• Livio Provenzi

Through the mirror: Video-feedback support for parents of children with disability

Every year, more than 50 million children worldwide receive a diagnosis of neurodevelopmental disabilities, representing more than 10% of all health problems in childhood. Even in the presence of child disability, parenting is key to promote the physical, socio-emotional, behavioral, and cognitive development of infants and children. Nonetheless, additional challenges and psychological burden apply to parenting in the presence of child neurodevelopmental disabilities.

Such challenges partially depends on the degree of impairment of the child and his/her degree of autonomy. Children with disability usually provide the caregiver with less appropriate and clear social signals compared to typically developing children at the same chronological age. The quality of parent-child interaction may be greatly affected by the social, cognitive and communicative skills of the child. Also, parents may have long-lasting psychological stress, depressive symptoms and anxiety. Their ability to develop a cohesive and integrated mental representation of the child is less obvious and may require more time and psychological resources.

At the same time, parenting still is a source of prevention and resilience even for children with neurodevelopmental disabilities.

Parental responsiveness and teaching associate with the developmental quotient of 23-to-47-month-old children with diverse ND. This is true for both mothers and fathers. As such, early supportive interventions directed at improving the quality of parental caregiving and parent–infant interaction should be prioritized even in this population.

The Video-Feedback is a specific methodological approach to therapeutic interventions where the patients - or their caregivers, as in the case of families of children with disabilities - first participate in a videotaped interaction and then review the video material together with the clinician. Although different Video-Feedback approaches have been used and demostrated efficacy in families of children with behavioral dysregulation and affective problems, less is known about its efficacy when applied with families of children with disability.

In a recently published mini-review, we provide insights about both advantages and challenges in applying Video-Feedback with parents of children with neurodevelopmental conditions. As one could expect, wide variations exist in the way this parental intervention was applied in previous studies. Nonetheless, the engagement of parents in video review sessions and the promotion of interactive discussions on this material with the clinician emerged as systematically associated with improvement in sensitive caregiving and children developmental outcomes. Inconsistent evidence emerged for the effects on parental well-being, indexed as reduction of depressive or anxious symptoms.

Promoting infants and children’s development through the active engagement of parents should be a priority in the presence of children with disability. Family centred interventions directed at the parent–infant system should be promoted during the early stages of infants’ development to maximize their efficacy [...]

In sum, the Video-Feedback approach appears to be a very promising and effective approach with these families. Nonetheless, it should not be used in a one-size-fits-all approach and should be implemented carefully both in home- and hospital-based settings.

The clinician’s specific knowledge of typical and atypical development as well as of mother–infant interaction is crucial, which means that the Video-Feedback should be applied and delivered only by well-trained healthcare professionals with an adequate background and experience in the field.

Finally, the integration of Video-Feedback protocols with validated individual interventions directed at promoting either psycho-motor adjustment of children and parental emotional well-being should be pursued in clinical settings and adequately documented in future studies.

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Article citation: Provenzi L, Giusti L, Caglia M, Rosa E, Mascheroni E and Montirosso R (2020) Evidence and Open Questions for the Use of Video-Feedback Interventions With Parents of Children With Neurodevelopmental Disabilities. Front. Psychol. 11:1374. https://doi.org/10.3389/fpsyg.2020.01374

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