The Pittsburgh Firstborns
at Age Nineteen Years
Elsie R. Broussard, M.D., Dr. P.H.
In our clinical practice, we are accustomed to having patients bring a presenting complaint of a current situation. We are then faced with assessing this situation and obtaining a retrospective history of what went wrong, attempting to formulate our hypotheses as to how best to achieve a "cure." It was my privilege in 1963 to begin a prospective longitudinal epidemiologic study of firstborns and their families. The opportunity to study developmental outcome in a prospective fashion provides rich data. These data have the potential for answering many questions about processes that can result either in children moving into young adulthood joyfully contemplating the future, welcoming challenges, and working at them or in young adults already showing ominous signals of constricted development and a vulnerability to psychosocial disorder.
In this paper I describe the psychosocial development at age nineteen of ninety-four firstborns who were at birth healthy, full‐ term singletons, summarize the findings of previous clinical evaluations of firstborns at ages four and one-half, ten and one-half, and
fifteen, and discuss the implications of the findings.
Although a detailed report of the study population and methodology have previously been reported (Broussard, 1970, 1971, 1976, 1979, 1983), some summary background information is indicated.
During clinical practice, I had noted that mothers of healthy newborns varied in their responses to their newborns and their needs. Some mothers made a smooth transition from pregnancy to motherhood, took pride and pleasure in raising their infants, and their infants thrived. Others lacked pride in their infants and evidenced little pleasure in motherhood, although their infants were found upon pediatric examination to be clinically healthy and appealing. It became apparent to me, as it had to others, that the way a mother relates to her baby is influenced by her perception of the baby, and that the baby's behavior is affected by her handling. These observations led me to develop an instrument to measure the mother's perception of her neonate and to conduct longitudinal studies of healthy neonates. This in____________________