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.

中文翻译：

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识别视力障碍儿童何时分享注意力：一种新的协议和视力的影响

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对象。CJE 的实现对健康发育至关重要，但在视力障碍 (VI) 婴儿中存在风险。对这些儿童 CJE 的研究是有限的，因为研究人员使用儿童在社会伙伴和对象之间的凝视切换来索引 CJE。需要研究使用不需要正常视力的行为来识别 VI 儿童的 CJE，并探索 CJE 与视觉功能之间的关系。本研究旨在 (a) 制定用于识别 VI 儿童 CJE 的方案，以及 (b) 探索 CJE 与婴儿视力 (VA) 和对比敏感度 (CS) 之间的关系，使用优先观察 (PL) 技术测量和视觉诱发电位 (VEP)。

方法

开发了包括 9 个不需要正常视力的 CJE 指数的协议，用于对 20 名 VI 婴儿（平均年龄 = 1 岁 6 个月 27 天）及其护理人员的视频进行编码。计算观察到每个指数的 CJE 发作的百分比。使用 Cohen's Kappa 测量编码器间的可靠性。线性回归分析用于检查婴儿视觉功能与CJE之间的关系。

结果

第一个编码器和两个第二个编码器中的每一个之间的评分者间可靠性分别为 0.98 和 0.90，用于确定孩子是否参加 CJE。以下指标被观察到最多（占 CJE 的 43-62%）：儿童对看护者的身体方向、看护者和物体之间的凝视切换以及对看护者的发声。唯一重要的模型包括 VA（用 PL 测量）作为单一预测因子​​，并解释了 CJE 中 26.8% 的方差。

结论

该新协议可用于识别具有良好编码器间可靠性的 VI 儿童的 CJE。数据表明，VA 较低的儿童表现出较少的 CJE。