A Good Start (Een goed begin)

In the Mother-Infant Neurodevelopment Study (MINDS)– Leiden is a longitudinal

study investigating 1) mechanisms through which neurobiological, neurocognitive and

social-environmental factors increase risk for emotional and behavioural problems in

early childhood, 2) effects of an intensive home-visiting program for first-time mothers

at high-risk on child neurobiological, neurocognitive and emotional and behavioural

development, and 3) which factors (neurobiological, neurocognitive and social-

environmental) predict variation in effects of the home-visiting program on child

emotional and behavioural outcomes. Families are classified as low-risk or high-risk

based on the presence of one or more risk factors (based on World Health

Organization-criteria: e.g. presence of maternal psychopathology, substance use,

and social adversity). High-risk women are randomly assigned to the intervention or

high-risk control group. Six assessment waves are conducted within a four-year

period, starting at 27 gestational weeks until the child is 42 months old. This study will

help identifying specific biomarkers, precursors of neurocognitive functions and

temperamental factors in infancy, facilitating the detection of children at risk for later

emotional and behaviour problems. Furthermore, this study may yield insights into

effective, targeted, and tailor-made components of prevention programs, ultimately

reducing the psychological and economic costs of mental health problems to society.

Behavioral problems, especially externalizing behavior such as aggression, starting in the early development of life has a poor prognosis. A large body of research on the etiology of antisocial behavior has focused on the role of environmental factors. A more recent area of research has focused on neurobiological and neurocognitive factors involved in the development of aggressive behavior. However, most of this research involves children in which aggressive behavior is already part of their behavioral repertoire. The focus of this study is on the first four years of life, when behavioral problems (i.e. aggressive behavior) first appear in the child’s behavioral repertoire. To prevent social, emotional and cognitive problems later in development and to prevent long lasting and expensive treatment programs, it is important to develop evidence-based treatment and preventive programs.



In the present study three important questions are addressed. First, which neurobiological and neurocognitive factors predict (directly, indirectly or in interaction with social-environmental factors) emotional and behavioral problems – specifically aggressive behavior – in the first four years of life? Second, what are the effects of an intensive home-visiting program for first-time mothers at risk on neurobiological, neurocognitive and emotional and behavioral development in children in the first years of life? Third, which factors (neurobiological, neurocognitive and social-environmental) predict variation in effects of the home-visiting program on child emotional and behavioral outcomes?

Assessments take place prenatally at 27 gestational weeks, and postnatally at 6, 12, 20, 30 and 42 months

Half of the high-risk families take part in an intensive home-visiting program based on ‘Minding the baby’ (MTB) .This preventive intervention program consists of home visits carried out by 'coaches', starting by the 28th week of pregnancy with weekly visits and continuing through the infant’s first year. The home visits are then tapered to every other week through the child’s second year. During the home visits, the coaches carry out three major activities: (a) stimulating maternal reflective functioning, (b) promoting secure attachment, (c) attention for mental and physical health in mother and child, and child’s development.



The high-risk and low-risk control subjects will receive the casual care.