Behavioral relationships consist of interactions between individuals and the environment. Behaviors originating from interactions between individuals are called social behaviors (Andery & Sério, 2006). The authors argued that knowing the social group in which the individual participates is important to identify those social antecedent stimuli that are significant as well as the processes involved. An example of a behavioral relationship involves the relationships between a mother and her baby.

Mother and infant interaction is built from the gestational period and vocal, visual, body and facial manifestations are essential in this relationship, characterizing the behaviors that ensure the construction of the emotional bond (Izidoro et al., 2020; Scortegagna et al., 2005). It is understood that the baby is born with a repertoire of reflexes and a predisposition to receive stimuli such as touch, voice and face, from the adult caregiver who is mainly a mother. As time goes by, this innate repertoire will be influenced by the contingencies that will be present in this interaction between the mother and her baby (Alvarenga et al., 2016).

Maternal responsiveness allows the child’s capacity for self-regulation and the acquisition of language assured by emotional support and secure attachment, In other words when the mother responds contingently to the child’s behavior, she conveys a feeling that her behavior generates changes in the environment, enhancing the learning of new behaviors (Ferreira et al., 2018). Latino (2015) studied the self-regulation behaviors of 100 infants, analyzing how they behave in stressful situations (absence of an adult or the termination/discontinuation of the mother’s interaction with the baby). The data showed that children’s self-regulation results from the baby’s ability to mobilize resources (for example, being distracted by toys or other nearby objects or parts of their body, such as feet and hands) and also from the support they receive to back their efforts (such as the availability of mobiles and other toys that are accessible and easy to use).

Another important aspect is the presence of affectivity in the mother-baby interaction (Izidoro et al., 2020). This affectivity may also be associated with the hormone oxytocin, which plays an important role in establishing social bonds early in life, an increase of this hormone in mothers when they behave more affectionately, demonstrate involvement and synchrony with their babies (Scatliffe et al., 2019).

Over time, the mother will learn to establish a routine and discriminate the child’s signals and preferences, which are characteristics of the beginning of the construction of the relationship between her and the baby (Zarske et al., 2021). In most cultures, the mother plays an essential role in the survival and well-being of her baby (Ribas & Seild de Moura, 2007) and her relationship with the baby may or may not favor the infant’s development. From the second semester of their life, infants will expand their interaction contexts that will go from dyadic to triadic, as they develop new motor, sensory and perceptual skills and interact with other objects (Izidoro et al., 2020). These new interactions help infants to direct their attention to the same object that your partner.

The mother’s interaction with her child may be adequate, but not contingent, that is, the child’s signal may not be responded to immediately by the mother or when there is this immediate response, but there is no involvement of affective aspects in this response (Chiodelli et al., 2020). Infants’ interactional responses are shaped by maternal and paternal responses.

Nunes and Salomão (2021), in their study with mothers and fathers on the parental concepts associated to the child characteristics that attract mothers’ attention most, highlighted the role of social interactions in the constitution of affective relationships and that parents tend to respond to babies contingently when they are influenced by their affective expressions in a positive way, which enhances babies’ interaction and learning. The results of the study indicated that participants attributed a greater influence to environmental factors than biological factors when explaining the positive characteristics of infants, however, when explaining their infants’ negative characteristics, they blamed it on the biological factors more than on the environmental factors.

Relationships between mothers and babies have been studied in several ways, including through filming. This was the most frequent study form found in review studies (Pederro & Rodrigues, 2019; Silva & Porto, 2016). It was also the method used in a national investigation by Alvarenga et al. (2018), Chiodelli et al. (2020, 2021), Conti et al. (2019), and Santos (2020). Silva and Porto (2016) reviewed 15 national scientific articles in the field of Psychology, retrieved from a search with the keywords “mother-baby” and “mother-baby interaction”. They indicated that the authors agree on the importance of mother-baby interaction for the child development and the need for preventive interventions. As strategies for studying it, they highlighted filming, which captures details and makes it possible to review scenes, when necessary.

One of the objectives of the study by Santos (2020) was to investigate the interactive behaviors of mothers and their three-months-old babies using footage of the dyad in a free playing framework. The results showed that caregivers exhibited more positive interactive behaviors compared to other behaviors such as negative and non-interactive behaviors, however, there were few responsive behaviors, the majority being stimulation behaviors. Another study using video footage was that of Conti et al. (2019), with a longitudinal design, which examined the effects of a home visit program on mother-child interaction, through film taking in a free playing situation. The investigators conducted statistical analyses separately for girls and boys, and the results indicated a significant improvement in interactions between girls and their mothers, with an increase in girls’ positive behaviors even in the absence of positive behaviors from their mothers.

The interactive behaviors of three-month-old infants and their mothers who showed signs of postpartum depression were assessed by Alvarenga et al. (2018) by filming the dyad in a free playing situation and found that the more the mothers touched or stimulated the infants with objects, plus the babies showed highly frequent behaviors for their age group, called stabilization. Conversely, when mothers acted intrusively, infants suffered an impaired motor development, causing a negative impact on their development. Hence, we can verify the influence on the infant’s development of the maternal interactive behaviors.

Other investigations have been conducted to assess the interactions of infants and their caregivers (Campos, 2016; Chiodelli et al., 2020; Ekas et al., 2013; Libertus & Needham, 2011), the relationships between mothers/fathers and babies with disabilities (Colus & Amorim, 2019; Gandolfine et al., 2021; Godoy & Gil, 2021; Portes & Vieira, 2022) and, even, the relationship of mothers and their babies with hearing impairment or at risk of hearing impairment (Ambrose, 2016; Paradis & Koester, 2015; Pederro, 2018, Yamada et al., 2014).

When compared with other problems that are detected by screening tests, hearing loss can be considered to have a high incidence, affecting around 7,8% of children (Barboza et al., 2013). Its prevalence ranges from one to six newborns for every 1,000 live births and, in the case of newborns released from the Neonatal Intensive Care Unit (NICU), the prevalence is one to four newborns per 100 babies (Ministério da Saúde, 2012).

Hearing loss can be mild, moderate, severe or profound, affecting one ear or both, with more than 5% of the world’s population requiring rehabilitation due to their condition. Almost 80% of people with hearing loss live in low- and middle-income countries (World Health Organization, 2021). Also, according to the World health Organization, the effects of hearing loss are more susceptible during critical periods of life, such as childhood and adolescence, among others.

The causes of hearing loss include premature birth, stay in the Neonatal Intensive Care Unit, congenital infections (rubella and toxoplasmosis, among others), postnatal bacterial or viral infections (herpes, cytomegalovirus, meningitis etc.). The presence of these risk factors requires special attention, even though all babies undergo Neonatal Hearing Screening (NHS), a mandatory exam since 2010 (Câmara dos Deputados, 2010). In 2012, the Ministry of Health issued the Neonatal Hearing Screening Care Guidelines (Ministério da Saúde, 2012).

Dias et al. (2022) carried out a literature review with the aim of demonstrating the importance of early diagnosis of hearing loss. The results of the 11 studies reviewed pointed to gains in development when the diagnosis was made as early as possible, enabling referral to the intervention services.

In the longitudinal study by Lima et al. (2019) to evaluate the effectiveness of an intervention program with six mothers of children affected by hearing impairment, aged two to three years. The mother-child interaction was assessed after four months and eight months of intervention, by film taking. For the six dyads, the results were positive after eight months of intervention, with statistically significant changes observed, an improvement, in all aspects, of the mother interaction with her hearing-impaired child.

Another study evaluated the joint involvement and emotional interactions availability between parents of children with moderate hearing loss and parents of children with typical hearing function, in which the dyads were filmed during a free playing session, in addition to the application of scales and tests (Dirks & Rieffe, 2019). The investigation demonstrated that children with hearing loss and their parents had more difficulty establishing a joint involvement and experienced shorter episodes of such involvement than the other group. Emotional availability and joint involvement were positively associated with the children’s language ability. The investigators suggested that early intervention programs, focused on the interaction between children with moderate hearing loss and their parents, be developed. And when a child is suspected of hearing loss and is in the diagnosis phase, do we observe differences in the interaction between mothers and their babies, when compared to mothers and their hearing babies? In this case, the intervention should start as of the mother’s hunch or the results of the ear test, a mandatory screening carried out in the first months of the baby’s life.

The present study aimed to describe and compare the interaction of mothers and babies at risk for hearing loss and mothers and hearing babies, in a free play setting. The first hypothesis tested was that infants at risk of hearing loss when interacting with their mothers would show fewer positive social approach behaviors, such as eye contact, smiling and/or vocalizing positively, when compared to hearing babies. The second hypothesis was that mothers of babies at risk for hearing loss would also show fewer positive sensitive behaviors, such as visual contact with the baby, touching and caressing her baby, having more caring behaviors, when compared to mothers in the group of hearing babies.