Sequential Associations Between Caregiver Talk and Child Play in Autism Spectrum Disorder and Typical Development

Background: In the early phases of development, caregiver-child play often involves caregiver talk about children’s play (McDuffie & Yoder, 2010; Siller & Sigman, 2008). Although originally studied to facilitate language, these types of utterances might elicit particular types of child play and visa versa. When children play at their most developmentally advanced level, this may prompt the caregiver to provide yet more talk related to the play experience, in a mutually reinforcing manner (Alessandri, 1992). These contingencies may be especially important to understand in children with autism spectrum disorder (ASD), to better support caregiver-child interactions within play contexts. We focused on two main types of caregiver talk: responsive talk that relates to the child’s current focus of attention, termed follow-in utterances; and utterances that relate to the caregiver’s focus of attention and not the child’s focus of attention, termed caregiver-focused utterances. Follow-in utterances can be further parsed into follow-in directives; those that suggest or direct the child to do something different with a toy the child is already playing with, and follow-in comments; those that describe the state of affairs regarding the toy the child is already playing with but do not suggest or direct the child to do something new.

Objectives:  To determine whether: (a) child functional play is more likely to elicit caregiver follow-in utterances than exploratory play, (b) follow-in utterances are more likely to elicit functional play than caregiver-focused utterances, (c) follow-in comments are more likely to elicit functional play than follow-in directives, and (d) any of the above sequential associations differed for children with ASD as compared to TD children.

Methods: Fifty children with ASD and 48 TD children who were group-wise matched on mental age (mean mental age ≈ 14 months across groups) were recorded during a free play interaction. Recordings were coded for caregiver talk and child play using 5 s partial-interval sampling. Sequential analysis methods were used to answer research questions. An index of sequential association was used as a dependent variable in mixed-effects models to account for nesting of behavioral sequences within caregiver-child dyads. Chronological age was used as a control variable in each mode.

Results: Analyses showed sequential associations between child play and caregiver follow-in utterances were stronger in the ASD group than the TD group, but did not differ according to play type. Follow-in utterances elicited functional play while caregiver-focused utterances had an inhibitory effect, and this distinction was more prominent for the ASD group than the TD group (Figure 1). Finally, across both groups of children, follow-in directives were more likely than follow-in comments to elicit functional play (Figure 2).

Conclusions: Our results indicate that, more so than TD caregivers, caregivers of children with ASD time their utterances to follow child play. Also, children with ASD may be particularly likely to benefit from caregiver’s follow-in talk when engaging with toy play. Our findings also invite a reappraisal of the role of directives (previously considered ‘asynchronous) in caregiver-child play, given our findings that follow-in directives elicit developmentally high-level play.