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Patterns of interaction in blind infant-parent dyads compared to similar patterns in sighted infants.

A Ph.D. research concerning patterns of interaction in the pre-verbal phase.

 

Author:                                                                     Anette Ingsholt

 

In general the research of infancy has gone through a revolutionary development in the last 40-50 years. The resulting knowledge has dramatically altered the expectations of infancy and infant behaviour.
The infant is no longer considered to be a passive human being, who the parents can form and make as they want to, independently of the infant himself. Today the infant is considered, from birth, as an individual born with the ability to be an active partner in interactions. Research of infancy has shown that infants are born with sensory abilities useable in social situations (Smith, L. et al., 1993).
Much research concerning the infant was previously based on descriptions from, for example, records of diaries and observations, where influences from behaviour, reactions and acts of other persons, for example the parents, seldom were described directly in relation to the development of the infant. The two partners, parent and infant, were described individually as if they were acting quite independently of each other. Analysis of the patterns of interaction between normal infants and parents have been focus of research during the last 20 years and this has resulted in emergence of descriptions of how patterns of interaction normally take place in the stages of early development (Stern, 1985, Schaffer, 1984). We are now aware of the mutual influences the infant and the parents have on each other. Interactions between infant-parent dyads are considered to be complex sequences of acts in which both, by their behaviour, influence the behaviour and reactions of the partner. Interactions consist of a continuous sequence of acts, where the next act of an actor has been influenced by the individual or mutual acts that just took place. In this way the partners have an effect on the behaviour of each other all the time and thereby on the continuous stream of behavioural acts.

When we look at interactions between blind infants and their parents very little research has been made. Also in this area most research has been made as observations, descriptions of experiences from the "real" world or as narrative reports. (Burlingham, 1965, Fraiberg, 1977, Preisler, 1991, Preisler et al., 1984, 1987, Urwin, 1978, 1983, Wills, 1979, 1979).
Many questions about blindness and its effects on the behaviour and daily life of an infant were discussed during the sixties and seventies. Several articles did not contain precisely scientific research. Often the articles were influenced by a psychoanalytic view of some of the authors and personal development thereby took a central place. Since a considerable number of blind children developed social-emotional difficulties like difficulties known from autistic children, the question was raised if blind children had a risk of developing autistic behaviour or other social disturbances because of the missing vision (Fraiberg, 1977, Burlingham, 1979).
These discussions are still going on. They are reinforced by the experiences we have in Denmark, where integration in nurseries, kindergartens and later in school has shown that especially the social part of integration for some blind children is difficult to cope with. This ongoing discussion is one of the reasons why the project was started.

The importance of the visual capacity in the pre-verbal phase.
Many researches concerning interaction of sighted children have found vision to be an essential component in the interactions (Brazelton, T.B. et al., 1979, Schaffer H.R. et al., 1977). The vision is from the first moments of life (Klaus, M. et al., 1982), used for example, in creating emotional bonds between infant and parents. Parents and infants use much of their time together in the early stages of interaction to establish emotional bonds between them. (Stern, 1985, Schaffer, 1984).
Vision is also used actively in the early stages of interaction as an important mean to regulate the interactions concerning content, duration and intensity (Schaffer, H.R., 1984, H. Als, 1982, H. Als et al., 1980)
The infants' use of vision in interactions with their parents is especially important at these early stages of development, where the infants' control and regulation of verbal and motoric acts are still undeveloped. During these early stages of interaction the parents are often seen to be intuitively attentive to their infant's use of vision and to react accordingly to this. (Brazelton et al., 1974, Stern, 1974)
During the early stages, vision is also a mean used by the infant to show what is the focus of his attention at a given moment. This behaviour helps the parents to follow the interests of their infant and to use his interests actively as part of the interactions and, through this help, in regulating both the content and the course of an ongoing interaction. In this manner for example, the possibilities to maintain the infants' attention for longer time is increased (H. Als, 1982).
The development of mutual attentive behaviour and the cognitive comprehension of this is, to a large extent, established by the help of vision. Parents of sighted infants co-orientate their vision with the infant by help of the direction of the vision of their infants. By doing so they know what their infant is interested in at a given moment. Sighted infant uses vision to ensure that this co-orientating takes place (Collis, 1977). Through the help of experiences like this, the sighted infant is gradually developing the knowledge that both partners are attentive to the same object and, in doing so, have reached to a state of mutual attention.
In the pre-verbal phase, vision is also used in developing the pointing gestures of infants. When a sighted infant starts to point, combined with the use of his sight, this gesture develops to a mean that enables the infant to show more precisely the focus of his attention. (Murphy et al., 1977). By looking at the acts of his parents the infant can be certain that the parents understand his gesture. When a sighted infant first by eye-pointing and later by a combination of eye-pointing and pointing with his hand, experiences that his wishes are understood by his parents, an important basis has been made for developing language and more advanced communicative skills.
Through the use of sight, the sighted infant is also able to collect affective information from parents and others. This information helps the infant to evaluate the safety of a situation (Campos, 1981). Social referencing is a help in developing a secure emotional basis for the infant in relation to activities in his surroundings.
Vision is part of many other activities that also influence the interactions. For example in imitation, recognition of distant objects and persons, where tactile and auditory impressions are not available, the loss of many visual stimuli to evoke and stimulate curiosity and locomotion. Much information is given spontaneously and quickly by help of vision. In the area of communication vision plays an important role too, in eye-contact, and as an effective signal in turn-taking among others.
We are able to imagine how it is to be without visual stimuli, but only through careful observations of blind infants interacting at early stages with their parents, are we able to get an answer to how the loss of vision affects the behaviour and development of blind infants.

What do we know until now about the potential influence of blindness?
Fraiberg (1977) wanted to know, why so many of her blind children had developed patterns of autistic behaviour. Kekelis et al. (1996) questioned why blind children have difficulties in being integrated and socially adapted into the world of sighted peers and proposed that the blind have difficulties in establishing a verbal dialogue. Als et al. (1980, 1982) has shown different patterns in interaction in the earliest stages of life in a blind infant-parent dyad compared to a dyad with a sighted infant-parent. Urwin (1983) wondered what influences the loss of visual capacities means in the pre-verbal phase . She found that her children did not develop indicative pointing or made gestures of demands such as reaching. This resulted in a delay of making requests. Preisler (1993) found the same absence of gestures.
Preisler (Preisler, 1991, Preisler et al., 1986) has shown that the communication between mothers and blind infants are very much alike the comparable interaction for sighted children and their mothers. Even if Preisler pointed out some minor differences and difficulties, she stressed that the mothers of blind children are very competent in handling their children and she pointed to ways in which the mothers found alternate paths for communication. Later on Preisler (1993) also concluded that higher demands are put on caregivers of blind infants, and that the missing vision diminishes the blind infant's opportunities to learn and understand interpersonal rules in communication. In my practical work I find that many blind children have difficulties in being socially integrated.

What are the reasons behind this?
The more technical parts of language development are managed well by many blind children. In several ways they match the sighted infants and children here. (Kekelis, 1996). But what do we know about their communicative skills from the early developmental stages?
We need more information about what is really going on between a blind infant and his parents in early interactions. Is the vision really so important in interactions at early stages, or are blind infants and their parents able to compensate and interact in another way than sighted infants and their parents?
This project was started in the hope of finding answers to these questions and through this attains more knowledge about the patterns of interaction between blind infants in the early stages of development and their parents, which afterwards could be used in programs of early intervention.

The project.
The aim of the project is to analyse patterns of interaction in blind infant-parent dyads and compare these with the similar patterns of interaction in sighted infant-parents dyads. The aim is also to find potential similarities, differences and development in patterns in the respective dyads. The essential focus is on the pre-verbal developmental phase.
The infants in the project consist of a birth cohort of blind infants, ten prematurely born infants, diagnosed with premature rethinopathy. Because of development of additional disabilities the infants in the project divided themselves into smaller groups. Five infants are barely blind, two infants are blind, mentally retarded and show difficulties in developing a verbal language, while three infants are blind, mentally retarded and have cerebral palsy. Three sighted premature children and three full- term infants were followed in the same manner as the blind infants.

Procedure.
The project is based on video-recordings of parents playing with their infants in their homes. The homes were chosen as a place for recording to ensure that both infants and parents had a secure basis for their being together. Well-known toys of the infants could be part of the situation if infant or parent wanted it. No instructions were given about the content or the course of the interactions. The parents were asked to play with their infant as they normally would do it. It was the goal to visit every family once a month, but because of practical reasons this was not practicable, but an attempt was made to come as close as possible to this interval. The youngest infants were 8 months at the first recording and the eldest was 27 months old, when the last video-recording was made. An evaluation of the development of the infant was made at every visit. This makes it is possible to compare the infants in relation to developmental age instead of chronological age. The developmental ages of the infants are between 3 to 36 months with most recordings in the age period between 9 to 24 months.
Eighty-eight videotapes were recorded. Each recording has a duration of 15-30 minutes. All tapes were viewed and an episode was chosen from each tape for a microanalysis. The duration of an episode varies from about 1 minute to about four minutes depending of when an episodic topic starts and ends. Sequences concerning play with an object were preferred, but if no such sequence was available an episode with motoric activities was chosen instead.
When an episode was identified for the microanalysis, the acts of infant and parent in each dyad were transcript according to selected categories. The list of categories consists of thirty groups of variables. Fourteen groups of variables include categories involving acts, sixteen groups of variables include more descriptive categories. Totally 150 values were used. The values and variables were chosen to fit into a computer-program, Theme, which are used to analyse the data.
The tapes were viewed several times. First all sounds were registered: vocalisations, verbal sounds and phrases. Afterwards the infant and the parent were registered separately. The motoric behaviour was then registered, for example movements of face, body and hands, how infants and parents manipulate toys, movement of reaching and contacting and affective expressions among others. Eighty-eight behaviour records were made in this manner based on the original video recordings. The applied time unit was 1/10 second. The last thing was to make an evaluation of the attentive behaviour of both infant and parent.

The methods:
The final and still ongoing phase of the project is to analyse the data by help of two different methods. g (1991) has developed a method to analyse dialogues. In processing the data I use a method Julie Feilberg (1991) has developed to analyse dialogues. Julie Feilberg worked with sighted dyads and were especially
concerned about how the dialogues between infant and parent took place. I have enlarged her method and also included an analysis of monologues. In this way I am able to analyse the continuous sequences of acts in the interactions.
All acts or chains of acts are evaluated as initiatives or responses. An initiative is an act pointing forwards in the dialogue. The initiatives are acts with potential influence on the future. A response is a reaction to an utterance that just took place or took place a short moment before. A response points backward, but sometimes a response can be both a response (pointing backwards) and an initiative (pointing forwards). A dialogue is established when a chain of acts is established in which both partners participate. Each partner can perform a chain of acts individually without any interruption from the partner. This is called a monologue.
When a new focus emerges, the initiative, which starts it, is called a global initiative. A global initiative presents a new focus in the interaction and it has potential thematically consequences for the next utterances associated to this new focus.
A registration of the verbal acts was made accordingly to their functional meaning as attention catchers, having a commentary function or was a dismissive reaction. Also the types of the verbal utterance were registered as for example, comment, questions, information, etc.
The principles of interaction analysis are used in the computer-program Theme (Magnusson, 1993, 1996). Interaction analysis is a relatively new method starting after the sound movies were available. The interaction analysis is created at anthropologically principles combined with a research method known from structural linguistic and considerations from cybernetics. (Kendon, 1990, Jordan et al., 1992.).
Careful analysis of human behaviour has shown, that human behaviour consists of recurrent patterns in individuals as well as in cultural encounters (Kendon, 1990). It is this principle of recurrent events in human behaviour that are used in the computer-program Theme. (Magnus Magnusson, 1993, 1996). By help of Theme it is possible to find patterns of interaction repeated over time. Subsequently these detected patterns of interaction are going to be analysed.

Results:
Because of limits of time of this presentation and because I am still working on processing the data I will concentrate on some of the preliminary results concerning the group of blind infants and the group of the sighted infants. The conclusions given here are preliminary, because the project is not finished.
Short considerations concerning following themes will be given at the conference: An analysis concerning respectively the group of blind and sighted infants of who takes the initiatives to start a dialogue, how the initiatives start, are maintained and closed. Problems in evaluating focus of attention will be shortly be described if time permits it.

The future:
I hope a project as the one described can bring our knowledge a little bit forward.
Much has been written in accordance with a narrative tradition of experiences from practical work. Still we need more knowledge to be able to clearly point out, what strengthens development positively and what has a negative effect. We still have a long way to go scientifically, before we clearly can pinpoint those elements. Our exact knowledge in this area is still too small.
We often work with small groups in research, but there is a growing tendency that qualitative research is accepted throughout the world. It is more and more accepted that results can be built on small samples and still have a "scientific" dimension. Careful analysis of small samples can have great value. This has made research possible in our field. Many of the observations from research on sighted infants have also been built on small groups, but when more and more samples from different places give similar results, hypotheses slowly become more plausible. This is how we often have to work, and this is why the interchange of information, experience and research results is so important across countries and frontiers, and makes a conference like this desirable and crucial.
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References:
Als, H. (1982): The unfolding of behavioral organization in the face of a biological violation. In Tronick, E.Z. (ed): Social interchange in infancy. University Park Press. Baltimore.
Als, H., Tronick E., Brazelton, T.B. (1980): Stages of early behavioral organization: The study of a sighted infant and a blind infant in interaction with their mothers. In Field, T.M., Goldberg, S., Stern D. & Sostek A.M.: (eds.): High Risk Infants and Children. Adult and Peer Interaction. Academic Press, Inc.
Brazelton, T.B., Als. H. (1979): Four early stages in the development of mother-infant interaction. The Psychoanalytic Study of the Child, Vol. 34., 349-369.
Burlingham, D. (1965): Some problems on ego development in blind children. The Psychoanalytic Study of the Child, Vol. 20.
Collis, G.M. (1977): Visual co-orientating and maternal speech. In Schaffer, H.R. (ed): Studies in mother-infant interaction. Academic Press, London.
Campos, J.J., Stenberg, C.R. (1981): Perception, appraisal and emotion: the onset of social referencing. In Lamb, M.E. & Sherrod, C.R. (eds): Infant social cognition: Emperical & theoretical considerations. Hillsdale, New Jersey.
Feilberg, J. (1991): To må man være. Mor-barn dialoger i et udviklingsperspektiv. Universitetet i Trondheim.
Fraiberg, S (1977): Insights from the blind. New York. Basic Books.
Jordan, B, Henderson, A. (1992): Interaction analysis: Foundations and practice. Unpublished paper.
Kekelis, L.S., Prinz, P.M. (1996): Blind and sighted children with their mothers: The development of discourse skills. Journal of Visual Impairment & Blindness, no. 5, 423-436.
Kendon, A. (1990): Conducting interaction. Cambridge University Press, Cambridge.
Klaus, Marshall H., and John Kennell (1982): Parent-Infant Bonding. St. Louis: Mosby.
Magnusson, Magnus S. (1993): Theme. Behavior research software. User's Manual. Unpublished Manuscript. University of Iceland, Reykjavik.
Magnusson, Magnus S. (1996): Hidden real-time patterns in intra- and inter-individual behavior: Description and detection. European Journal of Psychological Assesment, Vol. 12, Issue 2, 112-123.
Murphy, C. M., Messer, D.J. (1977): Mothers, infants and pointing: A study of a gesture. In Schaffer, H.R. (ed): Studies in mother-infant interaction. Academic Press, London.
Preisler, G. M. (1991): Early pattern of interaction between blind infants and their sighted mothers. Child, Care, Health and Development, 2, 65-90.
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Preisler G., Palmer, C. (1986): The function of vocalization in early parent-blind child interaction. In Lindblom, Björn, Zetterström, R.(eds): Precursors of early speech.
Schaffer, H.R. (1984): The child's entry into a social world. Academic Press, London.
Schaffer, H. R., Collis, G.M., Parsons, G. (1977): Vocal interchange and visual regard in verbal and pre-verbal children. In Schaffer, H.R. (ed): Studies in Mother-Infant Interaction. Academic Press, London.
Smith, Lars, Ulvund, Stein Erik (1993): Spedbarnsalderen. Universitetsforlaget, Oslo.
Stern, D.N. (1974): The dyadic interaction involving facial, vocal, and gaze behaviors. In Lewis M. & Rosenblum, L. (eds): The effect of the infant on its caregiver. New York.
Stern, Daniel N. (1985): The interpersonal world of the infant. Basic Books, Inc., Publishers. New York.
Urwin, C. (1978): The development of communication between blind infants and their parents. In Lock A. (ed): Action, gesture and symbol. Academic Press, London.
Urwin, C. (1983): Dialogue and cognitive functioning in the early language development of three blind children. In Mills, A.E. (ed): Language acquisition in the blind child. Croom Helm, London & Canberra.
Wills, D. (1979) : The ordinary devoted mother and her blind baby. The Psychoanalytic Study of the Child, 34, 31-48.
Wills D.M. (1979): Early speech development in blind children. The Psychoanalytic Study of the Child, vol. 34, 85-117.
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Anette Ingsholt
Refsnaesskolen
National Institute for Blind and Partially Sighted Children and Youth in Denmark
Kystvejen 112
4400 Kalundborg
Denmark
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E-mail: anette.ingsholt@vip.cybercity.dk (Home)
Refsnaes@inet.uni-c.dk (Work)
 
 
 
 

th , July, 1997
9th July, 1997

Ms. Brandi Furry
ICEVI 10th World Conference
Overbrook School for the Blind
6333 Malvern Avenue
Philadelphia, PA 19151-2597
USA
 
 
 
 

Workshop paper by Anette Ingsholt, Refsnaesskolen, National Institute for Blind and Partially Sighted Children and Youth, Kystvejen 112, DK-4400 Kalundborg, Denmark.

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