Fostering a social child with autism: a moment-by-moment sequential analysis of an early social engagement intervention

Scoping review of behavioral coding measures used to evaluate parent responsiveness of children with autism or elevated risk of autism

LAY ABSTRACT

The topic of how parents react (e.g., how they talk and act) to their child with autism or elevated likelihood of autism, often called parent responsiveness, has been studied by researchers for over 50 years. Many methods for measuring behaviors around parent responsiveness have been created depending on what researchers were interested in discovering. For example, some include only the behaviors that the parent does/says in reacting to something the child does/says. Other systems look at all behaviors in a period of time between child and parent (e.g., who talked/acted first, how much the child or parent said/did). The purpose of this article was to provide a summary of how and what researchers looked at around parent responsiveness, describe the strengths and barriers of these approaches, and suggest a "best practices" method of looking at parent responsiveness. The model suggested could make it more possible to look across studies to compare study methods and results. The model could be used in the future by researchers, clinicians, and policymakers to provide more effective services to children and their families.

Measuring Transactional Engagement Among Young Children with Elevated Likelihood for Later Autism Spectrum Disorder Diagnosis

This analytical study documented the presence of transactions in parent-child engagement within a sample of young children at an elevated likelihood for an eventual diagnosis of autism spectrum disorder (ASD). Specifically, the study examined the establishment of transactional engagement through reciprocal behaviors between parents and their young children at-risk for ASD. In the study sample, established transactional engagement occurred at a higher rate than other levels of engagement. Additionally, transactional engagement had a higher likelihood of being established when parents initiated. Post-hoc analyses revealed possible early markers of ASD within a certain behavior displayed in transactions. This study signifies the initial efforts in identifying transactions within parent-child engagement, and foremost, how transactional engagement is established.

Selective Mutism and Its Relations to Social Anxiety Disorder and Autism Spectrum Disorder

In current classification systems, selective mutism (SM) is included in the broad anxiety disorders category. Indeed, there is abundant evidence showing that anxiety, and social anxiety in particular, is a prominent feature of SM. In this article, we point out that autism spectrum problems in addition to anxiety problems are sometimes also implicated in SM. To build our case, we summarize evidence showing that SM, social anxiety disorder (SAD), and autism spectrum disorder (ASD) are allied clinical conditions and share communalities in the realm of social difficulties. Following this, we address the role of a prototypical class of ASD symptoms, restricted and repetitive behaviors and interests (RRBIs), which are hypothesized to play a special role in the preservation and exacerbation of social difficulties. We then substantiate our point that SM is sometimes more than an anxiety disorder by addressing its special link with ASD in more detail. Finally, we close by noting that the possible involvement of ASD in SM has a number of consequences for clinical practice with regard to its classification, assessment, and treatment of children with SM and highlight a number of directions for future research.

Non-reciprocal Friendships in a School-Age Boy with Autism: The Ties that Build?

This mixed-methods study examined differences in social interaction patterns between a school-age boy with autism and his friends, non-reciprocal friends, and non-friends during recess time at a mainstream school (third grade of elementary school). Through a combination of observational methodology and social network analysis with an idiographic, follow-up and multidimensional design approach, we used lag sequential and polar coordinate analysis to ascertain the associations between various interactive behaviors as a function of type of friendship relation. After 40 sessions, we found that the non-reciprocal friendship relations of the boy with autism could have significantly greater potential than his reciprocal friendships to increase active engagement and reduce the time he spent alone during recess.

A Pilot Randomized Clinical Trial of an Enhanced Pivotal Response Treatment Approach for Young Children with Autism: The PRISM Model

The symptoms of autism spectrum disorder are conceptualized to alter the quality of parent-children interactions, exposure to social learning exchanges, and ultimately the course of child development. There is evidence that modifying the procedures of Pivotal Response Treatment (PRT) to explicitly target social motivation enhances child engagement and parent-child synchrony in moment-by-moment exchanges. However, it is unclear if these within session improvements ultimately yield favorable developmental outcomes over time. The current investigation presents feasibility, utility, and preliminary efficacy data of a pilot randomized clinical trial (RCT) of a Pivotal Response Intervention for Social Motivation (PRISM) model. Data on participant factors, treatment protocol acceptability, and outcome variance and effect size are highly favorable and support the pursuit of a future, large scale RCT.

An investigation of the effects of a parent delivered stimulus-stimulus pairing intervention on vocalizations of two children with Autism Spectrum Disorder

Communication deficits in children with Autism Spectrum Disorder (ASD) can manifest in a myriad of lifelong social and educational challenges. Many children with ASD fail to learn vocal verbal behavior and may require intensive individualized intervention to learn early verbal operants. The current research aimed to evaluate the effects of a parent delivered stimulus-stimulus pairing (SSP) procedure on target vocalizations of two young children with ASD who did not present with vocal verbal behavior. Results indicated the intervention was successful in increasing the frequency of the target vocalizations for both participants. Social validity results indicated that parents were satisfied with the intervention and their own implementation of these procedures. These results are discussed in terms of their implications for parent delivered interventions.

Long-Term Perspectives of Family Quality of Life Following Music Therapy With Young Children on the Autism Spectrum: A Phenomenological Study

Background

Parents of children on the autism spectrum have consistently reported feeling uncertain in their parenting role, and desire more practical advice from service providers about how to support their child in the home. There is growing recognition of the need for interventions to provide support to the family as well as fostering child development outcomes.

Objective

This study explores mothers' follow-up perspectives of family-centered music therapy (FCMT) four years after participating in a 16-week home-based program, and therefore provides a unique long-term viewpoint on FCMT outcomes.

Methods

Eight mothers who previously participated in FCMT sessions with their young children on the autism spectrum were interviewed to explore their perception of any long-term outcomes.

Results

A descriptive phenomenological analysis revealed five global themes, including: improvement in mothers' confidence to engage their child; rare opportunities for mutual mother-child enjoyment; improved child social communication and quality of life; mothers' new understanding of the child's interests and strengths; and more opportunities for continuing the child's interest in music.

Conclusions

Mothers perceived long-term benefits to social relationships within the family, leading to perceived enrichment in child and family quality of life following music therapy sessions.

The Impact of Prior Activity History on the Influence of Restricted Repetitive Behaviors on Socialization for Children With High-Functioning Autism

Research has demonstrated that incorporating restricted interests of an individual with autism into recess activities is effective at increasing socialization with typically developing peers. However, certain activity contexts may alter the reinforcing influence of the restricted repetitive behaviors (RRBs) depending on an individual’s history in that activity. Using an alternating treatment design, this study examined whether an individual’s history with an activity affected socialization. RRBs were embedded into activities with a reported positive history (i.e., prior history of positive experiences) and activities with a reported negative history (i.e., prior history of aversive experiences) for participants. Data indicated that socialization increased and remained above baseline levels when RRBs were introduced during activities with a positive history, whereas socialization was minimal when RRBs were introduced in activities with a negative history. Social significance and implications for designing activities that incorporate a child’s RRBs are discussed.