The effects of relationship focused intervention on Korean parents and their young children with disabilities

Research in Developmental Disabilities 26 (2005) 117–130

The effects of relationship focused intervention on Korean parents and their young children with disabilities Jeong Mee Kim, Gerald Mahoney* Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-7164, USA Received 2 September 2003; received in revised form 27 February 2004; accepted 6 August 2004

Abstract This study was conducted to examine the impact of Relationship Focused Intervention (RFI) on a sample of Korean mothers and their preschool-aged children with disabilities. Subjects were 18 mothers of children with developmental problems (ages 3–8 years). Ten of these mothers were assigned to an RFI Treatment group and eight to a No RFI Control group. The RFI was adopted from the Family/Child Curriculum (Mahoney, G. (1999; Family/Child Curriculum: A relationship focused approach to parent education/early intervention. Tallmadge, OH: Family Child Learning Center). This intervention focused on teaching mothers to use responsive interactive strategies through a process of modeling, coaching, role-playing and video feedback. It was implemented with parents during weekly group and individual intervention sessions that were conducted over three months period. Comparison of pre- and post-intervention assessments of parent–child interaction indicated that RFI was effective at encouraging parents to become more responsive, affective and achievement oriented with their children. These changes in mothers’ interactional style were associated with an 18% increase in children’s interactive behaviors. Regression analyses indicated that increases in children’s behavior were associated positively with maternal responsiveness and negatively with maternal achievement orientation. Results from this study are discussed in terms of (a) implementing RFI with Korean mothers and (b) the mechanisms by which RFI promotes children’s development. # 2004 Elsevier Ltd. All rights reserved. Keywords: Relationship Focused Intervention; Disability; Parent–child relationship

* Corresponding author. Tel.: +1 216 368 1824. E-mail address: [email protected] (G. Mahoney). 0891-4222/$ – see front matter # 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.ridd.2004.08.001

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Relationship Focused Intervention (RFI) is based upon the assumption that how responsive parents are with their children during daily routines is a key influence on most aspects of children’s developmental functioning. It is derived from the numerous child development research reports which have shown that parental responsiveness is positively associated with (and presumably causally related to) several child development outcomes. These include children’s attachment to their parents (Ainsworth, Blehar, Waters, & Wall, 1978), as well as their cognitive (Beckwith & Cohen, 1989; Bradley, 1989), language (Hoff-Ginsberg & Shatz, 1982; Nelson, 1973; Siller & Sigman, 2002) and socio-emotional well-being (Crockenberg & Litman, 1990). At least 13 studies have been reported that have examined the impact of RFI on at-risk children and children with disabilities, 10 of which were reviewed by McCollum and Hemmeter (1997). The common element of these studies is that they: (a) provided services by working directly with parents and their children usually during weekly sessions; and (b) they taught parents strategies that would help them interact more responsively with their children. Although these interventions had slightly different emphases, there was considerable overlap in the interaction strategies they used (e.g., balanced interactions, follow the child’s lead, contingent responding). When examined as a whole, these studies produce relatively consistent findings. RFI is effective at helping, at least, some parents become more responsive and interactive with their children. Parents’ use of RFI strategies appears to help children with a range of developmental vulnerabilities make significant improvements in their cognitive (Fewell & Wheeden, 1998; Mahoney & Powell, 1988; Seifer, Clark, & Sameroff, 1991), communication (Kaiser et al., 1996; MacDonald, 1989) and socio-emotional functioning (Mahoney & Perales, 2003). However, numerous questions remained unanswered about this approach. Most pertinent to this investigation, there is a lack of clarity regarding (a) the types of parents and families most likely to respond to this approach and (b) the mechanisms through which responsive interaction contributes to children’s developmental functioning. The majority of RFI studies have been conducted with convenience samples of Caucasian parents from middle to upper SES American and Canadian families. As a result, there are legitimate questions about the populations of parents most likely to benefit from this type of intervention. However, at least two studies have been reported that indicate that RFI may be effective with parents with diverse characteristics and family backgrounds. One is a study reported by Fewell and Wheeden (1998) that was conducted with unmarried, low income, African American and Hispanic teenage mothers. The other was a study by Seifer et al. (1991) conducted with a sample of American mothers of children with disabilities who were heterogeneous on socioeconomic, racial and marital status. While both of these studies reported that children made significant developmental improvements, it still remains unclear how characteristics of parents and families affect this type of intervention. In particular, it has yet to be determined whether characteristics reported to influence the manner that parents typically interact with their children, such as parental stress or parents’ child rearing beliefs and values might also contribute to the effectiveness of the RFI approach. This was the major concern that generated the need for this study. RFI differs substantially from the types of services typically offered in South Korea. The early

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intervention services provided in this country generally begin when children are three years old, and are implemented in self contained, center-based classrooms that use didactic or behavior-oriented developmental curricula. While many programs encourage parents or other family members to participate in support groups or parent education sessions, seldom are parents asked to be directly involved in carrying out intervention activities with their children. We also wanted to determine whether the social–cultural climate of South Korea (e.g., social policies regarding children with disabilities, restricted access to early intervention services before children are three years old) might make it stressful for mothers to carry out RFI. Another important question about RFI is related to the mechanisms through which this approach influences children’s development. For the most part, contemporary early intervention conceptualizes development as resulting from children acquiring the skills and behaviors that characterize higher, or more advanced, levels of developmental functioning (e.g., Bricker, Pretti-Frontzcak, & McComas, 1998). Based upon this conceptualization, cognitive, communication and socio-emotional interventions typically attempt to directly teach the skills and behaviors that are the hallmarks of higher levels of functioning. Yet, most RFI discourage rather than emphasize this type of direct teaching. Rather they emphasize that adults engage in interactions that support and encourage the behaviors or activities that children are able to initiate or produce spontaneously. In fact, it is nearly impossible for adults to encourage children to produce the kinds of behaviors commonly identified as intervention objectives (e.g., behaviors or skills that children do not know how to do) by using responsive strategies such as ‘‘imitating a child’’ or ‘‘following a child’s lead’’. To illustrate this, results from a study of the Responsive Interaction intervention model which encouraged parents to use responsive strategies with children with delayed language development showed that on average these children were able to spontaneously produce only four new language targets after six months of intervention (Kaiser et al., 1996). As reflected in the most recent best practice guidelines published by the Division on Early Childhood (Sandall, Mclean, & Smith, 2000), the field of early intervention clearly acknowledges the importance of responsive interaction for children’s learning and development. Yet, presumably because of the limitations of responsive interaction at teaching discrete intervention objectives, these guidelines also recommend that didactic teaching procedures be used to help children learn individualized intervention objectives. Such recommendations are reflected in RFI curricula that characterize themselves as complementing traditional early intervention approaches by setting the stage for instruction through optimizing parent–child interaction (e.g., McCollum, Gooler, Appel, & Yates, 2001). They are also reflected in hybrid curricula such as the Hanen Program (Bricker & Waddell, 2003; Manolson, Ward, & Dodington, 1995) that embed direct teaching of intervention targets into responsive adult–child interactions. Despite the tendency of early intervention to stress direct teaching of intervention objectives as a means to promote children’s development, contemporary child development theories have stressed the role of child initiated, constructivist activities in developmental learning. For example, Piaget’s theory of cognitive development (Piaget, 1963) implies that children’s awareness, insight and newly formed cognitive schema evolve from the information children gain both about their own behavior and their

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immediate world as they go about the active processes of exploring, manipulating and problem solving both with objects and people. Similarly, communication theories of language development emphasize the role that children’s efforts to convey their intentions and observations plays in language development (Bates, Benigni, Bretherton, Camaioni, & Volterra, 1979; Bruner, 1974, 1983). From this perspective early language development is less dependent on children learning discrete words than it is on their learning to communicate increasingly complex intentions by engaging in nonverbal and preverbal communication with others. The question remains how does RFI influence children’s development. Does RFI promote development primarily by creating a context in which children are more apt to benefit from direct teaching? Or conversely does RFI directly promote critical skills that are the foundations for developmental learning. In this study we attempted to address this question by analyzing the impact that RFI had on several child behaviors that constructivist theories of development have identified as critical to developmental striving. These include behaviors such as attention, initiation, interest, persistence, cooperation, joint attention and affect. While a number of previous studies have reported that RFI enhances several elements of children’s interactive behavior (cf. McCollum & Hemmeter, 1997), none of these studies have attempted to link these findings to constructivist theories of development. Our hypothesis is that the influence of RFI on children’s development is mediated by the impact that Responsive Interaction has on the interactive behaviors that constructivist theories purport to be the basis for developmental learning. In summary, this study was conducted to assess the feasibility of RFI with a sample of Korean parents and their young children with disabilities and to examine how this intervention impacts children’s interactive behavior. There were three questions this investigation addressed. First, what impact, if any, does RFI have on Korean mothers’ interactions with their children? Second, what impact does RFI have on these mothers’ level of stress? Third, what effects do RFI strategies have on children’s interactive behavior?

1. Method 1.1. Participants Subjects were 18 mothers and their children with disabilities all of whom were attending the Civic Special Education Institute in Korea. In this program children attended full day classes and individual therapy sessions three days a week. All children were living at home with both of their parents in an urban area of Korea. Subjects were recruited by their children’s teachers. The researcher (Kim) informed parents about the purpose and procedures of the study and obtained their consent to participate. The RFI Treatment group had 10 mother–child dyads (boys = 7, girls = 3). Initially, this group had 13 dyads, but three were dropped from the study. One child left the center, one child was hospitalized and one parent missed more than three intervention sessions. The comparison group had 8 dyads (boys = 3, girls = 5). Two dyads were dropped from the initial comparison group, one because the child was hospitalized and the other because the parent refused to be videotaped at the second observation. The final sample of children

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ranged in age from 3 to 8 years and had a variety of developmental disorders. These included cerebral palsy (nTreatment = 4; nComparison = 2), developmental delay (nTreatment = 6; nComparison = 5), and mental retardation associated with biological conditions including microcephaly or Down syndrome (nTreatment = 2; nComparison = 1). All children were functioning at developmental levels substantially lower than expected for their chronological ages. They had been diagnosed with mental retardation or developmental disorders by a pediatric psychiatrist or clinical psychologist. They also met the DSM-IV (APA, 1994) criteria for mental retardation, motor skills disorder, or pervasive developmental disorders. The average age of the mothers was 34 years. Only one mother from the Treatment and two from the Comparison group were employed, all others were homemakers. As indicated on Table 1 the groups were matched on several variables likely to affect parents’ participation and children’s response to RFI. These included the age, years of education and level of stress of the mothers, as well as the age and level of functioning of the children as measured by the Vineland Adaptive Behavior Scale. Group differences on the distribution of boys and girls were not significant [F (d.f. 17,1) = 1.89, p = .188]. 1.2. Procedures 1.2.1. Relationship focused intervention The intervention used with the RFI Treatment group was adapted from the Family/Child Curriculum (Mahoney, 1999) and the Principles of Program Learning (Skinner, 1958). The Family/Child Curriculum (Mahoney, 1999) was the source for the RFI strategies, Turntaking and Interactive Match. The Principles of Programmed Learning (Skinner, 1958) was used to structure this intervention by incorporating the principles of small steps, overt responding, immediate feedback, and self-pacing into the curriculum. Table 1 Characteristics of mothers and children Variable

Treatment group (n = 10)

Comparison group (n = 8)

M

S.D.

M

34.00 13.60 60.20

2.87 2.07 13.44

34.00 12.63 61.50

5.88 2.33 6.99

0.00 0.94 0.25

6.20 3.99

1.69 2.50

6.13 3.96

1.81 2.31

0.09 0.30

Carolina Curriculum developmental age (months) Cognition 31.80 Communication 25.14 Social adaptation 36.40 Fine motor 39.90 Gross motor 37.80

17.80 14.84 19.65 22.32 23.29

32.85 28.50 37.88 37.88 38.25

19.35 18.42 22.40 24.04 24.04

0.20 0.43 0.15 0.18 0.04

Mothers’ characteristics Age (years) Education (years) PSI Total score Children’s characteristics Chronological age (years) Vineland Social Maturity age (years)

t

S.D.

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The RFI addressed 10 topics designed to help parents learn and incorporate responsive interactions into their daily routines with their children. These included: (1) the importance of responsive interaction between parents and children, (2) understanding children with disabilities according to their level of developmental functioning, (3) interacting with children in play, (4) turntaking, (5) following the child’s lead, (6) increasing the number of responses, (7) decreasing a number of directives, (8) behavioral understanding of child development, (9) feedback about parent–child interaction in their daily routine, and (10) implementing responsive interaction strategies in the daily routine. RFI Treatment mothers received 1.5–2 h of instruction once each week for 3 months. The intervention had four components: classroom-based instruction; home-based instruction; feedback and evaluation. The classroom-based instruction was implemented for eight sessions. During these sessions mothers learned about the goals and philosophy of this intervention, they observed videotaped examples of parent–child interaction as well as the instructor modeling responsive interaction strategies, and they participated in discussions about the practical applications of these strategies. The home-based instruction was implemented for two sessions with mothers and their children. During these sessions, the interventionist modeled RFI strategies and coached parents to use these strategies in their daily routines with their children. Feedback was implemented for two sessions. Mothers were trained to observe and rate their own interactive behavior. Evaluation sessions consisted of videotape observations of parent–child interaction, and administrations of the Carolina Curriculum, Vineland Social Maturity Scale, and Parenting Stress Index. 1.2.2. Comparison group Comparison group children attended the Civic Special Education Institute at the same time as the Treatment children. However, none of these parents or children participated in any of the activities associated with the RFI Treatment except for the data collection activities conducted at pre- and post-intervention. 1.3. Instruments All instruments and observations were administered in participants’ homes in one session at the beginning and end of intervention. The following describes each of the scales used for data collection. All scales were based upon Korean translations of English language versions of these instruments. Except where noted below, the scoring criteria were based upon the procedures developed for the English version of the instrument. 1.3.1. Child development Two instruments were used to assess children’s current level of developmental functioning. These included the Vineland Social Maturity Scale (Doll, 1965) and the Carolina Curriculum for Preschoolers with Special Needs (CCPSN; Johnson-Matin, Attermeier, & Hacker, 1991). The Korean Vineland Social Maturity Scale (Choi & Kim, 1998) was based on the 1965 edition of Doll’s the Vineland Social Maturity Scale. This scale was restandardized with

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representative samples of 1980 Korean subjects from birth to 30 years of age. The Korean version of this scale consists of 117 items that assess children’s self-help, self-direction, locomotion, occupation, communication and social relations functioning. By employing the Thomson method of calculating average age norms for items {M = A + 1 (S%/ 100)}, the items of the scale were arranged in an order of average age progression. The Korean Carolina Curriculum for Preschoolers with Special Needs (Choi, Kim, Yun, Lee, & Lee, 1996) is a Korean translation of the American version of the 1991 edition of the CCPSN. It is designed to be used with children functioning is between 2 and 5 years developmental age. It assesses children’s development across of five domains (i.e., cognition, communication, self-help, fine motor skills, and gross motor skills). This curriculum is designed to be used to assess, plan, and teach developmental skills to children with developmental disabilities. 1.3.2. Maternal interactive behavior To assess mothers’ style of interacting with their children, we videotaped 10 min observations of mothers playing with their children with toys. For these observations, mothers were instructed to play with their children as they normally do, using only the toys provided. Toys included a xylophone, picture books, picture cards, a toy used in playing house, a toy car, wooden puzzles, stacking rings, nesting block, and wooden dominoes. Videotapes of these observations were coded with the Maternal Behavior Rating Scale (MBRS) (Mahoney, 1999; Mahoney & Robenalt, 1986). This 12-item scale assesses four dimensions of parenting style: Responsiveness, Affect, Achievement Orientation and Directiveness. Research indicates that this scale assesses parenting characteristics associated with children’s developmental growth, and is sensitive to the effects of parentmediated interventions (Mahoney, Boyce, Fewell, Spiker, & Wheeden, 1998; Mahoney & Powell, 1988). The Korean MBRS (Kim, Sung, & Hyun, 2000) has been translated and revalidated by this researcher (Kim). The results indicated Cronbach’s alpha was 0.89 and Kaiser–Meyer–Olkin (KMO) was 0.86. 1.3.3. Children’s interactive behavior Children’s interactive behavior was assessed from the videotaped observation of mother–child interaction described above. We assessed the quality of children’s behavior with their mothers using the Child Behavior Rating Scale (Mahoney & Wheeden, 1998). This scale consists of seven global items that were adapted from scales reported previously by Meisels, Plunkett, Roloff, Pasick, and Stiefel (1986) and Egeland and Sroufe (1981). The behaviors measured by this scale differentiate children’s interactions with teachers during instruction and free play and are sensitive to the effects of teachers’ style of interaction on children (Mahoney & Wheeden, 1998). The Korean CBRS (Kim et al., 2000) was translated and validated by this researcher (Kim). The results indicated that Cronbach’s alpha was 0.88 and KMO was 0.73. 1.3.4. Parenting stress The Parenting Stress Inventory (Short Form) (PSI) (Abidin, 1990) is a 36 items selfreport questionnaire which assesses the effects of children on parents and families. It

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measures three sources of stress: parental role distress; stress related to parent–child interaction; and stress related to the child difficulty. correlations of the Total Stress scores from the short from with scores from the long for a sample of 530 subjects were reported to be r = .94. The Korean version of the PSI (Shin, 1997) was revalidated with representative 833 samples of Korean mothers. It includes 20 of the items from the original scale that assess three sources of stress: stress-related to child’s temperament; stress on parent–child relationship; and stress-related to learning expectation. Cronbach’s alphas for the Korean version of the PSI ranged from 0.74 to 0.81 for the three subscales and 0.85 for Total Stress scores. 1.4. Reliability Videotaped observations were coded by two raters who were blinded to the intervention condition using MBRS and the CBRS. These raters had masters’ degrees in child development and they received a total of 30 h of training until they had attained interrater agreement of 90% overall agreement on each of the two scales. Reliability was computed based on interrater agreement for all of the observations used for the final study. Interrater agreement was coded according to the formula {[agreements/ agreement + disagreements]  100}. For the MBRS the average interrater agreement was 86.6%, with agreement for individual scale items ranging from 75% to 100%. For the CBRS overall interrater agreement was 90.1%, with agreement for individual scale items ranging from 71.4% to 100% for individual scale items.

2. Results Means and standard deviation for the MBRS, CBRS, and PSI for the Treatment and Control groups at pre- and post-intervention are presented in Table 2. In the following we compare the data on these measures for the Treatment and Control Groups from pre- to post- intervention. 2.1. Maternal behavior A repeated measures multivariate analysis of variance (MANOVA) was computed to examine differences between the groups at pre- and post-intervention across the four MBRS factors. At pre-intervention there were no significant group differences on any of these factors [F (d.f. 4,13) = 1.43; p > .05]. Both groups of mothers had scores on three of the MBRS factors that were below the mean Likert Rating of 3 (Responsiveness, Affect and Achievement Orientation) while their scores on Directiveness averaged approximately 1/3 of a point above the mean. At post-intervention all four factor scores declined in the Control group but increased for the Treatment group. As indicated on Table 2, results from the MANOVA showed an overall Treatment  Time interaction (p < .001). Univariate analyses indicated that three of the four MBRS factors including Responsiveness, Affect and Achievement Orientation were significantly higher for the RFI Treatment group at

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Table 2 Mean and S.D. of MBRS, CBRS, and PSI scores over time and treatment Variable

Treatment group (n = 10)

Comparison group (n = 8)

Pre

Pre

M

Post S.D. M

S.D. M

F (Treatment  ES Time)

Post S.D. M

S.D.

Maternal Behavior Rating Scale Responsiveness Affect Achievement Orientation Directiveness

2.68 2.39 2.75 3.35

0.91 0.75 0.67 0.43

3.20 3.33 3.10 3.55

0.73 0.66 0.38 0.44

2.79 2.50 2.84 3.34

0.92 0.64 0.63 0.64

1.77 1.88 2.03 3.06

0.53 0.47 0.89 0.62

Child Behavior Rating Scale Interest Attention to activity Persistence Initiation Affect Joint attention Cooperation

2.25 2.80 3.05 2.30 2.70 2.45 3.30

0.72 0.67 0.96 0.48 0.48 0.96 0.85

3.20 3.25 3.20 3.00 3.55 3.05 3.40

0.92 0.63 0.82 0.94 0.60 0.76 0.84

2.44 2.88 3.06 2.63 3.13 2.31 3.19

0.94 0.99 1.08 0.95 0.69 1.28 1.07

2.81 2.75 2.63 3.25 3.00 3.00 2.88

0.75 1.04 1.19 0.71 0.53 0.46 0.64

Parenting Stress Index Child temperament Parent–child relationship Learning expectation

22.30 6.95 21.0 27.20 5.73 23.5 10.70 2.71 10.8

7.60 26.50 3.46 27.50 2.98 5.48 22.25 3.81 23.25 5.20 2.10 12.75 2.44 11.38 2.72

13.90*** 16.19*** 30.67*** 15.39*** 1.38

0.81 0.50 0.66 0.49 0.08

2.62 (0.08) 1.38 0.94 0.63 4.01 (0.06) 5.93* 0.04 0.41

0.65 0.08 0.06 0.04 0.20 0.27 0.00 0.03

3.47* 2.32 8.44** 1.54

0.20 0.13 0.35 0.09

*

p < .05. p < .01. *** p < .001. **

post-intervention than for Control group (p < .001). There was a large positive treatment effect on the overall MBRS score (ES = 0.81) and moderate to large treatment effects on three of the four MBRS factors (ES = 0.49–0.66). 2.1.1. Parental stress To analyze the effects of RFI on parental stress we compared the two groups at pre- and post-intervention on the three subscales of the PSI: stress related to children’s temperament, stress related to parent–child relationships and stress related to learning expectations. As indicated on Table 2, results indicated a significant Treatment  Time effect. RFI had an overall effect in reducing parental stress (p > .05). Univariate analyses of variance showed that this effect could be attributed primarily to the significant decease in stress-related parent– child relationships (p < .01). Treatment effects on total PSI scores (ES = 0.20) and stress related to children’s temperament (ES = 0.13) were small, while the effect on stress related to the parent–child relationship (ES = 0.35) was in the moderate range. 2.1.2. Children’s behavior A repeated measures MANOVA was computed to examine differences between two groups of children at pre- and post-intervention on the seven items of the Child Behavior Rating Scale. At pre-intervention the groups did not differ on any of the CBRS items [F (d.f. 7,10) = 0.74; p > .05]. As indicated on Table 2, at post-intervention children in the

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RFI Treatment group had higher scores on five of the seven CBRS items, while the Control group had higher scores on one item (i.e., joint attention). While the average CBRS scores were 18% higher for the Treatment than they were for the Comparison Group, results from the MANOVA (see Table 2) indicated that the Treatment  Time interaction did not reach statistical significance (p = .08) indicating that the effects of RFI on children’s overall behavior were not statistically significant. However, univariate analyses of variance indicated that one of the CBRS items (Affect) was statistically higher for the Treatment than for the Comparison Group (p < .05) at post-intervention. 2.1.3. Post hoc analyses of children’s behavior The small sample for this study limited the power of our research design and increased the likelihood of Type I error. Because of this, we conducted several post hoc analyses to further explore the nonsignificant RFI effect on children’s behavior. First we conducted a series of multiple regressions to examine how the MBRS factors that increased for the RFI Treatment group (i.e., Responsiveness, Affect, and Achievement Orientation) contributed to children’s Interactive Behavior at post-intervention. For these analyses we computed a composite Interactive Behavior score by calculating the mean of the seven items on the Child Behavior Rating Scale. To meet to the sample size requirements for regression analyses, each of these three equations was limited to two independent variables. Results from these analyses are reported in Table 3. In general, results indicated that mothers’ style of interaction had a significant relationship with children’s Interactive Behavior at postintervention, accounting for between 34% to 46% of the variance. Maternal Responsiveness and Affect were both positively associated with children’s Interactive Behavior, while Achievement Orientation was negatively associated. Mothers’ Responsive and Affect factor scores were highly correlated with each other (r = .92, p < .001). As a result, problems of co-linearity make it difficult to differentiate the contribution of these two factors to children’s interactive behavior using multiple regression procedures. Nonetheless, the pattern of results on Table 3, indicate that consistent with the emphasis of RFI, Responsiveness had a stronger influence on children’s Interactive Behavior than did Affect. Second, to illustrate results from the regression analyses, we divided the sample into two groups: High Responsive (n = 8) and Low Responsive (n = 10), using a midpoint score for Table 3 The relationship between MBRS factor scores and children’s level of pivotal behavior at post-intervention Independent variables

Regression equations Model 1

Responsiveness Affect Achievement Orientation R2 F

Model 2

b

t-value

0.53 0.14 –

1.09 0.29 – .36 5.80**

* **

p < .05. p < .01.

Model 3 t-value

b

3.60** – 1.71

1.06 – 0.50 .46 8.30**

t-value

b – 0.78 22.00

– 2.77* 0.77 .34 5.30*

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responsiveness at post-intervention as the criteria for forming groups. The eight mothers in the High Responsive group were all from the RFI Treatment group, while the two treatment mothers who did not exceed the midpoint on responsiveness during intervention were assigned to the Low Responsive group. A univariate analysis of variance was used to compare children’s behavior at post-intervention, controlling their behavior at preintervention. Results indicated that maternal responsiveness had a significant relationship with children’s behavior [F (d.f. 1,15) = 4.40; p < .05, ES = 0.23]. Children of High Responsive mothers had Interactive Behavior scores at post-intervention that were 23% greater than children of Low Responsive mothers.

3. Discussion In this study we examined the effects of RFI on a sample of Korean mothers and their young children. There were three major findings to this study. First, RFI was effective in encouraging these parents to modify their interactions with their children. In particular, mothers in the RFI Treatment group made increases in three components of interactional style: Responsiveness, Affect and Achievement Orientation. Second, RFI resulted in significant, although small, decreases in mothers’ stress. This was primarily related to mothers’ experiencing lower levels of stress associated with interacting with their children. Third, for mothers who increased their level of responsiveness, we found evidence that their children increased their use of general interactive behaviors. This effect was most apparent when we compared the interactive behavior of children of parents who were highly responsive at the end of intervention versus those who were less responsive. These findings have several implications. First, they demonstrate that RFI which evolved primarily from investigations of parenting in Western countries can be successfully implemented with Korean mothers. Our sample was not representative of the entire population of Korean parents. However, since the participants in this study had demographic characteristics comparable to mothers from the United States and Canada who participated in previous RFI studies (cf. McCollum & Hemmeter, 1997), these findings indicate that RFI can be used effectively with populations of Korean parents that have educational and socio-economic characteristics similar to the Western parents with whom this intervention has been demonstrated. Second, the fact that these mothers experienced slight reductions in their child rearing stress suggests that RFI was an appropriate method to use with them. Had these mothers been incapable of reconciling the philosophy underlying RFI with their own personal views about child rearing, they would likely have reacted in one of two ways. They would have either: (a) failed to follow through with the intervention by not becoming more responsive with their children; or (b) felt conflicted in trying to implement RFI and experienced increased levels of child rearing stress. However, neither of these outcomes occurred. Not only was this sample of mothers capable of making the kinds of interactive changes that RFI is designed to promote, but this intervention appeared to reduce rather than increase their stress associated with interacting with their children. The third implication from this study is that the effects of RFI may be mediated through the impact it has on children’s Interactive Behavior. Post hoc analyses indicated that

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increases in children’s behavior did not occur simply because children participated in RFI, but rather depended on their mothers actually making the interactive changes encouraged by RFI. When we regrouped the two Treatment dyads that did not become responsive during intervention with the comparison subjects, we found that RFI had a significant effect on enhancing children’s interactive behavior. This result was only significant at p < .05 level, but the mean difference in interactive behavior between the two groups of children was much greater than this significance level implies: children of high responsive mothers had 23% higher ratings in their interactive behavior than children of low responsive mothers. How might this effect of RFI on children’s interactive behavior help to explain the mechanisms through which it promotes child development? The MBRS has been shown to measure qualities of parents’ interactional style that are not only associated with children’s current levels of developmental functioning (Mahoney, Fingers, & Powell, 1985) but with their past and future levels of functioning as well (Fewell & Wheeden, 1998). Thus, not only does the MBRS elements of interactive style that support or enhance children’s development, but, as demonstrated in longitudinal studies (Mahoney & Bella, 1998; Masur & Turner, 2001), it also measures qualities of parental interaction that are stable over extended periods of time unless parents are involved in interventions designed to change their interactions. To the extent that parents’ style of interaction is stable over time, extrapolating from the results from this study it appears that highly responsive parents likely encourage their children to produce high levels of interactive behavior each time they interact with them. As a result, a responsive style of interaction has the potential to enhance children’s opportunities to engage in constructive learning behaviors in each of the interactive episodes they have with their parents. In addition, parents’ constant use of responsive interaction during the thousands of episodes they have during the developmental period likely teaches their children to become habitual users of constructive learning behaviors. By interacting responsively, parents may inadvertently teach and encourage their children to become independent, active or constructive learners. This is an overarching competency that has the potential to optimize the developmental stimulation value of every learning opportunity children encounter during their daily routine. Finally, the use of RFI with Korean parents and the effects of RFI on children’s behavior are inherently linked with each other. There has been concern about using RFI with diverse groups of parents because of its potential to undermine individually and culturally determined child rearing practices (Baird & Peterson, 1997; McCollum & Hemmeter, 1997). Indeed, so long as responsiveness is construed to be an element of effective parenting that was identified from research on selected groups of parents, such as middle class Caucasian or Western parents, this concern is legitimate. However, the more we are able isolate how responsiveness affects children’s behavior and understand RFI in terms of general principles of developmental learning, the less need there is to debate the cultural merits of this intervention. To the extent that RFI can be linked to promoting children’s active or constructive learning, the question facing Korean or any other group of parents who are considering RFI should be to what extent their children can be expected to benefit from an intervention that promotes active or constructive developmental learning.

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In summary, in this investigation we demonstrated the effectiveness of RFI with a small sample of Korean mothers and their children with disabilities. We observed that this intervention was appropriate for this group of parents, and that the intervention appeared to enhance children’s use of several constructive learning behaviors. We conjectured that results from this study suggest that RFI enhances children’s development by encouraging them to use active or constructive learning behaviors. We recognize, however, that this speculation, although consistent with the data reported from this study, requires more extensive empirical support. There is a continued need to replicate this type of study with a larger, more heterogeneous sample of parents and children, over a longer period of time. Of particular importance is the need to examine whether changes in children behavior are associated with the developmental improvements they attain during RFI.

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