Title

Caregiver-Child Interactions During Daily Occupations for Young Children Born Very Low Birthweight

Presenter Information

Mary Beth Kadlec, Boston University

Start Time

15-11-2002 10:30 AM

End Time

15-11-2002 11:45 AM

Abstract

Introduction. Intervention for young children at risk for developmental delays focuses on supporting effective engagement of children and families within the social context of their lives. Caregivers provide one aspect of the social context for young children within the home setting to guide their engagement in daily occupations. Recent evidence suggests the way in which families construct their daily routines has a significant impact on child abilities and subsequent participation within the family, regardless of biological risk factors. Research is only beginning to identify the critical features of caregiver-child interactions that promote the effective participation in daily occupations for children at risk for negative developmental outcomes. One particular group at risk for challenges with daily occupations is children born very low birthweight (VLBW). Studies of the developmental outcomes of children born VLBW demonstrated that these children, especially those with high co-morbid medical risk profiles, are challenged more than children born low birthweight or fullterm. This study examined caregiver assistance (scaffolding) and the performance of daily occupations by children born VLBW with and without White Matter Disorder (WMD) compared to matched peers born fullterm (FT). Methods. Two measures were developed to examine the interactional (qualitative) and behavioral (quantitative) aspects of caregiver-child interactions during daily occupations (dressing and snack tasks). The participants were from a longitudinal study at a local hospital, which was following the developmental sequelae for the at risk groups. There were 12 dyads in each of the three groups (VLBW with WMD, VLBW without WMD, and FT). Interactional qualities were rated by occupational and physical therapists using the Caregiver-Child Rating Scales (CCRS) while viewing select videoclips from the study protocol. The Occupational Performance Coding System (OPCS) was developed to examine the behavioral aspects of the types of caregiver social engagement and assistance (e.g., scaffolding, such as, verbal instruction, gesture or physical assistance) and child performance during the entire protocol. Results. The three groups were compared on the CCRS and OPCS by conducting ANOVAs and correlations. The proportion of time the caregivers utilized a particular scaffolding (assistance) strategy did not differ between groups, however, the proportion of social engagement (SE) strategies (sustaining engagement, not providing assistance) were significantly different between the three groups. Caregivers of children born VLBW with WMD used more SE than caregivers of children born VLBW without WMD, who used more SE than caregivers of children born FT. In addition, caregivers of children born VLBW with WMD used a distinctly different pattern of scaffolding strategies than the caregivers of children in the other two groups. Discussion. Results will be discussed related to the similarities and differences in the interactional patterns of caregivers and the performance of their young children with daily occupations. Discussion will also focus on the importance of understanding the influence of context on occupational performance and expanding this line of inquiry.

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Nov 15th, 10:30 AM Nov 15th, 11:45 AM

Caregiver-Child Interactions During Daily Occupations for Young Children Born Very Low Birthweight

Introduction. Intervention for young children at risk for developmental delays focuses on supporting effective engagement of children and families within the social context of their lives. Caregivers provide one aspect of the social context for young children within the home setting to guide their engagement in daily occupations. Recent evidence suggests the way in which families construct their daily routines has a significant impact on child abilities and subsequent participation within the family, regardless of biological risk factors. Research is only beginning to identify the critical features of caregiver-child interactions that promote the effective participation in daily occupations for children at risk for negative developmental outcomes. One particular group at risk for challenges with daily occupations is children born very low birthweight (VLBW). Studies of the developmental outcomes of children born VLBW demonstrated that these children, especially those with high co-morbid medical risk profiles, are challenged more than children born low birthweight or fullterm. This study examined caregiver assistance (scaffolding) and the performance of daily occupations by children born VLBW with and without White Matter Disorder (WMD) compared to matched peers born fullterm (FT). Methods. Two measures were developed to examine the interactional (qualitative) and behavioral (quantitative) aspects of caregiver-child interactions during daily occupations (dressing and snack tasks). The participants were from a longitudinal study at a local hospital, which was following the developmental sequelae for the at risk groups. There were 12 dyads in each of the three groups (VLBW with WMD, VLBW without WMD, and FT). Interactional qualities were rated by occupational and physical therapists using the Caregiver-Child Rating Scales (CCRS) while viewing select videoclips from the study protocol. The Occupational Performance Coding System (OPCS) was developed to examine the behavioral aspects of the types of caregiver social engagement and assistance (e.g., scaffolding, such as, verbal instruction, gesture or physical assistance) and child performance during the entire protocol. Results. The three groups were compared on the CCRS and OPCS by conducting ANOVAs and correlations. The proportion of time the caregivers utilized a particular scaffolding (assistance) strategy did not differ between groups, however, the proportion of social engagement (SE) strategies (sustaining engagement, not providing assistance) were significantly different between the three groups. Caregivers of children born VLBW with WMD used more SE than caregivers of children born VLBW without WMD, who used more SE than caregivers of children born FT. In addition, caregivers of children born VLBW with WMD used a distinctly different pattern of scaffolding strategies than the caregivers of children in the other two groups. Discussion. Results will be discussed related to the similarities and differences in the interactional patterns of caregivers and the performance of their young children with daily occupations. Discussion will also focus on the importance of understanding the influence of context on occupational performance and expanding this line of inquiry.