An Outcome Study of the Psychosocial Adaptation of Children at Risk: Protective Factors in the Severely Ill Newborn

In the study of child development, retrospective analysis of data reported by adults or observed by mothers has many methodological faults. Freud (1920) recognized this problem.

So long as we trace the development from its final outcome backwards, the chain of events appears continuous, and we feel we have gained an insight which is completely satisfactory or even exhaustive. But if we proceed the reverse way, if we start from the premises inferred from the analysis and try to follow these up to the final result, then we no longer get the impression of an inevitable sequence of events which could not have been otherwise determined. We notice at once that there might have been another result and that we might have been just as well able to understand and explain the latter. The synthesis is thus not so satisfactory as the analysis; in other words, from the knowledge of the premises, we could not have foretold the nature of the result [p 167].

Many inferences are made about mother-infant interaction from retrospective data. There has been little study of children prospectively who have had difficult experiences during their neonatal period. Explanations based on retrospective data to explain outcomes have been less than satisfactory. It is important to develop data that is prospective to test our assumptions concerning maternal-infant behavior and its resultant outcome. A paradigm for such study is available in the observation of infants,