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.

Fathers of Young Deaf or Hard-of-Hearing Children: A Systematic Review

Much of the literature exploring the role of parents of children who are deaf or hard of hearing (DHH) has focused on mothers; yet, the involvement and perspectives of fathers is valuable and warrants attention. Following the PRISMA guidelines, this systematic literature review examined the peer-reviewed research that has differentially explored the experiences of fathers and mothers of young DHH children. Utilizing three databases (Web of Science, PsychINFO, Scopus) and spanning 50 years (1969-2019), 457 non-duplicated articles were identified that included the fathers of DHH children, birth to six years. Independent review of the titles, abstracts, and keywords by the authors limited these to 119. Full manuscripts were assessed for eligibility; 37 were deemed appropriate for inclusion in this systematic review. The papers included have been organized into the following themes: perspectives on parenting, parental stress and coping, parent-child interaction, involvement in early intervention, parental self-efficacy, and benefits of fathers' inclusion. Recommendations for future research include: (a) actively recruiting fathers in research, (b) differentially analyzing fathers' and mothers' experiences in research studies, (c) using information gleaned from research regarding father-child and mother-child interactions to guide interventions/programming, (d) recognizing the bidirectional influences of fathers and their DHH children, (e) moving beyond descriptive studies to explore fathers' influences on child outcomes, and (f) recognizing diverse family constellations.

Autistic-Like Features in Visually Impaired Children: A Review of Literature and Directions for Future Research

There remains great interest in understanding the relationship between visual impairment (VI) and autism spectrum disorder (ASD) due to the extraordinarily high prevalence of ASD in blind and visually impaired children. The broad variability across individuals and assessment methodologies have made it difficult to understand whether autistic-like symptoms shown by some children with VI might reflect the influence of the visual deficit, or represent a primary neurodevelopmental condition that occurs independently of the VI itself. In the absence of a valid methodology adapted for the visually impaired population, diagnosis of ASD in children with VI is often based on non-objective clinical impression, with inconclusive prevalence data. In this review, we discuss the current state of knowledge and suggest directions for future research.

Literacy in Early Intervention for Children with Visual Impairments: Insights from Individual Cases

A qualitative case study design was used to investigate the ways in which two early interventionists supported emergent literacy development for infants and toddlers with visual impairment. Three themes are addressed: (1) the importance of a family-centered approach in addressing emergent literacy in early intervention; (2) the role of the early interventionist in language and concept development; and (3) the need to focus on the senses as they relate to literacy. The findings provide practical insights into the role of the early interventionist in supporting early literacy development.

Social-emotional competences in very young visually impaired children

Social-emotional competences are an important developmental domain for children with a visual impairment (VI). Therefore, early diagnosis in this regard is needed to ensure that VI children receive appropriate support. In this study, we used two preliminary German versions of the Infant–Toddler Social Emotional Assessment (ITSEA) and the Social-Emotional Assessment/Evaluation Measure (SEAM) to assess social-emotional competences in 92 VI infants and toddlers aged 12–36 months. Our results indicate that both instruments provide valid, reliable data and are suitable for use in practice. The results still reveal that understanding the emotions of other persons, paying attention to things around them and engaging with their environment, in addition to relating to other peers, seem to be the most important challenges for early intervention in VI toddlers. An additional disability is yet another condition that poses a specific challenge for VI education. The data also corroborate well-known findings from other research on the education of children with different conditions; in particular, the role of parental responsivity for the development of social-emotional competences is confirmed. Overall, the results suggest that the two instruments employed provide important information for educational practice, but further research is needed to demonstrate their full value.

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.

Autistic tendencies: Are there different pathways for blindness and Autism Spectrum Disorder?

For many of the children who are blind and who also display features of Autism Spectrum Disorder (ASD) it is possible that their characteristics, while being representative of ASD, actually follow a different pathway to those children who have ASD and are sighted. It is proposed that these children should be viewed as having specific features rather than being a part of the collective of ASD. This article explores this issue by comparing the criteria for ASD with behaviours of both children who are sighted and those who are blind. Additionally, the diagnoses of blindness associated with neurological involvement and early medical complications are discussed. The effectiveness of intervention strategies and programmes is explored.

Intersubjective Interaction Between Deaf Parents/Deaf Infants During the Infant's First 18 Months

This study is part of a larger longitudinal project with the aim of focusing early social interaction and development of mentalizing ability in 12 deaf infants, including the interaction between the infants and their deaf parents. The aim of the present paper is to describe early social interaction and moments of intersubjectivity between the deaf infants and their deaf parents during the first 18 months of the infant's life. The study is focused on the dyadic interaction rather than on the behaviors of the infant and the caregiver separately. In the analysis, the Intersubjective Developmental Theory Model (Loots, Devisé, & Sermijn, 2003) and the definitions of moments of intersubjectivity (Loots, Devisé, & Jacquet, 2005) were used. The findings show that the participating infants follow a typical developmental trajectory of intersubjectivity, both with regard to developmental stages and age. This development is supported by a visual, simultaneous way of communicating by gaze rather than having constant eye contact. Parents use complex visual communication skills in maintaining joint attention and also expect the infant to grasp the meaning of the interaction by use of gaze contact.

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.