Parent Responsiveness Mediates the Association between Child Hypo-Reactivity and Later Communication

Background:

Infants and toddlers who are at high-risk (HR) for developing Autism Spectrum Disorder (ASD) often display hypo-reactivity to sensory stimuli. Research indicates that child hypo-reactivity to sensory stimuli is related to 1) lower child language and communication abilities (Watson et al., 2011; Patten, Ausderau, Watson, & Baranek, 2013) and 2) lower parent responsiveness (Kinard et al., 2017). Studies also suggest that higher parent responsiveness is related to increased child communication and language abilities (Siller & Sigman, 2008; Watson et al., 2017). Many parent-mediated interventions have resulted in increased parent responsiveness over the course of treatment (Green et al., 2015; Siller et al., 2013; Watson et al., 2017). Yet, whether parent responsiveness mediates the relationship between child hypo-reactivity and later communication outcomes remains unexplored.

Objectives:

To evaluate whether parent responsiveness mediates the relationship between child hypo-reactivity to sensory stimuli at one year and child communication at two years.

Methods:

This study includes 83 HR children (56 boys) identified at 12 months based on community screenings with the First Year Inventory 2.0 (Baranek et al., 2003). Children were seen at 14 months old (+/- 0.77; Time 1) and completed the Sensory Processing Assessment (SPA; Baranek, 1999) while parents completed the Sensory Experiences Questionnaire (SEQ; Baranek, 1999). Children were seen again 9 months later (mean age 23 months +/- 0.90; Time 2); parents completed the Vineland Adaptive Behavior Scales (VABS; Sparrow, Cicchetti, & Balla, 2005) at Time 2. Parent Verbal Responsiveness (PVR) was coded at Time 1 and Time 2 from 10-minute video samples using a coding system adapted from Yoder et al. (2015). An average of PVR (AvgPVR) was calculated [(PVR Time 1 + PVR Time 2)/2]. 50% (n=45) of the children were randomly assigned to an experimental intervention. A series of mediation analyses, controlling for intervention group, were conducted using Process v3.1 (http://www.afhayes.com) in SPSS.

Results:

Mediation analyses revealed that the relationship between SPA Hypo-reactivity at Time 1 and VABS Communication at Time 2 was mediated by AvgPVR (See Figure 1). Additional mediation analyses indicated that, when using SPA, this mediation effect was specific to the VABS Communication domain. Mediation analyses were also conducted using the Hypo-reactivity domain of the SEQ. Consistent with SPA results, the relationship between SEQ Hypo-reactivity at Time 1 and VABS Communication domain at Time 2 was mediated by AvgPVR (See Figure 2). When using the SEQ, AvgPVR also mediated the relationship between Hypo-reactivity and later VABS Social domain.

Conclusions:

Child hypo-reactivity negatively impacts later child language outcomes, though this work suggests that parent verbal responsiveness may attenuate this negative impact. Based on these results, parent-mediated interventions may want to focus on parent responsiveness given the subsequent effect this transactional behavior has on child language development. In addition, this work also indicates that parent responsiveness may have an impact on later child socialization skills.