78 Grief and Loss Across the Lifespan
early care experiences as well as the developing child’s capacity to engage
with others, explore the environment and engage in active learning. To
support parenting capacity and the developmental well-being of children,
practitioners and researchers recognize the complex interplay of individual,
familial, cultural, and social factors that combine to shape a particular child’s
caregiving environment (Fraiberg, 1987; Onunaku, 2005).
Infants who lack access to empathically attuned care can exhibit patterns
of behavior characterized by withdrawal, “freezing,” and/or marked disorga-
nization in their relational interactions (Applegate & Shapiro, 2005; Fraiberg,
1987). These behavioral responses, while adaptive in the short-run, impede the
infant’s ongoing developmental progress by limiting opportunities for inter-
action and challenging the formation of attachment bonds. The prevalence
of maternal depression combined with the developmental risks it poses to
infant and child well-being suggests the importance of primary prevention
efforts and timely assessment and early intervention (Onunaku, 2005). Early
outreach and improved depression awareness can assist mother-infant dyads
to promote attuned caregiving to build an infant’s attachment and brain devel-
opment in a way that promotes their own, and societal, well-being.A Case of Perinatal Stroke: Examining Multiple Layers of Loss
Jennifer Boiler
A licensed clinical social worker in New Jersey, Jennifer serves as associate director
of Field Education Operations and an instructor for the Rutgers University School of
Social Work. Jennifer has extensive experience as a medical social worker focusing on
medical transition, hospice, and palliative care. Jennifer currently maintains a private
practice providing therapy to individuals, couples, and families.Melanie H. is a 32-year-old African American female with a master’s degree
in Special Education and a bachelor’s degree in Elementary Education and is
tenured as an elementary school Special Education teacher. Melanie has been
happily married to Frank H. for 10 years. Frank is a 30-year-old Caucasian male.
Frank has been employed as a real estate broker and has a bachelor’s degree
in Business Administration; he has been working with his firm for 4 years.
They are financially secure as long as they both remain employed in full-time
work; they have collective student load debt as well as a mortgage payment
and a car payment. Together, Melanie and Frank are the biological parents of
their 4-year-old daughter Lina H. Melanie and Frank maintain a strong con-
nection to Frank’s immediate family (his mother and father and older sister)
and receive much support as his parents and sister live locally and are very
involved in Lina’s life. Frank’s family has been transporting Lina three times a
week to and from preschool; they have been active in caring for Lina if needed.
Melanie’s parents and her younger brother (in college) reside several hours
away and are not able to visit often due to increasingly poor health and the
inability to travel. Melanie and Frank have a solid support system of friends,
neighbors, and colleagues who have young children and similar interests.