The purpose of this study was to investigate the mother-child (FI-child) interactions in the children with ADHD compared to the TD children using a qualitative perspective with respect to conversational contributions and repair by the mother and the complexity of responses from the child during the interaction in the recorded sessions. The qualitative analyses enable discussion of the clinical distinguishing characteristics in the participants with ADHD, which could provide further understanding of the difficulties experienced by the participants with ADHD.
The research questions were:
1) What is the difference between the children with ADHD and the TD children, with respect to complexity of responses?
2) What is the difference between the mothers of children with ADHD and the mothers of TD children, with respect to conversational contributions and repair?
140 5.3 Methodology
A qualitative approach to analyzing the same recorded data as that used in the quantitative study was undertaken in order to answer the research questions of section 5.2, above. To investigate conversational repairs by the interlocutor and the complexity of the responses from the child in the audio-visual recorded data, all speech dyadic interactions were orthographically and verbatim transcribed and that was followed by analysis, including the use of a coding system. There are several available procedures that are suitable for analyzing conversational samples (Perkins, 2007; Adams & Bishop, 1989). Gardner and Forrester (2010) described conversation analysis procedures that have been used for much more fine-grained qualitative analysis, and have frequently been used for single cases and small cohorts. Putting and Kirchner (1987) described an analysis in which a participant‟s contribution to 15 minutes of spontaneous conversation with a familiar partner is coded for several target behaviours. The target pragmatic behaviour is rated simply as either present or absent. This approach has been valuable in research studies which are relevant to the current research study. The coding of Kim and Kaiser (2000) has been replicated to form the majority of the coded utterances while the addition of mazes has been made based on the work of Redmond (2004). See chapter two for more details about criteria, recruitment, data collection, and setting.
5.3.1 Participants and data
Only the FI-child sessions were analyzed in the qualitative study. The language sample of ADHD and TD participants during interaction with FI was transcribed and coded by the researcher using transcription codes (See Appendix C). Examples
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included in this thesis have been translated into English. Every attempt was made to ensure that the transcripts accurately represented the participant‟s verbal interaction and repeated listening was used alongside inter-rater reliability for the coding structure. Any parts that were unintelligible were designated on the transcripts as being unintelligible and were not considered for any further analysis. The total number of minutes that was transcribed and analyzed was 300 minutes (15 minutes each with 10 participants with ADHD and with 10 TD participants).
5.3.2 Conversation coding and analysis
The samples were transcribed by the author. Each mother or child turn was entered in a separate line for easier identification. A turn was defined as an interval filled by one or more words by one speaker. Coded data was compared one by one for all targeted verbal behaviours from the FI or the child during their interactions.
5.3.2.1 FI’s interaction
The codes applied to the FI‟s verbal interactions were “non-verbal cues”, “questions”, “rephrase”, “repetitions”, “comments”, and “command”. The use of the following non-verbal cues was recorded: pointing, using hand gestures or presenting an object to accentuate the spoken words or substitute them in conveying the meaning (Example: “You mean that one / at the same time the mother points to the yellow car”. Questions were coded according to whether they were 'choice', 'yes/no' or 'wh-' questions. examples would be as follows.
142 or bubbles?"
Yes/No: Offering a single option, for example "Do you want to play with the car? ". Note that in Arabic, as in English, Yes/No question can be asked by saying words or a phrase with a rising intonation, as in “More?” and “ All done? ”.
Wh-question: questions that start with “what”, “who”, “where”, “when”, “why” or “how”, for example "Where is the red car? ".
A "Rephrase" code was used for when the FI reworded a preceding utterance, for example "that one.. yes I mean the doll."
A "Repetition" code was used for when the FI repeated what was said one or more times in order to establish and/or maintain communication, for example "car.. car.. car.. yes this is the car."
A "Comment" code was used when the interlocutor commented on what the child was doing or saying, for example “yes it nice and big car, I really like it."
A "Command" code was used when the interlocutor made a request for action, for example "LOOK!"
Interjections (e.g., „mmm‟) or other non-words, were not counted in the current analysis. 5.3.2.2 Child’s interaction
The codes applied to the complexity of responses from the child during the interaction with FI were: “no verbal response”, “single word production”, “multi word production”, and “maze”.
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The “no verbal response” code refers to the child failing to respond at all to an initiation from the FI (i.e., a silent interval while the FI waited for a response, after which the FI tried again to elicit a response).
A "Single word production" was any verbal production that contained one single word.
A "Multi word production" was any verbal production that included more than one word.
A "maze" was any false start, repetition, or reformulation. When maze words are removed from the utterance, the remaining words can stand alone.
The outcomes for the previously mentioned variables in the outputs of child participants or FI participants were managed descriptively. The targeted behaviours were included because they had been identified as important by previous research. Furthermore, their inclusion was felt to be consistent with the intention of the study to describe in detail the resources of mother-child interaction in children with ADHD compared to the TD peers.
5.3.3 Inter-observer reliability
To estimate inter-observer reliability, two qualified speech and language pathologists independently re-transcribed and recoded 10 minutes of two randomly selected sessions, one ADHD and one TD using the same coding protocol. Recoded data sheets were compared item-by-item with the researcher's coding sheets. An inter- observer agreement was calculated by dividing the number of agreements between the researcher‟s codes and the two speech-language pathologists‟ codes by the number of
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agreements plus disagreements and then multiplying by 100. For all targeted verbal behaviours agreement with first coder was 96% and the agreement with the second coder was 97%. The kappa coefficient was calculated on the relationship between the researcher‟s codes and those of each of the other two coders. The results revealed a high level of agreement; it was found that the kappa coefficient was 0.95 in the case of the first coder and 0.96 in the case of the second coder, which is almost perfect agreement in all coding areas.