识别具有视力障碍的儿童何时共享注意力：一种新方案及视力的影响。

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

机构信息

School of Optometry, Université de Montréal, Montréal, Quebec, Canada; Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Quebec, Canada.

Donders Institute for Brain, Cognition and Behaviour, Radboud University, the Netherlands.

出版信息

Infant Behav Dev. 2021 Aug;64:101585. doi: 10.1016/j.infbeh.2021.101585. Epub 2021 May 29.

DOI:10.1016/j.infbeh.2021.101585

PMID:34058632

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.

摘要

背景

在协调联合参与（CJE）中，儿童承认他们和他们的社会伙伴正在关注同一个物体。对于健康发展至关重要的 CJE 的实现，对于有视力障碍（VI）的婴儿来说存在风险。由于研究人员使用儿童在社会伙伴和物体之间的目光转换来标记 CJE，因此对这些儿童的 CJE 研究有限。需要研究使用不需要正常视力的行为来识别 VI 儿童的 CJE，并探讨 CJE 与视觉功能之间的关系。本研究旨在：（a）制定一种识别 VI 儿童 CJE 的方案；（b）探讨 CJE 与婴儿视力（VA）和对比敏感度（CS）之间的关系，这些通过偏好注视（PL）技术和视觉诱发电位（VEP）进行测量。

方法

制定了一种不需要正常视力的 9 项 CJE 指标的方案，以对 20 名 VI 婴儿（平均年龄= 1 岁 6 个月 27 天）及其照顾者的视频进行编码。计算观察到的每个指标的 CJE 发作百分比。使用 Cohen's Kappa 测量了编码员之间的可靠性。线性回归分析用于检验婴儿视觉功能与 CJE 之间的关系。

结果

第一位编码员与两位第二位编码员之间的组间可靠性分别为 0.98 和 0.90，用于确定孩子是否参与了 CJE。观察到最多的指标（43-62%的 CJE）是：孩子对照顾者的身体方向、照顾者和物体之间的目光转换以及对照顾者的发声。唯一显著的模型包括 VA（通过 PL 测量）作为单一预测因子，解释了 CJE 方差的 26.8%。