A report published in Acta Paediatrica – The Welch Emotional Connection Screen: validation of a brief mother–infant relational health screen – presents findings from the first validation study of the WECS.
The Welch Emotional Connection Screen (WECS) was developed by the Nurture Science Program to meet a pressing need. Many children exhibit emotional, behavioral, or developmental disorders that create problems at home and at school that can lead to lifelong struggles. The screen is named for Martha G. Welch, MD, director of the Nurture Science Program, who led the effort to develop this new screening tool.
It is important to assess relational health early in life so children and families can receive the support they need to overcome or prevent problems. Current evaluations are costly, time-consuming, and often are difficult to obtain. A better approach was needed.
The validation of the WECS is important because a quick, reliable emotional connection screen paves the way for earlier detection and treatment of emotional problems.
A New Approach
The WECS is a powerful new approach to identify children at risk for emotional, behavioral and developmental disorders. This work is based on three new ideas:
- The autonomic nervous system plays a key role in the regulation of emotions and emotional behavior.
- Co-regulation of the autonomic nervous system underlies parent-child emotional connection.
- Establishing emotional connection addresses and prevents emotional, behavioral, and developmental problems.
Emotional connection between mother and infant, a mutually positive nurturing relationship, is the key to the future emotional well-being of both.
Process for Validating the WECS
The WECS is a new approach, designed to assess emotional connection between mothers and infants. It rates four elements of parent-child interaction: attraction, vocal communication, facial expressiveness, and sensitivity/reciprocity. The WECS includes a global assessment that evaluates if the mother-child dyad is emotionally connected. It is important to remember that emotional connection is fluid: various common circumstances such as separations or even misunderstandings can cause disconnect which can and must be repaired in an ongoing manner as they occur. The WECS makes it possible to assess when additional support is needed to repair emotional connection.
To assess the validity of the WECS, videos of mothers with their infants in the neonatal intensive care unit (NICU) were analyzed for maternal caregiving behavior, and they were also analyzed using the WECS. These same mother-infant dyads were also filmed when the baby was four months old, as they engaged in face-to-face play. These videos at four months were coded for maternal positivity, infant social engagement, still-face paradigm, and with the WECS. Electrocardiograms were acquired for the four-month-old infants, to measure their autonomic response to the still-face paradigm, where the mother is responsive to the baby, then holds a “still face” before becoming responsive to the baby again.
When the babies were still in the NICU, the WECS assessment of emotional connection was associated with more sensitive maternal caregiving. When the babies were four months old, the WECS assessment of emotional connection was positively correlated with maternal positivity and infant social engagement. Babies and mothers who had a strong emotional connection, as evaluated by the WECS, had less autonomic dysregulation (as measured by the electrocardiogram) and displayed more approach-seeking behavior during the still-face paradigm.
These results showed that the WECS has concurrent validity, construct validity, and is correlated with biobehavioral regulation in preterm infants during the still-face paradigm.
Implications and Next Steps
The WECS is an easy-to-use screen for rating mother-child emotional connection with concurrent and construct validity. It makes routine evaluation of parent-child relational health practical. The WECS can be completed in as little as three minutes. It does not include any parent self-report, nor does it require lengthy coding.
Additional validation studies are underway, and a group of clinical practitioners and training experts are working together to develop and test a WECS training program designed to translate into various settings, such as pediatric office visits and home visiting programs.