Identifying when children with visual impairment share attention: A novel protocol and the impact of visual acuity

Andrea Urqueta Alfaro; Stefania Vacaru; Walter Wittich; Paula S. Sterkenburg

doi:10.1016/j.infbeh.2021.101585

Identifying when children with visual impairment share attention: A novel protocol and the impact of visual acuity

Andrea Urqueta Alfaro^*, Stefania Vacaru, Walter Wittich, Paula S. Sterkenburg

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

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Abstract

Background: In Coordinated Joint Engagement (CJE), children acknowledge that they and their social partners are paying attention to the same object. The achievement of CJE, critical for healthy development, is at risk in infants with visual impairment (VI). Research on CJE in these children is limited because investigators use a child's gaze switch between social partner and object to index CJE. Research is needed that identifies CJE in children with VI using behaviors that do not require normal vision and that explores the relationship between CJE and visual function. This study aimed to (a) develop a protocol for identifying CJE in children with VI, and (b) explore the relationship between CJE and infants’ visual acuity (VA) and contrast sensitivity (CS), measured with Preferential Looking (PL) techniques and Visual Evoked Potential (VEP). Methods: A protocol that included 9 indices of CJE that did not require normal vision was developed to code videos of 20 infants with VI (mean age =1 year, 6 months, 27 days) and their caregivers. The percentage of CJE episodes in which each index was observed was calculated. Inter-coder reliability was measured using Cohen's Kappa. Linear regression analysis was used to examine the relationship between the infants’ visual function and CJE. Results: Inter-rater reliability between a first coder and each of two second coders were 0.98 and 0.90 for determining whether the child participated in CJE. The following indices were observed the most (in 43–62 % of CJE): child's body orientation to caregiver, gaze switch between caregiver and object, and vocalization to caregiver. The only significant model included VA (measured with PL) as a single predictor and explained 26.8 % of the variance in CJE. Conclusions: The novel protocol can be used to identify CJE in children with VI with good inter-coder reliability. The data suggest that children with lower VA exhibited less CJE.

Original language	English
Article number	101585
Pages (from-to)	1-11
Number of pages	11
Journal	Infant Behavior and Development
Volume	64
Early online date	29 May 2021
DOIs	https://doi.org/10.1016/j.infbeh.2021.101585
Publication status	Published - Aug 2021

Bibliographical note

Funding Information:
Gratitude is expressed to the Blind Babies Foundation, CA; and the infants and caregivers who participated in this study. We would also like to acknowledge our research assistants Christine Xu and Th?r?se Pham for their exceptional work and dedication. Urqueta Alfaro was supported by a post-doctoral fellowship by the Institut Nazareth et Louis-Braille du CISSS de la Mont?r?gie-Centre, Montr?al. Wittich is supported by a Junior 2 chercheur boursier Career Award, funded by the Fonds de recherche du Qu?bec - Sant? (#281454).

Funding Information:
Gratitude is expressed to the Blind Babies Foundation, CA ; and the infants and caregivers who participated in this study. We would also like to acknowledge our research assistants Christine Xu and Thérèse Pham for their exceptional work and dedication. Urqueta Alfaro was supported by a post-doctoral fellowship by the Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal . Wittich is supported by a Junior 2 chercheur boursier Career Award, funded by the Fonds de recherche du Québec - Santé (# 281454 ).

Publisher Copyright:
© 2021

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Funding

Gratitude is expressed to the Blind Babies Foundation, CA; and the infants and caregivers who participated in this study. We would also like to acknowledge our research assistants Christine Xu and Th?r?se Pham for their exceptional work and dedication. Urqueta Alfaro was supported by a post-doctoral fellowship by the Institut Nazareth et Louis-Braille du CISSS de la Mont?r?gie-Centre, Montr?al. Wittich is supported by a Junior 2 chercheur boursier Career Award, funded by the Fonds de recherche du Qu?bec - Sant? (#281454). Gratitude is expressed to the Blind Babies Foundation, CA ; and the infants and caregivers who participated in this study. We would also like to acknowledge our research assistants Christine Xu and Thérèse Pham for their exceptional work and dedication. Urqueta Alfaro was supported by a post-doctoral fellowship by the Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal . Wittich is supported by a Junior 2 chercheur boursier Career Award, funded by the Fonds de recherche du Québec - Santé (# 281454 ).

Keywords

Blindness
Joint attention
Joint engagement
Low vision
Shared attention
Visual impairment

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10.1016/j.infbeh.2021.101585

Identifying when children with visual impairment share attentionFinal published version, 1.43 MBLicence: Article 25fa Dutch Copyright Act

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Cite this

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title = "Identifying when children with visual impairment share attention: A novel protocol and the impact of visual acuity",

abstract = "Background: In Coordinated Joint Engagement (CJE), children acknowledge that they and their social partners are paying attention to the same object. The achievement of CJE, critical for healthy development, is at risk in infants with visual impairment (VI). Research on CJE in these children is limited because investigators use a child's gaze switch between social partner and object to index CJE. Research is needed that identifies CJE in children with VI using behaviors that do not require normal vision and that explores the relationship between CJE and visual function. This study aimed to (a) develop a protocol for identifying CJE in children with VI, and (b) explore the relationship between CJE and infants{\textquoteright} visual acuity (VA) and contrast sensitivity (CS), measured with Preferential Looking (PL) techniques and Visual Evoked Potential (VEP). Methods: A protocol that included 9 indices of CJE that did not require normal vision was developed to code videos of 20 infants with VI (mean age =1 year, 6 months, 27 days) and their caregivers. The percentage of CJE episodes in which each index was observed was calculated. Inter-coder reliability was measured using Cohen's Kappa. Linear regression analysis was used to examine the relationship between the infants{\textquoteright} visual function and CJE. Results: Inter-rater reliability between a first coder and each of two second coders were 0.98 and 0.90 for determining whether the child participated in CJE. The following indices were observed the most (in 43–62 % of CJE): child's body orientation to caregiver, gaze switch between caregiver and object, and vocalization to caregiver. The only significant model included VA (measured with PL) as a single predictor and explained 26.8 % of the variance in CJE. Conclusions: The novel protocol can be used to identify CJE in children with VI with good inter-coder reliability. The data suggest that children with lower VA exhibited less CJE.",

keywords = "Blindness, Joint attention, Joint engagement, Low vision, Shared attention, Visual impairment",

author = "{Urqueta Alfaro}, Andrea and Stefania Vacaru and Walter Wittich and Sterkenburg, {Paula S.}",

note = "Funding Information: Gratitude is expressed to the Blind Babies Foundation, CA; and the infants and caregivers who participated in this study. We would also like to acknowledge our research assistants Christine Xu and Th?r?se Pham for their exceptional work and dedication. Urqueta Alfaro was supported by a post-doctoral fellowship by the Institut Nazareth et Louis-Braille du CISSS de la Mont?r?gie-Centre, Montr?al. Wittich is supported by a Junior 2 chercheur boursier Career Award, funded by the Fonds de recherche du Qu?bec - Sant? (#281454). Funding Information: Gratitude is expressed to the Blind Babies Foundation, CA ; and the infants and caregivers who participated in this study. We would also like to acknowledge our research assistants Christine Xu and Th{\'e}r{\`e}se Pham for their exceptional work and dedication. Urqueta Alfaro was supported by a post-doctoral fellowship by the Institut Nazareth et Louis-Braille du CISSS de la Mont{\'e}r{\'e}gie-Centre, Montr{\'e}al . Wittich is supported by a Junior 2 chercheur boursier Career Award, funded by the Fonds de recherche du Qu{\'e}bec - Sant{\'e} (# 281454 ). Publisher Copyright: {\textcopyright} 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = aug,

doi = "10.1016/j.infbeh.2021.101585",

language = "English",

volume = "64",

pages = "1--11",

journal = "Infant Behavior and Development",

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AU - Wittich, Walter

AU - Sterkenburg, Paula S.

N1 - Funding Information: Gratitude is expressed to the Blind Babies Foundation, CA; and the infants and caregivers who participated in this study. We would also like to acknowledge our research assistants Christine Xu and Th?r?se Pham for their exceptional work and dedication. Urqueta Alfaro was supported by a post-doctoral fellowship by the Institut Nazareth et Louis-Braille du CISSS de la Mont?r?gie-Centre, Montr?al. Wittich is supported by a Junior 2 chercheur boursier Career Award, funded by the Fonds de recherche du Qu?bec - Sant? (#281454). Funding Information: Gratitude is expressed to the Blind Babies Foundation, CA ; and the infants and caregivers who participated in this study. We would also like to acknowledge our research assistants Christine Xu and Thérèse Pham for their exceptional work and dedication. Urqueta Alfaro was supported by a post-doctoral fellowship by the Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal . Wittich is supported by a Junior 2 chercheur boursier Career Award, funded by the Fonds de recherche du Québec - Santé (# 281454 ). Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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N2 - Background: In Coordinated Joint Engagement (CJE), children acknowledge that they and their social partners are paying attention to the same object. The achievement of CJE, critical for healthy development, is at risk in infants with visual impairment (VI). Research on CJE in these children is limited because investigators use a child's gaze switch between social partner and object to index CJE. Research is needed that identifies CJE in children with VI using behaviors that do not require normal vision and that explores the relationship between CJE and visual function. This study aimed to (a) develop a protocol for identifying CJE in children with VI, and (b) explore the relationship between CJE and infants’ visual acuity (VA) and contrast sensitivity (CS), measured with Preferential Looking (PL) techniques and Visual Evoked Potential (VEP). Methods: A protocol that included 9 indices of CJE that did not require normal vision was developed to code videos of 20 infants with VI (mean age =1 year, 6 months, 27 days) and their caregivers. The percentage of CJE episodes in which each index was observed was calculated. Inter-coder reliability was measured using Cohen's Kappa. Linear regression analysis was used to examine the relationship between the infants’ visual function and CJE. Results: Inter-rater reliability between a first coder and each of two second coders were 0.98 and 0.90 for determining whether the child participated in CJE. The following indices were observed the most (in 43–62 % of CJE): child's body orientation to caregiver, gaze switch between caregiver and object, and vocalization to caregiver. The only significant model included VA (measured with PL) as a single predictor and explained 26.8 % of the variance in CJE. Conclusions: The novel protocol can be used to identify CJE in children with VI with good inter-coder reliability. The data suggest that children with lower VA exhibited less CJE.

AB - Background: In Coordinated Joint Engagement (CJE), children acknowledge that they and their social partners are paying attention to the same object. The achievement of CJE, critical for healthy development, is at risk in infants with visual impairment (VI). Research on CJE in these children is limited because investigators use a child's gaze switch between social partner and object to index CJE. Research is needed that identifies CJE in children with VI using behaviors that do not require normal vision and that explores the relationship between CJE and visual function. This study aimed to (a) develop a protocol for identifying CJE in children with VI, and (b) explore the relationship between CJE and infants’ visual acuity (VA) and contrast sensitivity (CS), measured with Preferential Looking (PL) techniques and Visual Evoked Potential (VEP). Methods: A protocol that included 9 indices of CJE that did not require normal vision was developed to code videos of 20 infants with VI (mean age =1 year, 6 months, 27 days) and their caregivers. The percentage of CJE episodes in which each index was observed was calculated. Inter-coder reliability was measured using Cohen's Kappa. Linear regression analysis was used to examine the relationship between the infants’ visual function and CJE. Results: Inter-rater reliability between a first coder and each of two second coders were 0.98 and 0.90 for determining whether the child participated in CJE. The following indices were observed the most (in 43–62 % of CJE): child's body orientation to caregiver, gaze switch between caregiver and object, and vocalization to caregiver. The only significant model included VA (measured with PL) as a single predictor and explained 26.8 % of the variance in CJE. Conclusions: The novel protocol can be used to identify CJE in children with VI with good inter-coder reliability. The data suggest that children with lower VA exhibited less CJE.

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Identifying when children with visual impairment share attention: A novel protocol and the impact of visual acuity

Abstract

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Keywords

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