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Resumen
En el estudio de casos presentado en este artículo se analizan cualitativamente las interacciones comunicativas y lingüísticas entre cuatro madres y sus hijos con síndrome de Down observadas en sus hogares durante siete meses. A lo largo de este tiempo se implementó un programa de intervención naturalista con las madres cuya finalidad era mejorar las interacciones con sus hijos, así como optimizar el desarrollo de la comunicación y el lenguaje de los niños. Las entrevistas de orientación con las madres constituyeron el instrument principal del programa de intervención. Para el análisis de las interacciones se utilizeó un instrumento de observación compuesto por tres bloques: 1) las estrategias de gestión de la comunicación y la conversación, 2) las estrategias de adaptación y ajuste del input y 3) las estrategias educativas. Los resultados indican que la intervención naturalista puede cambiar en sentido positivo la calidad de las interacciones diádicas entre las madres y sus hijos con síndrome de Down.
Abstract
This paper presents the results of four case studies that analyse qualitatively the communicative and linguistic interactions between four mothers and their children with Down syndrome. These interactions were examined at home over a seven month period. During this period, a naturalistic intervention programme was implemented with the mothers. The main goal of this intervention was to improve mother-child interaction as well as the communicative and linguistic development of the children. The intervention was based on the orientation sessions with the mothers. A three—part observational instrument was used to analyse the following mother—child interactions: 1) conversation management strategies; 2) input adjustment and adaptation strategies; and 3) educational strategies. The results show that naturalistic intervention has the potential for positively changing the quality of dyadic interaction between mothers and their children with Down syndrome.
Extended Summary
Numerous studies state that the characteristics of mother-child interactions and the communicative and linguistic activity that they display are an important factor—though not the only one—in explaining the development of communication and language (Nelson, 1977; Moerk, 1983, 1992, 1998; Rondal, 1985; Gallaway and Richards, 1994). Some researchers have investigated whether these characteristics are also present in interactions between mothers and children with communication and language delay; and, if so, how they affect children's communication and language development. The results of these studies show that while some characteristics of mother-child interactions are also present in exchanges between the mother and a developmentally delayed child, there are also certain differences (Conti-Ramsden, 1994). Indeed, it seems that the mother's interaction style is negatively influenced by the child's delay. In most cases, it is possible to improve this low-level interaction.
Based on the above results, various authors have carried out naturalistic interventions aimed at teaching these mothers a set of skills to aid the child's communicative and linguistic development (Mahoney and Powell, 1986; Girolametto, 1988; Iacono, Chan, and Waring, 1998). During interaction with the child, the experimenter displays a set of strategies that are often used by mothers and other adults in interactions with young children. This includes such strategies as: 1) Following the child's lead; 2) organizing the context; 3) giving the child enough time to participate in the conversation; 4) interpreting the child's acts; and 5) retaking and expanding utterances.
The present study undertook qualitative analyses of the communicative and linguistic interactions of four mothers and their children with Down syndrome and language delay. The children's chronological age ranged from 3 to 7 years, and their developmental age from 26 to 36 months.
A naturalistic intervention programme with these mothers was carried out at their home over a 6–7 month period. Its aim was to improve mother-child interaction and optimize the children's communication and language development. The principal intervention strategy involved structured counselling sessions with the mother. During these sessions, video recordings of the communicative interactions with the child were shown to the mother. Then, to help improve her interaction with the child, the experimenter suggested specific strategies that were adjusted to the particular communicative characteristics of the child. At all times the experimenter's attitude was flexible and adapted to the characteristics of each dyad.
To analyse the interactions, a three-part observational instrument was used involving: a) Communication and conversation management strategies, b) input adjustment and adaptation strategies, and c) educational strategies. In addition, three types of qualitative analyses were undertaken. First, the data quantification of categories coded in the transcription of recordings were interpreted. Second, we undertook a detailed interpretation of certain mother-child communicative sequences that had previously been coded based on a set of categories. Third, we attempted to explain other data collected during the intervention period; such as, observations that were not transcribed, some counselling sessions with the mother, and meetings with the therapists of two of the children.
In general, the results suggest that the intervention contributed to the improvement of the communicative strategies used by mothers; and as a result the quality of their interactions also improved. These improved interactions had the effect of increasing the communicative and linguistic performance of their children.
This research project has helped us understand the peculiarities and complexities of the interactions displayed by these four mothers and their children with Down syndrome. Likewise, this research has allowed us to understand the difficulties involved in implementing a naturalistic intervention programme aimed at increasing the quality of mother-child interactions, and in turn improving the communicative and linguistic development of the children. We think that the results obtained in this study can be useful for future researchers and for therapists working in clinical and educational intervention areas.