Sequential Associations between Supported Joint Engagement and Parent Talk in Children with ASD and Typical Development

Background: Previous research indicates that caregiver talk that is tailored to the child’s attentional focus (follow-in utterances) elicits child play, and more so for children with ASD than TD children (Bottema-Beutel et al., 2017). Further, follow-in directives, a subset of follow-in utterances, has been shown to be especially elicitative of high-level play in both children with ASD and TD children, as compared to follow-in comments. It is yet to be explored if particular types of caregiver talk elicit caregiver-child joint engagement. An important form of caregiver-child engagement is supported joint engagement (SJE), in which the caregiver influences the child’s play, but the child does not visually reference the adult. SJE is a robust predictor of language development in TD children and children with ASD (Adamson et al., 2009).

Objectives: This project examines different combinations of SJE and caregiver talk sequences to explore temporal relationships between these constructs. Follow-in utterances, and especially follow-in directives, may be particularly suited to eliciting SJE in comparison to other types of caregiver talk. Further, SJE may elicit follow-in utterances, and potentially more so in dyads that include a child with ASD as compared to a TD child.

Methods: We compared sequential associations (SAs) between different types of caregiver talk and joint engagement sequences, and between children with ASD and typical development (TD). SAs quantify the extent to which one behavior is likely to follow another behavior, while controlling for each behavior’s base rates (Yoder & Symons, 2010). SAs were calculated from a coded play session for each child. Mixed-effects models were used to determine effects of group and sequence on mean SAs.

Fifty children with ASD and 48 children with TD participated. Groups were matched on mental age (~13.5 months). Caregiver-child dyads engaged with toys during a 15-min, video recorded free-play procedure. Coding schemes for joint engagement and caregiver talk were applied to these videos, using a 5-s partial interval sampling method.

Results: Follow-in utterances were more likely to elicit SJE than utterances related to the caregiver’s focus of attention (p =.05), and this association did not differ by group. Further, follow-in directives were more likely to elicit SJE than follow-in comments (p < .05), but this association did not differ by group. Finally, SJE was more likely to elicit follow-in utterances in the ASD group as compared to the TD group (p < .05).

Conclusions: Providing talk that (a) is related to what the child is doing, and (b) provides suggestions about what the child might do with the toys (i.e., follow-in directives), elicits SJE to a greater extent than other forms of caregiver talk. Additionally, caregivers of children with ASD appear particularly attuned to providing talk at moments when their child is highly engaged, which may correspond to moments when the child is likely to be processing such talk (Bottema-Beutel et al., 2014). These findings can be used to improve intervention practices for children with ASD that seek to maximize joint engagement as a means to support development (e.g., Kasari et al., 2006/2008).