Video Analysis of Mother-Child Interactions: Does the Role of Experience Affect the Accuracy and Reliability of Clinical Observations?

During the pre- and post-implant habilitation process, mothers of children using cochlear implants may be coached by clinicians to use appropriate communicative strategies during play according to the family's choice of communication approach. The present study compared observations made by experienced and inexperienced individuals in the analysis of one year post-implant mother-child play interactions. The study (a) explored intra-rater reliability differences in observations made by experienced clinicians versus inexperienced individuals and (b) investigated whether experienced clinicians and inexperienced individuals were able to identify communication approaches used by mothers in the play interactions. Children with prelingual hearing loss, who were implanted prior to 25 months of age, were recruited from early intervention programmes which used aural-oral (n = 7) or sign and speech (n = 5) habilitation approaches. Demographic information and one year post-operative mother-child play interaction video samples were obtained for the twelve children. Raters (n = 23) with varying levels of clinical experience watched five-minute play interaction video recordings of the mother-child dyads and evaluated key mother and child characteristics using the Maternal And Child Interaction Analysis (MACIA) rating form. Findings revealed that 39.13 per cent of all raters demonstrated a moderate level intra-rater agreement (K > 0.4). A higher proportion of experienced clinicians (60 per cent) was consistent their observations of a repeated mother-child video sample as compared to inexperienced individuals (33.3 per cent). All raters tended to under-identify mothers using a signing approach. Experienced clinicians identified communication approaches used by mothers with greater accuracy than inexperienced individuals. The MACIA rating form allowed for the documentation and comparison of observations made between raters.