You, Me, Our Family: Exploring family patterns of interaction in young children with a significant cognitive and motor developmental delay

Due to the complex interplay of their limitations, young children with a significant cognitive and motor developmental delay are highly dependent on their immediate social setting. Parents and professionals are confronted with unique challenges in the children's upbringing and support, while research on this specific target group is very scarce. Based on the 'Developmental Systems Approach' of Guralnick (2011), this PhD project aims to characterize parent-child interactions and family-orchestrated child experiences within this specific target group as well as to examine the interrelationships between these family factors and the child's developmental characteristics, cross-sectionally and over time. First, a systematic literature review (manuscript 1) revealed that family and parenting factors are one of the most striking gaps in the current literature about the development of children with ID, and also, that further research on long-term developmental changes and bidirectional influences is necessary. Secondly, the characteristics of, and the association between, parental behavior and children's interactive engagement were explored. Parent-child dyads (with children aged 6-59 months) were video-taped during a 15-minute unstructured play situation. The video-taped observations were scored at macro-level using the Child and Maternal Behavior Rating scales. Cross-sectionally (manuscript 2), low levels of parental discipline and child initiation were found. Parental responsive behavior was positively related to child interactive engagement (i.e. attention and initiation) within the interaction. Longitudinally, this relation was confirmed to be consistent over the course of two years (manuscript 3). Also, initial child initiation seemed to positively predict parent's achievement orientation and directive behavior, two years later. Going beyond macro-level and correlational analyses, the frequency, intra-individual co-occurrence and inter-individual temporal dependency of specific interactive behaviors were explored by continuously coding the video-taped parent-child interactions using a self-developed coding scheme (manuscript 4). While children's socially oriented behavior(al cluster)s seemed to need a parental 'trigger', parents were found to more often independently engage with their child despite low child responsiveness. Thirdly, family-orchestrated child experiences of young children with a significant cognitive and motor developmental delay were explored and compared to those of typically developing children. Using a quantitative approach, concrete family activities were characterized in terms of diversity, frequency, child engagement and family member's presence based on a questionnaire (manuscript 5). Children in the study group generally experienced less diverse activities (with an additional lower frequency of out-of-home activities) and showed lower engagement levels compared to typically developing children. Taking a more qualitative approach, the sustainability of family routines was explored through an interview procedure and characterized in terms of ecological fit, congruence and meaningfulness (manuscript 6). Taking this ecocultural perspective, a myriad of common as well as group-specific indicators of ecological fit, strategies for reaching congruence as well as reported family values were identified. It was concluded that parents actively influence family life sustainability, but that families including a child with complex needs are more dependent on others and could benefit greatly from improving the organization of formal support. This dissertation was a first step in characterizing the contextual influences on child developmental characteristics in young children with a significant cognitive and motor developmental delay. Next to formulating some practical implications, suggestions for future research are made based on this dissertation's empirical findings and methodological reflections.

Jaar van publicatie:2020

Toegankelijkheid:Open