One doll fits all: Validation of the Leiden Infant Simulator Sensitivity Assessment (LISSA)

Alexandra Voorthuis, Dorothée Out, Rixt van der Veen, Ritu Bhandari, Marinus H. van IJzendoorn, Marian J. Bakermans-Kranenburg

Research output: Contribution to JournalArticleAcademicpeer-review


Children vary hugely in how demanding of their caregivers they are. This creates differences in demands on parents during observation, making the comparison of sensitivity between parents difficult. It would therefore be of interest to create standard situations in which all caregivers are faced with the same level of demand. This study developed an ecologically valid but standardized setting using an infant simulator with interactive features, the Leiden Infant Simulator Sensitivity Assessment (LISSA). The infant simulator resembles a real infant in appearance and it produces crying sounds that are life-like. The simulator begins with fussing and progresses to more intense crying in case of no care or inappropriate care. It responds by being calm again if appropriate care is given. One hundred and eighty-one female participants took care of the infant simulator for two evenings and in a 30 min lab session with increasing competing demands. Sensitive parenting behavior during the lab session was coded with the Ainsworth Sensitivity Scale. Sensitivity ratings covered the whole range of the scale (1-9), and were stable across settings (free play, competing demands). Sensitivity was related to an increase of positive affect during caretaking, and insensitivity was related to intended harsh caregiving response during a computerized cry paradigm. Sensitivity was unrelated to social desirability and self-reported quality of care given to the infant simulator. We discuss the potentials of the infant simulator for research on sensitive parenting, for preventive interventions, and for clinical practices.

Original languageEnglish
Pages (from-to)603-617
Number of pages15
JournalAttachment and Human Development
Issue number5-6
Publication statusPublished - 19 Dec 2013
Externally publishedYes


  • Ainsworth
  • infant simulator
  • Leiden Infant Simulator Sensitivity Assessment (LISSA)
  • sensitivity
  • validation


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