This thesis focused on two studies designed to investigate the influence of communicative context on parent-child interactions. Study 1 looked at the effects of different communication intervention systems (Baby Sign (BS), Enhanced Verbal (EV), and Enhanced Nonverbal (ENV) techniques) on language acquisition, nonverbal behaviours, and socio-emotional development. Study 2 measured the effects of chronic otitis media with effusion (OME) on interactions between parent and child. The investigative platform for both studies was to ascertain how the environment in which parent-infant interactions occur may be affected positively by the enhancement of communication and/or negatively by constitutional conditions (such as OME). Study 1 compared BS to other types of intervention. Typically-developing infants were recruited between the ages of 9-11 months and followed longitudinally for 20 months. BS was chosen due to its claims of advancement in IQ rates, symbolic development, complex language acquisition and development, as well as self-esteem (for example, www.babysigns.com). Using the MacArthur Bates Communicative Development Inventories (MCDIs) results showed that infants in all the intervention groups (at around 14 months of age) evidenced early language comprehension benefits (for phrases). BS also appeared to have an effect on single word comprehension. This may be a temporary advancement. No single group showed specifically enhanced benefits for language production over the others. Equally, there were no significant differences between the groups for the type of emerging lexicon. By 24 months the BS group evidenced a significant improvement in socioemotional development not evident in other groups, although the mechanism behind this was unclear. It was concluded that effects of BS on language development were restricted to early improvements in comprehension; and that these benefits may impact on subsequent socioemotional development especially around the 24 month age. This impact was not evident in the other intervention groups or in the non intervention control. This study has added to previous literature on BS by embedding the technique in context (taking into consideration the full communicative environment, verbal and nonverbal behaviours of parent and infant; and related areas of development, such as attachment and socioemotional changes). This is important as there are many pressures on parents to optimise their infant’s development and specific methods may be marketed as better than others. Findings here suggest that the quality of the interaction rather than the mode may be the key ingredient, although there are still questions regarding the effects of BS on socioemotional development. Study 2 measured the effects of chronic otitis media with effusion (OME) on interactions between parent and child and how OME impacted on the parent’s quality of life. OME is often asymptomatic; therefore parents can be unaware of the condition’s effects. Previous studies have tended to focus on the full OM spectrum and its effects on language development. Some, however, have shown that behavioural problems can result from persistent episodes of chronic OME (Maw et al., 1999) although many of these studies investigated older children, targeted attention as a behavioural measure, or included aspects such as reading ability as a behavioural outcome. This thesis explored the impact of OME on communicative style through the comparison of three groups: Group 1 - children with chronic OME; Group 2 - children with chronic throat and nose conditions; and Group 3 a non-medical control. Data for Groups 1 and 2 were collected during single appointments and involved dyads sourced from two ENT outpatient departments. Children were between the ages of 17-47 months. Results showed significant differences between the OME group and the other two for nonverbal and socioemotional behaviours. During parent-child play interactions, OME children glanced (with rapid, short glances) towards the parent more often than children in the other groups. One interpretation of this is that children with chronic OME persist in active triadic attention strategies whilst other children locate the topic of reference from the speech signal alone. Secondly, parents of children with OME raised significantly more concerns regarding their child’s socio-emotional development – especially in interacting with others - than parents in the other 2 groups. They also reported more family tension and arguments than in the non-OME ENT group. This suggests that experiencing chronic OME and its associated periods of hearing loss has either a direct or indirect detrimental impact on a child’s socioemotional wellbeing. This may relate to similar socioemotional difficulties reported in children with different types of communication problems e.g. late talkers (van Balkom et al, 2010). These concerns however were not reflected in the Parental QoL Questionnaire - used with the two medical groups. Findings imply the Ages and Stages Questionnaire: Socioemotional (AQS: SE) may be a more accurate measure for assessing parental concerns regarding socioemotional behaviour. Study 2 adds to previous research into the socioemotional development of children with OME by showing that nonverbal and pragmatic skills can be altered by the condition and thereby can affect the communicative context of parent-infant interaction. More research in this area is implicated.
|Publication status||Accepted/In press - 2012|