Qualities of Caregiver–Child Interaction During Daily Activities of Children Born Very Low Birth Weight With and Without White Matter Disorder

Abstract

The purpose of this study was to examine qualities of caregiver-child interactions during daily activities of healthy children born full-term and of children born prematurely and very low birth weight with and without white matter disorder. Three groups of 12 caregiver-child dyads, representing three levels of child biological risk, were matched on birth history, maternal education, ethnicity, and child gender. Ten expert clinicians used videotapes to rate behaviors of caregivers and their 30-month-old children engaging in dressing and snack activities. Correlations between ratings of three qualities were examined: caregiver directiveness, caregiver engagement, and child engagement. There were no significant differences between groups for the average caregiver and child ratings. However, correlations between caregiver directiveness and caregiver engagement ranged across the three groups from greatest to least biological risk (i.e., r= .63, .35, -.67, respectively). In the full-term group, correlations between the caregiver qualities of directiveness and engagement and child engagement were r= .62 and -.69, respectively. In contrast, the correlations between the caregiver and child qualities were small in the two very-low-birth-weight groups. Results suggest patterns of caregiver interactions during daily activities may vary according to the child's level of biological risk. Caregivers of children with the greatest risk (i.e., white matter disorder) were both engaging and directive of their children during the activities, whereas caregivers of full-term children were less engaging when directive. The findings suggest that caregivers may be adjusting the level of their social and emotional assistance during caregiver-child interactions to the level of their children's abilities.