Phase III: Post-intervention procedures

The third phase of the post-intervention procedures included:

1. Completing the post-intervention questionnaire;

2. Choosing video clips for parent interviews;

3. Parent interviews.

These steps will be now described in detail.

3.8.3.1 Post-intervention questionnaire

The purpose of the post-intervention questionnaire was identical to the pre-intervention questionnaire, namely to provide some information regarding the child’s music-related behaviors/experiences at home since the child was implanted with the additional requirement from the parents of taking into consideration the time that elapsed since the music therapy intervention and the play sessions. As with the pre-intervention questionnaire, the same procedure (section 3.8.1.3) was re-explained to the parents by the researcher and was written in the questionnaire as well. Each questionnaire was separately completed by the mother and father in order to get each one's independent perspective. The questionnaires were completed within two weeks upon the completion of the study (Appendix J- J1, J2) Data collection from the questionnaires as well as analyses will be described in section 3.9.3.

3.8.3.2 Choosing video clips for parent interviews

As mentioned in section 3.4.5, the parent interview was based on watching ten minutes of selected short video clips from the music therapy sessions. These video clips were chosen by a systematic process that consisted of the following steps:

1. The researcher watched all the video material from the music therapy sessions for each child and chose those video clips that clearly demonstrated the greatest number of spontaneous communicative interactions. The video clips could be of different duration.

2. The best excerpts from the above chosen video clips, whose total duration was approximately 20 minutes, were downloaded to the computer and burned to a DVD. The number of clips on each DVD varied from one child to the other, but its total duration for each child was constant: approximately 20 minutes.

The researcher rank-ordered these clips by giving the maximum points to the best clip and the minimum- to the one she considered to be the least good.

Scoring was done as follows: If a specific DVD had 12 video clips, the best clip received 12 points and the least good - one point; if it had 14 clips, the best one got 14 points, etc. Each DVD was then duplicated.

3. As soon as the preparation of each DVD was complete, separate copies were given to two clinically experienced and qualified music therapists who also received guidelines from the researcher related to the procedure for choosing the video clips for the parent interview (Appendix R). They were asked to

independently watch each DVD, choose the clips they thought clearly demonstrated the greatest number of spontaneous communicative interactions and rank them as described above. They were purposely given only general instructions so that they would focus on their overall impressions of whether or not there was much communication going on, rather than on detailed definitions related to the different communicative interactions.

4. In order to obtain a final score for each video clip, the researcher added together the points from all three raters to get a final score for each clip. The clips that received the highest scores from the three raters and were of approximately 10 minutes duration were chosen for the parent interview. No tied scores occurred.

3.8.3.3 Parent interview

After the clinical trials were completed for a specific child, and the video clips from the music therapy intervention were chosen and burned onto a DVD for the interview, the researcher contacted the parents and explained the interview procedure to them.

The parents were aware that they were going to be interviewed because it was mentioned in the ‘Parent information sheet’ (Appendix B) they received prior to the research trials. As mentioned in section 3.4.5, the purpose of the interviews was to enable each parent to reflect on what he/she saw and felt in relation to the child’s participation in this study.

The setting where an interview takes place can make a difference. People tend to feel more comfortable in a setting with which they are familiar. Therefore, the interviews were carried out in the nursery schools where the children were treated, except for one couple who was interviewed at their home due to personal difficulties.

The interviewer was the clinical social worker from “Shemaya” in B’nei B’rak (an Orthodox community). There were two reasons for this decision:

• In order to avoid the parents being influenced in their answers, which could happen where they might feel they should either tell the researcher what they feel she expected or wanted to hear, of conversely the opposite, it was decided between the researcher and the supervisor that a person other than the researcher/therapist should undertake the interviews.

• It was important that someone close to the religious Jewish sector interview

the parents since most of them were Orthodox (O’s, Ay’s and C’s parents, and Af’s mother were Orthodox; Z’s parents were Conservatives, but refused to be interviewed as will be explained later this section). The social worker from

“Shemaya” was a Conservative Jew. Since she was religious, although not Orthodox, all parents (except for Z’s) agreed to be interviewed by her. This obviously facilitated the establishment of rapport with the parents, an important issue when carrying out a semi-structured interview. It becomes even more so when a woman is interviewing Orthodox men.

The researcher discussed and advised the interviewer on each of the specific questions to address during the semi-structured interview. Also explored were ways the interviewer might handle parent responses that were not readily forthcoming, too short or too long and irrelevant.

During a semi-structured interview, the interviewer tries to encourage the development of a relationship of trust and openness with the interviewee. It can be difficult to develop rapport with an interviewee if the interviewer is attempting to take copious notes. It may also interfere with eye contact and non-verbal communication;

therefore, audio-taping was preferred because this was less intrusive and allowed the researcher to accurately transcribe the interviewee’s replies at a later date for analysis (Gall et al., 1999); however, taping the interview may also affect what is being said, because interviewees are not entirely comfortable and relaxed in the presence of tape or video recorder. To minimize this effect, the researcher explained to the parents why the recording was important and how it was going to be used. They were also told that they could switch the tape recorder off at any time.

All the parents gave their permission to record the interview and use the data for future analysis by signing consent forms (Appendix D). The interviews were recorded on a Sony Cassette-Corder TCM-200DV (section 3.5.3.2). None of the parents asked to switch off the tape recorder during the interview.

Prior to the commencement of the interview, the interviewer explained to the parents that they would be shown a 10 minute DVD of short video segments chosen from the music therapy sessions. The 10 minute clips were deemed a reasonable amount of time to give each parent the opportunity to better remember and process the material. The parents were asked to watch the video clips twice. The first viewing was to form an impression of the chosen video clips. The purpose of the second

viewing was to enable the parent to answer the questions in the interview more in depth should he/she choose to do so. The interviewer explained that before the second viewing, she would ask two specific questions regarding a moment that the parent liked the most in the video clips, and a moment, which he/she liked the least. These questions were designed to help the parent pinpoint his/her response to certain aspects of the video. Then she concluded the introduction by telling the parents that after each one answered the specific questions, she would ask each one of them a few more questions of a general nature.

Each pair of parents watched the DVD at the same time unless only one parent was willing to be interviewed, as in the case of C’s mother. The interview was carried out on an individual basis, one parent after the other. When one parent was interviewed, the other one left the room. Watching the DVD and answering the interview questions lasted approximately one hour. The parent could use as much time as needed to answer the questions. The DVD was viewed on a laptop.

Out of ten parents (five pairs), only four mothers and three fathers were interviewed (Appendix M). As previously mentioned, C’s father refused to watch the video clips due to his religious beliefs as an Orthodox Jew. Z’s parents did not cooperate and refused to be interviewed. Z completed only 11 sessions out of 16 since she vehemently refused to come to the sessions. At that time, she was going through a difficult phase and also became uncooperative with other adults in most areas of her life, as reported to the researcher by the staff. This troubled time naturally affected her parents and stressed them to the limits of their tolerance. Some of this stress and frustration was directed at the therapist and resulted in their refusal to be interviewed.

As mentioned in section 3.4.4, C’s, and Ay’s mothers attended all sessions, except for unusual circumstances. Although they were familiar with all the selected video clips due to their attendance in the sessions, it was still relevant and valuable to interview them since during the sessions they may not have been totally focused on what was taking place. In addition, while the sessions were going on, they might have been going through a myriad of emotional experiences related to the child’s behavior.

Being interviewed, gave them the opportunity to share their thoughts and feelings, especially in the question designed specifically for them, which related to the comparison between their experiences during the sessions with what they were experiencing while watching the video clips (Additional benefits of the interviews were detailed in section 3.4.4).

The recorded interviews were precisely transcribed and translated into English.

In an effort to retain the authenticity of the parent interviews, the translation was made as closely as possible to the parents’ own words, phrases and speech rhythm patterns. The English was not polished. Repetitious phrases, in which the parents struggled to find an answer that reflected their feelings and thoughts, were not deleted from the translation. In the transcription, the researcher also noted whether there were pauses, sighs or laughter in the parent’s answer.