Systematic Literature Review Impact of parent-child ...vigknowledge.wikispaces.com/file/view/Systematic+Literature+Review.… · outcomes are defined in accordance with the Diagnostic

PCI VIDEO-FEEDBACK INTERVENTIONS 1

Systematic Literature Review

Impact of parent-child interaction video feedback interventions on child

neurocognitive and neurobiological outcomes: a systematic review

your UCL candidate number: LZFW6

the word count for abstract: 120

word count for the paper (excluding title page, abstract, references, tables, and

figures): 2940


Abstract

This systematic literature review aims to investigate the impact of Parent-Child

Interaction (PCI) video-feedback interventions on child neurocognitive and

neurobiological outcomes. Nine studies were reviewed, and the findings suggest a

positive impact of parent-child interaction video-feedback interventions on child

neurobehavioural and neurobiological outcomes. Overall, the studies provide

moderate-strong evidence in support of such interventions, particularly the long-term

impact; positive child outcomes appear to be more pronounced at follow-up, than

post-intervention. Furthermore, positive results were found for ‘at-risk’ and targeted

population, such as developmental delay and Autism Spectrum Disorder (ASD).

There is, however, large variability in outcomes studied and the outcome measures

used, making comparison across studies difficult. Additionally, significant variation

exists in the types of video-feedback interventions used.

Key words: Video Feedback Intervention; Parent-child interaction; child

development; neurobiological outcomes; neurocognitive outcomes


Introduction

Parent-child (PC) attachment is a time-honoured and widely researched subject. John

Bowlby, Mary Ainsworth and other established theories have framed our

understanding of parenting in child development. There is growing research and

policies about the societal costs of insecure parent-child attachment and consequential

unfavourable child outcomes, resulting in a need for clinicians to develop evidence

based, cost-effective interventions.

This review aims to investigate the impact of Parent-Child Interaction (PCI) video-

feedback interventions on child neurocognitive and neurobiological outcomes; and

highlights how clinicians can help mitigate the costs of insecure attachment styles.

Previous reviews conducted focus on parent outcomes (Bakermans-Kranenburg, Van

Ijzendoorn, Pijlman, Mesman, & Juffer, 2008; Fukkink, 2008); to the author’s

knowledge, this is the first review focusing on child outcomes.

Attachment and Child Outcomes

Empirical research has built upon attachment theories and today it is widely accepted

that the PC relationship holds a unique role in influencing scholastic achievement,

emotional, social and behavioural adjustment, and physical health (Lerner &

Castellino, 2002; Puig, Englund, Simpson, & Collins, 2013; Sroufe, 2005). Forcada-

Guex et al. (2006) identify that maternal and infant interactional behaviours tended to

match in a predictable way; sensitive mothers with cooperative children and

controlling or unresponsive mothers with compliant, difficult, or passive children,

with the type of dyad having an impact on emotional, behaviour and somatic

outcomes.

Advances in neuroscience have allowed researchers to focus on the neurological


impact of parent-child interactions. In animal studies, early experiences are found to

impact brain structure and gene expression (Kaffman & Meaney, 2007; Marshall &

Kenney, 2009; Stiles, Barkham, Mellor-Clark, & Connell, 2008). While human

studies are scarce; they all lend to the hypothesis that early experiences, including PC

attachment, have an impact on brain development (Gunnar, 2001; Rutter, Kreppner, &

Sonuga-Barke, 2009; Shore, 2002). Interestingly, parenting seems to play a mediating

role in the development of neurological stress response (Hostinar, Sullivan, &

Gunnar, 2014; Sheikh et al., 2014). Additionally, pre and postnatal stress impacts

synaptic organisation, even into adulthood (Richard & McEwen, 2012). Such research

highlights the importance of identifying ways to promote reciprocity and sensitivity in

parent-child attachments.

Parent-Child Interaction (PCI) Interventions

A meta-analysis of attachment-based interventions demonstrates that short-term

programs oriented directly at increasing the predictability, consistency, and warmth of

parental behavior are more effective than longer term, representational approaches

(Bakermans-Kranenburg et al., 2008; Femmie Juffer & Steele, 2014). Further studies

show that capacity-building interventions focused on strengthening family-systems,

have direct effects on parent self-efficacy and well-being, and indirect effects on

parent-child interactions and child development (Trivette, Dunst, & Hamby, 2010).

Video Feedback PCI Interventions

Video-feedback interventions involve a practitioner videoing a parent-child

interaction, so as to enhance parenting practices, parental sensitivity and parent-child

reciprocity through reflection and/or instruction. The types of video-feedback

interventions vary considerably, however all are built upon attachment theory by


developing attuned interactions (Figure 1) to develop PCI.

Figure 1. Attuned Interactions explained (Kennedy, Landor, & Todd, 2011)

A meta-analysis by Fukkink et al. (2008) found that shorter programs appear more

effective in improving parenting skills. Overall, video-feedback interventions are

found to positively impact parental sensitivity, attitudes and behavior, and child

attachment security. Hoffenkamp et al.’s (2015) RCT reported a positive impact on

parental sensitive behaviour and diminished withdrawn behaviour towards pre-term

infants.

PCI video feedback interventions are recommended in the UK by the National

Institute of Clinical Excellence (NICE) (Excellence, 2012, 2013) and National

Society for the Prevention of Cruelty to Children (NSPCC) (Whalley & Williams,

2015).

Why study child outcomes?

Research demonstrates what many caregivers and theorists know intuitively - being

consistently available, sensitive and receptive to an infant's signals promotes healthy

DISCORDANT CYCLEATTUNED CYCLE

YES NO

Child receives parent’s

turn

Child misses

Parent’s turn

Parent receives

child’s initiative

Parent misses

child’s initiative


attachment. What is yet to be robustly identified, is if intervening early and

developing the parent-child attachment can alter a child’s development; and which

interventions are most effective/efficient.

This Review

The purpose of this review is to examine the impact of PCI video-feedback

intervention on child neurocognitive and neurobiological outcomes. Neurocognitive

outcomes are defined in accordance with the Diagnostic and Statistical Manual 5th

Edition (DSM-5) (Association, 2013), referencing six key neurocognitive domains:

learning and memory, executive functioning, perception and motor functioning,

language, complex attention and social cognition. Neurobiological outcomes are

defined in accordance with Stedman’s Medical Dictionary (Lanthrop, 2008) as the

“biology of the nervous system”.

Methods

Search Process

Online research databases (PubMed and Psychinfo) were systematically scanned for

studies that met the inclusion criteria (see table 1). Keywords for the relevant

intervention [“parent child interact*” AND “feedback”, “playback”, “parental

training”, “intervention”, “treatment” and “video*”] were combined with terms for

family populations [“parent*”, “family*”, “child*”, “marital”, “mother*”, and

“father*”]. Once relevant articles were identified, ancestral searches through reference

lists of primary journals in the field were also carried out as per Figure 2.


Table 1

Inclusions Criteria

Inclusion Exclusion

1. Written in English Not written in English

2. Published before 2016

3. Include the words ‘video’, and ‘child’

or ‘parent’ in the title/abstract

Does not include the words ‘video-

feedback’, ‘outcomes’, ‘child’ or ‘parent’

and in the title/abstract

4. Participants must be parents and their

child/children that participated in a

video-feedback intervention focused

on the quality of parent-child

attachment.

Participants are not parents and their

child/children

5. Studies that are a Randomised

Control Trial (RCT) and provide

empirical data on the neurocognitive

or neurobiological outcomes of the

child

Studies that are not a RCT and do not

provide empirical data on the

neurocognitive or neurobiological

outcomes of the child

7. Journal Article/Dissertation/thesis Book

8. Intervention identified as an

attachment focused parent-child

video-feedback intervention

Intervention not identified as an

attachment focused parent-child video-

feedback intervention

10. Novel, empirical data is produced

Data from a review of studies


Figure 2. Search Process flow chart

Eligibility Criteria

Eligible studies were written in English and implemented a video-feedback

intervention focused on PCI. No age restriction was applied so as to increase the pool

of studies. There was no start date, and the end date was 2016, as this is when the

review was carried out. Journal articles, theses and dissertations were considered,

provided they were empirical studies, with novel data.

Randomized control studies with matched control groups, examining the impact

through pre/post intervention data collection were deemed most appropriate for the


review question. Reasons for exclusion of studies can be provided by contacting the

author.

Nine RCT studies were identified as meeting the eligibility criteria. These are

summarized in Table 2.


Table 2.

Summary of Studies’ Characteristics

Study WoE Intervention Context Parents Children

Bakermans et al.

(2008)

High

VIPP-SD

Early Intervention

4 monthly sessions + 2 alt. monthly

sessions (1.5 hours)

Manual with themes

Playback: Edited/selected

Focus: Positive – sensitive parenting

Community

support

Child behaviour

support

Netherlands

Community Sample Emotional Behaviour

Difficulties

Age: 1year-3years

Clear description

Hoivik et al.

(2015)

High

VIPI- Video Feedback of Infant-Parent

interaction

Therapists described

Community –

interactional

problems

Community Sample

Parent-child interaction

problems

Age: 0 to 24 months


8 sessions

Manualised



-Parent/social

worker

Trondheim & Oslo

Norway

Green et al.

(2015)

Medium

iBASIS- VIPP

12 sessions – 6 VIPP + 6 boosters

(According to need)

Manual with themes


Treatment fidelity checked


Targeted ‘at risk’

ASD

Home based

UK

Mother Sibling ASD

Age: 9-14 months

No medical

Juffer et al.

(1997)

Medium

Targeted Intervention

3 sessions video feedback

+ Book on sensitive parenting


Adoption

Netherlands

White families

Well described

Age: 5-12 months

Adopted Asian children



Mendelsohn et al.

(2005)

Medium

Video Interaction Project VIP + standard

care

12 sessions

Early Intervention

Playback: Immediate

New York Latino

Low education (no grad.

High school)

No psychosocial issues

Age: 2wks-3 years; 21-

month follow-up

Latino

Risk of dev delay

No medical complications

Mendelsohn et al.

(2007)

High

Video Interaction Project VIP + standard

care

12 sessions

Early Intervention

Playback: Immediate

New York Latino mothers

Low maternal education

poverty

Age: 2wks-3 years; 33-

month follow-up

Latino

Risk of dev delay

No medical complications

Poslawsky et al.

(2015)

High

VIPP-AUTI

5 sessions + 1 boosters

Manal with themes


Home-based

Netherlands

90% mothers

Middle/upper SES

Age: ASD diagnosis

16-61 month



Treatment fidelity checked

Greene et al.

(2010)

High

PACT intervention

12 sessions over 6 months

6 monthly follow up session

20-30 minutes between session family

activities

Focus: parenting in ASD population

Clinic based

UK

Parents of children with

ASD

Autism diagnosis – ‘core

autism’

Age:

Pickles et al.

(2016)

High

PACT intervention

12 sessions over 6 months

6 monthly follow up session

20-30 minutes between session family

activities

Focus: parenting in ASD population

Clinic based

UK

Parents of children with

ASD

Autism diagnosis – ‘core

autism’

Age: 2-4:11 years old


Data Extraction

The information in table 3 was extracted for each of the studies.

Table 3.

Data Extracted from Studies

Research Design Randomised Control Trial

Type of Allocation

Blind/unblinded to researcher and participant

Statistical analysis and

appropriateness

Appropriateness of statistical analysis to the data

Appropriateness of statistical analysis to RQ

Correction for Type 1 error (if needed)

Sample size and

characteristics

Sample size + Power analysis

Detail given

Location Country

Setting

Intervention Type Established programme/not

Manualised/non-manualised

Number of sessions

Programme duration

Type of Clip selection (Immediate or later edited)

Focus of the intervention (if any)

Outcome measures Development and standardisation

Reliability and validity on current sample

Number of sources/informants


Number of methods used

Child outcomes Aspect of development related to

Quality Assessment/Coding

The methodological quality was assessed using a coding protocol adapted from

Kratochwill (2003) (see Appendix 1) with studies subsequently weighted according to

the Weight of Evidence (WoE) Framework (Gough, 2007) as summarized in Table 4

and weightings outlined in Table 5.

Table 4

Weight of Evidence Criteria

Weight of evidence A – with consideration to the study’s methodological quality:

coherence and integrity of the information gathered. A study scored either high,

medium or low if it addresses most of the criteria in the relevant section.

High: Random assignment of comparison group/random selection of

participants if empirically validated intervention is used; Reliability of

measures for current sample calculated (alpha equal or over .70); Two or

more informants on measures; Intervention outlined in high level of

detail which would allow for replication.

Medium: Comparison group present/clear description of participant recruitment

with validated intervention, although non-random, or unclear assignment

to group (or selection); Reliability of measures calculated, but below


0.70; Clear informant on each measure; Intervention outlined in some

general detail which could lead to replication.

Low: No comparison group/non-random selection of participants; Reliability

of measures not calculated for the current sample; unclear who the

informant is in the measures; Intervention not outlined in sufficient

detail to understand specifics, and cannot be replicated

Weight of evidence B – with consideration to the research design and their

relevance for answering the review question. Rating as follows:

High Compares pre-post increases on measures of effectiveness of PCI video-

feedback interventions, when compared to a TAU control group

Medium Compares pre-post increases on measures of effectiveness of PCI video-

feedback interventions.

Low Study design does not allow for of pre-post PCI video-feedback

interventions,

Weight of evidence C – with consideration to the relevance of the evidence to the

current review question. Rating as follows:

High Examination of a PCI video-feedback intervention with primary focus

on multiple child neurobehavioral and neurobiological related outcomes

Medium Examination of a PCI video feedback intervention with child

neurobehavioral and neurobiological outcomes as secondary outcomes


Low Examination of a PCI video feedback intervention, outcomes not child

neurobehavioral and neurobiological outcomes (for example: number of

sessions attended, dropout rates rather than child related outcomes)

Weight of evidence D – judgements from weightings A, B and C are

combined to create an overall assessment of evidence weighting. This is an average

across weightings A, B and C.

Table 5.

Study’s Weightings

Study WoE A WoE B WoE C WoE

Bakermans et al. (2008)

Medium High High High

Hoivik et al. (2015)

High High High High

Green et al. (2015)

Medium High Medium Medium

Juffer et al. (1997)

Medium Medium Medium Medium

Mendelsohn et al. (2005)

Medium Medium High Medium

Mendelsohn et al. (2007)

High Medium High High

Poslawsky et al. (2015) High High High High


Green et al. (2010) High High High High

Pickles et al (2016) High High High High

Description of Studies

Intervention

All nine studies used a PCI video-feedback intervention underpinned by positive

psychology; focused on parents’ strengths, aiming to promote sensitive and

responsive parenting. Eight studies utilised a manualised programme and one study

was led by the client’s goals. The number of sessions ranged from three to twelve. In

two studies’ the interventionist engaged in feedback with the parents immediately

following videoing; seven utilised programmes that required the interventionist to edit

footage and select clips to playback at a later date. Seven studies had participants

solely undergoing this intervention; whereas two were an add-on to treatment as usual

(Mendelsohn et al., 2005; Mendelsohn et al., 2007). A summary of the studies’

interventions can be found in Table 6.

Table 6.

Summary of Studies’ Interventions

Study

WoE

Name Manual Sessions Length Immediate

(I) or

later/edited

playback

(E)

Number Frequency Duration


Bakermans

et al. (2008)

High

VIPP-

SD

Y 6 4 monthly

2 alt.

month

1.5 hrs 8m E

Hoivik et al.

(2015)

High

VIPI Y 8 - - - E

Green et al.

(2015)

Medium

iBASIS-

VIPP

Y 12 - - - E

Juffer et al.

(1997)

Medium

- N 3 - - - E

Mendelsohn

et al. (2005)

Medium

VIP N 12 - - 3Years I

Mendelsohn

et al. (2007)

High

VIP N 12 - - 3

Years

I

Poslawsky et

al. (2015)

High

VIPP-

AUTI

Y 6 E

Greene et al.

(2010)

High

PACT Y 18 2/per

month for

6 months;

20-30

minutes

- E


follow-up

every 6

months

Pickles et al.

(2016)

High

PACT Y 18 2/per

month for

6 months;

follow-up

every 6

months

20-30

minutes

- E

Demographics

Four studies were UK based, three in the Netherlands, two in New York and one in

Norway. Children ranged from 0 to 61 months across the studies. All studies had a

target population, which included:

• children at risk for developmental delay (based on maternal education)

(Mendelsohn et al., 2005; Mendelsohn et al., 2007)

• children at risk for developing ASD based on sibling diagnosis (Green et al.,

2015)

• children with ASD (Green et al., 2010; Green et al., 2015; Poslawsky et al.,

2015)

• children with emotional and behaviour difficulties (Bakermans-Kranenburg et

al., 2008)

• Adopted children (F Juffer, Hoksbergen, Riksen-Walraven, & Kohnstamm,

1997)

• Parent-child interaction problems (Hoivik et al., 2015)


Research Design

Control group. All studies were RCTs with a matched control group. The

control group type varied: seven studies used treatment as usual (TAU), one utilised

ongoing telephone support and another used a no intervention control group. All

studies conducted a post-hoc analysis comparison between control and treatment

groups; in instances where a clinical population was used, groups were also matched

based on the criteria for diagnosis. The type of control group utilised impacted WoE

A.

Sample size. Study samples ranged from 54 to 237, with clear descriptions of

participants provided, enhancing the replicability of the study. Bakermans-

Kranenburg et al. (2008) had a small sample within each group, however no power

calculation was conducted, making the reliability and validity of their results

questionable; the sample size and power analysis was accounted for in the weighting

of studies.

Time points. Two pairs of articles are taken from two longitudinal studies:

Mendelsohn et al. (2007) followed up the VIP project 12-months after Mendelsohn et

al. (2005); Pickles et al. (2016) followed up the PACT intervention 6-years after

Green et al. (2010). Two further studies employed a follow-up design: Hoivik carried

out a 6-month follow-up and Poslawsky carried out a 3-month follow-up. Three

studies employed between-group pre-post intervention designs, whereas Green et al.

(2015) employed a within-group pre-post intervention design. The validity of the

results is impacted by the study’s design and effects the WoE A.


Statistical analysis. Most studies utilised statistical analyses appropriate to the

research question. However, Green et al. (2015) analysed within-group change to

estimate intervention effect; no further statistical analysis to compare between group

differences were computed. Within group statistical analysis for intervention effect

has been found to be statically invalid and not clinically useful as it does not account

for within-group natural changes over time and regression towards the mean (Bland &

Altman, 2011).

Noteworthy, is that Mendelsohn et al. (2005) carried out a number of t-tests,

increasing the possibility of type 1 error. Given the small N in each group, and

dichotomous variables, Juffer et al. (1997) appropriately carried out a Mann Whitney

U; however, the non-parametric analysis reduces the power of the findings.

Outcomes and Outcome Measures. As will be discussed below, there was a

large variability in the outcomes studied. Bakermans et al. (2015) and Green et al.

(2010) were the only studies to measure child outcomes as a primary outcome; .in

seven studies child-focused outcomes were secondary outcomes. For the purpose of

this review only child neurocognitive and neurobiological outcomes were considered.

Eight studies measured each variable using one outcome measure; this varied from

well-standardised tools, to protocols created for the purpose of the study. Juffer et al.

(1997) used a protocol created for their study, with a reported ICC of 1.0. Poslwasky

et al. (2015), Mendelsohn et al. (2005) and Green et al. (2016) used standardized


observational tools, and reported the ICC, enhancing the validity of their findings; the

remaining studies did not report the reliability for their study’s sample.

Green et al. (2010) and Pickles et al. (2016) utilised multiple sources of data

collection from multiple informants, including researchers, parents and teachers,

which positively impacted their rating on WoE B. They did not report the alpha

coefficient for their current sample for most of the measures used. Outcomes and

outcome measures are summarised in Table 7. Outcomes termed by the studies’

authors are listed in Table 8.

Table 8

Outcomes Termed by Studies’ Authors

Study Outcome Definition

Juffer et al. (1997) Infant Exploratory

Competence

Contingency analysis (ability to

learn relationship between an act

and consequence) and the

amount and quality of

exploration, are considered to

reflect children's exploratory

competences

Green et al. (2010)

and Pickles et al.

(2016)

Autism Severity As measured by the Autism

Diagnostic Schedule


Green et al. (2015) Gap-overlap task The gap overlap task uses Tobii

1750/YX120 eye trackers to

assess the time taken to shift

their eye gaze between visual

stimuli.

Social Behaviour As measured by the Autism

Observation Scale for Infants

Poslawski et al. (2015) Initiated Joint

Attention (IJA)

“the child’s ability to initiate

spontaneously another person’s

visual attention to share”.

Responsive Joint

Attention (RJA)

“child’s ability to follow and

share another person’s visual

lead”.

Play Behaviour Observed during a 15 minute

videotape which were then coded

for coded for toy preference and

level of play category;

manipulative, relational,

functional, and symbolic play

Results

Biological

Bakermans et al. (2015) was the only study to have a bio-behavioural focus. With an

overall ‘high’ weighting, the results are promising for the field of PCI video-feedback

interventions. The intervention reports a significant positive impact on challenging


behaviour (n2 = 0.05) and cortisol levels (n2 = 0.04) in children with the dopamine

receptor gene (DRD4).

Learning and Intellectual Development

A team of researchers at New York University School of Medicine reported a

longitudinal study investigating the impact of the Video Intervention Project (VIP): a

PCI video-feedback intervention, augmenting treatment as usual for children aged 2-

weeks to 3-years-old deemed ‘at risk’ for developmental delay. When compared to a

TAU control group, at 21-months old Mendelson et al. (2005) reported a non-

significant intervention effect on cognitive development, with a significant effect in

mothers with a low education level: 7th – 11th grade (d= 0.41). In Mendelson et al.

(2007) at 33-months the VIP intervention had an overall significant, moderate effect

(r = .20). Similar to the 2005 paper, they also found a greater impact on mothers with

an education level between 7-11th grade (r= 0.39).

Juffer et al. (1997) investigated ‘exploratory competence’ of 5-12 month olds in

adoptive families. They report significant intervention effect on their measure of

infants ‘ability to ‘learn a contingency’ and a positive trend for ‘exploratory

behaviour’. Conversely, Poslawky et al. (2015) found that VIPP-AUTI in children

with autism had no significant effect on play behaviour; hypothesising that the

neuroatypical profile of ASD needs more explicit guidance with play.

Social

Green et al. (2010) and Pickles et al. (2016) investigated long-term impacts of the

PACT intervention on a range of child outcomes. Green et al. (2010) found a positive


trend for the reduction in ‘autism severity’. Subsequently, 6 years later, Pickles et al.

(2016) found a significant intervention effect in ‘autism severity’, as well as ‘child

communication initiations’ and ‘repetitive behaviours’. However, no change was

found for teacher-reported adaptive functioning.

Following the intervention ‘Video feedback of Infant-Parent Interaction’ (VIPI),

Hoivik et al. (2015) found a post-intervention positive trend, as well as a significant

positive effect on social-emotional development at 6-month follow-up.

Poslawsky et al.’s (2015) study found that the VIPP-AUTI group showed significant

positive change in ‘initiated joint attention’ with a large effect size, and positive trend

for responsive joint attention. Interestingly, no change on infant involvement was

found at post-intervention and follow-up.

In their small pilot study, Green et al. (2015) investigated the impact of VIPP-iBASIS

in a sample characterised as ‘at risk’ for ASD. They found an overall within-group

change for the intervention group, largely mediated by increased caregiver non-

directedness. They also found a significant within-group change on social behaviour,

as measured by the AOSI and parental reports. The intervention group showed faster

disengagement in the ‘gap-overlap task’, which is suggestive of improved attentional

switching; typically, an area of difficulty for children with ASD. The resulting

conclusion was that the intervention group showed reduced signs of typical ASD-

behaviours. Conversely, there were no changes in infant attentiveness and parent-

reported infant communication skills decreased. Of note, however, is that this was a

small sample using within-group comparisons; therefore, competing hypotheses,


cannot be ruled out and we cannot conclude that the within-group change is due the

intervention.

Language

At the 21-month follow-up Mendelson et al. (2005) found that the VIP intervention

had significant impact on expressive language development, while not on receptive

language development for the overall sample. At 33-months, Mendelson et al. (2007)

found no between-group difference in language; however, they reported a global

score, and so the impact on receptive and expressive language is unknown.

Following the VIPP-iBASIS Green et al. (2015) found no within-group change on

parent reported vocabulary development, and no change on the Mullen Language

Scales. Similarly, Green et al. (2010) and Pickles et al. (2016) found no intervention

effect on receptive and expressive language.


Table 7.

Summary of Studies’ Outcomes

Study

WoE

N= Control

group

Design Statistics Measures Significant findings Non-significant

Findings

Bakermans

et al. (2008)

High

237

Telephone

conversation

Post hoc

Comparison

RCT

Pre-Post

MANOVA Behaviour/temperament:

Infant Characteristic

Questionnaire (ICQ)

Child Behaviour

Checklist (CBCL)

Cortisol:

Established protocol

DRD4 genotyping

Intervention group

(IG):

Intervention + Gene

N2 = 0.05

Intervention + Gene +

Cortisol n2 = 0.04


Hoivik et al.

(2015)

High

152

Power

Analysis

TAU

Post hoc

Comparison

RCT

Pre-Post

& FU

(6m)

ANCOVA Ages and Stages

Questionnaire: Social-

Emotional (ASQ-SE)

FU: ASQ-SE not

delayed

ES: NR

+VE TREND AT

POST

Green et al.

(2015)

Medium

54

Power

Analysis

No

intervention

Post hoc

Comparison

RCT

(block)

Pre-Post

Within

group

Within

group

Effect size

Infant attentiveness:

Manchester Assessment

of Caregiver–Infant

interaction

ICC = 0.64-.75

Atypical social-

behaviour:

Autism Observation

Scale for Infants (AOSI)

IG improvement:

AOSI (0.50)

Faster disengagement

(0.48)

Adaptive behaviour

Infant attentiveness

No difference:

MCDI, Mullen, ERP


Attention

disengagement:

Gap-overlap task

Development:

Mullen Scales Emotional

Learning (MSEL)

Adaptive behaviour:

Vineland Adaptive

Behaviour Questionnaire

Vocabulary:

MacArthur-Bates

Communicative


Development Inventory

(MCDI)

Juffer et al.

(1997)

Medium

90

(small N

in each

group)

TAU

Only book

Post Hoc

Comparison

Adjusted

RCT

B Pre-

Post

Mann-

Whittney-U

Infant Exploratory

Competence

Devised – observation

and task

IR = 1.0

IG: Faster learning

tempo in mastering a

contingency

+ve trend:

exploratory

behaviour

Mendelsohn

et al. (2005)

High -

medium

93

TAU

Post hoc

RCT

Pre-Post

Intervention

x maternal

education

2x2

ANOVA

Cognitive ‘mental’

Development:

Bayley’s

Expressive Language:

Preschool Language

Scale–3 (PLS-3)

+ve Main VIP effect

positive effect: group x

maternal education x

expressive language

Maternal Education 7th

– 11th Grade:

+ve trend: group x

maternal education x

cognitive

development

Maternal Education:

7-11th Grade


Between

group

t-tests

type 1 error

Semi- structured

observation

Receptive Language:

PLS-3

IRR = 0.84

Cognitive development

r= 0.41

expressive language

r=0.40

Maternal Education

<7th Grade

Expressive language

+ve trend: Receptive

Language

<7th Grade

+ve trend:

cognitive

development

language

development

Mendelsohn

et al. (2007)

High

99 TAU

Post hoc

RCT

12

months

Follow-

up

T-test

Spearman

Rank

Development:

Bayley’s

PLS-3

CBCL

IG: normal

Development

r=0.39

+ve trend in

Behaviour and

language


Poslawsky

et al. (2015)

High

78

TAU

Home visits

Post hoc

analysis

RCT

Pre –

post –

follow-up

3 months

MANOVA Infant Joint

Attention/Responsive

Joint Attention

Early social

communication scales –

Protocol

ICC: 0.92-0.94

Play behaviour

Ethogram by Naber et al.

(2008)

ICC = 0.71 – 0.99

Responsive/Involvement:

IJA

N2=0.24

P=0.03

+ve trend:

RJA

Involvement

Play Level behaviour


Parental Emotional

Availability Scale

ICC= 0.73-0.75

Greene et

al. (2010)

High

152 TAU Autism Severity:

Autism Diagnostic

Observation Schedule-G

(ADOS –G)

ICC = 0.83

Communication &

Language:

Child Communication

Initiation

Pre-school language

scales

Autism Severity

d= -.04

Communication &

Language

+ve increase CCI

d = 0.07 (PLS

receptive language)

d=0.35 (PLS

expressive language)

no group difference

MCI, CCSB


MacArthur

communication

inventory (Parents)

Communication and

Symbolic Behavior

Scales Developmental

Profile

ICC = 0.59

Child adaptive

functioning

Vineland Adaptive

Behaviour Scale

(Teacher)

Child adaptive

functioning

No difference


Pickles et

al. (2016)

High

125 TAU RCT

Between

Follow-

up (6

years)

ITT Autism Severity:

ADOS-CCS

Social Communication

Questionnaire

Repetitive Behaviour

Questionnaire (RBQ)

ICC = 0.73

Communication &

Language:

Child communication

initiation

Strengths & Difficulties

Questionnaire (SDQ)

Autism Severity

d = 0.55 (0.009)

0.4

0.87 & 0.82

Communication &

Language

d = 0.44 (0.004) (CCI)

Communication &

Language

d = 0.15 (CELF-IV)

d=0.4 (SDQ)

Child adaptive

functioning

d=0.27

0.34

Co-morbid

psychopathology

d=0.07; =0.13; 0.11;

0.51


Clinical Evaluation of

Language Function –IV

(CELF-IV)

ICC = 0.8

Child adaptive

functioning:

Vineland Adaptive

Behaviour Scale

(Teacher & Parent)

Co-morbid

psychopathology:


Development and Well-

Being Assessment

(DAWBA)


Conclusion

The aim of this review was to establish the impact of PCI video-feedback interventions on

child-related neurocognitive and neurobiological outcomes. Nine papers were identified

according to inclusion criteria. The ratings of these studies varied between ‘medium to high’

(Gough, 2007). Current research indicates positive results, providing moderate-strong

evidence in support of video-feedback interventions. There is, however, large variability in

types of video-feedback interventions, outcomes studied and the outcome measures used,

making comparison across studies difficult.

Bakermans et al. (2015) found promising results for the bio-behavioural impact of video-

feedback interventions, with a gene mediated effect on cortisol levels. This study provides an

explanatory framework for the differential responses to interventions, and links to Ellis &

Boyce’s research (2005; 2008) where they discuss differential biological sensitivity to stress.

It resonates with research, that has identified that different attachment styles are needed for

different temperaments (Bates & McFayden-Ketchum, 2000). This highlights the importance

of identifying biomarkers, so that targeted intervention can be provided. Distinctively, a

differential effect of the interventions was also found in relation to demographic variables;

Mendelsohn et al. (2005; 2007) found better results for lower maternal education.

Longitudinal studies highlight the importance of long-term monitoring of interventions due to

‘delayed effects’, as all showed more favourable child outcomes at follow-up. This suggests a

potential delayed intervention impact on the child, as a consequence of the positive changes

in parenting practices; which has been well documented (Fukkink et al. 2008).

Such findings resonate with theories of interactive specialisation (M. H. Johnson, 2011)

which propose the interactive nature of genetic factors and environmental factors in child


development. The above research provides promise for developing intervention that can

adapt environmental factors, such as PCI, to promote child development.

Positive results are also indicated for targeted populations. The impact of video-feedback

interventions in the ASD population show positive results, with the range of interventions

used. Results indicate positive impacts on ‘core’ ASD symptoms (Green et al 2010; Pickles et

al 2016), and social skills (Green et al 2014; Poslawsky et al. 2015). However, there is

limited effectiveness for language development (Green et al 2010; Pickles et al 2016;

Mendelsohn et al. 2005; 2007); suggesting that explicit, targeted intervention may be

required to promote language development.

Clinical Impact

This review has strong implications for clinical practice. Firstly, highlighting the promise of

video-feedback interventions in promoting child development. Secondly, serving as a

reminder that gains may not be immediate, and long-term follow-up is essential in

understanding the impact of interventions. Additionally, it highlights the differential

responses to the same intervention, and the importance of accounting for this in both clinical

practice and future research.

Further Research

This review highlights the promise of video-feedback interventions and emphasises the need

for longitudinal studies. However, variability exists in the type of video-feedback

interventions, outcomes and populations studied, meaning firm conclusions cannot be drawn.

The general positive trend highlights the importance of further studies, with the suggestion of

a differential response warranting the need for comparison studies across populations. At the


time this review was written, there was insufficient evidence to compare the outcomes based

on the video-feedback interventions characteristics (e.g. manualised vs. non-manualised);

however, future reviews and research should begin to explore this, so as to understand the

clinical utility of the different interventions.


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