Parent Interaction Between an Infant with a Cochlear Implant and Additional Disabilities

Pediatric hearing loss has many spoken language learning issues that can impact parent-infant interaction. Moreover, additional disabilities are likely to increase stress, which could have cascading effects on communication. The purpose of the study was to examine interactions between mother- and father-child dyads with and without hearing loss and/or Autism Spectrum Disorder (ASD), Cytomegalovirus (CMV), and global delay. Recordings of the parents speaking with six infants in the study were analyzed: an infant with cochlear implants and ASD (low socioeconomic status, SES), two infants with cochlear implants and normal development (high SES and low SES), one infant with a cochlear implant and CMV (average SES), one infant with a cochlear implant and global delay (average SES), and one infant who was typically developing and had normal hearing (high SES). After analyzing the results for communication measures, such as vocalization attempts, turn-taking in utterances, mean-length of utterances, and type-token ratio, it was concluded that maternal and paternal interaction was negatively affected due not only to the difficulty of the hearing loss and/or additional disability, but rather due to a combination of factors, including the disability, SES, maternal and paternal education, and the home environment

Language of mothers and fathers in interaction with their autistic children

IntroductionVerbal language is one of the most immediate and significant means parents have to express affect and information to their children. Parental speech directed to children has been thoroughly examined in typical development. However, the characteristics of parental speech directed to children with neurodevelopmental disorders are far less well documented, and no recent studies have been carried out that involve autistic1 children and their fathers. Therefore, the present study aims to analyze and compare maternal and paternal speech directed to young autistic children, focusing on fathers’ elements of speech in comparison with maternal language.MethodsN = 88 dyads participated in this study. 44 autistic children (41 males and 3 females) (chronological age: M = 40.01 months; SD = 11.96) in interaction with their fathers (paternal age M = 41.84 years; SD = 7.02) and the same 44 children in interaction with their mothers (maternal age M = 37.37 years; SD = 5.45). The language was verbatim transcribed using ELAN software (ELAN Version 6.4, 2022) and coded with an observational tool (Penman) for analyzing functions and referents of speech after reaching a satisfactory level of agreement between two independent transcribers.ResultsNo differences emerged considering the affective aspects of speech. However, mothers seem to direct more informative salient statements (W = 1,259; p = 0.02) and call the child’s attention more often than fathers (W = 1,253.5; p = 0.02). Regarding referents of informative speech, fathers focused more on the child’s internal states rather than mothers (W = 727; p = 0.04).DiscussionThese results reveal that fathers seem to display a relationship-based approach focused on a non-intrusive style with few demands while talking with their children, providing a complementary role to mothers that allows complete and harmonious stimulation of all areas of child development

An exploration of mothers’ relationships with their young, non-verbal children with an autism spectrum disorder: A case study approach

There is currently considerable knowledge relating to the relationship between a mother and her child. This relationship is based upon the proposition that both mother and child are innately programmed to be sociable and the child is pre-programmed to respond to social situations and therefore elicit caregiving. Equally, adults are programmed to respond to their children. However, many parents of young children with autism have suggested that little prepares them for the limited responsiveness that many of their children exhibit. This qualitative study, using six case studies, focused upon the reciprocal nature of the mother-child relationship in young children with autism who were also non-verbal, and sought to explore any factors which influenced the relationship experienced by the mother with her child. To date no published study has explored this relationship. This study is based upon a naturalistic paradigm and comprised six in-depth case studies using mixed methods of data collection. Each case study includes a mother and her young child diagnosed with autism who is non-verbal. Data collection methods included a semi-structured interview, observation of mother-child interaction and the Parenting Stress Index (PSI) questionnaire which is commonly used in clinical practice. The qualitative data were coded and themes were generated. The numerical data were analysed resulting in descriptive statistics. Each case study was initially analysed separately, which was followed by cross-case analysis. The qualitative and quantitative data were integrated using a conceptually clustered matrix, which was followed by the development of an association network which displays relationships amongst the variables and has an associated narrative text describing the meaning of the connections between the variables. Findings suggest that these mothers experienced difficulties in forming and maintaining a connection or an attachment with their children and deemed the interactions within the relationship to be very one-sided. This resulted in the mothers feeling rejected and unloved by their children and therefore they often did not reciprocate love for their children. Five of the mothers and children included in this study received autism-specific interventions and support. This resulted in an improvement in their children’s communication and interaction, together with an increase in the mothers’ understanding of autism and of their children. Conversely this resulted in an increase in the mothers’ ability to be responsive and synchronise their behaviours with their children’s, and in an increase in maternal confidence which culminated in a possible strengthening of the mother-child relationship. Changes to the strategic and operational practice of professionals working with these dyads are proposed which include specific objectives for professionals comprising workshops, further research and undergraduate training to raise awareness and alter practice

Effectiveness and feasibility of a joint attention (JA)-based parent-mediated intervention (PMI) for Malaysian children with autism spectrum disorder (ASD): cultural considerations

Background Social interaction and social cognition models underpinning joint attention (JA)-based parent-mediated interventions (PMIs), advocate family-centred practices and child-directed interactions as current best practices for autism spectrum disorder (ASD) early language intervention. PMIs place emphasis on Speech-language Therapist (SLT)-parents partnership. Parents are coached to become co-therapist by learning and applying a series of interaction and language facilitation strategies, aimed to enhance parent-child interactions and support their children’s JA, language, and social communication development. While the effectiveness of PMIs is mainly grounded on evidence from Western and high-resource countries, the effectiveness of PMIs in other cultures is unknown. Objective This study aimed to investigate (a) the effects of the Malay-based Hanen More Than Words (M-HMTW), a PMI, on mothers’ beliefs in family-centred intervention and practices of mother-child interactions; (b) the effects of the M-HMTW on the following child outcomes, i.e. JA, language, and social communication; and (c) the feasibility of implementing the M-HMTW among the Malay mothers of preschool children with ASD in Malaysia. Method Participants included 59 dyads of Malay mothers and their preschool children aged two to five years old with a provisional and/or diagnosis of ASD. 31 dyads were randomly assigned to the M-HMTW group, and 28 dyads were randomly assigned to a treatment-as-usual (TAU) group (i.e. conventional one-to-one therapist-mediated language intervention). The interventions were provided in four months. Mothers’ beliefs in family-centred intervention and practices of mother-child interactions were measured through the Parental Beliefs and Practices Questionnaire (Pappas et al., 2008; Simmons & Johnston, 2007). Pre- (T1) and post- (T2) intervention child measures in joint engagement (JE), total vocabulary, and social communication skills were measured via the Joint Engagement Rating Inventory (JERI; Adamson et al., 2016), the Trilingual MacArthur-Bates Communicative Development Inventories (Trilingual MCDI; Low, 2009), and the Language Use Inventory (LUI; O’Neill, 2009), respectively. The feasibility of the M-HMTW was examined through attrition rates and Gadke et al.’s (2021) ten dimensions of feasibility protocol. Results Only 32 dyads (n M-HMTW = 14; n TAU = 18) completed the four months intervention. They were included in the per-protocol and gain scores to analyse the effectiveness of the M-HMTW. The study found only a medium effect of the M-HMTW intervention on mothers’ beliefs in family-centred intervention. A lack of intervention effects was found on the gain scores in the practices of mother-child interactions and all child outcomes between the two groups. Within the M-HMTW group, from T1 to T2, the children showed significant increases in their total expressive vocabulary and social communication skills. Within the TAU, the only significant increase observed from T1 to T2 was the children’s social communication skills. Following Gadke et al.’s (2021) feasibility protocol, this M-HMTW study showed adequate feasibility in the dimensions of practicality, adaptability, and implementation; partial feasibility in the dimensions of data collection, design procedure, social validity, integration, and effectiveness; and poor feasibility in the dimensions of recruitment capability and generalisability. Conclusions This study preliminary shows the impact of the M-HMTW intervention in changing the Malay mothers’ beliefs in family-centred intervention. Issues such as attrition rates, assessment time points, and sensitivity of instruments that limited the feasibility of the study were discussed

Vocal and Non-Vocal Verbal Behavior Between Mothers and Their Children Diagnosed with Autism Spectrum Disorder

I conducted a descriptive analysis on the emission of vocal and non-vocal social/verbal interactions between 35 dyads of preschool-aged-children diagnosed with Autism Spectrum Disorder (ASD) and their mothers. Using previously recorded videos of 5-min isolated free-play sessions between the mother-child dyads, I transduced each occurrence of verbal operants, attempted verbal operants (i.e., emissions not reinforced by a listener), and additional verbal behaviors such as fantasy play emitted by the child, and approvals and disapprovals emitted by the mother. Each verbal behavior was defined as either vocal verbal behavior, non-lexical vocal verbal behavior, or non-vocal verbal behavior, all with a function to communicate. The procedure consisted of identifying each instance of verbal behavior emitted between the mother and child rotating across listener and speaker responses until either no response occurred, or the session concluded. The listener and speaker responses were further transduced into individual initiated conversational units (speaker-listener-speaker rotations). These data were statistically analyzed with previously collected child educational variables and mother demographic variables: child's level of verbal behavior in accordance with the Verbal Behavior Developmental Assessment-Revised (VBDA-R), number of acquired objectives on the Comprehensive Application of Behavior Analysis to Schooling International Curriculum and Inventory of Repertoires for Children from Preschool through Kindergarten (C-PIRK), the Autism Diagnosis Observation Schedule-Second Edition (ADOS-2) severity scores, and the scores on the Vineland-3 Adaptive Behavior Scales-Third Edition (VABS-3). The mother demographic variables were level of education and household income. The results of the study were as follow: (1) a significant relationship was shown between the child's level of verbal behavior (extracted from the VBDA-R) and performance on the C-PIRK, VABS-3, and between the ADOS-2 Modules used to assess for ASD severity; (2) the results did not show a significant difference between the child's level of verbal behavior and the number of child-initiated conversational units. The differences in the verbal behavior exchanged between the mother and child were, however, indicated across the child's form of verbal behavior - vocal, non-lexical, and non-vocal verbal behavior - emitted with the mother. Results are interpreted as parents of children without vocal verbal behavior require parent training tailored to their child's verbal developmental repertoires rather than their chronological age to ensure all communicative opportunities are captured. Educational implications, limitations, and future avenues of research are discussed

Doctor of Philosophy

dissertationPrior to the onset of spoken words, infants acquire gestures through early social interactions with their parents. Research on typically developing children has demonstrated an important relationship between maternal gesture use and child gesture and language development. Specifically, the variety and frequency of maternal gesture use has been shown to function as a scaffold for the development of language and an infant's own gesture development. This study examined gesture use in mothers of toddlers with expressive and receptive language delay during a naturalistic interaction with their young children. Maternal gestures were coded using a detailed coding scheme, according to category, specific type, and the presence or absence of co-occurring speech. The relationship between maternal gesture, child language, child gesture, and autism spectrum disorder (ASD) risk status was also examined. Participants included 54 parents of toddlers enrolled in a longitudinal study of language delay as a risk factor for ASD (language delay (LD) = 27, typically developing (TD) = 27). Results suggested similar gesture profiles across groups of mothers. Mothers of toddlers in the LD and TD groups were found to use gestures at the same frequency and convey a similar number of meanings though gesture (Wilks' Λ = 0.99, F (2, 51) = 0.273, p = 0.76, partial η2 = 0.01). Mothers in both groups used more deictic gestures than other gesture types F (1.39, 72.23) = 88.63, p 70%) and the gestures tended to emphasize the message conveyed in speech. Results for mothers in the language delay group revealed a significant negative relationship between maternal gesture and concurrent child receptive language ( p = 0.04) as well as a significant negative relationship to a change in expressive language over time ( p = 0.02). Maternal gesture in the TD group was positively related to concurrent child gesture ( p = 0.04). This research demonstrated that mothers of toddlers with severe language delays are similar in their gestural communication to mothers of typically developing infants

How Child Gestures Relates To Parent Gesture Input in Older Children with Autism and Typical Development

Young children with autism spectrum disorder (ASD) differ from typically developing (TD) children in their overall production of gesture, producing fewer deictic gestures and supplemental gesture-speech combinations. In this study, we ask whether older children with ASD continue to differ from TD children in the types of gestures and gesture-speech combinations they produce, and whether this reflects differences in parental gesture input. Our study examined the gestures and speech produced by 42 children (20 ASD, 22 TD), comparable in expressive vocabulary, and their parents, and showed that children with ASD were similar to TD children in the amount and types of gestures that they produced, but differed in their gesture-speech combinations, using gesture primarily to complement their speech. Parents, however, did not show the same group differences in their gesture-speech combinations, suggesting that differences observed in children’s gesture use may not reflect parental input, but rather the child’s communicative needs

Parental Broad Autism Phenotype and the Language Skills of Children with Autism Spectrum Disorder

Father–child and mother–child interactions were examined in order to investigate concurrent associations between three characteristics of parental broad autism phenotype (i.e., aloofness, rigidity, pragmatic language deficits), parental verbal responsiveness, and language skills of children with ASD. Results for mothers indicated that aloofness and rigidity were negatively associated with both child-initiated engagement and child language skills. Maternal aloofness was also negatively correlated with verbal responsiveness to their children, but rigidity was not. Results suggest that the association between aloofness and child language are potentially mediated by maternal use of responsive verbal behaviors. Maternal pragmatic language deficits were not concurrently related to child-initiated engagement or language skills. In contrast, for fathers, aloofness and rigidity were unrelated to child-initiated engagement and language skills. Paternal pragmatic deficits were also not associated with child language, however significant positive associations were found between paternal pragmatic language deficits and frequency of child-initiated engagement. Results are discussed in reference to potential clinical implications and directions for future research