Efficacy of a Parent-Mediated Intervention in Improving Social Sophistication of Communication in Toddlers with Autism

• In Event: Poster Session 06
  In Poster Session: PS 06 Topic - Developmental Disabilities

Abstract

Background & aims: Pathways Early Autism Intervention (Pathways) is a parent-mediated naturalistic developmental behavioral intervention for toddlers with ASD that coaches parents to facilitate early social skills during parent-child interactions. Data from a 12-week randomized control trial were analyzed to evaluate the efficacy of Pathways in improving the social sophistication of communication in a culturally and socioeconomically diverse sample of toddlers with ASD as compared to community-based services as usual (SAU). Social sophistication of communication was assessed by combining two historically distinct perspectives of analyzing communicative acts (CAs): the level of the pragmatic force behind the communicative intention and the behaviors with which the intention was produced (e.g., words, vocalizations, gestures). We asked the following research question: Do toddlers with ASD whose parents receive Pathways make greater gains in social sophistication of communication in terms of level of coordination of communicative behaviors at each level of communicative intention?

Methods: Participants included 56 ethnically diverse toddlers with ASD (Pathways = 32, SAU = 24). The Pathways intervention consisted of weekly parent coaching sessions of approximately 90 minutes provided by a trained clinician in the child’s home. Children in the SAU group continued to receive community-based services as usual.

Parent–child interactions were recorded at baseline and post-intervention. Two streams of video were collected to facilitate coding: a body view via an iPad and a face view via hidden camera glasses worn by the parent. Each 10-minute video was transcribed for all verbal, vocal, and gestural behaviors (using the conventions of the Child Language Data Exchange System), coded for eye gaze/shared affect, and coded for communicative intention using the Inventory of Communicative Acts- Abridged (INCA-A). All coders met and maintained a minimum inter-rater reliability (Cohen’s kappa of .80). Coders were blind to group assignment and time (baseline versus post-intervention).

Social sophistication was measured as the number of child CAs consisting of a behavior produced in isolation (e.g., word, vocalization, gesture) or in coordination with at least one other behavior (e.g., word + gesture) within three distinct categories of communicative intention (from least to most sophisticated: Behavior Regulation, Routine, and Mutual Attention). Analysis was conducted on the change scores (post-intervention minus baseline) for these six measures.

Results: Because few CAs were produced within Mutual Attention, this interchange was excluded from further analysis. To avoid inflating Type I error, alpha was set at .01 (.05 divided by 4, the number of tests performed). Results of Mann-Whitney U tests indicate, in comparison to SAU, Pathways made significantly more change in CAs containing two or more coordinated behaviors within Behavior Regulation, with a moderate effect size. There was no significant difference between the groups for CAs produced with coordination within Routine or in isolation at either level of intention.

Implications: Our analysis supports the efficacy of Pathways in improving the social sophistication of communicative behaviors in a culturally and socioeconomically diverse sample of toddlers with ASD, as compared to community-based services as usual.

Authors

• Adrienne De Froy, The University of Texas at Dallas
  Presenting Author

• Pamela Rollins, The University of Texas at Dallas
  Non-Presenting Author