Social Communication and Parent Verbal Responsiveness Across Interaction Contexts in Toddlers on the Autism Spectrum.

PURPOSE: Interactions with caregivers during the ordinary activities that occur as families go about their everyday lives are critical to supporting children's acquisition of social communication and language skills. The purpose of this study was to examine child communication and parent verbal responsiveness across interaction contexts in 211 children (Mage = 20 months) on the autism spectrum (n = 121), with developmental delay (n = 46), or with typical development (n = 44). METHOD: Families participated in up to eight activities during an hour-long, video-recorded home observation. We tested differences in the strength of associations between diagnostic group and interaction context using linear mixed-effects models, with child rate per minute of communication and proportions of parent follow-in comments and directives as outcome variables. Child communicative functions expressed across contexts were also examined. RESULTS: Children across groups communicated at significantly higher rates per minute during book sharing and play with people compared to other interaction contexts. Most child communication was for the function of joint attention during book sharing, for social interaction during play with people, and for behavior regulation during necessary activities such as family chores and meals. On average, parents of children responded using proportionally more follow-in comments during book sharing and play compared to necessary activities, during which parents used more follow-in directives. CONCLUSION: Results provide a glimpse into the dyadic communication that may occur within everyday activities at home, which supports the need for future intervention research and may aid clinicians seeking to identify activities that serve as important contexts for intervention.

Interprofessional Collaborative Practice in Early Intervention.

Professionals in pediatric practice encounter infants and toddlers with developmental delays, disabilities, or complex chronic health conditions eligible for Part C early intervention (EI) services. The most frequently identified concern by families is communication emphasizing the importance of the role of the speech language pathologist (SLP). This article provides a conceptual framework for SLP services in early intervention, based on the principles of interprofessional collaboration. The history of collaboration, EI, and the role of SLPs as members of the EI team are summarized. The competencies mandated for interprofessional education and practice are juxtaposed with the principles of EI and guidelines for SLPs.

Collaborative consultation in natural environments: strategies to enhance family-centered supports and services.

PURPOSE: This article presents current information on recommended practices related to the delivery of early intervention (EI) supports and services to infants and toddlers with, or at risk for, communication deficits and their families. METHOD: The focus is on presenting the changing paradigm for speech-language pathologists (SLPs) working in EI based on the best available research evidence and expert opinion. The article includes a brief review of the recommended and promising practices for early communication intervention and applies the content to the role of the SLP as a consultant to caregivers. It provides strategies for "how to" join into the everyday activities/routines and places with the caregiver and child in order to facilitate caregiver-implemented intervention that will enhance caregiver-child interactions and promote the child's participation and learning. The importance of, and strategies for, collaborative consultation with diverse caregivers within a family-centered approach is presented. IMPLICATIONS: This article provides important and timely information for professionals and families related to family-centered EI practices, caregiver-implemented interventions, adult teaching strategies, and collaborative consultation with families of infants and toddlers with, or at risk for, communication deficits. SLPs can use the information presented to inform their practices when working with these young children and their families.

Early Identification of and Intervention for Infants and Toddlers Who Are at Risk for Autism Spectrum Disorder.

Providing intensive early intervention is critical to maximizing outcomes for children with autism spectrum disorder (ASD), and evidence suggests that the earlier intervention can begin, the better the outcome. The first purpose of this article is to review the earliest indicators of ASD in very young children-social and communication impairments-which have important implications for early identification. The second purpose is to review evidence-based intervention practices for children with ASD and to develop a set of guiding principles for providing intervention for infants and toddlers who are at risk for ASD. Issues that are delineated include providing intervention in natural environments, supporting families in early intervention, and embedding intervention in daily routines.