The Use of Lausanne Trilogue Play in Three Cases of Gastroschisis Diagnosed during Pregnancy.

Sandra Pellizzoni,Rosella Giuliani,Andrea Clarici,Marina Miscioscia,Antonella Tripani

doi:10.3389/fpsyg.2017.00509

Abstract

From pregnancy to the 1st years of a child’s life, families develop and increase representations and interactive competences toward the child. Prenatal diagnosis of a severe fetus’ defect could profoundly alter the parental perception and development of these representations. The aim of the study was to evaluate triadic interactions in families, whose baby was prenatally diagnosed with severe gastroschisis. Three families took part in the preliminary case study, which was carried out when the babies were 6 months old. The Lausanne Trilogue Play shows that prenatal diagnosis of fetal malformation may affect family triadic interactions as follows: (a) parents, especially mothers, tend to be intrusive during the play; (b) parents presents maladjustments in the child stimulations, especially during the third part, when both parents have to simultaneously interact with the baby; (c) parents experience difficulties in creating a space that allows them to communicate directly with each other, leaving the child in a peripheral position. Observational data and clinical implications are discussed.

Highlights

Gastroschisis is a birth defect affecting the intestinal wall, which results in the intra-amniotic extrusion of parts of the fetus’ intestine
Numerous studies in the field highlighted the importance of triadic family interaction as one of the most relevant factors in structuring the baby’s psychosocial development (Parke and Buriel, 1998) in various salient aspects, such as attachment (Erdman and Caffery, 2003), school adjustment (McHale and Rasmussen, 1998), psychopathological development (Jacobvitz et al, 2004; Clarici et al, 2015; Gatta et al, 2017), and theory of mind (Favez et al, 2012)
LTP is an instrument allowing for the observation of triadic interaction dynamics within a family through the analysis of relational capabilities and resources, as well as limits of interactive abilities that parents and children display when engaging in a semi-structured play activity

Summary

INTRODUCTION

Gastroschisis is a birth defect affecting the intestinal wall, which results in the intra-amniotic extrusion of parts of the fetus’ intestine. LTP is an instrument allowing for the observation of triadic interaction dynamics within a family through the analysis of relational capabilities and resources, as well as limits of interactive abilities that parents and children display when engaging in a semi-structured play activity. This play activity distinguishes between four relational configurations: (I) one parent interacts with the baby, while the other is present, but passive; (II) same as (I), but with roles reversed; (III) parents and baby play together; (IV) parents interact with each other in the presence of the baby. Analysis of the clinical cases reported below was carried out using all 15 LTP variables (e.g., the “Inclusion” variable measures whether and to what extent the parties engage in the interaction, and whether they take each other into account; the “Parental scaffolding” variable measures parental stimulation with respect to the child’s age and state) (Favez et al, 2011)

BACKGROUND

DISCUSSION