Togetherness, beyond the eyes: A systematic review on the interaction between visually impaired children and their parents

BACKGROUND

Parent-child interaction is essential to promote adaptive emotional, cognitive, and social development. The majority of previous research on parent-child interaction is largely dependent on face-to-face exchanges that require the interactive partners to visually recognize reciprocal communicative bids. Therefore, previous findings in the field can only partially apply to the early interactive patterns occurring between visually impaired infants and their parents. The present study was aimed to systematically review the available evidence on parent-child interaction in the context of developmental visual impairment.

METHODS

Fourteen papers were finally selected after literature search on PubMed and Scopus. Data synthesis was focused on three core topics: visually impaired children's contribution to the interaction, parental caregiving behaviors with visually impaired children, and the association between parents' behaviors and the developmental outcomes of children with visual impairment.

RESULTS

Visually impaired children may exhibit reduced reactivity to maternal stimuli and less-than-optimal levels of interactive initiations in social exchanges. Parents of children with visual impairment may use more descriptive communicative acts and greater directiveness compared to mothers of sighted counterparts. Specific caregiving behaviors (e.g., responsiveness and goal setting) of parents of children with visual impairment may significantly support language and socio-emotional development as well as sensorimotor integration.

DISCUSSION

Children with visual impairment may be less responsive and they may produce less clear communicative bids while interacting with their parents. Their parents may face specific challenges while engaging with them and they may become increasingly directive and intrusive. Nonetheless, even in the presence of visual impairment, the quality of parental caregiving behaviors appears to play a potential preventive role in the face of children's socio-emotional and cognitive outcomes. These results suggest that early interventions focused on parent-child interactions are especially needed in this population.

A Systematic Review of the Literature on Parenting of Young Children with Visual Impairments and the Adaptions for Video-Feedback Intervention to Promote Positive Parenting (VIPP)

Secure parent-child attachment may help children to overcome the challenges of growing up with a visual or visual-and-intellectual impairment. A large literature exists that provides a blueprint for interventions that promote parental sensitivity and secure attachment. The Video-feedback Intervention to promote Positive Parenting (VIPP) is based on that blueprint. While it has been adapted to several specific at risk populations, children with visual impairment may require additional adjustments. This study aimed to identify the themes that should be addressed in adapting VIPP and similar interventions. A Delphi-consultation was conducted with 13 professionals in the field of visual impairment to select the themes for relationship-focused intervention. These themes informed a systematic literature search. Interaction, intersubjectivity, joint attention, exploration, play and specific behavior were the themes mentioned in the Delphi-group. Paired with visual impairment or vision disorders, infants or young children (and their parents) the search yielded 74 articles, making the six themes for intervention adaptation more specific and concrete. The rich literature on six visual impairment specific themes was dominated by the themes interaction, intersubjectivity, and joint attention. These themes need to be addressed in adapting intervention programs developed for other populations, such as VIPP which currently focuses on higher order constructs of sensitivity and attachment.

Análise da interação mãe e criança cega

Resumo No estudo do desenvolvimento da criança com deficiência visual uma questão relevante se refere ao processo de interação mãe-criança. Esta pesquisa objetivou descrever essa interação em situações de cuidados básicos (alimentação e higiene). Participaram três crianças cegas, de zero a três anos de idade, e suas mães. As filmagens foram realizadas pelas mães e analisadas pelo emprego de dois protocolos de análise de interação diádica (Protocolo de Categorias de Análise das Filmagens de Interação e Protocolo de Avaliação da Interação Diádica). Os resultados indicaram que as mães utilizaram, principalmente, comandos e motivação durante as atividades, além de comportamentos de afeto e responsividade ao filho. As crianças mantiveram-se atentas e engajadas nas atividades. Foram verificados comportamentos das mães para estimular o desenvolvimento cognitivo e da linguagem da criança. Os resultados demonstram a importância da interação mãe-filho para o desenvolvimento infantil e podem contribuir na elaboração de programas de intervenção com mães e filhos com deficiência visual.

Story discourse and use of mental state language between mothers and school-aged children with and without visual impairment

BACKGROUND

Lack of sight compromises insight into other people's mental states. Little is known about the role of maternal language in assisting the development of mental state language in children with visual impairment (VI).

AIMS

To investigate mental state language strategies of mothers of school-aged children with VI and to compare these with mothers of comparable children with typically developing vision. To investigate whether the characteristics of mother-child discourse were associated with the child's socio-communicative competence.

METHODS & PROCEDURES

Mother-child discourse with twelve 6-12-year-old children with VI was coded during a shared book-reading narrative and compared with 14 typically sighted children matched in age and verbal ability.

OUTCOMES & RESULTS

Mothers of children with VI elaborated more and made significantly more references to story characters' mental states and descriptive elaborations than mothers of sighted children. Mental state elaborations of mothers in the VI group related positively with the level produced by their children, with the association remaining after mothers' overall verbosity and children's developmental levels were controlled for. Frequency of maternal elaborations, including their mental state language, was related to socio-communicative competence of children with VI.

CONCLUSIONS & IMPLICATIONS

The findings offer insights into the potential contribution of maternal verbal scaffolding to mentalistic language and social-communicative competences of children with VI.

Intervenção precoce na comunicação pais-bebê com deficiência visual

A deficiência visual congênita, que pode levar à cegueira, tem sido vista como risco para a interação mãe-bebê e para o desenvolvimento psicológico da criança. O bebê que nasce com uma deficiência visual acentuada tem uma relação diferenciada com o mundo, sendo que outras vias de comunicação e percepção terão de ser ativadas para que ele alcance o desenvolvimento. Os pais são de extrema importância para o desenvolvimento desse bebê, o qual, mais do que nunca, necessita deles para entrar em contato com seu ambiente. Nesse sentido, o objetivo deste artigo é revisar a produção científica na área de intervenção precoce com pais e bebês que apresentam deficiência visual congênita. Para isto, identificam-se controvérsias teóricas acerca do desenvolvimento destes bebês, aspectos da intervenção que favorecem a interação pais-bebê e dificuldades metodológicas dos estudos nesta área.