Effects of video-feedback intervention on harmonious parent-child interaction and sensitive discipline of parents with intellectual disabilities: A randomized controlled trial.

BACKGROUND: This study tested whether video-feedback intervention based on attachment and coercion theory increased harmonious parent-child interaction and sensitive discipline of parents with mild intellectual disabilities or borderline intellectual functioning. METHODS: Observer ratings of video-recorded structured interaction tasks at home formed pretest, post-test, and 3-month follow-up outcome data in a randomized controlled trial with 85 families. Repeated measures analyses of variance and covariance were conducted to test for the intervention effect and possible moderation by IQ and adaptive functioning. RESULTS: The intervention effect on harmonious parent-child interaction was conditional on parental social adaptive behaviour at pretest, with lower adaptive functioning associated with stronger intervention benefit at post-test and follow-up compared to care as usual. Intervention effects were not conditional on parental IQ. Intervention effects for sensitive discipline were not found. CONCLUSION: Although the video-feedback intervention did not affect observed parenting for the average parent, it may benefit interaction between children and parents with lower parental adaptive functioning.

Parenting stress and child behaviour problems among parents with intellectual disabilities: the buffering role of resources.

BACKGROUND: Parents with intellectual disabilities (ID) are at risk for high levels of parenting stress. The present study evaluated resources, including parental adaptive functioning, financial resources and access to a support network, as moderators of the association between child behaviour problems and parenting stress. METHOD: A total of 134 parents with ID and their children (ages 1-7 years) were recruited from 10 Dutch care organisations. Questionnaires were administered to the parents to obtain information on parenting stress in the parent and child domain, financial resources and their support network. Teachers and care workers reported on child behaviour problems and parental adaptive functioning, respectively. RESULTS: Parents experienced more stress with regard to their children than towards their own functioning and situation. Parenting stress was less in parents who were not experiencing financial hardship. Child behaviour problems were associated with high child-related parenting stress, not parent-related parenting stress. Large support networks decreased the association between child behaviour problems and child-related parenting stress. Financial resources did not significantly moderate the association. CONCLUSIONS: Parenting stress among parents with ID is focused on problems with the child, especially when little social support is available.

Effects of video-feedback interaction training for professional caregivers of children and adults with visual and intellectual disabilities.

BACKGROUND: Individuals in group homes may experience poor quality of social interaction with their professional caregivers, limiting their quality of life. The video-based Contact programme may help caregivers to improve their interaction with clients. METHOD: Seventy-two caregivers of 12 individuals with visual and intellectual disabilities received a training programme and four individual video-feedback sessions. Quality of interaction was independently measured in an AB-design across subjects with two baseline and three intervention observations, using a time sampling coding system for interactive behaviour as well as a rating for affective mutuality. RESULTS: From baseline to intervention, significant increases were found for the frequency with which caregivers confirmed the signals of clients, for the proportion of initiatives taken by clients that were responded to by the caregivers, and the affective mutuality as a quality of the interaction. No significant increase in client responsiveness was observed. Caregivers evaluated the intervention as useful and feasible. CONCLUSIONS: The start of the Contact programme coincided with improved quality of interaction between professional caregivers and clients with visual and intellectual disabilities in group homes. Further research is necessary regarding the generalisability, long-term effects and effects on quality of life.

'People who need people': attachment and professional caregiving.

From the perspective of attachment theory, this paper discusses individual differences in the quality of caregiving by direct-care staff for persons with intellectual disabilities. Theoretical arguments and findings from related literature are cited to support the probable role of professionals' own attachment experiences and their mental representations thereof. Case examples are drawn from a study on video-based interaction guidance for direct-care staff in group homes for persons with multiple, serious disabilities. These examples illustrate how interventions may avoid attachment-related defences against changing the quality and affective mutuality of personal contact with clients. However, the possibility is discussed that in parallel processes, quality management systems and institutional culture may selectively reinforce care patterns associated with insecure, dismissing attachment, while failing to reward the positive contribution that sensitive, affectively attuned caregiving makes to wellbeing of persons with disabilities.

Internalizing problem behavior and family environment of children with burns: a Dutch pilot study.

The psychosocial development of children with burns is at risk. Children with health care issues tend to develop internalizing problems. Several areas of protective or risk factors were composed into a conceptual model on how internalizing problems might develop or might be prevented after getting burned. The purpose of this study was to explore the relation between post burn internalizing problems on the one hand and child characteristics, burn characteristics and the family environment on the other hand. Data have been collected from 28 mothers and 27 fathers of children with burns (N=29) in six burn centers in The Netherlands and Belgium. The age of the participating children ranged from 2 to 14, TBSA ranged from 1 to 42%. Parents reported problem behavior on the child behavior checklist (CBCL). Three scales of the family environment scale (FES) have been used to explore family conflict, family cohesion and family control. Relations between a clinical level of internalizing problems, reported in 25% of the sample and the family environment were found.