JMIR Publications

ABSTRACT

Background:

The early language environment is important to language development and a child’s life-course trajectory. Risk factors associated with poor child language outcomes include maternal anxiety and depression, low educational attainment, substance misuse and low socioeconomic status. LENA (Language Environment Analysis) is a wearable technology designed to promote caregiver’s engagement in supporting their child’s language development. LENA provides quantitative linguistic feedback which has been shown to improve caregiver language output, thus enhancing a child’s language environment. There is limited research around the uptake of this technology by families with developmentally at-risk children.

Objective:

This qualitative study aims to explore the conditions under which mothers with children at risk of poor developmental outcomes are willing to adopt the use of LENA to monitor and improve caregiver language output.

Methods:

Using a qualitative interpretive design, semi-structured, in-depth interviews were conducted with eight mothers. Participants were recruited purposively to select maximal variation of socio-economic and ethno-demographic background. Transcribed interview data was analyzed thematically and interpretatively. Themes were mapped abductively to an extended Unified Theory of Acceptance and Use of Technology (UTAUT), which included contextual factors for LENA acceptance.

Results:

Factors that influenced intention to use LENA included both technology specific acceptance factors and contextual factors. Technology acceptance themes included reassurance, feeling overwhelmed and trust. These themes mapped to performance expectancy, effort expectancy and social influence. Contextual themes included emergent success and intrusion of past difficulty. These mapped to parenting self-efficacy and perceived risk. The theme of building on success described behavioural intention. Mothers were more likely to adopt LENA when the technology was viewed as acceptable and this was influenced by parenting self-efficacy and perceived risk.

Conclusions:

LENA is a technology that has acceptability to mothers with risk factors for poor child language development outcomes. Further studies are needed to establish LENA’s effectiveness as an adjunct to strategies to enrich a child’s early language environment.