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New test scores emotional weight of parent-child connections

by  /  17 November 2016
Dynamic duo: Autism may interrupt the back-and-forth that builds emotional connections between a mother and her child.

Monashee Alonso / Getty Images

Videos of mothers and their infants interacting with each other may contain clues to autism risk. The unpublished results were presented Tuesday at the 2016 Society for Neuroscience annual meeting in San Diego.

The researchers presented a new screen, called the Welch Emotional Connection Scale, that can assess the degree of connectedness between a mother and her child.

Touch between a parent and child leads to a state of calm in both. In other words, photos of infants sleeping peacefully on a snoozing parent’s chest aren’t just cute, they represent ‘co-regulation,’ a fundamental concept in human biology. And this phenomenon may play a key role in autism, the researchers say.

“We think the key element for social development is co-regulation,” says study leader Martha Welch, director of the Nurture Science Program at Columbia University Medical Center in New York. “The idea of the screen was to pick up whether this [co-regulation] was happening.”

The screen looks at, for example, how often the mother looks at and touches the child, and how often the child reaches for and gazes at the mother. It also assesses whether the mother and infant respond to each other’s emotional cues: Does the mother pick up and soothe the baby when he cries? When the mother smiles at the baby, does the baby smile back?

Simple screen:

Autism is thought to interrupt reciprocal interactions between mother and child that build a foundation for developing social skills. Infants with the condition may resist physical contact, look away from their mother or fail to respond when she talks and coos. Over time, this can in turn shape how the mother interacts with the child.

In a pilot study, the researchers evaluated 75 mother-infant pairs when the infants were 4 months old. This screen identified 75 percent of the children who went on to have a high score on the M-CHAT, a standardized questionnaire for assessing autism risk, when they were 18 months old. The test also correctly identified 76 percent of infants who scored as low risk on the M-CHAT.

One of the tool’s strengths is that a trained observer can score it after less than 10 minutes of observation of a mother-infant pair, either by video or in person.

“Pediatric practices have a lot of obligations,” Welch says, so the tool must to be short in order to be clinically useful.

Welch and her colleagues analyzed videos of mother-infant pairs with the new screen and with a gold-standard method of evaluating social behavior, known as Noldus coding. This involves painstakingly recording the exact duration of behaviors such as the mother smiling at the infant or the infant looking away from the mother.

It took a year to complete the Noldus analysis of the videos, and only three months for the new screen. Yet the screen’s scores closely match the Noldus results, Welch says. The results suggest that the screen is a practical tool for scientific research.

The team next plans to replicate the findings in larger groups of mother-infant pairs.

For more reports from the 2016 Society for Neuroscience annual meeting, please click here.

  • Ethyl

    Holding time and attachment therapy is ABUSIVE! I know, because I tried it on my son at age 6 months after attending a seminar for child carers… Spectrum, I am ashamed of you. This is just evil disguised as science. We will go years backward if this is allowed. For the love of God, people…autism is a neurological disorder. You can’t “love away” autism. This literally makes me shake. This is not science.

  • Amie Hane, Ph.D.

    I am a Developmental Psychologist and a co-author of the Welch Emotional
    Connection Scales (WECS). Our measure is in the development phase and is
    designed to be a screening instrument to support early identification of
    mothers and infants who may be at-risk for a range of developmental
    challenges associated with preterm birth and the experience of the ecology
    of the NICU. Preliminary data suggest that this instrument may be able to
    detect infants who are at-risk for Autism early in infancy, at corrected (for
    gestational age) age 4-months, in a sample of infants born
    prematurely. The broad goal of the WECS is to create an
    evidence-based screening tool that is grounded in the science of observing
    mother-infant social behavior, not attachment. For instance, the
    WECS involves observing the infant’s social gaze behavior, which is a
    well-established difference seen in children diagnosed with Autism. The
    WECS also observes the infant’s vocal behavior, and the ‘serve-and-return’
    vocal exchanges that even preverbal infants engage in. This is a
    behavioral screening tool, not an intervention for Autism, and it is not a
    measure that is related to Attachment therapies. Preliminary data suggest
    this may be a measure that assists in the early identification of
    Autism. We will continue to explore this in our ongoing research, as
    developmental science indicates that early identification and intervention
    for Autism with contemporary, evidence-based approaches are critically important
    for the developing brain. For those interested in learning more about The Nurture Science Program, the latest research and its science-based approach, please visit

    • Katie

      There are over 10,000 published studies on early signs of autism and thousands more in eye gazing and autism. We do not need more. Physicians need to read the studies that already exist. Early identification science is the one area of autism research that is over saturated with funds. Additionally the Nuture program is horribly unsuitable paradigm for autism causation science.

  • Robert J Ludwig

    I understand your concern, Ethyl. I am Associate Director of the Nurture Science Program at Columbia University Medical School. Please know that the Welch Method Holding Time was misunderstood and co-opted by others immediately after it was published. None of the controversial therapies were ever linked to Dr. Welch or her therapy, though many articles failed to make this clear.

    As background, Dr. Welch left private practice in 1997 and turned all of her efforts to research to better understand the underpinnings of mother-child nurture. This led to research on neuropeptides of nurture and calming cycle in animal models, and the Family Nurture Intervention mentioned in the article. This new field has in common with her prior work some lessons learned about the power of emotional enrichment to ameliorate and to prevent behavioral and developmental disorders. Family Nurture Intervention restores the missing mother-infant touch, talk, cuddling, and holding – all biologically relevant interactions and an integral part of normal behavior of full term infants and mothers that are compromised by preterm birth.

    • Linda Rosa

      Dr. Ludwig: As one who has seen several videos of Martha Welch’s Holding Time (all sessions she supervised), I can say without reservation that this practice is highly abusive and potentially dangerous.

      Your attempt to assure the public that her unvalidated practice was never controversial, implying its safety/efficacy is grossly irresponsible.

      Have you watched Welch’s 4-part videos on Welch Method?

      Here is one clip from Welch’s videos: You can hear Martha Welch supervising these sessions. Do you consider this humane therapy? Should they have adults lie on top of them? Should children be believed when they say they “can’t breathe” because of a large weight on their abdomen? What about adults licking their faces? Deny them food? Be forced to give kisses and affection?

      • Linda Rosa

        Wikipedia lists Robert J. Ludwig as the “partner” of Martha Welch. So surely Ludwig is fully aware of the nature of the Welch Method which he claims is “misunderstood.” It would seem that Columbia University has a lot of explaining to do regarding its continue association with Ludwig and Welch.

  • Katie Wright, MA, EdM

    The insensitivity and foolishness of this research is astonishing. Martha Welch’s work “restores the parent infant bond…cuddling and holding.” Autism is not caused by or cured by affection. If only it were that easy! In 2016 Spectrum is stating that poor parental nurturing of children causes autism?

    Welch’s work should be better directed to at risk mothers, such a teenagers or mother in recovery. There is no evidence that poor nurturing causes autism and it is so irresponsible for “Spectrum” to indulge in this nonsense. At a time when autistic children are truly suffering because of a dearth research into treatment of self injurious behaviors, GI and autoimmune interventions/ chronic illness, the fact that such wasteful research is funded and published is sad.

    Also we must move beyond that naive belief that early intervention = cure or even prevention. Behavioral intervention alone is rarely sufficient, except for those mildly affected. Autism is more often a immune mediated / whole body disorder. Instead of funding wasteful and Bettelheim era science need to see meaningful investment in treatment research that meets an actual gap in the science,

    • Ethyl

      If poor nurturing causes autism, perhaps it also causes the 40x increase of SUDEP among those kids with ID and Autism.

      • Rose Walker

        But maybe licking your children is good for them….what do I know?


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