A Preliminary Analysis of In Home Parent-Child Communication Interaction In Families with Toddlers with Autism and the Influence of a Parent Training Program

Background:  Researchers have demonstrated that the style and frequency of parents’ engagement with their children impacts language development (e.g. Hart & Risley, 1995). In contrast to families of typically developing children, families of children with autism spectrum disorder (ASD) demonstrate differences in the style (Wilder, Axelsson & Granlund, 2004) and decreases in the frequency (Konstantareas & Homatidis, 1992) of interaction. As such, various intervention programs have been designed to help parents learn to initiate and sustain interactions with their child, to support the child’s language development. The purpose of this study was to explore the nature of in home communicative interactions between parents and their toddlers with ASD and the influence of a parent education intervention program on those interactions, using both video and new audio capture technology, the digital language processor (DLP) (Gilkerson & Richards, 2008). 

Objectives:  Specific questions addressed in this pilot study include: (1) what is base duration of child engagement and parent-child interaction in the home of toddlers with ASD? and (2) does the duration of these interactions and frequency of child engagement change after parent participation in the More Than Words (MTW) program?

Methods:  Ten families and their toddlers with ASD (age 29-39m) were recruited from a local agency providing the MTW program (Sussman, 1999). Parent-child interaction data were collected over a three month period including measures prior to and immediately after participation in MTW. Video was utilized to capture engagement in interactions and examined using criteria by Bakeman & Adamson (1984) while the DLP designed for use in unstructured environments, was utilized to capture audio data. Computer software was used to examine the duration of parent-child interaction defined as communicative turns between parent and child separated by less than 5 second of silence.

Results:  Video data indicated children both significantly decreased their object only engagement (t(9)=3.12, p=0.012, d=1.348) and increased their coordinated joint engagement (t(9)=-2.67, p=0.028, d=.957) post intervention. Audio data indicated few communicative interactions were taking place between parents and toddlers. Parents engaged in communicative turns with their child for an average total of 146.52 seconds/hour where the mean duration of interaction was 19.67 seconds. Post intervention, mean score differences indicated an increase of 3.92 seconds in duration of interaction, a 19.88% increase over baseline. This preliminary trend suggests that parents may be maintaining their children’s engagement in dyadic interaction for longer instances during a 10 minute video play situation after intervention however, the duration of in home interactions was not significantly different.  

Conclusions:  Little is understood about the home language environments of toddlers with ASD or the supports necessary to effect change in this setting. Further, what can be considered meaningful change in this environment when so few interactions are taking place is also relatively unknown. Although the data suggest that children may be more engaged in dyadic interaction post intervention, this change may not be transferring to daily home interactions where only a small fraction of the child’s day is spent engaged in communicative interaction with a parent.