Online Resource 2

Manchester Assessment of Caregiver-Infant Interaction (MACI) domains

Domain (and labels of extremes of the 1-7 scale) / Brief description
Caregiver
Sensitive responsiveness (minimally sensitively responsive to very sensitively responsive) / Contingent and appropriate behavioural responses to identified infant behaviours as is required and optimal to meet the infant’s immediate and developmental needs. Responsiveness considers quality, and its broad definition includes an attentive attitude, and appropriate engagement, support and structuring in response to both infant behaviour and a lack of behaviour.
Nondirectiveness (highly directive to highly nondirective) / A behavioural and mental focus on the infant’s experience, which promotes infant initiation, rather than on the caregiver’s own desires and agenda that are not at the service of the infant’s experience. Demanding, intrusive, and negative behaviours and comments directed at the infants, and behaviour that controls the infant’s body position that may be intrusive, impact negatively on nondirectiveness. Accepting and encouraging behaviour, and positive comments that reflect the infant experience impact positively here.
Infant
Attentiveness to caregiver (inattentive to very highly attentive) / The amount and quality of interest in, and visual contact with, the parent as opposed to focus on other stimuli or self-absorption. Attentiveness can be direct (common in younger infants) or through mutual interest in a joint activity. Considerations include infant body/face orientation toward the caregiver, an interest in and acceptance of objects highlighted or demonstrated by the parent, imitation, and social referencing.
Positive affect (highly negative affect to
highly positive affect) / The extent of positive mood displayed voluntarily (excluding in response to tickles etc.) through positive expression, vocalisation and behaviour, weighed against negative affect as demonstrated by negative expression, vocalisation and bodily gestures.
Liveliness (unlively to extremely lively) / The level of physical activity, independent of the nature of the activity, weighting particularly behaviour initiated by the infant spontaneously over that which is in response to the mother’s actions. Reflex movements and those controlled by the parent (e.g. by manipulating limbs) are excluded.
Dyadic
Mutuality (very low mutuality to very high mutuality) / The degree of dyadic togetherness, ‘tunefulness’, and sharedness of the interactive experience, including shared attention, infant acceptance of maternal involvement, playing together, interactive flow, and shared body orientation.
Intensity of engagement (almost no engagement to very intense engagement) / The intensity (not quantity) of engagement by both parties at its optimal point, directly or through mutual focus on a third object. Higher intensity involves greater interest, arousal and/or positivity, including smiling, vocalisations, an observed deepening of interest, mirroring, and peaks of infant excitement.