Diagnoses and interactive patterns of infants referred to a community-based infant mental health clinic

Objectives: To describe the distribution of symptoms and diagnoses in a com munity-based infant mental health clinic and to compare play and feeding in teractions of referred and nonreferred infants. Method: The Diagnostic Clas sification of Mental Health and Developmental Disorders of Infancy and Earl y Childhood (DC 0-3) was used to diagnose 113 referred infants (60% were bo ys). Thirty additional dyads were matched with 30 nonreferred dyads. Feedin g, play interactions, and home environment were compared. Results: Two peak s of referral were found: 0 to 6 and 12 to 18 months. The main reasons for referral were eating problems, sleep problems, aggressive behavior, irritab ility, and maternal depression. The most common DC 0-3 diagnosis was a comb ination of primary infant disorder, parent-child relationship disorder, and parental psychopathology. Mothers of referred children provided lower leve ls of sensitivity, support, and structuring of the interaction, and less op timal home environment. The dyadic relationship showed a lower degree of mu tuality and higher negative exchanges. Feeding interactions elicited more n egative interactions than play. Conclusions: Infants referred by community health workers showed less optimal mother-infant interactions and had less optimal environment, compared with nonreferred dyads. Symptoms of emotional distress in infancy are best apprehended when assessed in multisituational contexts and formulated in a multiaxial approach.