Targeted Parent Support of Social Behavior Among Toddlers with Autism

Background: Autism spectrum disorder (ASD) affects 1 in 59 children in the United States (Centers for Disease Control and Prevention [CDC], 2018). Parent-mediated early interventions, which aim to support parent facilitation of toddler social communication, are a major focus of research (Green et al., 2017). Systematic review of the experimental literature revealed that out of 25 studies of parent-mediated interventions to improve toddler social communication outcomes, only seven (28%) used a measure designed to assess both parent and toddler behavior during observed parent-child interaction (Moore, Barger, Baggett, 2018). Measures reported in this literature tend to require high levels of training, are time burdensome to administer and score, and are not designed for repeated measurement. Consequently, they are of limited utility for community early childhood practitioners in monitoring progress of parent support of toddler social communication within early intervention programs. To address this limitation, a progress monitoring measure designed for practitioners, was used for secondary coding and analysis of parent-child interaction video data from a recently published study of a parent-mediated intervention program (Schertz, Odom, Baggett, & Sideris, 2017).

Objectives: The aim was to examine whether or not a practical and psychometrically sound practitioner progress monitoring measure was useful for examining relationships between targeted parent support and toddler social communication among dyads enrolled in a parent-mediated intervention study. The following research questions were addressed: Is parent positive support behavior significantly and positively related toddler social behavior? Do toddlers whose parents engage in high levels of targeted support demonstrate more positive social behavior compared to toddlers whose parents engage in low levels of targeted support?

Methods: The sample consisted of 131 toddlers and their parents enrolled in a parent-mediated RCT (Schertz et al., 2017). Direct observation of 10-minute video recorded parent-child interactions at home were conducted using the Indicator of Parent Child Interaction-2 (IPCI-2; Baggett et al., 2011). Interobserver agreement was examined for 20% of coded videos. Mean percent agreement was 92.5%, Analyses were conducted to examine parent support of toddler social behavior at the time of enrollment. Descriptive statistics are provided for parent targeted support (Facilitators) and toddler Engagement with parents. Bivariate regression analyses were conducted to examine parent Facilitators and toddler Engagement with parents.

Results: Parents obtained a mean Facilitator score of 217.9 (SD= 59.8, range=285) and children obtained a mean engagement score of 126.37 (SD= 40.0, range= 190). Parent Facilitators and child Engagement were highly and significantly correlated, r=.747, p<.0001. Toddler engagement differed significantly depending upon whether their caregivers engaged in low, medium, or high levels of targeted support (facilitators), F (2, 128) = 47.72, p < .0001.

Conclusions: This study highlights the relevance of a practitioner monitoring measure to assess parent-child interaction. Results demonstrate that a practitioner observation measure, with high interobserver agreement, can be used to capture targeted parent support, crucial to promoting social engagement among toddlers with ASD.