Autistic preschoolers' engagement and language use in gross motor versus symbolic play settings.

Background and aims: Although adjustment of the environment is recommended as a support strategy in evidence-based interventions for children with autism, the impact of doing so (and the how and why) is not well understood. One essential environmental factor to consider when providing supports for preschool-aged autistic children is the play setting, specifically, the materials available in the child's play context. The aim of this study was to compare engagement states and number of utterances produced by preschool-aged autistic children within symbolic vs. gross motor play settings. Examining the relationship between gross motor play settings and children's social engagement and spoken language use is particularly important to explore for autistic children given differences in their sensory processing, motor skill development, and choice of and interaction with toys relative to neurotypical peers. Methods: Seventy autistic children aged 25-57 months were videotaped during natural play interactions with a parent. Children's social engagement and number of spoken utterances were examined in five minutes each of play with symbolic toys and play with gross motor toys. Continuous time-tagged video coding of the child-caregiver engagement states was conducted, and the child's frequency of spoken language was identified using language sample analysis. The specific variables examined were; (a) engagement with caregiver, (b) engagement with objects only, (c) unengaged (no evident engagement with objects or people), and (d) total number of spoken utterances. The relationship between play setting (symbolic vs gross motor) and child language and engagement state variables was examined with linear mixed effects modelling. Results: Significant main effects were revealed for the interaction between play setting and autistic children's engagement. Young autistic children were more likely to engage with caregivers in play environments with gross motor toys (moderate effect) and also were more likely to have periods of unengaged time (not overtly directing their attention to objects or people; small effect) in this setting. Further, when in a setting with symbolic toys, autistic children were more likely to spend their time focusing attention solely on objects (large effect). No interaction was found between play setting and total number of utterances spoken by autistic children. Conclusions and implications: This study confirmed the importance of continued research focused on understanding the relationship between children's play settings and their social engagement and language use. Although preliminary, findings support the idea that there is an interaction between preschool-aged autistic children's social engagement and their play settings. Further, our results suggest that there can be value in clinicians differentiating children's play settings (i.e., gross motor vs symbolic) when assessing and supporting social engagement capacities of young autistic children.

A realist synthesis of social connectivity interventions during transition to parenthood: The value of relationships.

BACKGROUND: Social connections are important during the transition to parenthood. A wide body of literature suggests that these connections enhance health and contribute to wellbeing. In the case of parents and families, social connections can influence child development. Nurses and public health agencies are in a unique position to advocate for resources and approaches to enhance social connectivity for parents during this important life transition. OBJECTIVES: The aim of this review was to identify the universal social connectivity interventions that work, and the conditions that foster social connections for parents and enhance child development. The review was undertaken as part of a larger research project to inform the question: What are the population-level interventions that public health can implement to promote social, emotional and cognitive development from the prenatal period to the end of the first year of life? Social connectivity is one of three domains that were explored in the full study. DESIGN: Realist synthesis. DATA SOURCES: Medline, CINAHL, ERIC, SocAbs, PsychINFO, grey literature. REVIEW METHODS: A literature search was conducted using relevant key words and MeSH headings. Nearly 2000 papers were reviewed by title and sorted based on inclusion and exclusion criteria. Data extraction aided quality appraisal and analysis and informed the development of an explanatory mechanism. RESULTS: Twenty-seven papers were included in the synthesis, with findings described in four theme areas: (a) connections in the community, (b) internet connections, (c) prenatal connections, and (d) connections for fathers. The literature available to answer the research question is scant and of varying quality. Community development, family-systems intervention practices, principles of father inclusive practice and group prenatal care models have been demonstrated to foster social connectivity for parents. Online social networking provides valuable informational support. CONCLUSIONS: Changing social structures and technology have influenced the way in which new parents access support. Social connections fostered in the parenting environment have the potential to enhance wellbeing for parents and thus contribute to children's positive development. Nurses are in a position to advocate for the use of evidence-informed approaches when planning programs and services for parents.

Parent education interventions designed to support the transition to parenthood: A realist review.

BACKGROUND: Public health nurses use parent education programmes to support individuals' transition to parenthood. A wide array of these programmes exists; however, the approach must be accommodated by resources available in a publicly funded system. For example, some new-parent education approaches use 1:1 home visiting (with a nurse or trained lay-home visitor) but the costs of this intensive approach can be prohibitive. Because of this limitation there is an interest in identifying effective and efficient new parent educational approaches that can realistically be provided at a universal level. Unfortunately, there is a lack of high-quality evaluation identifying programmes or educational processes that meet these criteria. OBJECTIVES: To identify potentially effective new-parenting education interventions that could be implemented at a population level during the transition to parenthood period. DESIGN: Realist synthesis. DATA SOURCES: Medline, CINAHL, ERIC, PsycINFO, Sociological Abstracts, grey literature. REVIEW METHODS: A realist review method generated a total of 72 papers that were used to inform the results. A three-pronged approach was used incorporating an initial search (6), a database search using applicable keywords and MeSH headings (58), and review of literature identified by advisory group (8 grey literature). An 'implementation chain' was developed to outline the overall logic and process behind parent education interventions and to guide the analysis. RESULTS: Seventy-two papers informed this review: 13 systematic reviews/meta-analyses, 34 intervention studies, 9 opinion papers, 8 programme reviews, and 8 grey literature reports. There was no compelling evidence to suggest that a single educational programme or delivery format was effective at a universal level. Some inherent issues were identified. For example, adult learning principles were overlooked and theories of parent-child interaction were not in evidence. No direct links between universal new-parent education programmes and child development outcomes were established. Programme reach and attrition were key challenges. Programme evaluation criteria were inconsistent, with an over-reliance on parent satisfaction or self-reported intention to change behaviour. There was evidence that effective facilitators helped increase parents' perceived satisfaction with programmes. CONCLUSIONS: It is unlikely that a single standardized format or programme will meet all the specific learning needs of parents. Multiple approaches that will allow people to access information or education at a time and in a format that suits them may be of value. The importance of the transition to parenthood and its impact on parent and child wellbeing warrant careful consideration of current programming and careful evaluation of future initiatives.

On the Meanings of Self-Regulation: Digital Humanities in Service of Conceptual Clarity.

Self-regulation is of interest both to psychologists and to teachers. But what the word means is unclear. To define it precisely, two studies examined the American Psychological Association's system of controlled vocabulary-specifically, the 447 associated terms it presents-and used techniques from the Digital Humanities to identify 88 closely related concepts and six broad conceptual clusters. The resulting analyses show how similar ideas are interrelated: self-control, self-management, self-observation, learning, social behavior, and the personality constructs related to self-monitoring. A full-color network map locates these concepts and clusters relative to each other. It also highlights some of the interests of different audiences, which can be described heuristically using two axes that have been labeled abstract versus practical and self-oriented versus other-oriented.

Measuring and supporting language function for children with autism: evidence from a randomized control trial of a social-interaction-based therapy.

In a report of the effectiveness of MEHRIT, a social-interaction-based intervention for autism, Casenhiser et al. (Autism 17(2):220-241, 2013) failed to find a significant advantage for language development in the treatment group using standardized language assessments. We present the results from a re-analysis of their results to illustrate the importance of measuring communicative language acts (formally called "speech acts"). Reanalysis confirmed that children in the MEHRIT group outperformed the community treatment group on measures of MLUm, number of utterances produced, and various speech act categories. The study underscores the importance of functional language measures in guiding and evaluating treatment for children with autism, and suggests that MEHRIT is effective in improving children's use of language during parent-child interactions.

The imaginary part of coherency in autism: differences in cortical functional connectivity in preschool children.

Cognition arises from the transient integration and segregation of activity across functionally distinct brain areas. Autism Spectrum Disorders (ASD), which encompass a wide range of developmental disabilities, have been presumed to be associated with a problem in cortical and sub-cortical dynamics of coordinated activity, often involving enhanced local but decreased long range coordination over areas of integration. In this paper we challenge this idea by presenting results from a relatively large population of ASD children and age-matched controls during a face-processing task. Over most of the explored domain, children with ASD exhibited enhanced synchronization, although finer detail reveals specific enhancement/reduction of synchrony depending on time, frequency and brain site. Our results are derived from the use of the imaginary part of coherency, a measure which is not susceptible to volume conduction artifacts and therefore presents a credible picture of coordinated brain activity. We also present evidence that this measure is a good candidate to provide features in building a classifier to be used as a potential biomarker for autism.

Learning through interaction in children with autism: preliminary data from asocial-communication-based intervention.

The study evaluates a social-communication-based approach to autism intervention aimed at improving the social interaction skills of children with autism spectrum disorder. We report preliminary results from an ongoing randomized controlled trial of 51 children aged 2 years 0 months to 4 years 11 months. Participants were assigned to either a target treatment or community treatment group. Families in the target treatment group were given 2 hours of therapy and coaching each week in an intervention emphasizing social-interaction and the parent-child relationship. Children in the community treatment group received a variety of services averaging 3.9 hours per week. After 12 months, outcomes were measured to determine changes in the groups in social interaction and communication. In addition, a regression analysis was conducted to determine whether changes in social interaction skills were associated with language development. Results suggest that children in the treatment group made significantly greater gains in social interaction skills in comparison to the community treatment group, but no between-group differences were found for standard language assessments. Initiation of joint attention, involvement, and severity of language delay were found to be significantly associated with improvement of language skills in children with autism. Finally caregiver skills targeted by the intervention were found to be significantly associated with changes in children's interaction skills.

The generativist-interactionist debate over specific language impairment: psycholinguistics at a crossroads.

Certain defining problems in psychology force us to clarify both the origins and the limits of a paradigm that has long governed our thinking in a particular area of research. The current debate over the nature and causes of specific language impairment is proving to be just such an issue. In particular, the existence of the KE family, 15 of whose 37 members suffer from specific language impairment, has raised far-reaching questions about the conceptual foundations of our current views about language deficits and, indeed, about language development in general.

The emergence of a new paradigm in ape language research.

In recent years we have seen a dramatic shift, in several different areas of communication studies, from an information-theoretic to a dynamic systems paradigm. In an information processing system, communication, whether between cells, mammals, apes, or humans, is said to occur when one organism encodes information into a signal that is transmitted to another organism that decodes the signal. In a dynamic system, all of the elements are continuously interacting with and changing in respect to one another, and an aggregate pattern emerges from this mutual co-action. Whereas the information-processing paradigm looks at communication as a linear, binary sequence of events, the dynamic systems paradigm looks at the relation between behaviors and how the whole configuration changes over time. One of the most dramatic examples of the significance of shifting from an information processing to a dynamic systems paradigm can be found in the debate over the interpretation of recent advances in ape language research (ALR). To some extent, many of the early ALR studies reinforced the stereotype that animal communication is functional and stimulus bound, precisely because they were based on an information-processing paradigm that promoted a static model of communicative development. But Savage-Rumbaugh's recent results with bonobos has introduced an entirely new dimension into this debate. Shifting the terms of the discussion from an information-processing to a dynamic systems paradigm not only highlights the striking differences between Savage-Rumbaugh's research and earlier ALR studies, but further, it sheds illuminating light on the factors that underpin the development of communication skills in great apes and humans, and the relationship between communicative development and the development of language.