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Comparing results between child mother and child father interactions

To verify relations between the oral language development of preterm children and the quality of mother-child interaction.

The subjects of this research were 20 mother and child dyads. An interview was conducted with the mother to obtain data about birth and life conditions. The development of oral language of the children was assessed using a test that evaluates phonology, fluency, vocabulary and pragmatics.

It was observed that the most part of mothers considered themselves the main caretaker and behavior's control and care are more important the stimulus in dyadic relation. All children scored bellow the expected for their age in the tests performed. Besides the contribution of biological factors associated to prematureness, these results can be attributed to the quantity and quality of mother-child interaction, since mothers informed to prioritize obedience and good behavior more than stimulation of the development.

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Likewise, the relationship between the quality of the child-family bonding - especially the mother-child boding - and development has also been established 2. However, a systematic literature review 3 has found that research on regarding the influence of such practices over the development of some aspects of language that are important for future schooling of premature babies, especially when they reach school age, is still rare.

The concept of 'preterm newborn' refers to babies that are born before 37 full weeks of gestational age 4. The causes have not been fully determined, although some predisposing factors have been isolated, such as primiparity, socioeconomic status, maternal nourishment, mothers' age, interval between gestations, maternal illnesses, previous fetal death history, low-weight and low-height mothers, fetal malformations, use of tobacco, etc 4.

Premature births are permeated by urgency and, therefore, might involve serious negative consequences, for both mother and baby, if skin-to-skin restrictions occur due to the immaturity and instability of the baby.

The mother, after the abrupt interruption of the birth, needs to cope with a great deal of conflicts, such as: This situation might generate feelings on the mother such as guilt, frustration, incompetence and negative expectations, like anxiety, and these might influence the quality of the interactions that established with the baby 5.

Many other feelings might appear alongside the comparing results between child mother and child father interactions of babies' prematurity, such as the fear that the child will not survive, that he will get sick easily or suffer long-term side effects 6-8. Thus, during hospitalization, the relationships are configured in a peculiar way between the baby, the hospital staff and the parents.

Preterm babies present a few peculiarities. The majority of these infants present, for instance, good neuropsychomotor evolution, but can, nevertheless, show some delay in such development 9. They will perform similar tasks as full-term babies, even if a bit later. This delay will depend on the complications and the environment's stimuli received by the baby, that might reduce or augment the resulting effects of prematurity 3,5,9,10.

Prematurity and development Regarding the influence that the mother-child interaction exerts on development, as assessed in preschool and school age children, a positive relationship between the following aspects has been verified: There is evidence that mothers of premature children that present normal language development have manifested more sensitivity to their children's clues and have more thoroughly stimulated their social and cognitive development than mothers whose children showed language issues.

It was verified, thus, that maternal responsiveness in the first four years of the child's life has a positive impact over the receptive and expressive language that the child displays at the age of four 3.

Age-appropriate linguistic development was also correlated with less punishment, less restriction and mother making available materials needed for playing. It is important to remember that preterm newborns tend to be delayed when it comes to behavioral organization, which, in turn, might lead to less social responsiveness, an important factor for comparing results between child mother and child father interactions establishment of the relationship with their mothers and other caretakers 11.

It is possible that, by virtue also of a lowered responsiveness, that the language development of preterm babies is below average, with behaviors of different complexity coexisting, as well as marked leaps in evolution. Environmental factors such as employment which leads to more positive and safer surroundingsintellectual level and family income higher income families tend to favor higher quality stimuli in the household are considered important factors for the development of language of preterm babies 3,10,12.

Although the mother is considered to be the conducting element of stimulation, when it comes to social ability in communicative exchanges, the infant's responsiveness contributes to the maintenance and increased complexity of the social interaction 11. The child's reduced adaptability to maternal intention may be related to attention problems once school age is reached 3. The interaction between the dyad becomes even more important if involving premature children who need accompaniment and stimuli so that their development is adequate to their chronological age, since they represent a risk group for impairments in several aspects, such as linguistic skills.

Thus the importance of orientating the mother regarding the baby's stimulation, because the richer and more varied it is, the higher the probability of a positive effect on the child's development.

  • For the analysis of the speech's structuring elements that were used by the children, it was considered;
  • Lack of an upshot.

Considering the results of the literature review this research had the objective of characterizing the development of the oral language of preschool age children who were preterm babies, and verify the influence of the mother-child interaction on the language development of these infants.

METHODS Subjects Twenty dyads were included in this study ten boys and ten girlswith ages ranging from 5 to 6 years old mean age 5 years and 5 monthsand their respective mothers. They have all been admitted to a neonatal intensive care unit NICU at birth and were selected from exams and records registered in the High Risk Ambulatory from the Hospital e Maternidade Celso Pierro, where they were studied and followed since birth.

From the identifying set of data regarding mother and child, researchers invited the mothers to participate in the study along with their children. Premature birth occurred at the same hospital in which the study was developed; 2.

  • This way, levels 1 and 2 refer to the initial years of school, corresponding to ages 6 and 7, respectively;
  • Defined main character, but one that vanishes along the story, however it may return just to disappear again or, yet, be replaced by another;
  • In the vocabulary test, it was verified, in each of the semantics' field that were evaluated, the usual designations, the non-designations and the replacement processes;
  • There are, also, phonetically balanced pictures, whose objective is to evaluate the phonologic development of children.

Agreement, on the part of the mother, to participate in the research and sign the Term of Consent; 3. The child needed to have received a prematurity diagnosis at birth, meaning a gestational age less than 37 weeks of corrected age and a birthweight lower than 2,000 grams. Age was corrected using the Capurro method and the New Ballard score for cases in which children had a gestational age of 25 weeks ; 4.

Hospitalization in the NICU; 5. The child had been followed at the High Risk ambulatory from the same hospital, since discharge; 6. Regularly attended a school from its local educational district. Children with central nervous system CNS alterations were excluded from the research, as well as those with syndromes; those hearing or eye impaired; children that were born at other hospitals; and children whose mothers, when invited, have not agreed to participate in the research.

The anamnesis approached aspects which were relative to identification data, family constitution, maternal records and child records at birth. Regarding the hospitalization, some questions were made about the maternal feeling during her interaction with the child, daily routines followed, availability for the child, type of activities undertaken, frequency at the daycare, what were her priorities regarding her child's education and the mother's expectations regarding the child Appendix 1.

The anamnesis was formulated so as to contemplate all aspects that involve the matter of prematurity and the dyadic relationship since birth, for example, maternal directivity and development.

A pilot test was conducted with two mothers, in order to adjust the guide for the population studied. In order to evaluate all aspects of children's language, the child was submitted to a speech test called ABFW 13which aims at the evaluation of language's four aspects: For the first two aspects, it was used an arrangement of figures from the same book, which contained images with blank lines to be filled with the correspondent names of animals, foods, furniture and utensils, transports, colors, shapes and toys.

There are, also, phonetically balanced pictures, whose objective is to evaluate the phonologic development of children. For the pragmatics and fluency tests a free, playful activity was proposed using various toys, such as a ball, dolls, fitting pieces etc.

Regarding the evaluation of the oral speech, the following materials were used: Procedures The evaluation was conducted in a therapy room from the Speech-Language Pathology Clinic of PUCCamp, according to what was described in the project that was approved by the Ethics Committee from the same institution, in a threefold session: In the second session the following aspects of the child's language were evaluated: The last session was dedicated solely to the child's play, so it could have a free and spare time to engage in playful situations, in which fluency and pragmatics were being evaluated.

All of the responses and participants' behaviors, as observed by the evaluator, were filmed and later on transcribed on the protocols. Analysis The responses that were obtained in the anamnesis were grouped according to the questions that were made to the mothers Chart 1. For the analysis of the speech's structuring elements that were used by the children, it was considered: Maintenance of the main character: Undefined main character, with several characters appearing through the story so that it isn't possible to determine the main character; C2: Defined main character, but one that vanishes along the story, however it may return just to disappear again or, yet, be replaced by another.

Defined main character that's kept all through the narrative. It's never replaced until the end of the story. Undefined topic, it is present in the beginning of the story, but it is replaced along the narrative. There is a topic in the beginning of the story that is replaced by another along the narrative, just to be brought back at the end of the story. The topic remains the same all through the story. It is possible to observe the outline of an event, or the presence of multiple ones, without the existence of a main one.

These are sequels of episodes or actions that aren't correlated. Several events, although it is hard to define which is the main one, even if there's some relationship among them. Presence of a main event, plot or problem situation which is central and defined, one that rules the entire story and the character's actions.

Upshot comparing results between child mother and child father interactions finishes and concludes the story: Lack of an upshot.

  • This has led to the finding that the smaller the Apgar score and GA are, the longer is the child's hospitalization time;
  • Once this is known, it is this study's suggestion that, early on in pregnancy, the mothers receive support and orientation from a multiprofessional team regarding the development that is expected from a child and the possible stimulations that are able to being put forth during hospitalization, in order to increment the maternal bond and the positive feelings towards the child.

The story is abruptly concluded. There is an upshot that, however, doesn't hold any link with the main event. Defined upshot and close linkage with the main event. C3; E3; T3; U3 The Level 1 classification is characterized by stories in which there is a change of topics and of events that are succeeded in a disconnected manner, which compromises the text comprehensibility. Nevertheless, Level 2 is different from its predecessor once there is a tendency to maintain the topic all along the narrative, even if it doesn't hold a precise relationship with the development of the story.

Level 3 is characterized by the maintenance of the topic and of the event all along the narrative. However, since here the upshot holds no relation with the events that were narrated, comprehension is jeopardized.

  1. The performance of the participants group regarding this aspect was below what was expected for their age group, once the average of syllables per minute for preschoolers is of approximately 170, a number that is much higher than the one verified by the studied children.
  2. In the phonology test, almost half of the subjects have presented phonological deviations, and most of these deviations were not expected for their present development. The remaining mothers have reported feeling confidence and trust during their hospitalization periods.
  3. In the vocabulary test, it was verified, in each of the semantics' field that were evaluated, the usual designations, the non-designations and the replacement processes. Besides the contribution of biological factors associated to prematureness, these results can be attributed to the quantity and quality of mother-child interaction, since mothers informed to prioritize obedience and good behavior more than stimulation of the development.

It presents a straight relationship with the events that were narrated as the story unfolded. According to the authors 15the levels are differentiated according to the level of schooling in which the children are. This way, levels 1 and 2 refer to the initial years of school, corresponding to ages 6 and 7, respectively. The oral language analysis was separated in four parts, according to the exams applied.

In the phonology exam, the focus of observation was to whether or not the child had performed any phonological change. In the occurrence of any phonological changes, the phonologic processes that were realized by the child during the test were analyzed, with the objective of verifying it those were somewhat expected for the child's age.

In the vocabulary test, it was verified, in each of the semantics' field that were evaluated, the usual designations, the non-designations and the replacement processes. Later on, there was an analysis of the outcomes, in terms of what was expected and what was obtained, regarding the chronological age of the child, according to the following classification: Pragmatics was analyzed according to the communicative acts realized by the subject, the comparing results between child mother and child father interactions medium and the communicative functions that were utilized: For this test, it is observed that, since 15 months of age, there is a balance between gestural communication and the sum of vocalizations and verbalizations.

Moreover, the number of communicative acts expressed in a minute varies a lot between different individuals, in diverse situations and with different interlocutors. However, the communicative acts of the studied strip were of approximately eight per minute. The last analysis concerned fluency. The typology of the disfluencies normal and stuttering was verified as well as speech speed word and syllables flow per minute and rupture frequency percentage of speech discontinuity and stuttering disfluencies.

The disfluencies' typologies are divided in two aspects 13 Chart 2. According to the author, repetition of syllables, words, segments and phrases are expected in younger children usually two, maximum three repetitions.

Up to two seconds' pauses are also expected. Generally, the normal disfluencies exceed the stuttering disfluencies. The frequency of words is of approximately 160 words per minute in adults, and this tax is slightly inferior in preschoolers, and those are expected to reach this limit in its school years.

Regarding the syllable, the tax for the adults is of, approximately, 212 syllables per minute and in preschoolers the articulatory speed remains around 170 syllables per minute.