Communication Skills and Communicative Autonomy of Prelinguistic Deaf and Hard-of-Hearing Children: Application of a Video Feedback Intervention

Background and Aim: Evidence on the efficacy of parenting interventions to support communication development in deaf and hard-of-hearing children is emerging. In previous research, we showed that parental participation in a video feedback–based intervention enhanced parental self-esteem and emotional availability to their deaf and hard-of-hearing children. This paper investigates the impact of the intervention on the development of the children’s prelingual communication skills and autonomy. Evidence on the efficacy of parenting interventions to support communication development is warranted. Methods: Sixteen hearing parents with a prelingual deaf and hard-of-hearing child (Mage = 2.05 years, SD = 1.77) were recruited by self-selection from pediatric audiological services and randomly stratified into intervention-first and waiting-list groups. Families completed three sessions of Video Interaction Guidance in their homes. Designed for maximal inclusion, the sample comprised children with complex developmental and social needs. The primary inclusion criterion was the child’s prelingual status (<50 signed/spoken words), which was established using speech and language therapy reports. Child communicative autonomy was assessed from a 20 min free-play video recording using a gold standard measure for deaf and hard-of-hearing children (Tait) before and after the intervention. Results: A Mann–Whitney U test indicated no significant difference between the two groups. The groups were collated, and a Wilcoxon signed-rank test with time (pre- /post-intervention) as a repeating variable was run. A significant increase in children’s communicative autonomy (Z = 3.517, p < 0.0001, d = 0.62) and decrease in children’s no-responses (Z = 3.111, p < 0.005, d = 0.55) were seen. There was no significant difference in the overall number of turn-taking between the parent and child, indicating differences in the quality of the parent–child interactions, not the quantity

Video feedback intervention: a case series in the context of childhood hearing impairment

Background: Recent research shows that parental sensitivity can explain a significant and unique amount of growth in speech and language outcomes in children with cochlear implants. In this intervention study we explored the impact of an intervention designed to support parental sensitivity on children's communication development. Aims: This study tests the effect of a complex intervention in the context of childhood hearing impairment using a case study design of three families. Propositions for each case were made using parental report of the child's development in an attempt to identify change in outcome measurements that were not likely to be due to general development in the child or a halo effect from the intervention. Methods and Results: Multiple pre- and post-intervention measures were taken. Outcome measures were mother–child contingencies to vocal utterances, emotional availability and an assessment of early communication in the child. Results for each case showed that improvements in some outcome measurements were found after the intervention and were maintained at follow-up. Conclusions & Implications: Taking account of developmental change in intervention studies with children is challenging. Single-subject intervention studies can be designed to allow research interventions to be tailored to meet families’ specific needs. Video interaction guidance may support pre-linguistic communicative development in children with hearing impairment

Video feedback intervention: a case series in the context of childhood hearing impairment

Background: Recent research shows that parental sensitivity can explain a significant and unique amount of growth in speech and language outcomes in children with cochlear implants. In this intervention study we explored the impact of an intervention designed to support parental sensitivity on children's communication development. Aims: This study tests the effect of a complex intervention in the context of childhood hearing impairment using a case study design of three families. Propositions for each case were made using parental report of the child's development in an attempt to identify change in outcome measurements that were not likely to be due to general development in the child or a halo effect from the intervention. Methods and Results: Multiple pre- and post-intervention measures were taken. Outcome measures were mother–child contingencies to vocal utterances, emotional availability and an assessment of early communication in the child. Results for each case showed that improvements in some outcome measurements were found after the intervention and were maintained at follow-up. Conclusions & Implications: Taking account of developmental change in intervention studies with children is challenging. Single-subject intervention studies can be designed to allow research interventions to be tailored to meet families’ specific needs. Video interaction guidance may support pre-linguistic communicative development in children with hearing impairment

‘Crippling and unfamiliar’: Analysing the concept of perinatal anxiety; definition, recognition and implications for psychological care provision for women during pregnancy and early motherhood

Aim: To clarify how perinatal anxiety is characterised within the current evidence base and discuss how a clearer definition and understanding of this condition may contribute to improving care provision by midwives and other healthcare professionals. Background: Perinatal anxiety is common, occurs more frequently than depression and carries significant morbidity for mother and infant. The concept of perinatal anxiety is ill-defined; this can pose a barrier to understanding, identification and appropriate treatment of the condition. Design: Concept Analysis paper. Method: Rodgers’ Evolutionary Model of Concept Analysis, with review based on PRISMA principles. Findings: While somatic presentation of perinatal anxiety shares characteristics with general anxiety, anxiety is a unique condition within the context of the perinatal period. The precursors to perinatal anxiety are grounded in biopsychosocial factors and the sequelae can be significant for mother, fetus, newborn and older child. Due to the unique nature of perinatal anxiety, questions arise about presentation and diagnosis within the context of adjustment to motherhood, whether services meet women’s needs and how midwives and other health professionals contribute to this. Most current evidence explores screening tools with little examination of the lived experience of perinatal anxiety. Conclusion: Examination of the lived experience of perinatal anxiety is needed to address the gap in evidence and further understand this condition. Service provision should account for the unique nature of the perinatal period and be adapted to meet women’s psychological needs at this time, even in cases of mild or moderate distress

A very, very lonely, unmagical time. The lived experience of perinatal anxiety: A longitudinal interpretative phenomenological analysis

Problem: Minimal longitudinal qualitative evidence examining lived experience of anxiety over the perinatal continuum limits holistic understanding of the course of antenatal and postnatal anxiety. Background: Perinatal anxiety has deleterious effects on the mother and infant and is more commonly experienced yet less well investigated than perinatal depression. Aim and method: To explore women's experiences living with perinatal anxiety to increase understanding of the condition; inform support given by midwives and other health professionals and provide practice, education, and research recommendations. Five women were interviewed at three timepoints, producing 15 datasets. Data was analysed using Longitudinal Interpretative Phenomenological Analysis. Findings: Nine Group Experiential Themes emerged: the anxious mother, transformation, sets of ears and the anxious pregnancy (antenatal); baby as external focus, returning to oneself and the emotional unknown (early postnatal); and moving on, and shifting sands (late postnatal). Three Longitudinal Experiential Concepts explicated lived experience over time: maternal eyes, transforming existence, and emotional kaleidoscope. The lived experience of perinatal anxiety was revealed as socially constructed, with relationships with self, others, and the world key. The collision between anxiety and motherhood as social constructs provides perinatal anxiety with its unique characteristics. Conclusion: Midwives and other healthcare professionals should understand the significance of perinatal anxiety, enabling disclosure of stigmatising and uncomfortable feelings without judgement. Research examining whether perinatal specific screening tools should be used by midwives and exploring the relationship between perinatal anxiety and depression is recommended. Education for clinicians on the significance of perinatal anxiety is essential