TWO OPEN WINDOWS

INFANT AND PARENT NEUROBIOLOGIC CHANGE
In this paper, we highlight the evidence in support of
investments in both parents and children during the paired
sensitive periods of early life and the transition to parenting.
A sensitive period is a specific and limited time when the
individual is especially open to environmental inputs, typically
because the brain and body are rapidly developing or
reorganizing during that time window. Importantly, the
openness to experience that occurs during sensitive periods
provides both opportunity and vulnerability.
by Pilyoung Kim and Sarah Enos Watamura
University of Denver; Stress, Early Experiences and
Development Research Center

 The evidence for early life as a
sensitive period is well-understood.
Here we argue that recent neural
and behavioral evidence from new
parents makes a compelling case
for the transition to parenting as
a distinct and important sensitive
period. Because the transition
to parenting typically co-occurs
with the first and most important
sensitive period of life, well-timed
two-generation approaches —
approaches that meet the needs
of both children and their parents
together — have the potential
to maximize their investment by
targeting both parents and children
in these paired sensitive periods
to create a cycle of opportunity.
Conversely, failure to do so may
result in exacerbated negative
outcomes during a special and
vulnerable time for both parents
and their children. Indeed, this
possibility is highlighted in the
toxic stress framework, which
differentiates three types of stressful
experiences: positive, tolerable,
and toxic (Shonkoff, Boyce &
McEwen, 2009). The toxic stress
framework emphasizes that much
of what makes a situation “toxic”
instead of “tolerable” is the lack of
a supportive buffering adult. In this
framework, positive stress includes
normative challenges experienced
with supportive adults that are
necessary for healthy growth and
development. Tolerable stress
includes stressful events that are
serious enough to potentially disrupt
healthy growth and development —
for example, a natural disaster — but

A sensitive period is a specific and limited time when the
individual is especially open to environmental inputs,
typically because the brain and body are rapidly developing or
reorganizing during that time window.
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Two Open Windows

do not disrupt healthy development
because of the protective role
served by supportive adults in the
child’s life. Toxic stress occurs when
stressful events are particularly severe
and unremitting and experienced
without the support of a buffering
adult — for example, maltreatment
perpetrated by a primary caregiver
or persistent poverty coupled
with untreated parental mental
illness. Thus, targeting parents and
children together in prevention and
intervention programs may help
protect against toxic stress and foster
healthy growth and development.
This paper is written for practitioners,
policy makers, researchers, and
parents. It aims to offer insights
into how parents’ brains develop
and function during the transition
to parenting — when both
parents and children are in critical
sensitive periods — with the goal
of encouraging positive, healthy,
and parent-driven change through
well-designed two-generation
approaches.

THE TRANSITION TO PARENTING AS A
SENSITIVE PERIOD
Humans are able to live all over the
globe, speak any language, choose
adult career and life pathways
completely divergent from their
families of origin, and create and
adapt to a rapidly evolving global
community because we have big
and malleable brains. It has been
understood for some time that this
plasticity is particularly evident
early in life and in adolescence.
However, very recent and exciting
work in humans (built on an extensive
research base using animal models)
increasingly identifies the transition
to parenting as an important
sensitive period for opportunity
and vulnerability in neural function,

 behavior, and health. Like all sensitive
periods, the environmental supports
and opportunities that exist during the
transition to parenting can contribute
to whether the changes that occur
increase health, productivity,
and well-being or whether new
vulnerabilities emerge or existing ones
are exacerbated.

THE LEGACY OF EARLY LIFE BRAIN
DEVELOPMENT RESEARCH AS A CATALYST FOR
CHANGE
Burgeoning work in the 1990s laid
firm groundwork for our current
understanding of early life as a
sensitive period for brain development.
The publication of Neurons to
Neighborhoods in 2000 organized
what was understood about the
incredible speed and extent of
neuron and synapse formation and
differentiation that occurs prenatally
and continues at a rapid pace
throughout the first few years of life.
This understanding and organizing
framework provided the motivation
and evidence to support a wide array
of policies and programs investing in
young children. Indeed, this science
base has continued to serve as a
key support for early education and
home-visitation programs and has
underscored the current focus on
prevention and intervention targeted
at reducing the impact of early life
stress and deprivation.

INVESTING IN CHANGE FOR CHILDREN BY
TARGETING PARENTS AS AGENTS OF CHANGE
Because parents are their children’s
first and most important teachers
and the creators of their children’s
early environments, some programs
that aim to promote early brain
development have targeted
parenting. For example, homevisitation programs typically include
a focus on increasing parents’

knowledge about child development
and on encouraging sensitive
and contingent responsiveness to
children’s cues and needs. A number
of current parenting programs also
use video-coaching methodologies
to support changes in parenting
behaviors, with the personalized
guidance and feedback that filming
allows. For example, the Filming
Interactions to Nurture Development
(FIND, Fisher, 2012) video-coaching
model (adapted from a popular
model developed in Europe, Marte
Meo), uses very short clips of parents
interacting with their own child.
These clips are used to illustrate and
encourage extended “serve and
return” interactions to build the child’s
brain architecture and support the
parent-child bond. In this model,
coaches help parents recognize a
child’s “serve,” make an appropriate
“return” that encourages extended
interaction, and recognize when the
child is signaling the beginning and
end of an interactive bout.
Although many studies and
programs focus on biological
parents, substantial literature has
targeted foster parents. Importantly,
interventions targeting foster parents
may also produce important
Infant and Parent Neurobiologic Change

3

 behavioral and brain changes
in children, reinforcing that the
adults in a child’s life are impactful
and important, even when not
biologically related. For example,
in a pilot study, neural responsivity
to feedback appeared to be
normalized in children receiving the
Multidimensional Treatment Foster
Care for Preschoolers intervention.
Children in the treatment group
showed more neural responsivity
to feedback than foster children
receiving treatment as usual, and
were similar to non-maltreated lowincome children (Bruce, McDermott,
Fisher, & Fox, 2009).

ANTI-POVERTY PROGRAMS: INVESTING IN
PARENTS AS PROVIDERS
Anti-poverty programs have targeted
parents as resource providers — for
example, with programs providing

educational or income supports or
in-kind services like food assistance
to help parents bring their families
out of poverty. With the passage of
the Personal Responsibility and Work
Opportunities Act in 1996, for the
first time, work requirements were
enforced even for single mothers with
children under five. To make it possible
for families with young children to
work, TANF (Temporary Assistance for
Needy Families) funds, provided to
states via block grants, can be used
for child care subsidies. In addition,
the Child Care Development Fund
(reauthorized in 2014) provides child
care subsidies for low-income families
who are working or in educational or
training programs. When resources
are marshalled effectively, child care
subsidies linked to economic supports
for low-income working parents can
result in the critical provision of highquality child care. However, subsidies

CORE COMPONENTS OF A TWO-GENERATION FRAMEWORK

social
capital

networks, friends,
and neighbors

health &
well-being
mental health
toxic stress
access to health care

4

Two Open Windows

early childhood
education
postsecondary &
employment
pathways

economic
assets

asset building
housing and public supports

 are not always sufficient to allow
families to obtain high-quality child
care, and high-quality child care,
especially for infants and toddlers, is
sometimes scarce. Without an explicit
focus on integrating anti-poverty
programs for adults with high-quality
care and education for children,
some families may have to choose
between engaging in work or training
at the expense of high-quality care
for their children or foregoing the work
or training opportunity.

THE CALL FOR INTEGRATED 2GEN INTERVENTION
APPROACHES
Most commonly, programs that
target parents are not coupled
with programs that target children.
Increasingly, this disconnect in
services — often delivered to
populations identified by similar
risk factors (poverty, low parental
education, involvement with child
protective services) — has been
challenged as illogical and inefficient,
and efforts to provide integrated and
explicit two generation interventions
have been increasing. For example, a
recent special issue of the journal The
Future of Children examines past and
current dual-generation programs
and identifies stress, education,
health, income, employment, and
assets as important pathways of
influence on a child’s development.
The national conversation on
this topic is reflected in a recent
Washington Post feature titled “The
New War on Poverty: Tackling Two
Generations at Once” and in National
Public Radio coverage of twogeneration demonstration programs.
Ascend at the Aspen Institute has
offered a framework for building a
cycle of opportunity that views early
childhood education, postsecondary
and employment pathways for
parents, economic assets, health
and well-being, and social capital

as integrated core components
of effective two-generation
approaches.

INVESTING IN PARENTS: AGENTS OF CHANGE
FOR CHILDREN AND IMPORTANT IN THEIR OWN
RIGHT
A key question that emerges in twogeneration approaches is whether
explicit investments in parents are
simply investments in parents as
agents of change, or whether they
are also investments in parents as
people. Ascend at the Aspen Institute
believes that investing in parents is a
worthy endeavor because parents
are critical agents of change for their
children, because moving the whole
family onto a path to educational
success and economic opportunity
requires investing in both children
and the adults in their lives, and
because parenting itself opens a
window of opportunity for meaningful
individual change. Indeed, the
current spotlight on two-generation
initiatives, coupled with pioneering
breakthroughs in neurobiology,
together provide the opportunity
to create transformational rather
than simply additive preventative
interventions for families that can
create intergenerational cycles of
opportunity (Shonkoff & Fisher, 2013).

TWO-GENERATION PROGRAMS – EVIDENCE AND
PROMISE
In the context of the current intensive
call for integrated two-generation
programs, a number of programs
exist somewhere on a continuum,
which starts with just beginning
to provide integrated services to
both parents and children and
progresses to providing services to
both children and parents while also
systematically evaluating outcomes
for both parents and children across
an array of indicators. We are not
Infant and Parent Neurobiologic Change

5

 aware of any programs to date
that explicitly target a) the needs
of parents; b) the needs of children;
and c) the parent-child relationship
while systematically collecting longterm data to evaluate whether these
program components separately or in
combination lead to both behavioral
and neurologic change as well as
improved academic and economic
achievement and physical and
mental wellness in both parents and
children.
However, a number of notable
programs have begun to
systematically provide, and in
some cases evaluate, explicit and
integrated two-generation programs.
For example, the Jeremiah program
provides single mothers and their
children with support for a careertrack college education, quality
early childhood education, a safe
and affordable place to live, and
empowerment and life skills training
(www.jeremiahprogram.org). The
Community Action Project of Tulsa
County (CAP Tulsa) also specifically
focuses on a two-generation
approach that aims to prepare
young children for future success in
school and provides their parents
with programs designed to increase
parenting skills, employability, and
earning potential (captulsa.org). In
a multi-year investigation, Lindsay
Chase-Lansdale and Christopher
King are collecting data regarding
the CareerAdvance® Program at
CAP Tulsa, which should provide
important insights. Other programs
that may have had the goal of
ultimately changing child or adult
outcomes at inception have also
provided evidence to suggest
changes in both parents and children.
Perhaps most famously, Nurse-Family
Partnership has reported changes in
both child outcomes and maternal
life course trajectory following home
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Two Open Windows

visitation of first-time mothers by a
nurse beginning during pregnancy
and continuing through the first
two years of the child’s life (www.
nursefamilypartnership.org). One
study found that mothers most often
enrolled in home-visitation programs
to obtain information about job
training followed by completing their
education (Tandon, Parillo, Mercer,
Keefer, & Duggan, 2008). Therefore,
home visitation may be an excellent
context for offering integrated twogeneration programming. Another
promising approach, Reach Out and
Read (www.reachoutandread.org),
takes advantage of the important
relationship between pediatricians
and families and uses well-baby
visits as an opportunity to provide
books and teach healthy and
developmentally appropriate parentchild interactions around books
beginning in infancy. Reach Out and
Read has documented impacts on
children, including enhanced child
language skills (Mendelsohn, Cates,
Weisleder, Berkule, & Dreyer, 2013).
Federally funded randomized control
trials have found that enhancements
to Reach Out and Read, namely the
Video Interaction Project (VIP), which
uses video-coaching, have reduced
parenting stress, demonstrated the
potential to impact parent-child
engagement, and reduced maternal
depressive symptoms (Berkule et al,
2014).

OVERALL THEORETICAL FRAMEWORK
The transition to parenting represents
a major reorganization of individual
priorities and goals to include a focus
on caring for a new infant who is
vulnerable, completely dependent,
and initially presents what can be
unclear signals regarding his or her
needs. For example, in the first few
days and weeks after birth, it may
be unclear whether a crying infant

 is hungry versus tired, and a sleeping
newborn may even need to be
woken up for feeding until a feeding
routine and nursing/bottle-feeding
skills are firmly established. To be
maximally effective caregivers, adults
must monitor their newborn’s safety,
establish synchronous caregiving
routines, and develop an emotional
bond, all in the context of resource
depletion (e.g., financial strain,
relationship strain, sleep deprivation).
Viewed in this light, it is perhaps not
surprising that this change in priorities
and focus is supported by substantial
neural reorganization or that this
reorganization happens in regions
of the brain that process rewards
and social signals and that help to
regulate emotion.

STRESS DURING THE TRANSITION TO
PARENTING
During the first year after a baby’s
arrival, parents face the highly
challenging task of taking care
of a newborn. Both mothers and
fathers, particularly first-time parents,
report high levels of anxiety and
concern about their infant’s wellbeing and health (Kim, Mayes,
Feldman, Leckman, & Swain, 2013).
This concern for the infant’s wellbeing can, of course, be healthy
and adaptive and is something
all parents experience to some
degree. However, high anxiety
along with heavy demands on
financial resources, lack of sleep,
and changes in marital relations can
create levels of stress that parents
often find overwhelming (Barnard
& Solchany, 2002; Condon, Boyce,
& Corkindale, 2004). Difficulties in
managing the stress of the transition
to parenting is a risk factor for severe
mood regulation problems, such
as postpartum depression, marital
problems, and harsh parenting (a
term that can include a range of

parenting behaviors, from corporal
punishment and verbal aggression to
child maltreatment), in both men and
women (Hayes, Roberts, & Davare,
2000; Perren, Von Wyl, Burgin, Simoni,
& von Klitzing, 2005).

NEURAL SUPPORTS OF THE TRANSITION TO
PARENTING
Given how important reproduction
and parenting are from an
evolutionary and survival point of
view, it is not surprising that there are
changes occurring in the brain to
support parenting, including those
that help with stress management,
the promotion of positive feelings
Infant and Parent Neurobiologic Change

7

 Mothers who reported more positive feelings about their
infant also had more structural growth in the reward circuit
in the first few months of the infant’s life. Mothers also
showed increased brain activity in this region when looking
at images of their baby as compared to other babies. This
increased activity appears significant as it is also associated
with more sensitive and caring maternal behaviors.
and supportive caregiving behaviors,
and the formation of the deep
emotional connections that parents
experience with their babies. In
fact, human parents share very
similar biological bases of parenting
with other mammals (Numan &
Insel, 2003). Studies with rodents, for
example, revealed that changes in
the brain right around birth cause a
switch from avoidant to approaching
behaviors toward pups (Numan &
Insel, 2003; Rosenblatt & Mayer, 1995).
Virgin female rats tend to avoid
being near pups and in some cases
even kill them because they usually
find pups aversive. However, after
giving birth, new mother rats exhibit
tireless efforts to protect, care for,
and feed their own pups, sometimes
while sacrificing their own safety and
well-being. In biparental species,
such as prairie voles and California
mice, male rodents also show similar
changes in the brain that cause the
onset of parental behaviors (Young,
Wang, & Insel, 1998). This intriguing
neural and behavioral switch in rats’
response to pups during the transition
to parenting is triggered by increased
levels of hormones, including oxytocin
and vasopressin. These hormones
prime several brain regions to respond
more sensitively and specifically to
pup-related information, including
their vocalizations and smell and
to elicit strong parental motivation
(Fleming & Li, 2002). Once parental
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Two Open Windows

motivation is activated in the brain,
continuous interaction with pups
maintains parental motivation and
behaviors. This important fact suggests
that support during the transition to
parenting that results in a positive
parent-child bond and healthy
mutually rewarding interaction
patterns sets into motion a positive
feed-forward loop that maintains
positive parenting. Interestingly,
during the postpartum period, female
rats also exhibit dampened reactivity
to stressors in the environment. This
reduced reactivity to stress may help
female rats effectively protect their
offspring from potential or real threats
and dangers in the environment
(Carter & Lightman, 1987).

NEURAL CHANGES IN HUMAN PARENTS
Studies of human parental brains
are much more recent due to the
development of new neuroimaging
techniques. These techniques allow
investigation of both structural
changes and changes in brain
activity in response to specific
events or stimuli. Overall, work with
human parents supports what
has been documented in animal
models: Neural changes likely play
an important role in supporting the
transition to parenthood. We will
review the evidence for changes in
three major brain circuits that are
involved in parenting — the reward
circuit, the social information circuit,
and the emotion regulation circuit.

NEURAL CHANGES IN THE REWARD CIRCUIT
The reward circuit includes the
midbrain (hypothalamus, ventral
tegmental area, nucleus accumbens,
and substantia nigra), striatum,
and medial prefrontal cortex. This
circuit is activated by the release of
dopamine in response to a number
of naturally occurring stimuli, like food

 REWARD CIRCUIT

REWARD / MOTIVATION CIRCUIT

Frontal lobe

Striatum

Substantia nigra

Ventral tegmental area

Key brain regions related to reward and
parental motivation processes.

and positive physical contact, and is
also activated by drugs like nicotine
and amphetamines. Interestingly,
during the postpartum period, the
increased levels of hormones such
as oxytocin together with dopamine
sensitize this circuit to focus on infantrelated information. During the first
few months after their child’s birth,
new mothers exhibit growth of the
midbrain region. Further, the amount
of growth was associated with the
degree to which mothers reported
positive feelings about their baby (e.g.,
beautiful, perfect) (Kim, Leckman,
Mayes, Feldman, et al., 2010). That
is, mothers who reported more
positive feelings about their infant
also had more structural growth in the
reward circuit in the first few months
of their infant’s life. Along with this
anatomical growth, mothers also
showed increased levels of activity
in the reward circuit in response to

their babies — for example, when
looking at images of their baby’s
smile compared to images of other
babies’ smiles (Noriuchi, Kikuchi, &
Senoo, 2008; Strathearn, Li, Fonagy,
& Montague, 2008). Importantly,
the increased activity in this region
appears significant because it has
been associated with more sensitive
and caring maternal behaviors
toward their babies (Atzil, Hendler, &
Feldman, 2011). These changes are
not limited to mothers and therefore
are not only the result of the many
changes that happen as part of
pregnancy and giving birth. Human
fathers also exhibited structural growth
in the striatum, a part of the reward
circuit, during the first few months
after their child’s birth (Kim et al.,
2014). As with mothers, this structural
growth in fathers is accompanied with
greater activation in the reward circuit
while looking at images of their child
Infant and Parent Neurobiologic Change

9

 compared to images of other children
(Mascaro, Hackett, & Rilling, 2013).

NEURAL CHANGES IN THE SOCIAL INFORMATION
CIRCUIT
The social information circuit includes
the insula, precuneus, superior
temporal gyrus, and fusiform gyrus.
Activation in this circuit has been
associated with empathy as well
as self-monitoring and reflection.
Aberrant structure and function in
this circuit has been documented
in cases of severe impairment in
social competence, such as in
autism (Uddin, Iacoboni, Lange, &
Keenan, 2007). New mothers and
fathers exhibit neural plasticity in this
circuit, including structural growth
(Kim, Leckman, Mayes, Feldman,
et al., 2010; Kim et al., 2014) and
heightened responses to infants’
cries and images of infants (Swain et
al., in press). These neural changes

have been interpreted as reflecting
the importance of this circuit for
accurately understanding infant
emotional and social cues during
interactions and in appropriately
responding to the cues. Thus, changes
in this circuit may help new parents
interpret their infant’s behavior and
learn how to parent sensitively and
responsively.

NEURAL CHANGES IN THE EMOTION REGULATION
CIRCUIT
The emotion regulation circuit
includes the amygdala, anterior
cingulate cortex, and medial and
lateral prefrontal cortex. Increased
amygdala activation is associated
with negative reactions to emotional
information, and the amygdala helps
detect threats in the environment. Its
size and function can be impacted
by stress exposure, resulting in larger
volume and faster processing of

EMOTION REGULATION AND THE SOCIAL BRAIN
Prefrontal
cortex

Auditory
cortex

Medial
region

Primary
visual
cortex

Orbito-frontal
region

Amygdala
Superior temporal
sulcus

Key brain regions related to emotion
regulation and social information processing.
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Two Open Windows

Fusiform
face area

 negative stimuli. In contrast,
increased anterior cingulate cortex
and prefrontal cortex activation
are associated with regulation
of negative emotional reactions
(Ochsner, Silvers, & Buhle, 2012).
Similar to animal findings, human
mothers exhibit reduced reactivity to
acute social and cognitive stressors,
such as preparing to give a speech
or performing mental arithmetic
out loud with corrective feedback
(Hillerer, Neumann, & Slattery, 2011).
During the postpartum period, in
both mothers and fathers, there was
structural growth (Kim, Leckman,
Mayes, Feldman, et al., 2010; Kim et
al., 2014) and increased activation
in the prefrontal cortex regions
supporting emotion regulation while
listening to and processing the
social signal of infant cries (Barrett
& Fleming, 2011; Kim et al., 2011;
Kuo, Carp, Light, & Grewen, 2012).
High levels of oxytocin in mothers
during the postpartum period
were also associated with reduced
amygdala reactivity to negative
emotional stimuli (Riem et al., 2011).
The reduced neural responses to
stressful experiences coupled with
increases in size and function in
emotion regulation regions may
play an important role in effective
emotion regulation in the face of
the increased stress and demands of
parenting.

FEWER SUPPORTIVE NEURAL CHANGES IN
PARENTS WITH GREATER TRAUMA, STRESS, AND
DEPRESSION HISTORY
The neural changes discussed above
are likely adaptive and supportive
of positive parenting. However, the
postpartum period is also a time
when parents can be vulnerable to
severe difficulties in mood regulation
and stress. Both new mothers and
fathers are exposed to heightened
levels of risk for mood disorders, such

Changes in the social information circuit may help new
parents to interpret their infant’s behavior and to learn how
to parent sensitively and responsively.

as postpartum depression. During
the first few months after a child’s
birth, a significant proportion of new
parents will experience depressed
and highly anxious moods (Kim &
Bianco, 2014; Segre, O’Hara, Arndt,
& Stuart, 2007). Specifically, 60 to
80 percent of new mothers report
“postpartum blues,” and up to 25
percent of all new mothers and
fathers report postpartum depression.
This is important because parental
depression has consistently been
linked to adverse long-term outcomes
for both parents and their children
(Goodman et al., 2011; Kim & Swain,
2007; Ramchandani, Stein, Evans, &
O’Connor, 2005).
In parental brains, increased
responses to infant cries and images
were associated with a more warm
and caring style of parenting, and
decreased responses to infant cries
and images were associated with
chronic stress, depression, and
substance abuse among parents.
Mothers who were depressed at the
time of the study exhibited reduced
neural responses in the emotion
regulation and social information
circuits in response to their own
infant’s cry sounds compared to
mothers who were not depressed
(Laurent & Ablow, 2011). Mothers
who used one or more substances
(e.g., tobacco, alcohol) during
pregnancy also showed reduced
responses in the emotion regulation
circuit in response to infant cry sounds
(Landi et al., 2011). This reduced
sensitivity in the brain to areas that
regulate emotional responses to
Infant and Parent Neurobiologic Change

11

 infant cries and that process social
signals may diminish mothers’ abilities
to regulate their own emotions in
response to their infant’s cries and
perhaps interfere with their ability to
detect the nature of the cry signal.
This pattern of higher emotionality
and less effective detection might
lead over time to more frustration,
less parenting self-efficacy, and
lower motivation to care for infants.
These neural differences also help
explain differences in caregiving
that have been documented in
parents suffering from depression.
If the supportive brain changes
that help mothers and fathers
parent responsively and sensitively
are diminished when parents are
depressed, they must cope with
their own emotional and physical
depression symptoms while trying
to override this less effective and
efficient signal.

The reduced neural responses to stressful experiences coupled
with increases in size and function in emotion regulation
regions may play an important role in effective emotion
regulation in the face of the increased stress and demands of
parenting.
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Two Open Windows

Mothers’ current or childhood trauma
may also significantly reduce neural
sensitivity toward their infant. Mothers
with interpersonal violence-related
post-traumatic stress disorder (IPVPTSD) report feeling more stressed
while watching their children on video
during a separation paradigm (where
mother and child are in different
rooms for a few minutes in an
unfamiliar lab setting) compared to
mothers without IPV-PTSD (Schechter
et al., 2012). Mothers with IPV-PTSD
in this study also exhibited increased
limbic activity (reactive to negative
stimuli) coupled with reduced
activation in the prefrontal cortex
(supportive of emotion regulation),
suggesting that the increased stress
they report may be due to both more
elicited emotion and less effective
emotion regulation during even mild
stress exposure (Schechter et al.,
2012).
Mothers who report having received
less warm and caring parenting from
their own mothers in childhood exhibit
reduced activation in the emotion
regulation and social information
circuits in response to infant cry
sounds compared to mothers who
reported receiving more warm and
caring parenting in childhood (Kim,
Leckman, Mayes, Newman, et al.,
2010). Insecure attachment, which
is likely based on negative early
social experience, is also associated
with greater amygdala reactivity
to infant cries, which may lead to
a tendency toward more avoidant
and negative responses to infants
(Riem, Bakermans-Kranenburg, van
Ijzendoorn, Out, & Rombouts, 2012).
Fathers’ individual differences in
neural responses to infants are much
less understood; however, one study
demonstrated that childhood abuse
and neglect for fathers was also
associated with altered responses to

 infant cry sounds in the insula, a part
of the brain’s social information circuit
(Bos, Montoya, Terburg, & van Honk,
2014). These findings are noteworthy
because they provide one possible
mechanism for intergenerational
transmission of insensitive parenting
— in addition to the behavioral
transmission mechanisms of poor
modeling (i.e., not having witnessed
or received sensitive parenting) and
cycles of coercion (i.e., explicitly
experiencing harsh or coercive
parenting and subsequently using
similar strategies with one’s own
children at increasing intensity as
child compliance decreases). If new
parents who received less sensitive
parenting themselves have brains
that respond more negatively to
infants’ cry sounds and that are less
able to regulate these negative
emotional responses when they
become new parents, they come
to the table with less supportive
parenting biology. This is of course
not at all definitive; parents can
and do bring assets like increased
motivation and learned behaviors
since childhood to override the
challenges of their own experiences.
However, understanding that one’s
own caregiving history can change
the way something as important
and basic as how the cry signal is
processed in the brain may help
parents attend to and better override
their own negative caregiving
experiences.

The reduced sensitivity in the brain to areas that regulate
emotional responses to infant cries and that process social
signals may diminish mothers’ abilities to regulate their
own emotions in response to their infants’ cries and perhaps
interfere with their ability to detect the nature of the cry signal.
This pattern of higher emotionality and less effective detection
might lead over time to more frustration, less parenting selfefficacy, and lower motivation to care for infants.

A

B

RESEARCH CHALLENGES AND FORWARDLOOKING OPPORTUNITIES
The pioneering emerging research
on the transition to parenting so far
has only looked at the immediate
changes that happen in the first few
months postpartum and has focused
on biological mothers and fathers. As
this line of work is very new (published
since 2010), beginning with biological

A: Anatomical (gray matter) increase from 2-4 weeks to 3-4 months
postpartum among new mothers. Regions showing the increase
are highlighted in red. B: A cluster of the reward and motivation
(midbrain) regions are circled in yellow. The anatomical increase 2-4
weeks and 3-4 months postpartum was predicted by mothers’ positive
perception of their own baby at 2-4 weeks postpartum.
Source: Kim, Leckman, Mayes, Feldman, et al., 2010.

Infant and Parent Neurobiologic Change

13

 Understanding that one’s own caregiving history can change
the way something as important and basic as how the cry
signal is processed in the brain may help parents attend to
and better override their own negative caregiving experiences.

parents and looking at immediate
changes makes sense. However,
questions of how long-lasting these
changes may be, whether similar
changes are seen in subsequent
births, whether non-biological parents
are similarly affected, and what
mechanisms are at play are still to
be explored. Although using different
methodology, there is promising
evidence that similar supportive
neurobiology may be present and
important in foster parents (Bick,
Dozier, Bernard, Grasso, & Simons,
2013). Specifically, during initial
relationship formation with a new
infant, foster parents with greater
oxytocin production had greater
neural activity in response to images
of infants and greater delight in their
foster infant. This result suggests that
adults differ in their neural-hormonal
preparedness for parenting, even
when they are not biologically related
to the child they have begun caring
for. Three months later, oxytocin
production in foster parents was
related to neural activity to their own
foster infant’s image specifically and
not to all babies, suggesting foster
parents’ brains changed in response
to parenting their foster infant. These
results support taking a broad lens
when defining family to include
children and all the important adults
in their lives. Future work would benefit
from assessing whether interventions
that change parenting behavior and
parent-child relationships do so in
part or most effectively when they
also change supportive parenting
neurobiology.
14

Two Open Windows

CONCLUSION
Real and lasting change happens
when people are biologically open
to change. Decades of research
strongly supports early life as a critical
time for supportive and appropriate
environmental inputs. New evidence
suggests that the transition to
parenting is another distinct and
important sensitive period when major
structural and functional changes
are happening in the brain, and
that these changes are supportive
of positive parenting. Indeed, these
changes are less evident in parents
with risk factors like postpartum
depression and a history of insensitive
parenting or among parents who
feel less positive about their new
infant. Without this supportive
biology, new parents face an even
more challenging task, and this cooccurs with the infant’s first and most
important sensitive period. Supporting
positive, healthy, self-actualizing, and
enabling changes in well-designed
two-generation approaches
during the transition to parenting —
particularly when new parents have a
legacy of risk — can build a cycle of
opportunity for parents as people and
for parents as agents of change for
their children by capitalizing on these
shared sensitive periods. Conversely,
failure to provide effective supports
may exacerbate risk during a special
and vulnerable time for both parents
and their children.

 5 RECOMMENDATIONS FOR PRACTICE
„„ Direct-service providers often
focus on filling the material gaps
families face (e.g., the lack of
food or housing). This research
offers compelling evidence for
thinking about mental health
services for families in a similar
fashion — as a key part of wraparound services that families need
to achieve stability.

preparedness for parenting
(including parenting self-efficacy
and exposure to positive parenting
models), and for early signs that
parents feel overwhelmed by the
parenting role. Parents with these
risk factors, and also those with
depression and anxiety during
or before pregnancy, should be
prioritized for additional services
around their child’s birth.

„„ Direct-service organizations
should consider the implications
of this research in terms of how
they prioritize services for families.
For example, services could be
allocated more deliberately near
the birth of a child, or the type of
services provided could take into
consideration how recently the
birth occurred.
„„ Providers of early education
should provide proactive and
positive support to new parents.
These findings point to the
critical neural changes in both
fathers and mothers, supporting
expanded efforts to strengthen
family connections, parent-child
involvement, and mental health
for both fathers and mothers.
„„ Health care practitioners serving
new mothers and their babies
should maximize well-baby and
similar opportunities to provide
supportive interventions for the
parents and the child together
within an integrated behavioral
health model. Awareness that the
already difficult task of becoming
a parent is magnified when
parents come to this role with
less supportive biology may be a
key component of well-designed
services.
„„ Direct-service agencies should
consider including screening for
parents’ own trauma, parents’
Infant and Parent Neurobiologic Change

15

 5 RECOMMENDATIONS FOR POLICY
„„ Increase efforts to support
economic security outcomes in
home-visiting programs. Funding
streams, such as Maternal, Infant,
and Early Childhood Home
Visiting, require that programs
demonstrate not just improved
child outcomes but also adult
outcomes. For example, front-line
home-visiting staff members should
be provided with professional
development to enhance
their knowledge and ability to
connect interested parents with
opportunities to improve family
economic self-sufficiency.
„„ Leverage opportunities in the
Affordable Care Act (ACA) to
improve economic security and
family health and well-being. For
example, states should expand
Medicaid coverage and also build
on progress made by community
health centers and patientcentered medical homes.
„„ Maximize opportunities for
whole-family diagnosis and
treatment for mental health. For
example, diagnosis, screening,
and treatment of mental health

16

Two Open Windows

concerns can be encouraged
for both parents and children
using the new preventive services
coverage under the ACA. Parity
in coverage between mental
and physical health for those
newly enrolled in Medicaid and
other health insurance plans can
further destigmatize mental health
issues and allow both families
and providers to cooperate
around screening, diagnosis, and
treatment.
„„ Expand paid family leave
coverage to enable families,
especially low-income families, to
be able to take time off to care for
a new baby during this critical and
stressful time.
„„ Support additional research efforts
to deepen the understanding of
the biological changes that occur
during the transition to parenting
and the ways in which programs
and policies can support both
parents and their children.

THE AUT

 AUTHORS

Dr. Sarah Enos Watamura is an Associate Professor
of Psychology at the University of Denver, where
she directs the Child Health and Development Lab
and co-directs the Stress, Early Experience and
Development Research Center. She has longstanding
interests in children’s physiologic regulation, their
development within caregiving contexts, and in
understanding mechanisms and trajectories from early
life stress to later physical, mental health, cognitive/
educational, and socio-emotional outcomes. Her
work examines the unique stressors and buffers in
families experiencing poverty and among newly
immigrated families, and includes testing promising
intervention approaches. Dr. Watamura is also an
Aspen Institute Ascend Fellow.
Dr. Pilyoung Kim is Assistant Professor of Psychology
and a director of the Family and Child Neuroscience
lab at the University of Denver. Kim received her BA in
Psychology and English Literature from Korea University
in South Korea, her EdM in Human Development and
Psychology at Harvard Graduate School of Education,
and her PhD in Developmental Psychology from
Cornell University. Dr. Kim completed a post-doctoral
fellowship in Developmental Affective Neuroscience
at the National Institute of Mental Health. She was a
recipient of the Victoria S. Levin Award for Early Career
Success in Young Children’s Mental Health from the
Society for Research in Child Development in 2014.
Her long-term research career trajectory is to examine
the early life origins of socioeconomic disparities in
health from a neurobiological perspective. Her current
work focuses on the prospective effects of perinatal
exposures to poverty-related chronic stress on the
neural systems in new mothers and infants. She aims
that the knowledge gained from her research will
advance understanding of specific neurobiological
processes by which poverty is associated with
magnified risks for parental depression, harsh
parenting in new parents, and for mental illness for
infants and young children. See more at:
http://www.pilyoungkim.org/

ORGANIZATIONS

Stress, Early Experiences and Development Research
Center: The SEED Research Center is focused on
understanding and mitigating the effects of early
life stress utilizing a psychobiological approach. In
particular, we focus on explicating the mechanisms
underlying the effects of early life stress on physical
and psychological health and development. Our
current cluster utilizes cutting-edge methodologies
including neuro-imaging (i.e. functional and structural

magnetic resonance imaging, and diffusion tensor
imaging), genotyping, bioassays (e.g. hormones,
immunological markers, indices of cellular aging) and
in-depth behavioral and observational approaches
(e.g., neurocognitive assessments of children
and adults, assessments of emotional regulation,
temperament, and parenting, noise-level monitoring,
and neighborhood and housing quality indices).
Our innovative approach employs prospective
longitudinal designs and sophisticated statistical
analysis techniques in order to identify pathways from
the prenatal period through adolescence by which
early life stress lead to increased disease risk. Further
we focus on important contextual and relational
influences (e.g. parenting, culture) on the experience
of early life stress – including both the contributing and
buffering potential of caregivers.
http://www.du.edu/ahss/psychology/seedresearch/
index.html
Ascend at the Aspen Institute: Ascend is the national
hub for breakthrough ideas and collaborations that
move children and the adults in their lives toward
educational success and economic security. We
take a two-generation approach to our work and
embrace a commitment to gender and racial equity
lenses.
http://ascend.aspeninstitute.org

ACKNOWLEDGEMENTS

Ascend is grateful to the following organizations for
their ongoing philanthropic support and partnership:
Ann B. Friedman and Thomas L. Friedman Family Foundation
Annie E. Casey Foundation
Bezos Family Foundation
Chambers Family Fund
Charlotte Perret Family Trust
The Ford Foundation
The Kresge Foundation
The Rocksprings Foundation
Scott and Patrice King Brickman Family Foundation
The Skillman Foundation
W.K. Kellogg Foundation
Pilyoung Kim would like to acknowledge the support
of the National Institute of Child Health and Human
Development, University of Denver, Faculty Research
Fund and the Professional Research Opportunities for
Faculty Fund.

Infant and Parent Neurobiologic Change

17

 BIBLIOGRAPHY
Atzil, S., Hendler, T., & Feldman, R. (2011). Specifying the neurobiological basis of human attachment: brain, hormones, and
behavior in synchronous and intrusive mothers. Neuropsychopharmacology, 36, 2603-2615.
Barnard, K E, & Solchany, J E. (2002). Mothering. In M H Bornstein (Ed.), Handbook of Parenting (Vol. 3, pp. 3-25). Mahwah,
N.J.: Erlbaum.
Barrett, J., & Fleming, A. S. (2011). Annual Research Review: All mothers are not created equal: neural and psychobiological
perspectives on mothering and the importance of individual differences. J Child Psychol Psychiatry, 52, 368-397.
Berkule, S. B., Cates, C. B., Dreyer, B. P., Huberman, H. S., Arevalo, J., Burtchen, N., ... & Mendelsohn, A. L. (2014). Reducing
Maternal Depressive Symptoms Through Promotion of Parenting in Pediatric Primary Care. Clinical pediatrics, 53(5), 460-469.
Bick, J., Dozier, M., Bernard, K., Grasso, D., & Simons, R. (2013). Foster mother–infant bonding: associations between foster
mothers’ oxytocin production, electrophysiological brain activity, feelings of commitment, and caregiving quality. Child
development, 84(3), 826-840.
Bos, P. A., Montoya, E. R., Terburg, D., & van Honk, J. (2014). Cortisol administration increases hippocampal activation to
infant crying in males depending on childhood neglect. Hum Brain Mapp.
Bruce, J., McDermott, J. M., Fisher, P. A., & Fox, N. A. (2009). Using behavioral and electrophysiological measures to assess
the effects of a preventive intervention: A preliminary study with preschool-aged foster children. Prevention Science, 10(2),
129-140.
Carter, D. A., & Lightman, S. L. (1987). Oxytocin responses to stress in lactating and hyperprolactinaemic rats.
Neuroendocrinology, 46, 532-537.
Condon, J. T., Boyce, P., & Corkindale, C. J. (2004). The First-Time Fathers Study: a prospective study of the mental health and
wellbeing of men during the transition to parenthood. Australian and New Zealand Journal of Psychiatry, 38, 56-64.
Fisher, P.A. (2012) Filming Interactions to Nurture Development (FIND) Implementation Guide, Version 1.00. FIND Development
Team, OSLC Developments, Inc.
Fleming, A S, & Li, M. (2002). Psychobiology of maternal behavior and its early determinants in nonhuman mammals. In Marc
H. Bornstein (Ed.), Handbook of Parenting (Vol. 2, pp. 61-97). Mahwah, N.J.: Erlbaum.
Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child
psychopathology: a meta-analytic review. Clin Child Fam Psychol Rev, 14, 1-27.
Hayes, M. J., Roberts, S., & Davare, A. (2000). Transactional conflict between psychobiology and culture in the etiology of
postpartum depression. Med Hypotheses, 55, 266-276.
Hillerer, K. M., Neumann, I. D., & Slattery, D. A. (2011). From Stress to Postpartum Mood and Anxiety Disorders: How Chronic
Peripartum Stress Can Impair Maternal Adaptations. Neuroendocrinology.
Kim, P, & Bianco, H. (2014). How Motherhood and Poverty Change the Brain. Zero to Three, 34, 29-36.
Kim, P., Feldman, R., Mayes, L. C., Eicher, V., Thompson, N., Leckman, J. F., & Swain, J. E. (2011). Breastfeeding, brain
activation to own infant cry, and maternal sensitivity. J Child Psychol Psychiatry, 52, 907-915.
Kim, P., Leckman, J. F., Mayes, L. C., Feldman, R., Wang, X., & Swain, J. E. (2010). The plasticity of human maternal brain:
Longitudinal changes in brain anatomy during the early postpartum period. Behavioral Neuroscience, 124, 695-700.
Kim, P., Leckman, J. F.., Mayes, L. C., Newman, M., Feldman, R., & Swain, J. E. (2010). Perceived quality of maternal care in
childhood and structure and function of mothers’ brain. Developmental Science, 13, 662-673.
Kim, P., Mayes, L., Feldman, R., Leckman, J. F., & Swain, J. E. (2013). Early Postpartum Parental Preoccupation and Positive
Parenting Thoughts: Relationship with ParentInfant Interaction. Infant Mental Health Journal, 34, 104-116.
Kim, P., Rigo, P., Mayes, L. C., Feldman, R., Leckman, J. F., & Swain, J. E. (2014). Neural plasticity in fathers of human infants.
Social Neuroscience, 9, 522-535.
Kim, P., & Swain, J. E. (2007). Sad dads: paternal postpartum depression. Psychiatry (Edgmont), 4, 35-47.
Kuo, P. X., Carp, J., Light, K. C., & Grewen, K. M. (2012). Neural responses to infants linked with behavioral interactions and
testosterone in fathers. Biol Psychol, 91, 302-306.
Landi, N., Montoya, J., Kober, H., Rutherford, H. J., Mencl, W. E., Worhunsky, P. D., . . . Mayes, L. C. (2011). Maternal neural
responses to infant cries and faces: relationships with substance use. Front Psychiatry, 2, 32.
Laurent, H. K., & Ablow, J. C. (2011). A cry in the dark: depressed mothers show reduced neural activation to their own
infant’s cry. Soc Cogn Affect Neurosci.
Mascaro, J. S., Hackett, P. D., & Rilling, J. K. (2013). Testicular volume is inversely correlated with nurturing-related brain
activity in human fathers. Proc Natl Acad Sci U S A, 110, 15746-15751.

18

Two Open Windows

 Mendelsohn, A.L., Cates, C.B., Weisleder, A., Berkule, S.B., & Dreyer, B.P. (2013). Promotion of early -school readiness using
pediatric primary care as an innovative platform. Zero to Three, 34(1), 29-40.
Noriuchi, M, Kikuchi, Y, & Senoo, A. (2008). The functional neuroanatomy of maternal love: mother’s response to infant’s
attachment behaviors. Biological Psychiatry, 63, 415-423.
Numan, M, & Insel, T R. (2003). The neurobiology of parental behavior. New York: Springer.
Ochsner, K. N., Silvers, J. A., & Buhle, J. T. (2012). Functional imaging studies of emotion regulation: a synthetic review and
evolving model of the cognitive control of emotion. Ann N Y Acad Sci, 1251, E1-E24.
Perren, S., Von Wyl, A., Burgin, D., Simoni, H., & von Klitzing, K. (2005). Depressive symptoms and psychosocial stress across
the transition to parenthood: Associations with parental psychopathology and child difficulty. Journal of Psychosomatic
Obstetrics and Gynecology, 26, 173-183.
Ramchandani, P., Stein, A., Evans, J., & O’Connor, T. G. (2005). Paternal depression in the postnatal period and child
development: a prospective population study. Lancet, 365, 2201-2205.
Riem, M. M., Bakermans-Kranenburg, M. J., Pieper, S., Tops, M., Boksem, M. A., Vermeiren, R. R., . . . Rombouts, S. A. (2011).
Oxytocin modulates amygdala, insula, and inferior frontal gyrus responses to infant crying: a randomized controlled trial. Biol
Psychiatry, 70, 291-297.
Riem, M. M. E., Bakermans-Kranenburg, M. J., van Ijzendoorn, M. H., Out, D., & Rombouts, Sarb. (2012). Attachment in the
brain: adult attachment representations predict amygdala and behavioral responses to infant crying. Attachment & Human
Development, 14, 533-551.
Rosenblatt, JS, & Mayer, AD. (1995). An analysis of approach/withdrawal processes in the initiation of maternal behavior in
the laboratory rat. In KE; Greenberg Hood, G;Tobach, E (Ed.), Behavioral development. New York: Garland Press.
Schechter, D. S., Moser, D. A., Wang, Z. S., Marsh, R., Hao, X. J., Duan, Y. S., . . . Peterson, B. S. (2012). An fMRI study of the
brain responses of traumatized mothers to viewing their toddlers during separation and play. Social Cognitive and Affective
Neuroscience, 7, 969-979.
Segre, L. S., O’Hara, M. W., Arndt, S., & Stuart, S. (2007). The prevalence of postpartum depression: the relative significance of
three social status indices. Soc Psychiatry Psychiatr Epidemiol, 42, 316-321.
Shonkoff, J. P., Boyce, W. T., & McEwen, B. S. (2009). Neuroscience, molecular biology, and the childhood roots of health
disparities: building a new framework for health promotion and disease prevention. Jama, 301(21), 2252-2259.
Shonkoff, J. P., & Fisher, P. A. (2013). Rethinking evidence-based practice and two-generation programs to create the future
of early childhood policy. Development and psychopathology, 25(4pt2), 1635-1653.
Shonkoff, J. P., & Phillips, D. A. (2000). From neurons to neighborhoods: The science of early childhood development.
National Academy Press, 2101 Constitution Avenue, NW, Lockbox 285, Washington, DC 20055.
Strathearn, L, Li, Jian, Fonagy, P, & Montague, P R. (2008). What’s in a smile? Maternal brain responses to infant facial cues.
Pediatrics, 122, 40-51.
Swain, J. E., Dayton, C. J., Kim, P., Ho, S. S., Tolman, R. M., & Volling, B. L. . (in press). Progress on the Paternal Brain: Theory,
Animal Models, Human Brain Research and Mental Health Implications. Infant Mental Health Journal.
Tandon, S. D., Parillo, K., Mercer, C., Keefer, M., & Duggan, A. K. (2008). Engagement in paraprofessional home visitation:
Families’ reasons for enrollment and program response to identified reasons. Women’s Health Issues, 18(2), 118-129.
Uddin, Lucina Q, Iacoboni, Marco, Lange, Claudia, & Keenan, Julian Paul. (2007). The self and social cognition: the role of
cortical midline structures and mirror neurons. Trends in cognitive sciences, 11, 153-157.
Young, Larry J, Wang, Zuoxin, & Insel, Thomas R. (1998). Neuroendocrine bases of monogamy. Trends in neurosciences, 21,
71-75.

Infant and Parent Neurobiologic Change

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