Parental representations after preterm birth: a narrative review.

Preterm birth accounts for nearly 15 million births annually worldwide and constitutes a considerable risk factor for atypical development. This birth context is a source of stress for the parents and often leads to an early separation between their child and them. Research on the influence of the birth status on the infant's attachment style has shown no systematic link between preterm birth and the development of insecure attachment in children born preterm. This has opened up research perspectives in understanding the role of environmental factors. A literature review was conducted to present an overview of the current findings on parental representations (PR), particularly maternal ones, and their role in the context of preterm birth. PR quality appears to be associated with specific dyadic interaction patterns, thus exposing vulnerability factors. Studies exploring PR have pointed out the importance of considering parental mental elaboration mechanisms and contextual moderators in supporting socio-emotional development among children born preterm. We discussed the challenges of investigating PR in the context of preterm birth for future studies and emphasized the need for research studies to be conducted according to a developmental and non-deterministic perspective. This narrative review also aimed to highlight the importance of family centered care interventions in the context of a public policy focused on the child's "First 1,000 days" of life.

Parenting stress and needs for social support in mothers and fathers of deaf or hard of hearing children.

Introduction: Hearing parents of deaf or hard of hearing (DHH) children may experience parenting stress and social support could be a buffer to this stress. Differences in levels of these two indicators may exist between mothers and fathers. This study focuses on the parenting stress and social support needs of mothers and fathers of DHH children. Methods: Twenty-seven French parental couples of DHH children completed the Parenting Stress Index and the Family Needs Survey, a questionnaire on social support needs. Results: Their overall stress scores showed no difference, but subdomain scores show that mothers and fathers are more stressed by the child's hyperactivity, and fathers by the child's adaptability, than parents of children with normal hearing. Mothers are more stressed than fathers by role restriction; they feel less free because of their parenting role. Fathers have a lower quality of attachment to their child than mothers. Parents have a high social support need, especially for obtaining information about their child's individual characteristics and health situation. The ranking of mothers and fathers in the top 10 needs reveals different needs profiles. Parenting stress profiles show that mothers and fathers with higher-than-normal stress levels have a greater overall need for social support than mothers and fathers with lower than normal stress levels. Discussion: This study highlights the value of assessing parenting stress and social support needs in parents of DHH children for a better understanding of their situation in research and its clinical implications, as well as the importance of differentiating outcomes for mothers and fathers.

Computer-Aided Screening of Autism Spectrum Disorder: Eye-Tracking Study Using Data Visualization and Deep Learning.

BACKGROUND: The early diagnosis of autism spectrum disorder (ASD) is highly desirable but remains a challenging task, which requires a set of cognitive tests and hours of clinical examinations. In addition, variations of such symptoms exist, which can make the identification of ASD even more difficult. Although diagnosis tests are largely developed by experts, they are still subject to human bias. In this respect, computer-assisted technologies can play a key role in supporting the screening process. OBJECTIVE: This paper follows on the path of using eye tracking as an integrated part of screening assessment in ASD based on the characteristic elements of the eye gaze. This study adds to the mounting efforts in using eye tracking technology to support the process of ASD screening. METHODS: The proposed approach basically aims to integrate eye tracking with visualization and machine learning. A group of 59 school-aged participants took part in the study. The participants were invited to watch a set of age-appropriate photographs and videos related to social cognition. Initially, eye-tracking scanpaths were transformed into a visual representation as a set of images. Subsequently, a convolutional neural network was trained to perform the image classification task. RESULTS: The experimental results demonstrated that the visual representation could simplify the diagnostic task and also attained high accuracy. Specifically, the convolutional neural network model could achieve a promising classification accuracy. This largely suggests that visualizations could successfully encode the information of gaze motion and its underlying dynamics. Further, we explored possible correlations between the autism severity and the dynamics of eye movement based on the maximal information coefficient. The findings primarily show that the combination of eye tracking, visualization, and machine learning have strong potential in developing an objective tool to assist in the screening of ASD. CONCLUSIONS: Broadly speaking, the approach we propose could be transferable to screening for other disorders, particularly neurodevelopmental disorders.

Visual Exploration of Dynamic or Static Joint Attention Bids in Children With Autism Syndrome Disorder.

Eye-tracking studies have revealed a specific visual exploration style characterizing individuals with autism spectrum disorder (ASD). The aim of this study is to investigate the impact of stimulus type (static vs. dynamic) on visual exploration in children with ASD. Twenty-eight children with ASD, 28 children matched for developmental communication age, and 28 children matched for chronological age watched a video and a series of photos involving the same joint attention scene. For each stimulus, areas of interest (AOI) were determined based on Voronoi diagrams, which were defined around participants' fixation densities, defined by the mean shift algorithm. To analyze the eye-tracking data on visual exploration, we used a method for creating AOI a posteriori, based on participants' actual fixations. The results showed the value of both kinds of stimuli. The photos allowed for the identification of more precise AOI and showed similarities in exploration between ASD and typical children. On the other hand, video revealed that, among ASD children only, there are few differences in the way they look at the target depending on the deictic cue used. This raises questions regarding their understanding of a joint attention bid recorded on a video. Finally, whatever the stimulus, pointing seems to be the most important element for children looking at the target.

The impact of verbal capacity on theory of mind in deaf and hard of hearing children.

Even when they have good language skills, many children with hearing loss lag several years behind hearing children in the ability to grasp beliefs of others. The researchers sought to determine whether this lag results from difficulty with the verbal demands of tasks or from conceptual delays. The researchers related children's performance on a nonverbal theory of mind task to their scores on verbal aptitude tests. Twelve French children (average age about 10 years) with severe to profound hearing loss and 12 French hearing children (average about 7 years) were evaluated. The children with hearing loss showed persistent difficulty with theory of mind tasks, even a nonverbal task, presenting results similar to those of hearing 6-year-olds. Also, the children with hearing loss showed a correlation between language level (lexical and morphosyntactic) and understanding of false beliefs. No such correlation was found in the hearing children.

Early hearing screening: what is the best strategy?

OBJECTIVES: A discussion concerning the relevance of universal newborn hearing screening has been conducted in France since the end of the 1990s. As a contribution to the choice of strategy to be implemented, we evaluated and compared the results of this screening and its impact on the parent-infant relationship as a function of the time at which screening was performed: during the infant's stay in the maternity unit, in the first strategy (strategy 1), or 2 months after birth, in the second strategy (strategy 2). PATIENTS AND METHOD: Five thousand seven hundred and ninety infants participated in the study: 3202 were included in the first strategy and 2588 were included in the second strategy. Within this population, 143 mother-infant pairs were submitted to psychological assessment. We compared the number of infants screened, the number of first positive tests, the number of false-positive tests and the number of infants not reviewed after screening. Adverse effects on the parent-infant relationship were evaluated in terms of maternal anxiety and the quality of early interactions. RESULTS: A statistically significant difference in favor of newborn screening was demonstrated for the number of infants screened: 95.72% for the first strategy [95.0%; 96.4%], 64.18% for the second strategy [62.3%; 66.0%]; the number of first positive tests: 1.11% during newborn screening [0.7%; 1.5%], 3.13% in the second strategy [2.3%; 4.0%]; the number of false-positive tests: 0.29% in the first strategy [0.10%; 0.49%] and 2.65% in the second strategy [1.88%; 3.42%]; and the number of infants not reviewed after screening: 8.8% during newborn screening [0.0%; 18.4%] and 38.5% in the second strategy [25.2%; 51.7%]. Analysis of the results of the psychological assessment showed that screening per se did not have any impact on maternal anxiety or on the quality of early interactions, regardless of the screening strategy used. However, the result of the test had a significant impact. Announcement of a positive result increased maternal anxiety and induced a deterioration of the mother's psychological state which affected the quality of early interactions. As the number of positive results is significantly lower in newborn hearing screening, there are consequently fewer psychological side effects with this strategy than with the second strategy. CONCLUSION: This study demonstrates that universal newborn hearing screening is the most efficient strategy.