurely

born infant's subsequent development (Haney & Klein, 1993; Seifer, Clark, &

Sameroff, 1991). Toward this end, the descriptive data from this study serve as a

foundation for developing an understanding of "how" parents can effectively

share a book with infants who were born prematurely and sick.



The procedures for data collection and analysis using qualitative

methodology are described in this chapter. The section begins with a summary

of the inquiry process as it relates to the research objective and the theoretical

perspective underlying the methodology. In the final section, the procedures and

instruments used for data collection and analysis are described.

The research objective was to describe the social dynamics of book sharing

in a sample of preterm infant-mother dyads. This task called for an investigative

approach that is appropriate for studying social interaction as it unfolds.

Qualitative methodology was selected because the fundamental act of inquiry is

description (Van Maanen, 1983). Qualitative research methods refer to an array

of procedures that produce descriptive data: people's spoken words and

observable behavior (Bogdan & Taylor, 1975) as the source of well grounded,

rich descriptions, and explanations of processes occurring in local contexts (Miles

& Huberman, 1984). Qualitative inquiry, as described by Wilcox (1982), is an

in-depth observational, descriptive, contextual, and open-ended approach to

research. The researcher's mode is noninterventional and nonmanipulative

(Rogers, 1984), the task is to produce an in-depth portrait of the phenomenon as

it takes place.

In general, qualitative data are "symbolic, contextually embedded, cryptic,

and reflexive" (Van Maanen, 1983, p. 10), standing ready through production and

analysis to yield meaningful interpretation. Data may be collected in a variety of

ways such as observation, interviews, excerpts from documents, or

audio-visual-recordings and are usually processed through dictation, typing-up,

editing, or transcription, yielding extended text upon completion (Miles &

Huberman, 1984). The following features of qualitative inquiry, identified by

Bogdan and Biklen (1982), apply in this study.

1. The researcher is the key instrument

2. The setting is the direct source of data

3. The focus is on process rather than product

4. Data are descriptive

5. Data are analyzed inductively

In summary, the research objective called for a flexible methodology that is

noninterventional, nonmanipulative, and yielding contextually embedded

descriptions of the social dynamics between mothers and their infants during the

book sharing experience. Qualitative methods match these requirements.

Research Perspective

Procedures for studying the social dynamics of book sharing were grounded

in the theoretical framework of symbolic interactionism, which posits that

individuals construct and acknowledge their understanding of social situations as

they interact (Blumer, 1969; Prus, 1996; Reynolds, 1990). As a social construct,

book sharing from the interactionists' perspective is not an inherent repertoire of

skills that are innately produced and practiced. Rather, the nature of the activity

is grounded in the human-lived-experience; the participants' communicative

conduct and content are essential (Denzin, 1992) to ildenril,,ing the experience

Three assumptions of this study of mother-infant book sharing were

embodied in tenets of social interactionism. First, the observable expressions of

talk and conduct reflect the schema that participants employ to produce and

manage the interaction. Therefore, the analysis of the nature of book sharing

focused primarily on the mothers' verbal and nonverbal expressions and actions

because she was credited with initiating and mediating the activity with her

prelinguistic child. The infant was not dismissed as a passive participant; rather,

in keeping with theoretical assumptions, the child was viewed as both affecting

and being affected by the demands of the dyad (Bell, 1974). Second, context

matters; the participants' expressions and actions cannot be interpreted

independently of the situations in which they occurred (Heritage, 1984). Entering

the setting through episodes of book sharing that were captured on

audio-videotape preserved the context of the mother-infant interactions, thereby

making it possible to generate a contextually based description of the social

dynamics that characterized the activity. Finally, the focus is on process rather

than product. Hence, the book sharing setting was approached as a practical

social-interactive phenomenon; the nature of the experience was studied through

examining features of interaction--verbal and nonverbal expressions and

actions--employed by the participants to carry out the request, "Would you please

share a book with your child?"

The following attributes of interaction were essential to revealing the

character of the experience:

1. Verbal behavior:

The manifest content of language and verbal utterance.

Extralinguistic behavior, consisting of expressive and noncontent

vocal qualifiers, such as tempo of speaking, tone, and pitch of voice.

2. Nonverbal behavior:

-Body actions such as posture, motor gestures, facial expressions,

eye contact, and tactile behavior

-Spatial behavior such as participants' attempts to structure the area

and participants' physical movement to establish proximity to each

other or to objects.

Attributes identified in the literature as influencing and/or reflecting the

nature of mother-infant relations were considered. These included tactile qualities

(e g., stroking, cuddling/caressing, kissing), visual qualities (e.g., eye coupling,

gazing, en face alignment, gaze averting), affective qualities (e.g., smiling,

fretting, crying, squirming, fussing), vocal qualities (e.g. crying, laughing), and

qualities of behavioral sequences (e.g., pausing, leading, following).

The Research Model

Description of the Research Site

Mother-infant book sharing took place in the living room/play area of a

developmental follow-up unit that served the evaluation component for a regional

perinatal intensive care center. It primarily functioned to monitor the long-term

consequences for infants who were born prematurely and/or seriously ill and

high-risk for developmental delays.

Follow-up personnel in this center included a team of professionals and

professionals-in-training from the following areas: counseling psychology,

developmental psychology, early childhood education, special education, speech

therapy, physical therapy, pediatric nursing, and pediatric medicine. The staff

provided an interdisciplinary multiphasic approach to assess the long-term

development of each child's medical, and developmental status. Follow-up also

included a family-focused approach to prevention and intervention for

developmental delay in premature and low-birth-weight infants.

As a part of the evaluation process, infants and their mothers were routinely

videotaped during 5 minutes of free-play. Free-play served to relax the dyads

and acclimate them to the surroundings prior to beginning the formal evaluation.

Audio-videotaped segments of social interaction were used as a part of the

interdisciplinary evaluation. Book sharing was added to the videotaped segment

as a means of observing interactions between infants and their primary caregiver

in a situation considered to be primarily language dependent.

Mother-infant Dyads: Selection Criteria

Participant selection for this study was based on the following criteria: (a)

the infant must have been prematurely born (less than 37 weeks gestational by

medical reports) and/or weighed less than 2,500 grams at birth, (b) no infants

who manifested obvious congenital abnormalities or serious physical handicaps

were included, (c) at the time of videotaping the infant was 6 months adjusted

gestational age (AGA), (d) the videotaped episode must have been at least the

second taping for the dyad, (e) the infant was videotaped with his or her primary

maternal caregiver, and (f) both mother and infant were audible and visible. In

consideration of the difficulties in preterm mother-infant relations reported in the

literature, it was expected that at 6 months (AGA) the dyads would be more

adapted in their interaction styles than at the 3-month taping.

There were 30 available book sharing episodes for the 6-month evaluation

group. Of these tapes, approximately 13 met the selection criteria for the present

study. Reasons for exclusion were (a) the infant was accompanied by someone

other than his or her maternal caregiver (n=3), (b) individuals were present during

the book sharing episode other than the mother and her infant (n=l), (c) the

episode was distorted due to mechanical difficulties (n=l), (d) the infant did not

meet the criteria for prematurity (n=12). Although the taped segment was their

second, some infants were not presented as scheduled or re-scheduling was not

within the actual 6-month (AGA) range. To adjust for this factor, I included infants

who were closest to 6 months (AGA)--not less than 7 days, not more than 15


The Study Participants

The participant dyads in this study consisted of 5 male and 8 female infants

and their mothers. The infants were born prematurely and sick, were high-risk for

developmental delays, and were Neonatal Intensive Care Unit (NICU) graduates

being monitored through a developmental evaluation follow-up program.

The dyads included 7 black and 6 white infants ranging in age from 5

months 23 days to 6 months 15 days (M = 6 months AGA); birth weights ranged

from 1,318 to 2,420 grams (M =1,848); gestational age ranged from 30 to 37

weeks (M = 33) The range of NICU confinement was 3 to 45 days (M =17). The

infants were all single deliveries. The infants' 1 and 5 minute Apgar scores

respectively ranged from 5-10 (M = 7) and 7-10 (M = 9). The participant mothers,

at the date of taping, consisted of 6 single, 5 married, and 2 divorced mothers.

They were 18 to 36 years of age (M = 25); levels of education completed ranged

from 11th grade to 2 years of college (M=12th grade); and family income

averaged between $4,000 to $8,000 annually (Table 1).

All mothers in this study signed consent and release forms granting

permission for videotapes and other illustrations of their children's evaluation.

They also consented to the use of these materials for research to further

understand concerns related to high-risk infants and their families.

Gaining Entry to the Site

Entry into the setting was facilitated through the program director.

Subsequent to discussions, permission was granted for me to conduct this study

in the clinical site, with access to appropriate data. Research is a usual activity

within the clinic; therefore, the clinical staff did not express apprehension upon

learning of this study. I assured the staff that the project would not be an

intrusion into clinical activities.

Description of the Book Sharing Setting

Episodes of mother-infant book sharing were audio-videotaped in the

semi-naturalistic setting of a living-room/play area. The setting was arranged to

insure that mother and infant were as comfortable as possible. The

living-room/play area was well lighted and well ventilated. The floor was covered

with carpet and pictures were attractively arranged on the walls. Furnishings

included the following: a 6' x 4' foam mat placed center floor, a basket containing

age appropriate toys and several children's picture books, a sofa, a cushioned

Table 1. Demographics for Infants and Mothers by Dyads


Apgars Hosp. AGA Marital Educ.
Dyad Race/Sex GA (Wks) BW (g) (1.5 min) (days) (mo/days) Status Age (years)

1520 5.7
1860 8.9
1900 9.9
2220 5.9
2250 7.8
1360 7.9
1960 10.1
2420 5.8
1350 4.7
2000 8.9
2040 8.9
1820 8.8
1318 7.9

D 27 12
S 25 12
M 30 12
S 21 12
S 18 11
M 36 13
S 21 12
D 27 12
M 30 14
S 21 12
S 24 12
S 24 12
M 22 12

M= 33 1848 7.9 17 6.00 M= 25 12


arm chair a child-size table with infant seat attached, and two child-size chairs

The video-camera-recorder was located in plain view, approximately 7 to 8 feet

from the mother-infant dyad (Figure 1).

Data Collection

The source of primary data was the setting of book sharing, captured on

audio-videotape recordings. The principal means for data collection and analysis

were (a) the researcher as principal instrument for observation, analysis, and

interpretation of data, (b) audio-videotaped recordings of mother-infant book

sharing, used to document a comprehensive record of the event; (c) unobtrusive

measures, as a means of capturing naturally occurring interactions; and (d) my

notebook, used to compile transcripts and observation notes on book sharing


Researcher as Principal Instrument for Observation

This descriptive study of book sharing required me, as the principal

instrument for observation, analysis, and interpretation of data to unobtrusively

collect and analyze data as both a moderate and nonparticipant observer

(Spradley, 1980). I entered the research site as a moderate participant observer

for the -clloAing purposes: (a) to collect data necessary to select the study

participants, (b) to document descriptions of the research site and the book

sharing setting, and (c) to assess and document the nature of obtrusiveness.

The data for the study were derived from audio-video episodes. Thus, I entered

the setting of book sharing as a nonparticipant observer for purposes of

collecting and analyzing data that led to the descriptive analysis of the event.

Figure 1. The Setting for Book Sharing

Videotaping: Procedures and Instructions

As a part of the infant's evaluation, the participants were routinely

videotaped during approximately 5 minutes of mother-infant free-play. Upon

entering the setting, each mother was encouraged to settle herself with her

infant on the mat in preparation for the free-play segment. When the dyad was

prepared, the recording equipment was engaged and the clinician left the room.

The clinician returned in approximately 5 minutes to request, "Will you please

share a book with your child? You may select one from the basket." The

clinician then left and returned approximately 5 minutes later to continue with the

evaluation process.

The term book sharing was used because of its neutral connotation.

Requesting mothers to "read a book" to their infant might specify an expected

behavior and it might not be appropriate in instances where mothers selected

wordless picture books. Share a book, then, was considered a relatively

unstructured request, enabling mothers to frame the activity within their own


Unobtrusive Measures

Unobtrusive measures refer to procedures that reduced the possibility of

manipulative events that might "change the world being examined" (Schwartz &

Jacobs, 1979, p. 75). The collection of data from clinical files, as well as my

entry into the book sharing setting through audio-videotaped episodes, served to

reduce the participants' and clinical staffs reactivity to my presence at the scene

of interactions and context of events being investigated (Denzin, 1978; Schwartz

& Jacobs, 1979). Additionally, the possibility that the act of book sharing might

be altered indirectly through the participants' or clinical staffs reaction to

knowledge of the study was probably minimal because research was a common

activity in the clinical site

The po:'ss'tli, of distortions in participants' behavior due to stress

associated with visiting the clinical site and participants' anxiety associated with

the video equipment within plain view were primary concerns. These issues

were assessed through observations of typical routines during clinic visits and

through informal discussions with clinical staff. I concluded that because the

episodes under study were taken during at least their second visit to the clinic,

mothers' anxiety was eased by their familiarity with the setting as well as with the

videotaping procedures. Mothers and infants were also familiar with the staff

member who conducted the videotaping, as he was a person who routinely

operated the recording equipment. In general, clinical relations were pleasant

and developed as the result of the staffs position that the evaluation process

relied heavily upon providing a nonthreatening environment. Therefore,

conscientious efforts were made to reduce anxiety producing conditions and to

establish a relationship of trust between participants and staff.

The following scenario from my notes attests to the successful development

of positive relationships. It is a capsule of informants' comments and my

observations over a 3-week period in the clinic. The description details one of

the mother-infant dyad's visit to the setting; it represents the usual experience

from arrival at the center through completion of videotaping.

Upon arrival mother and infant were greeted by the receptionist who
escorted them into the clerk's office where they were "checked-in." As

mother and clerk engaged in conversation, information for the child's record
was requested and recorded by the clerk.

Following the check-in process, the mother and infant were accompanied to
the living-room/play area by a clinical evaluator who coordinated the
remaining activities during the visit.

After entering the living room/play setting, mother and clinician talked
informally as the mother placed her child on the mat and placed a toy in
front of him. Observing the infant trying to touch the toy, the clinician
commented, "He's doing a nice job. [His] motor development is coming
along..... I can see that you are really working with him."

The mother responded with a smile. Continuing in an informal
conversational mode, the clinician encouraged the mother to make her
infant and herself comfortable for the formal evaluation routine. At the
6-month evaluation, mothers were aware of the videotaping; thus, in the
following conversation the mother seemed to be familiar with the reference
to "starting the camera." The clinician continued, "Would you like to get
him ready and make yourself comfortable here on the mat? I'll come back in
a few minutes and start the camera." [The clinician then left the room].

The mother responded to this suggestion by removing the infant's shoes
and a sweater; she took a pacifier and small towel from what appeared to
be a baby bag or a large purse. Accompanied by the staff member who
routinely managed the video-recorder, the clinician returned and requested
the free-play activity, "Will you play with him for a few minutes so that he
can relax before we begin [the evaluation] and we can get some tape on
the two of you together?

You may use any of the toys in the basket. Greg will begin the tape and
come back in a few minutes." Greg then focused the recorder. Mother and
infant were left to their experience. Approximately 5 minutes later, the
clinician returned, stepped into the doorway and asked, "Would you please
share a book with your child? "You may select one from the basket." The
clinician left, returning in approximately 5 minutes to continue the
evaluation process.

Positive comments, according to the clinicians, were a means to establish

trust and reduce anxiety in the clinical setting. As one clinician explained,

These are honest remarks, and they indicate to the moms that we have an
interest in them as clients and families. ... Some of their children have
had a rocky course and it helps mom to cope if she realizes that her child is
making progress and that she has a support system at the clinic.

Another clinician stated that she always tried to begin the evaluation with "small

talk ... I mean nonthreatening conversation." A third explained,

Sometimes what you must report to them [mothers] is not pleasant, so you
want to seize every opportunity for encouragement. Some mothers are
apprehensive about the clinical procedures. It's important to get them
to relax, to trust themselves and trust you [the clinician], in order to get the
best evaluation. If the mother is uncomfortable, her behavior may be
different; the infant could sense his mother's frustration and become
irritable. Then what you get may not be an accurate picture of the infant's
performance or the caregiving relationship.

Through informal discussions with clinicians and observations of clinical

activities, it became apparent that, in general, participants and clinicians

established rapport and that mothers were at ease in the setting. These factors,

coupled with the lack of directives and manipulation of the book sharing

experience, maintained a level of unobtrusiveness necessary to gather a

realistic picture of mother-infant book sharing.

The Researcher's Notebook

The researcher's notebook was used to bind written data including

participants' demographic data and verbatim transcripts of each episode. It also

held accounts of pre-analysis activities with demo tapes. As book sharing was

examined, anecdotal notes on individual episodes; speculations, questions,

conceptions, and misconceptions related to conjectures and findings were also

entered in the notebook. These contents were helpful in building the conceptual

framework and formulating questions that served to focus the inquiry process.

Analysis of Data

The procedures used to accomplish the descriptive analysis of

mother-infant book sharing were adapted from Spradley's (1980) Developmental

Research Sequence model (DRS). The cyclic nature of the process is both

descriptive and analytic and therefore compatible with the objectives and

questions that powered this investigation. I began with one broad question that

guided the inquiry. The process of finding patterns and determining how they

related led to more specific questions that served to focus the inquiry. The

holistic picture of book sharing emerged through the arai,ile process of the


Transcription of Data

Following the collection of the raw data on audio-videotape, each of the

episodes of book sharing was transcribed into a running record. This written

protocol was a detailed narrative of the sequential event. It reflected the

mothers' and the infants' verbal and nonverbal. Notations of mothers' and

infants' posture, gestures, facial expressions, spatial proximity, and vocal

qualifiers (pitch, tone, and rate of speaking) were included. The running

narrative was recorded in column form (left of the page) leaving the right half of

the page open to enter written comments (Appendix A).

Conclusion Drawing

The primary task in conclusion drawing was s, siematicall, searching the

data to "determine parts, the relationship among parts, and their relationship to

the whole" (Spradley, 1980; p. 85). Bogdan and Biklen (1982) summarized the

process as "working with data, organizing it, breaking it into manageable units,

s, rniesizng it, searching for patterns, discovering what is important and what is

to be learned, and deciding what you will tell others" ( p. 145). The DRS

consisted of four interwoven phases or cycles of analysis: (a) domain analysis,

(b) taxonomic analysis, (c) componential analysis, and (c) theme analysis.

Domain analysis involved searching the protocols for "cultural domains" by

examining the written protocols with specific questions in mind. Spradley (1980)

suggested asking the following kinds of questions to reveal categories of

meaning: Are there "kinds of" things? Kinds of reasons for things? Kinds of

characteristics of -r,,r,,ng Kinds of uses for things and ways to do things? In

this study, kinds of verbal behavior and kinds of nonverbal behavior represented

the two broad initial domains. These domains were filled in with

subsets--behaviors that related to the broad cultural domain. For example,

Kinds of verbal behavior: Kinds of nonverbal behavior:
statements smiling
questions touching
comments looking
laughing pausing

Taxonomic analysis expanded the cultural domains by dividing the subsets.

The taxonomies included attributes that were all related to a broad domain. For

example, kinds of verbal behavior was expanded by the inclusions.

Kinds of statements

From the domain kinds of nonverbal behavior the subset "pointing" was

expanded by the following inclusions:

Pointing is a way to X (e.g., X= indicate)
where to look
where C is already looking
where M is looking
-the object of talk

As the data were analyzed, the contents of domains and taxonomies were

constantly reworked. Some were expanded, others were discarded through

integrating the contents

Componential analysis was the systematic search for attributes that would

tie the domains and taxonomies together. For example, the search for regularly

associated interactive patterns such as sequences of behaviors and functions of

behaviors occurring around a particular time tied the components of domains

and taxonomies together, revealing how the behavioral contents were organized

into a book sharing format.

Theme analysis, the final level, was the search across domains,

taxonomies, and components for themes in the recurrent attributes. Theme

analysis focused the data in terms of the semantic content of interactive

sequences; i.e., statements about: X taking place during a particular sequence

of interactive behavior. For example,

Statements about:
handling the book
the child's behavior toward the book

This final level of analysis revealed the cultural theme, that accompanied the

social dynamics, through which these 13 mothers projected their understanding

of". .. please share a book with your child."

Val',i'it, Measure.

Validity has to do with "how one's findings match reality" (Merriam, 1988,

p. 166). Some of the measures taken to ensure the validity of the reported

findings from this study have been described in the nonintervention,

nonmanipulative research model. Specifically, the unobtrusive nature of data

collection through videotaped episodes, my role as a nonparticipant observer,

and the taping of episodes during the normal routine of the participants' visit to

the clinical setting, reduced the chances of "altering the world being examined"

(Schwartz & Jacobs, 1979, p. 75).

The credibility of findings was challenged throughout the analysis process.

For example, as hypotheses emerged, they were vigorously challenged through

searching anecdotal notes and the contents of domains and taxonomies for sets

of comparative and contrasting evidence that would either support or discredit

the idea. Thus, findings were held tentative, absent an exhaustive search for

corroborating evidence. The process of challenging credibility, through locating

examples and nonexamples across episodes, also served to support the

conclusions that the evidence represented either patterns in the sample,

contradictions to an established pattern or incidents that could be considered

idiosyncratic or indicative of a subsample.

Finally, as an independent measure of concurrence, the data were

categorized using The Reading Observation Instrument developed by Resnick et

al. (1987) to identify a range of maternal behaviors in preterm mother-infant

reading dyads. Two graduate students, who were trained to use the Reading

Observation Instrument, coded each of the 13 episodes. Dividing the total

number of agreements by the number of agreements plus disagreements

provided the finding that coder agreement was above 90%. Considering

behaviors identified in the DRS analysis with those identified using the Resnick

instrument served as a second lens through which to weigh the evidence that

supported this descriptive analysis of book sharing.

Chapter Summary

The objective of this research was to document a descriptive analysis of the

social dynamics of book sharing in the preterm infant-mother dyad. Book sharing

was conceived as a social interactive literacy event that can be descriptively

defined through analyzing the social dynamics employed by participants to

construct and acknowledge their understanding of the experience with their

6-month-old baby. From this perspective, the focus of this inquiry was on the

interactive process. The behaviors of interest were the participants' verbal and

nonverbal expressions and actions, employed to carry out the request, "Would

you please share a book with your child?" A qualitative research method was

selected because the fundamental focus of this approach is description and

because it is appropriate for the objective and questions that guided this inquiry.



The purpose of this study was to describe the nature of book sharing in the

mother-infant dyad. The major focus of this inquiry was on the verbal and

nonverbal expressions through which mothers interpreted the request "Would

you please share a book with your child?" The inquiry was powered by one

broad question: What features characterized the social dynamics observed in

book sharing episodes of 13 mothers and their 6-month-old infants who were

born prematurely and sick? This chapter is a descriptive analysis of the social

dynamics through which these mother-infant dyads carried out the event.

The Book Sharing Format

"What behaviors did a sample of 13 mothers of preterm infants employ in

response to the request 'Would you please share a book with your child?"'

The goal for this inquiry was to discern the character of the social dynamics

that comprised "book sharing." In accord with the theoretical framework,

symbolic interactionism, the meaning of behavior derives from social functioning,

making it possible to discern the nature of book sharing through the

moment-to-moment events taking place between the mothers and their infants.

Hence, the interpretation of a discrete behavior is entwined in the unity of the

total episode, is situation dependent, and derives its communicative value as the

rhythms, patterns, and cycles of social interactions unfold. Brazelton, Koslowski,

and Main (1974) explained this condition of meaning in context:

The behavior of any one member becomes a part of a cluster of behaviors
which interact with a cluster of behaviors from the other member of the
dyad. No single behavior can be separated from the cluster for analysis
without losing its meaning in the sequence. The effect of clustering and of
sequencing takes over in assessing the value of particular behaviors, and
in the same way the dyadic nature of interactions supersedes the
importance of an individual member's clusters and sequences. (pp. 55-56)

The mothers responded to the request to "share a book" by chaining a

stream of discrete verbal and nonverbal behaviors. In view of the relationship

between context and meaning, it was not unusual that a single behavior or

gestural sequence carried multiple meanings (Jakobson, 1960; Lewis &

Lee-Painter, 1974). Consequently, the actual meaning of a behavior can hardly

be interpreted without regard to the whole course of interaction. For example,

the behavior looking into the child's face was not always assigned the same

meaning, as demonstrated in the as following excerpts.

1. Looking into the child's face was a way to determine where the baby

was looking:

4.1 M: See the pup pup? (Adjusts the book in front of C)
See the pup pup now?
C: Looking into the book.
M: (Looks into C's face, follows C's line of gaze to the book)
I bet I know which one you're looking at. (Crooning, looks from C
to the book two times)
I bet I know which one you're looking at. (Quickly glances from C's
face to the book, then back to C)
See? (As if meaning, I ESTIMATED CORRECTLY, DIDN'T I?)

2. In the following excerpts, pausing and looking into the child's face was a

way that the mother indicated her baby's turn.

4.2 M: Wanna see that? (Looking into C's face with her head bent
down to C's eye level)
See, huh? (Pause, holding the book directly in front of C)

4.3 M: Turns the page)
C: (Looking into the book)
M: Ah, see the donkey? [Statement, with a questioning
inflection] (Pause, looks into C's face as if waiting for C's
C: (Continues to look into the book)

4.4 M: What's this, a lamb?
A lamb, huh?
Is that what it is? ( Pause, looking into C's face, as if
waiting for C to respond]

This point of meaning in context may be readily realized when the

structure and character of the social dynamics of book sharing are revealed.

Therefore, in the interest of clarity, the issue of the mothers' behavioral

repertoire is revisited and elaborated in the subsequent section, Pathways to


The second and third questions that guided this inquiry were: How did a

sample of 13 mothers of preterm infants format their behaviors to carry out book

sharing with their preterm infant and what features characterized the verbal and

nonverbal expressions and conduct employed by a sample of 13 mothers to

carry out book sharing with their preterm infant? The responses to these

questions revealed the structural organization and the character of the social

dynamics through which each mother mediated book sharing with her infant.

The social dynamics of book sharing was characterized by the mothers'

efforts to strike a balance between the physical and social environments that

would support the roles each mother envisioned for herself and her infant.

Throughout this interactive framework, organizing and negotiating were central

themes. Specifically, the mother's portrayal of book sharing was highlighted by

her efforts (a) to prepare a context for book sharing (i.e., setting the stage by

organizing the physical environment), (b) to motivate the baby to engage mutual

interchanges around the book (i.e., incorporating the baby in book sharing by

organizing the child's spontaneous behavioral repertoire into the dyadic roles

that the mother considered appropriate for interacting with a book as a literacy

artifact), and (c) to negotiate the give and take of interacting with a less

competent partner (i.e., maintaining an appetitive social atmosphere that

sustained the infant's participation in book sharing).

When mothers responded to the request, a book sharing format emerged

around three sequential activities: (a) organizing the setting, (b) entraining in

book sharing and, finally, (c) closing book sharing. The interactions within these

sequences were characterized by the mothers' efforts to engage and maintain a

flow of mutual interchanges that mirrored their understanding of "share a book."

The descriptions that follow reveal the character of the social dynamics that

comprised the three activity formats. As the format is described, examples from

the protocol are provided to illustrate the findings.

Phase I: Organizing the Setting for Book Sharing

Organizing the setting featured the mothers creating a physical

environment for book sharing. Each dyad was seated on a cushioned mat

engaged in play with one or more toys. The clinician entered and made the

request, "Will you please share a book with your child?" Although at liberty to

move to a cushioned chair or couch, all of the mothers remained on the mat.

However, it appeared that they considered book sharing to require a particular

arrangement that was different from play; thus, mothers prepared a setting that

was appropriate for book sharing to take place.

The book sharing episode opened with the mothers organizing their

surroundings; they first arranged the physical environment. Within an average

of 5 seconds after the clinician's request, most of the mothers prepared a space

on the mat. They began by clearing toys from the area immediately surrounding

the dyad. Five of the mothers cleared the mat of toys and also removed the toys

from their infants' grasps.

Without breaking their flow of behavior, the mothers proceeded to arrange

the dyad into a book sharing posture. Their objective seemed to be to establish

close proximity to each other. Five different postures were observed when the

mothers initiated interactions with their infant around the book. Seven of the

mothers were adjacent to their infants (the neighbors posture) and three mothers

were seated with their babies sandwiched between their legs (the sandwich

posture). The remaining three mothers each assumed a unique position: one

mother positioned the baby on her lap (the lapsit posture) one mother sat

face-to-face opposite the baby (the en face posture), and one sat coupled

behind her baby (the caboose posture). These five postures are depicted in the

following descriptions.

The neighbors posture. The mother positioned the dyad so that she was

beside her infant, both partners facing the same direction. One form of the

neighbors posture featured both partners seated up-right looking into the book.

The mother placed the book on the mat or held it in front of the child and she

leaned, with both hands extended in front of the child, to manipulate the book

(Figure 1). A second form of the neighbors posture featured the mother kneeling

(supported on both knees) and the infant either lying stomach down on the mat

or sitting upright beside the mother. In the kneeling posture, the mother

manipulated the book on the mat in front of her baby.

The sandwich posture. Seated on the mat, the mother nestled her infant

between her thighs (upper legs). Both partners sat upright facing the same

direction with the infant's back against the mother's upper torso. Complete body

contact was made as the mother enveloped the infant's body within the embrace

of her arms. She manipulated the book with both hands in front of the dyad

(Figure 2).

The lap-sit posture. Seated on the mat, the mother sat the infant on one or

both of her thighs (upper legs). Both partners sat upright, facing the same

direction, and with the infant's back against the mother's upper torso. Complete

body contact was made as the mother enveloped the child's body with her arms.

She manipulated the book with both hands in front of the dyad (Figure 3).

The en face posture. The mother seated her infant, in an upright posture,

across from her in a face-to-face position. The book was placed between the

partners and open in front of the child (which was upside down for the mother).

The mother leaned forward to view the book and she used both hands to

manipulate the book (Figure 4).

The caboose posture. Both mother and infant were seated upright facing the

same direction. The infant's back was to the mother who was seated directly

behind the baby. The dyad appeared coupled together, in the fashion of cable

cars. The book was placed open in front of the child. The mother leaned around

the child's shoulder to view the book and she extended her arm around her baby

so that she could manipulate the book (Figure 5).

Figure 1.
The Neighbors Posture

Figure 3.
The Lap-sit Posture

Figure 2
The Sandwich Posture

Figure 4.
The En Face Posture

Figure 5.
The Caboose Posture

Demos (1982) indicated that the mothers' spatial arrangements provide

some idea of their conception of the situation. When mothers establish close

proximity with their baby right from the start, they perceive the activity as a joint

venture. Conversely, when the mother is nearby with the baby beyond her arm's

reach, she considers the venture a child activity. On this basis, organizing the

setting might be explained as the mothers' intention to set the stage in

accordance with the expectation that book sharing would evolve as a joint

experience that required close proximity to the infant.

On the basis of the comments that mothers made while organizing the

setting, two additional factors were taken into consideration. First, they did not

consider book sharing to be the same as playing with a toy, and they wanted

their child to know that the experience would be different and that toys had no

place in the activity that was about to take place. One mother indicated this

when her child reached for a toy that she had just removed; "Gotta leave them

rings (toys) alone. O.K. Leave them rings alone just for a minute." Second, it

appeared that the mothers anticipated that toys would be a distraction to the

infant; hence, clearing the immediate area coupled with removing toys from the

infant's grasp was a measure to set the stage for the child's attentive

participation. As one mother moved the toy she stated, "Oh, we should not show

you that; [put] that away," as if she intended, IF YOU SEE THE TOYS, YOU

WON'T BE INTERESTED IN THE BOOK. In what seemed to be an intuitive

maneuver, several mothers covered the toy with the book as if to shield the

child's view as she removed the potential distractor. Thus, it was apparent that

the mothers were trying to avoid competing for their children's interest by

removing potential distractions.

The mothers arranged physical proximity with their infant so that both

could comfortably interact around the book. It seemed that they intended to

organize a dyadic posture (i.e., a position that would facilitate the baby's

participation as well as their own). For example checking and adjusting the

baby's position, as if reassuring that the child's legs were properly placed, and

comments to the child such as "You all set?" and 'There you go" indicated that

comfort was an important factor in their choice of postures. Thus, arranging

posture was a way to get comfortable for interacting together around the book.

Phase II: Entraining the Infant in Book Sharing

Entraining the dyad in book sharing featured the mothers and infants

negotiating the rules for the turn taking model of dialogue that the mothers

attempted to establish with their babies. If successful through this repetitive

process, the mother and infant would become entrained in an exchange of

reciprocal turns that gave the appearance of a conversation. The entraining

process included three sequential levels of activity.

1. Soliciting the infant's participation in book sharing was the initiating

phase. It featured the mother introducing her baby to the activity and getting the

child to visually focus on the book, followed by setting expectations for their

respective mother-infant roles in the book sharing process.

2. Engaging the infant in book sharing was a negotiating phase. It featured

the mother's efforts to establish shared visual attention (coorientation) toward

the book and thereafter bring the infant's behavior into accord with her

expectations to engage mutual exchanges of point/say and look/listen around

the book.

3. Entraininq tne ja. In r, ook sharing was the proto-conversational phase.

It featured the mother and infant locking into an organized ritual of reciprocal

turns that gave the appearance of a conversation where both partners

alternately initiated and reciprocated ideas and tasks that referenced the book.

Level I: Soliciting the infant's participation

The prelude to book sharing was getting the infant interested in the book as

an object. The activity opened with the mother soliciting the baby's visual

orientation to the book. Visual gaze (looking) indicates the readiness and

intention to engage in interaction (Collis, 1977; Goffman 1963). The main

indication of the infant's localized interest is cues from head and eye movements

in fixation and tracking. "From very early on the mother can best attract the

infant's attention to objects by handling them" (Collis, 1977, p. 357). Thus,

getting the child to visually focus on the book was not difficult because the

curious babies visually tracked their mother's hand movements from the moment

that she reached for the book. Thereafter, in a continuous flow of activity the

mother promptly proceeded as if she intended to seize the moment of curiosity to

persuade her baby to interact with her around the book.

The mother customarily maintained her baby's interest through an array of

novel behaviors such as playfully smiling and looking pleasantly wide-eyed,

speaking in an infantile voice or an exaggerated high pitch, expressing warmth

and affection through touching such as cheek to cheek contact, speaking in

moderately low tones, or whispering and cooing. The mother's display of

"infant-modified" (Stern,1977) expressions held the baby's attention as she

opened and placed the book directly in the child's line of sight.

Once the book was in place, the mother continued to capitalize on the

infant's attentiveness as her crPponnunii, to introduce the activity and set the

expectation for their respective roles. The idea that the baby would look and

listen and the mother would "read" and "show" the book was implicit in the

introduction of the activity. In their initial utterances to the infant, the mothers

used one of three modes to solicit looking and listening behaviors:

1. Without pointing, five mothers immediately requested the child to look at

a picture or look and listen to her comments about a picture:

4. 5 M. (Holding the book in front of C.
Speaking in a soft, tender voice)
Look at this.
See the baby animals? (Pause, looks into
C's face).
C. (Looking at the book and waiving her arms)

4. 6 M: (Placing the book in front of C as she speaks)
So look.
C: (Looking intently at the open book)

4. 7 M: (Opening the book as she speaks)
Look. (Moderate tone, slight pause)
C: (Looks and touches the book).

4. 8 M: Look at this boy. (Warm, excited tone).
C: (Touching the book, looking and wiggling legs).

4. 9 M: Look at this. (Exaggerated infantile tone/baby talk)
Look-a here.
C: (Looking).

2. Three mothers immediately pointed to and described or labeled a


4. 10 M: (Holding the book in front of C)
See something red? (Pointing; glances into C's face)
C: (Looking and reaching for the book)

4. 11 M: (Placed and opened the book in front of C)
Aa-a-ah, (Mock surprise; glances quickly at C)
Bunny rabbit. (Pointing to the picture, speaking in a
moderately excited tone)
C: (Looking intently at the book).

4. 12 M: (Placed and opened the book in front of C)
Here are the animals. (Pointing, speaking in an
expressive tone)
C: (Looking at the book, then looks away).

3. While opening or picking the book up, four of the mothers immediately

issued invitations to their infants to look at the book, and they announced their

intention to read or show the book to their infants.

4. 13 M: (Speaking as she opens the book)
Want to look at a book? (Speaking in a moderately
low voice; moderately excited tone)
C: (Looking, reaches and touches the book,
then looks away)

4.14 M: (Speaking as she picks the book up)
Wanna look at the book? (Speaking in a moderately
low, excited tone)
Mama read to you.
C: (Looking and reaching for the book)

4.15 M: (Speaking as she opens and places the book in front of
I'm gonna show you this book. (Speaking in a
whispering, cooing tone)
C: (Looking intently at the book)

4.16 M: (Speaking as she approaches C with the book)
Come on, let's look in the book. (Speaking in a
moderately low tone)
C: Vocalizes, as the mother approaches
(Looking and reaching for the book)

One mother did not fit either of these modes. In essence she implied the

reverse of the roles that others expressed, suggesting that the baby, rather than

she, would read and label. Nonetheless, her verbal expressions paralleled the

general notion of others that book sharing would involve reading, looking, and


4.17 M: (Holding the open book in front of C)
Can you read?
Ki-Ki (Calling C's name in a sing-song fashion)
(Pause, looking at C's face)
Do you know what that is? (Looking at the book)
C: (Looking and holding the book).

Through these modes of initiating, the mothers introduced their babies to

the activity and they expressed the expectation that their babies would look and

listen. As the episode progressed it became more apparent that the activity

would be governed by the rule of taking turns looking, listening, showing,

reading, and labeling. The infant's principal activity would be looking and

listening (spectator/listener) in response to the mother showing, labeling, and

reading the book (performer/speaker). Hence, their reciprocal roles would

feature alternating sequences of the following nature:

Mother: performer/speaker

4.18 M: Look (pointing to the picture).
A dog.
A dog, like Frizbee.

Infant: spectator/listener

4.19 C: (Visually follows M's hand to the picture.
Looks intently at the picture).

Level II: Engqaing the infant in book sharing

When the baby was visually focused, the mother's next efforts progressed

to engagement. Engaging the infant in book sharing featured the mother's

efforts to bring the infant's behavior into accord with expectations for taking turns

interacting with her around the book. Most of the mothers tried to organize the

activity into a flow of reciprocal exchanges involving their infants responding to

the requests to "look" and "listen." However, this quality of interaction was not

easily established, especially with very active infants, largely because the

children introduced an array of unsolicited behaviors. Usually, during the

soliciting level a mother did not respond to her child's combined behaviors. Her

initial goal seemed to be getting the child interested. She appeared to be

concerned primarily with the child's visual orientation toward the book, as a

signal that the baby was attending to the book and ready to interact.

Once a baby visually focused on the book, the mother's next effort was to

establish "coorientation" (Collis, 1977) in which the infant expressed an interest

in the book and the mother reflected a responsiveness to the baby's interest.

The apparent objectives were to establish joint attention (i.e., visually focus on

the same aspect of the book) and thereafter to channel the infant's behaviors

into coordinated sequences of looking and listening in response to her pointing

and labeling.

Organizing the dyadic behavior into a flow of coordinated exchanges was

not easily accomplished because once the baby visually focused, spontaneous

behaviors either accompanied or followed visual orientation. Customarily, the

infant' behavioral repertoire toward the book included combinations of looking,

listening, reaching, touching, patting, grasping, pulling, and mouthing the book.

Sometimes the infant introduced preverbal vocalizations and body movements

such as waving arms, wiggling, and squirming. In addition, they alternated

looking at the book with looking away from the book. At this point in the book

sharing format, the 13 dyads diverged.

Two patterns of book sharing evolved primarily as the result of the ways

mothers addressed their infant's unsolicited behavior. The alternating and

sometimes simultaneous motor and language exchanges between mother and

child were either task-related or nontask-related units of exchange. Task-related

exchanges were comprised of gestures that gave the appearance of agreeing on

an idea relating to the book and cooperating in performing actions toward the

book. This quality usually emerged as the result of the mother synchronizing her

response to incorporate the infant's unsolicited behavior into a dyadic script

around the book.

Coorientation to the book was made as the result of the mother following

her baby's direction of gaze, rather than the baby following the mother (Collis,

1977) and synchronizing with the baby ensured the mother's efforts to engage

reciprocal turns. A mother who successfully engaged task related exchanges

synchronized with her infant by imputing meaning to the child's spontaneous

actions that complimented what she considered appropriate for interacting with a

book. The mother customarily incorporated the child by reversing her script so

that the baby's role became performer and speaker; in turn, the mother played

out the spectator-listener role. This effect is demonstrated in excerpts 4.20-4.22.

4. 20 C: L-'":'4-rn into the book, touches the page
and strokes the page aimlessly)
M: (leans, inspects C's face as if to see where she is
Kitty? (pause)
Uh huh, kitty.

Designating the baby as performer. The mother established that the baby

was trying to reference a specific part of the text. By looking into the child's face

and following her line of sight, the mother interpreted the child's use of eyes to

indicate a place of interest. Additionally, the infant's random hand movements

were interpreted as the intent to "show" (point to) the mother exactly where to

look. In turn, assuming the role of spectator, the mother looked where the baby


Designating the baby as speaker. The mother supplied the child's voice

and content of expression. "Kitty?" (pause as if waiting for C to respond).

Although she provided a label, the interrogative inflection implied that the baby

asked a question, perhaps meaning IS THAT A KITTY? In turn, the mother

demonstrated that she was listening, ("Kitty"), perhaps meaning: DO YOU

MEAN IS THAT A KITTY? Then she confirmed, ("Un, huh, kitty."), perhaps

meaning' YES, THAT IS A KITTY. The gist of the sequence was that the

mother followed the child's line of vision and assigned the child's ocular

orientation as the child's way of pointing to the picture. She asked the child's

question, then, she answered the question as if the baby had spoken. Through

this means the mother established their mutual exchange.

Designating the baby as leader. Maintaining the exchange sequence

usually meant yielding the lead to the baby. The effect of yielding was that the

baby was permitted to establish the topic of book sharing. This effect was

demonstrated when the mother adjusted her actions to compliment the child's

unsolicited actions toward the book (4.21-4 22). First, the mother attempted to

introduce her topic about the dog; the child looked, but at the same time he

grasped and waved the page of the book (4.21). The mother maintained the

synchronous rhn, nm by following along as if the child stated, I WANT TO TURN


4.21 M: (Turns the page, points to a picture)
Look Jim, a dog.
See that dog? (Pause, as if waiting for a response).
C: (Grabs the corner of the page as it turns
and waves the page back and forth)

4.22 M: (Looking into C's face, smiling)
[Do] You want to turn the page for me? [A statement
with an interrogative inflection]
C: (Waving the page back and forth)

This mother allowed her child to lead. Additionally, as the result of the mother's

imputation, the child also established "page turning" as the topic of activity. In

this way, the child's visual and tactile behaviors toward the book appeared to

express the thoughts that his mother spoke.

In the unit (4.21) the mother attempted to lead and to introduce her topic

about the dog. At the same time however, the infant grasped and waved the

page of the book. In turn, the mother again yielded to the baby by coordinating

her behavior with the child's activity (4.22). Consequently, she again

incorporated the child's unsolicited actions into the activity sequence; thus,

maintaining the flow of reciprocal exchanges.

The action sequence of a mother who engaged in task related exchanges

was consistent with the notion that, at first, turn taking was entirely due to the

mother's initiative (Schaffer, Collis, & Parsons,1977). The appearance of the

child's intention lies only in the mother's mind; she tends to act as though the

baby were a communicative partner by endowing the child's responses with a

signal value, which in fact, the infant does not possess (Newson, 1977).

Mothers who were able to mutually engage their infants usually did so by

ascribing meaning to spontaneous behavior that would readily establish the

children's participation as appropriate for the occasion. The most frequent types

of synchronized responses that mothers used to engage mutual turns were (a)

interpreting the children's gestures as if the babies intended to make appropriate

contributions to the action sequence, (b) commenting on the children's gestures

as if affirming that the children's contributions to the interaction sequence were

appropriate, (c) answering the children's gestures as if the children asked

questions, and (d) soliciting gestures as if acknowledging that the children were

communicative partners who were entitled to equal turns in the action sequence.

In effect, by imputing the baby's intentions the each mother gave their

prelinguistic partner a voice in the activity. Such responses enabled the mother

to incorporate almost anything that the baby did toward the book into book

sharing. As the result of the mother matching her response with the baby's

unsolicited actions, the dyad acquired a cooperative and communicative nature.

For example,

1. Interpreting gestures as if her child stated, I WANT TO HOLD THIS


4 23 C: (Scratching the page)
M: (Whispering into C's ear)
You want to get it out, huh?

2. Commenting on gestures by evaluating the baby's performance:

4. 24 C: (Holding and swinging the page; turns it and lets it go)
M: You turned it. (Soft, mildly excited tone)
You turned it all by yourself.

3 Answering gestures by responding as if her child asked the question,


4.25 C: (Turning the page back and forth; looking
intently at the swaying page)
M: That's just the way books are read.

4. Soliciting gestures by encouraging the child to emit or repeat a specific


4.26 C: (Leans forward into the book, almost touching the
page with her face)
M: Do you want to smell it?
Ye-e-a-ah, you want to smell it.
Smell it.

These types of task related exchanges gave the appearance of both

partners speaking and cooperating. The infant's gestures appeared to be

intentional and appropriate for the occasion, hence giving the appearance of the

mother and baby alternately initiating and reciprocating turns in a conversation

about the book.

In contrast to the mother-infant synchrony and the appearance of

agreement that dominated task related interactions, the asynchronous pattern of

nontask related book sharing was dominated by exchanges that gave the

appearance of opposition. Nontask related exchanges emerged as the result of

the mother's failure to adjust her responses to incorporate the child's unsolicited

behavior into interaction sequences with her. The pattern was customarily

overshadowed by negative affect in the sense that the mother routinely excluded

her baby from participating by interpreting the child's spontaneous conduct

(other than looking and listening) as inappropriate and by making negative

comments about the child's intentions. In essence, the mother failed to

acknowledge the infant's actions as meeting her expectation for what would take

place around the book. Such behavior was counterproductive to her efforts to

engage the baby in sequences of reciprocal turns around the book. This pattern

of dialogue was illustrated in the following excerpts from an episode in progress:

Initially, this mother refused to incorporate her infant's unsolicited behavior

by ignoring the child.

4.27 C: (Reaches and grasps the book but does not
succeed in maintaining his grasp)
M: (Ignores C's grasping)
See the girl? [ A statement with a questioning
[The] girl is swinging.

As the activity progressed, her comments and imputations for the child's

behavior became increasingly negative. The mother indicated her intentions for

the child to look and see, as she displays the contents of the book.

4.28 C: (Grasping for the book)
M: (Tilting the book away from C's grasp)
Don't try to tear that book.
Look at the book.

4.29 C: (Continues to try to grasp the book)
M: (Leans around the book, looks into C's face with a
scolding facial expression and verbal tone)
Don't tear the book.
Trying to tear up the book.
Don't try to tear up the book.

4.30 M: (Turns the page)

See the girl?
C: (Attempted to grasp the turning page and continues to
grasp for the page)

4.31 M: (Moving and tilting the book away from C)
What you gonna do with the book?
Tear it up?
C: (Continues to grasp for the book)
M: (Uses her arm to block C's grasp)

This interaction suggested that the mother's idea of book sharing would

permit only the adult to initiate topics and direct the activity (i.e., only the mother

should point and say) In turn, the infant should follow her directives to look and

listen. It appeared that this mother failed to engage reciprocal exchanges

because she believed that the child's actions did not compliment her perception

of the child's role in book sharing. As the result of the mother's refusal to

incorporate her infant's unsolicited reaching and touching behaviors, the episode

was marked by exchanges that alienated the baby and, in effect, precluded

engaging a pattern of task related book sharing.

The preceding excerpts portrayed examples of all-or-nothing patterns of

reciprocal exchanges. However, neither pattern represented a majority of the 13

dyads. It appeared that the point-say/look-listen model served as the framework

for producing book sharing; that is, most of the mothers expected that the activity

would be governed by the communication rule of taking reciprocal turns doing

and saying something about the book. Evaluating the participants in terms of

the model of reciprocating turns as the framework for accomplishing book

sharing, the dyads were either communicative, rai'gnajii communicative, or

noncommunicative partners, depending on the degree of task and nontask

related exchanges that dominated their interactions.


In the four communicative dyads, an average of 90% of their exchanges

(range = 79-95%) were task related.

In the three T-arginaiij -communicative dyads, an average of 59% of

their exchanges (range = 55-65%) were task related.

In the six noncommunicative dyads, an average of 29% of their

exchanges (range = 0-39%) were task related.

Table 2 indicates the distribution of task and nontask related exchanges among

the dyads.

Level III: Entraining the dyad in book sharing

The cornerstone of entraining was engaging the infant in reciprocal

exchanges. If the dyad successfully entrained in book sharing, the interactions

would mesh into an ongoing flow of task related gestures. Such gestures would

model taking turns in a conversation about the book. Because the infants were

prelinguistic, their principal means of "speaking" consisted primarily of body

actions such as looking, smiling, reaching, and touching. Babies sometimes

vocalized. However, the episodes were not rich with vocalizations. The

mothers' principal means of speaking included language as well as body actions.

In order to entrain, the mother had to first channel the infant's behavioral

repertoire into sequences of mutual exchanges with her. Noncommunicative

dyads were characterized by a flow of nontask related exchanges that were

typical of excerpts 4.27-4.31. Noncommunicative dyads were not able to engage

a flow of reciprocal exchanges. Consequently, these mothers and their infants

did not progress to the entraining phase; instead, the persistent discord led to

closure. Communicative dyads were dominated by sequences of nuluaii,

Table 2
Distribution of Task and Nontask Related Exchanges by Groups and Dyads

Dyads Frequency Percentage
N=13 Task Nontask Task Nontask Exchanges

Conmrrimuncati.e (n=4)

1 20 1 95 5 21
2 33 2 94 6 35
3 29 3 91 9 32
4 23 6 79 21 29
m 26 3 90 10 29
Marqinally-Comm. (n=3)
5 22 12 65 35 34
6 9 7 56 44 16
7 12 10 55 45 22
m 14 10 59 41 24
Noncommunicative (n=6)
8 7 11 39 61 18
9 5 8 38 62 13
10 3 6 33 67 9
11 4 8 33 66 12
12 2 5 29 71 7
13 0 10 0 100 10

m 4 9 29 71 12

Note: The numerical order corresponds with the order of dyads in Table 1.

reciprocal interactions. These partners were able to successfully entrain in

dialogue around the book. Marginally-communicative dyads were initially

dominated by discord that closely resembled the noncommunicative dyads.

Eventually, they were able to negotiate a flow of mutual exchanges; however,

they did not successfully entrain in book sharing. Communicative and

marginally communicative dyads are described as they appeared during


Communicative dyads. Typically, in the four communicative dyads

where entrainment was successful, the partners engaged in mutual exchanges

within the first three to four turns and subsequently meshed into an ongoing

ritual-like sequence that resembled taking turns in a conversation. These

mothers were able to maintain the sequence by getting their children caught-up

into repetitive cycles. It appeared that repetition promoted the infants' ability to

reliably contribute the actions that were expected of them in order to sustain the

flow of reciprocal dialogue. Consequently, as the episode progressed, it

appeared that the mothers and their infants became more proficient in their

ability to appropriately respond to each other's cues. This effect was explained

by Fogel (1977) who summarized that repetition sustains the infant's attention

and the increased redundancy creates a more predictable environment for the

sake of the infant's immature information processing capacities. The infant's

repetition then becomes "an incentive to the mother to maintain her own

repetitive series of acts" (p. 149). The repetitive and communicative nature of

entrainment is demonstrated in the following excerpts:

M solicited and affirmed C's visual orientation toward the book:

4.32 M: Look at this. (Speaking in a soft tender voice)
See the baby animals?
C: (Looking at the book and waving her arms)

4.33 M: Look at the baby animals. (Pause)
C: (Reaching for the book)

4.34 C: (Touching the book with both hands)
M: Ye-e-a-ah. (Pause)
Say, "I like books."

The mother responded to the baby's looking behavior as if the child intended to

indicate that a certain picture was of interest.

4.35 C: I Sirilng
M: (Inspects C's face, as if to determine where C is
What is that? (Whispering and crooning)

The mother incorporated her child's tactile behavior into dialogue around the

book, then proceeded to channel the behavior into repetitive exchanges of

turning the page. It appears that the child's cue to turn the page is the mother's


4.36 C: (Pats the page, draws the book toward herself, then
looks into M's face)
M: (Looking into C's face while turning the page.
M's face is very close to C's face)
You want to turn the page?

4.37 C: (Holding onto the book)
M: (Holding, without closing the page)
Want to turn the page? (Pause, looking at C)

4.38 C: (Turns the page)
M: That's right.

As if rehearsing the script for their mutually supportive tasks, the dyad

accelerated to entrainment (i.e., locking into sequences of repetitive exchanges

that gave the appearance of both partners intentionally sharing joint tasks

around the book).

4.39 M Ah! (Mock surprise Pointing to a picture)
Those are ducks.
Quack, quack! (pause).
C: (Turns the page)

4.40 M: Here's a puppy dog, puppy (Pointing to the
We have a puppy dog (pause).

4.41 C: (Turns the page, looks toward M)
M: Ye-e-a-ah.
What else do we have here?
A-a-a-ah! [Mock surprise. Slight pause)
Here are baby chicks.

4.42 M: (Turns the page)
C: (Looks at the book then looks at M)

The child responded as if the mother had violated the established repetitive

exchange cycle. This seemed to have interrupted the rhythm of their exchanges.

Although the mother attempted to repair the violation, book sharing was destined

for closure.

4.43 M: Do you want to turn the page again? (Said as if



realizing that she had over stepped her bounds or as if
M: (Begins to turn another page, hesitates, looking into
C's face as if trying to draw C's attention back to
the task and regain the synchronized rhythm)
C: (Looking at the book trying to turn the page)

M: Do you want to? (Pause)
Do you want to turn the page?
C. (Smiling and looking at M; turns the page)

M: Yeah! (Looking at C)
That's right.
You want to turn the page.

C: (Rocking)
Vocalizes! (Excitedly)

4.46 M: You want to turn the page? (pause)
C: (Turns another page then looks into M's face)
M: Yeah, that's right.

4.47 M: (Points to the picture then into C's face)
Oh, this is a horse, a baby horse.
(Pointing to another picture)
And a baby calf that says, "Moo!"
C: (Has a big smile, wiggles, holding the book)
M: Ye-e-e-ah!
That's right, "Moo."

4. 48 C: (Bangs on the floor with her hand then places the
hand back on the book and pulls it toward her mouth)

M: So now you're going to taste it.
(Looking into C's face and speaking with an
approving tone)

The baby's banging then mouthing behaviors seemed to be erratic shifts in

behavior that may have been associated with excitement or overload, and the

need to take a break. However, this mother's interpretation was different. She

promptly switched speakers as if the baby asked, WHAT DOES IT TASTE LIKE?

She incorporated the idea into their dyadic script. As if the baby initiated the

topic, the mother encouraged the child to emit the behavior again so that she

could describe what the child demonstrated.

4. 49 M: Taste it.
Does that taste good? (Pause; looks at C:
Looks at the book)

4. 50 M: (Pointing to the book)
Taste good.
Did it taste Good? (Pause, looks at C)
C: Vocalizes (neutral tone)

The baby's neutral vocalization appeared to be associated with the early

mouthing and banging behaviors, which seemed to signal the baby's need to

withdraw; again, the mother ignores it. The mother attempted to take the lead

and redirect the child's action to their page turning routine. However, the baby

no longer appeared to be interested in the book

4. 51 M: Do you want to turn another page?
Do you want to all by yourself? (Pause; looks at C)
C: (Leans, looking away from the book; spots a toy
and reaches for it)

Implicit in her response was that she interpreted the baby's visual behavior

as a gesture to mark the target of interest. Accordingly, when the baby looked at

the toy, the mother interpreted the gesture to mean, I DON'T WANT TO READ


In turn, she promptly obliged.

4. 52 M: [Do] You want to see that? [Referring to the toy]
Shall we get it? (Looking at C)
End of episode.

The exchanges between this mother and her infant meshed into a

continuous flow wherein the infant reliably participated with minimum prompting

from her mother Their synchronized exchanges gave the appearance of a

conversation where the mother and baby alternately reciprocated and initiated

ideas and tasks that referenced the book. This pattern of interaction illustrates

the quality of turn-taking that was projected by most of the mothers during the

soliciting phase.

Marginally communicative dyads. Early exchanges did not indicate whether

dyads would eventually accomplish reciprocal book sharing However,

successful entrainment appeared to firmly depend upon the length of time that

was spent getting the infant engaged in mutual exchanges. The three

marginally-communicative dyads were able to engage mutual exchanges around

the book; however, they were not able to entrain in sequences of

conversational-like turns because the babies withdrew under what appeared to be

fatigue from their mothers' prolonged attempts to negotiate their reciprocal roles.

Typically, these mothers resorted to a trial-and-error approach before discovering

how to get the dyad in rhythm. As the episode progressed the mothers were

eventually able to channel their children's behaviors into task-related exchanges;

nonetheless, they were not able to lock into a dyadic ritual.

This result was demonstrated in the following episode by a mother who

spent a major portion of the engaging level struggling to get her baby to

cooperate. It appears that through trial and error, the mother eventually decided

that mutual turn-taking could be achieved if she cooperated with her infant.

Subsequently, the mother coaxed her child to produce the behaviors that she

initially prohibited; in turn, the mother synchronized her actions to complement

the child's productions. It appears that she intuitively began to incorporate her

infant by composing a dyadic script around the book and the child's behavior.

Finally, the mother attempted to lock the dyad into book sharing by encouraging

the infant's repetitive behavior. However, she was not successful because

around this time the infant no longer expressed interest.

M solicited her child's visual orientation toward the book then she struggled

to persuade the baby to cooperate with her. Their interaction was dominated by

sequences of nontask-related exchanges.

4.53 M: Look (Opening the book)
C, (Looking at the book. Grasps the page
and attempts to turn it)

4.54 M: (Pushes the page back)
Wait a minute.
C: (Maintains grasp, continues attempts to turn)

4.55 M: (Restrains C's hand with her thumb; looking at the
C: (Removes hand from the book)

4 56 M: (Places her left hand on C's abdomen and presses
C's body back [C is sandwiched between M's legs])
C: (Places hand on the book)

4.57 M: (Removes C's hand from the book)
C: (Trying to maintain a grasp Tips the book upward,
almost closing it)

4.58 M: (Grasping the book with both hands)
Wait Katie.
C: (Swipes at the book)

4.59 M: (Left hand is on the book, right hand is on C's
See that.
See the picture?
C: (Grasps the book)

4.60 M: Strugjging to keep C from grasping the book)
C: (Hand on the book)

The nontask related exchanges continued until, finally, the mother seems to

have concluded that if she cooperated with her baby, the two could engage

mutual exchanges around the book. Thereafter, she encouraged and

incorporated her baby's behavior into the activity. Consequently, the remaining

interaction was dominated by sequences of task-related exchanges.

4.61 C: (Moves arms and hands away from the book)
M (Takes C's right hand and places it on the page)

M began to engage C. It seemed that she intuitively composed a dyadic script

around the child's interests. As the episode progressed, the interaction closely

resembled the communicative dyads. The mother established reciprocal

exchanges that referenced the book by affirming, assisting, and interpreting the

baby's actions as appropriate toward the book.

4.62 C: Leans forward, as if to grasp the book)
M: (Guides C's hand to the page, places it under the page
and assists C to turn the page)
Ye-e-a-ah. (Exaggerated "yeah")
You turned the page.

4.63 C: (Leaning forward and touching the page)
M: See that!
See the picture?
(Lowers her voice to a whisper)
You wanna get that picture? (Head close to C's)

Despite the mother's affectionate bids, her child appears tired and no longer

willing to participate further in the activity. On the basis of their verbal

comments, the mother seems to appropriately interpret the baby's cues to stop;

however, the mother does not conform.

4.64 C: (Looking away from the book, to her side)
M: (Moves the book away from C)
She's getting mad.

4.65 M: (Moves the book into C's line of sight)
Look, Katie.
C: (Leans into the book, touches the pages with
both hands, then looks away from the book)

4.66 M: (Looking into C's face, as if determining where C is
That's right, touch it.
C: (Looks away from M).

Mothers in the three marginally-communicative dyads resorted to this

trial-and-error approach before incorporating their children in book sharing by

synchronizing with their children's spontaneous actions. As the activity

progressed, the mother seemed to become a more responsive and proficient

with respect to figuring out how to incorporate, synchronize, and support her

infant's participation in reciprocal book sharing. Unfortunately, at the time when

entrainment might have been within reach, the child seemed to be tired.

Consequently, although these mothers were eventually able to engage their

infant in mutual exchanges, the dyad was unable to lock into an on-going

sequence of conversational-like turns. Thus, in marginally communicative

dyads, as the result of prolonged negotiation of reciprocal roles, book sharing

was derailed at the margin of entrainment.

Phase III: Closing Book Sharing

Closing book sharing featured the mothers and infants negotiating the

conclusion of interactions around the book.

The most important rule for maintaining an interaction seemed to be that a
mother develop a sensitivity to her infant's capacity for attention and his
need for withdrawal--partial or complete--after a period of attention to her.
(Brazelton, Koslowski, & Main, 1974, p. 59)

Cycles of looking and withdrawal are not unusual during mother-infant

interaction. When infants are over aroused, they cannot tone down the volume

of a voice or walk away; they look away (Adamson,1995). The babies might look

away to reduce the intensity of the interaction, to take time to recover from the

excitement it engenders, and to digest what has been taken in during the

interaction. Thus looking away and voluntarily returning represents a recovery

phase that allows infants to self-regulate their internal state (Stern, 1974), at a

time when constant stimulation, without relief, could overwhelm the baby

(Brazelton et al., 1974). Similarly, arousal may be increased by turning away

from a redundant and boring stimulus to seek a new stimulus (Fantz. 1964;

Kagan & Lewis, 1965).

Closing book sharing was usually initiated by the infant. Reduced intensity

of the child's interaction (Stern, 1977) and prolonged gaze averting (Chance,

1962) were the infant's way to serve notice that termination of the activity around

the book was forth coming. The following behaviors featured prominently as the

child's way to end book sharing:

1. Averting gaze without voluntarily returning to the book.

2. A.eri.rg gaze, staring fixedly on a toy and motioning as if reaching for

the toy; this sometimes also signaled that there was a competing interest.

3. Ceasing exploration or trying to explore the book (e.g., abandons

reaching, touching, and holding the book).

4. Mouthing or trying to mouth the book.

5. Emitting stressful vocalizations.

6. Crawling away or pushing away from the book.

7. Squirming as if to leave the mother's lap.

8. Arching to avoid looking at a picture that is placed in his or her direct

line of sight.

9. Refusing to make eye contact by turning away when the mother

attempted to make eye contact.

Analogous to this interpretation of the infants' behavior as their intention to

signal the closing of book sharing, Brazelton et al. (1974), identified four ways

that infants indicate and cope with unpleasant or inappropriate stimuli:

1. Actively withdrawing from it--that is increasing the physical
distance between the stimulus and oneself by changing one's
position, for example arching, turning, shrinking.

2. Rejecting it, that is dealing with it by pushing it away with hands and
feet while maintaining one's position.

3. Decreasing its power to disturb by maintaining a presently held
position but decreasing sensitivity to the stimulus--looking dull,
yawning, or withdrawing into a sleep state.

4. Signaling behavior, for example, fussing or crying which has the
initially unplanned effect of bringing adults or other caregivers to the
infant to aid him in dealing with the unpleasant stimulus. (p. 59)

Closing book sharing closely conformed to the dyadic rhythms that

characterized participants' communicative competence. In the communicative

dyads where the pattern of interaction was dominated by task-related

exchanges, the mothers seemed to appropriately interpret their infants'

withdrawal as the request to close; in turn they promptly ended the episode. In

two of the dyads, at the child's first instance of prolonged averted gaze without

voluntarily returning to the book, the mother promptly interpreted the behavior to

mean, I'VE LOST INTEREST IN THIS BOOK. For example, the child looked

away and visually scanned the room, then intently focused on a toy with an

extended arm, as if reaching for it. The mother responded as if the child said, I


ANY LONGER. In response, the mother closed book sharing. Two of the

mothers in communicative dyads did not immediately interpret gaze averting and

reaching away as closure. However, when the baby combined mouthing the

book with averting gaze, the mother responded to the combination behaviors by

closing the activity. The dialogue in excerpts 4.48-4.52 was typical of this

closing in two of the communicative dyads.

Typically, the noncommunicative and marginally communicative mother did

not respond promptly to her baby's cues. She seemed to ignore or

inappropriately interpret her child's signals. Consequently, the baby added on

behaviors that intensified the baby's request to end. The least synchronized

endings were observed in the noncommunicative dyads. Until the end, it

appeared that the mothers in these dyads were preoccupied with persuading their

children to look and listen. The effect of asynchronous interaction was explained

by Brazelton et al. (1974):

When the interaction is not going well, more intense withdrawal or active
rejection of the other actor may occur. This may be the result of a specific
inappropriate stimulus, or after a series that overloads his capacity for
responsiveness. (p. 59)

In what seemed to be insensitivity to their infants' cues, noncommunicative

mothers did not overtly respond to their babies' declining tactile and visual actions

toward the book. Perhaps they interpreted the decline as successfully bringing the

infants' behaviors into accord with their expectations that the children would settle

down and look and listen. It was not unusual that, amid the stream of disconnected

exchanges, noncommunicative mothers ignored the babies' gaze averting,

squirming, and attempts to distance themselves by crawling away. Rather than end

the activity, these mothers continued coaxing their babies to look at the book,

sometimes resorting to physical restraints. When her child turned away from the

book, one mother pulled the child back. Two mothers who were seated with their

infant sandwiched between their legs, enveloped their babies in their arms and

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