Academic journal article Journal of Visual Impairment & Blindness

Enhancing Sustained Interaction between Children with Congenital Deaf-Blindness and Their Educators

Academic journal article Journal of Visual Impairment & Blindness

Enhancing Sustained Interaction between Children with Congenital Deaf-Blindness and Their Educators

Article excerpt

Educators and children with congenital deaf-blindness experience major challenges in building interactions that are reciprocated and sustained (Chen, Klein, & Haney, 2007; Vervloed, Van Dijk, Knoors, & Van Dijk, 2006). Interaction is defined as the process of two individuals mutually influencing each other's behavior (Janssen, Riksen-Walraven, & Van Dijk, 2003b).

Sustained interaction is defined here as interaction with a reciprocal three-turn structure (Levinson, 1983; Linell, 2009): One of the interaction partners takes an initiative; the other reacts with a confirmation, an answer, or a new initiative; and then the first reacts again. The absence of breakdowns is important for good interaction and is a basis for high-quality communication in which intentions and meanings are expressed (Reddy, 2008; Rodbroe & Souriau, 1999).

Earlier studies have shown that affect attunement and sensitive responsiveness are crucial for a child to feel recognized and for synchronizing early conversations (Janssen et al., 2003b; Stem, 1985-1998; Trevarthen & Aitken, 2001). We previously presented the Diagnostic Intervention Model (DIM) as a guide for designing and implementing interventions to foster harmonious interactions (Janssen et al., 2003a) and examined the efficacy of the DIM in the Contact effect study (Janssen et al., 2003b). Considerable effects were found on core interaction categories for both the educators and the children (see Janssen et al., 2003a; Janssen, Riksen-Walraven, Van Dijk, Ruijssenaars, & Vlaskamp, 2007; Janssen, Riksen-Walraven, Van Dijk, & Ruijssenaars, 2010). However, the dyadic category of sustained interaction was not evaluated.

The study presented here demonstrated the effects of the DIM on sustained interaction within a reciprocal three-turn structure (such as the educator-child-educator or the child-educator-child). We reanalyzed observational data from the Contact effect study (Janssen et al., 2003a) and looked at the duration of sustained interaction, the duration of the longest interaction sequence, and the mean number of turns in a sequence. The results are evaluated and discussed here.

METHOD

Participants

The study followed the tenets of the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was approved by the Institutional Review Board of Royal Kentalis in the Netherlands. Informed consent was obtained from the parents and educators.

The study included six children and adolescents with congenital deaf-blindness: Rolf and Ruud (both aged 3), Sam (aged 5), Kris (aged 10), Nicole (aged 16), and Anton (aged 19), referred to here as "the children." The children were selected using three criteria: dual sensory impairments since birth; a limited expressive vocabulary; and the requests of their parents, teachers, or caregivers for interaction coaching. Rolf is visually and hearing impaired (as a result of Cornelia de Lange syndrome) and uses the visual, auditory, and tactile modalities in communication. Ruud is blind and hearing impaired (as a result of Leber's congenital amaurosis) and uses the auditory and tactile modalities. Sam is blind and hearing impaired (as a result of Zellweger syndrome) and uses the auditory and tactile modalities. Kris is deaf and blind for four months (as a result of congenital rubella) and uses the tactile modality. Nicole is hearing and visually impaired (as a result of congenital rubella) and uses visual and auditory modalities. Anton is hearing impaired and blind (as a result of congenital rubella), and uses mainly the tactile modality. Thirteen educators (2 mothers, 1 teacher, and 10 caregivers) participated in the intervention, as did three interaction coaches.

INTERVENTION

Interaction categories

Eight interaction categories were used to formulate and evaluate the intervention aims:

1. …

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