Examining variability in Naturalistic Developmental Behavioral Intervention strategy use in caregivers of children with autism spectrum disorders.

BACKGROUND: Naturalistic Developmental Behavioral Interventions (NDBIs) for young children with autism spectrum disorder commonly involve caregiver-mediated approaches. However, to date, there is limited research on how caregivers' skills change, and, in turn, impact child outcomes. METHODS: We evaluated the NDBI strategy use of 191 caregivers prior to participation in NDBIs (or control groups) across multiple randomized controlled trials, using the Measure of NDBI Strategy Implementation, Caregiver Change (MONSI-CC). Clustering analyses were used to examine caregiver variability in NDBI strategy use at intervention entry. Generalized Linear Mixed Models were used to examine changes in caregiver strategy use over the course of intervention and its impact on changes in children's social communication. RESULTS: Using clustering analysis, we found that caregivers' baseline skills fit four profiles: limited, emerging, variable, and consistent/high, with few demographic factors distinguishing these groups. Caregivers starting with limited or emerging skills improved in their strategy use with intervention. Caregivers starting with more skills (consistent/high or variable) maintained higher skills over intervention. Children of caregivers in these groups who received target NDBIs improved in their social communication skills. CONCLUSIONS: Results suggested that caregiver skills improve through participation in NDBIs and may directly contribute to their children's outcomes, although more research on mediating factors is needed. Individualized approaches for caregivers and their children starting with differing skill profiles at intervention entry may be warranted.

Analyzing input quality along three dimensions: interactive, linguistic, and conceptual.

This paper provides an overview of the features of caregiver input that facilitate language learning across early childhood. We discuss three dimensions of input quality: interactive, linguistic, and conceptual. All three types of input features have been shown to predict children's language learning, though perhaps through somewhat different mechanisms. We argue that input best designed to promote language learning is interactionally supportive, linguistically adapted, and conceptually challenging for the child's age/level. Furthermore, input features interact across dimensions to promote learning. Some but not all qualities of input vary based on parent socioeconomic status, language, or culture, and contexts such as book-reading or pretend play generate uniquely facilitative input features. The review confirms that we know a great deal about the role of input quality in promoting children's development, but that there is much more to learn. Future research should examine input features across the boundaries of the dimensions distinguished here.

Early Word Order Usage in Preschool Mandarin-Speaking Typical Children and Children With Autism Spectrum Disorder: Influences of Caregiver Input?

This study explores the emergence and productivity of word order usage in Mandarin-speaking typically-developing (TD) children and children with autism spectrum disorder (ASD), and examines how this emergence relates to frequency of use in caregiver input. Forty-two caregiver-child dyads participated in video-recorded 30-min semi-structured play sessions. Eleven children with ASD were matched with 10 20-month-old TD children and another 11 children with ASD were matched with 10 26-month-old TD children, on expressive language. We report four major findings: (1) Preschool Mandarin-speaking children with ASD produced word order structures with pervasive ellipsis at similar rates to language-matched TD children, but also displayed differences from TD children in their usage of SVt and VtO frames; (2) Grammatical productivity was observed in both TD children and children with ASD; moreover, children with ASD with higher expressive language produced less stereotyped language; (3) Both TD children and children with ASD heard a range of word orders in their caregivers' input, with TD children's input greater in amount and complexity; however, caregivers of both groups also showed no age/language-related changes in word order usage; (4) Few word-order-specific correlations emerged between caregivers and their children; however, strong correlations were observed for mean length of utterances (MLU) for both groups: Caregivers who produced longer/more complex utterances had children who did the same. Taken together, it seems that despite their pragmatic deficits, the early grammatical knowledge of word order in Mandarin-exposed children with ASD is well preserved and in general follows the typical developmental pattern. Moreover, caregiver input is broadly rather than finely tuned to the linguistic development of TD children and children with ASD, and plays a more important role in children's general syntactic development than in specific word order acquisition. Thus, early word order usage in preschool Mandarin-speaking TD children and children with ASD may be influenced by both caregiver input and child abilities.

Children with Autism Spectrum Disorder May Learn from Caregiver Verb Input Better in Certain Engagement States.

The relation between caregiver follow-in utterances with verbs presented in different states of dyadic engagement and later child expressive verb vocabulary in children with autism spectrum disorder (ASD) was examined in 29 toddlers with ASD and their caregivers. Caregiver verb input in follow-in utterances presented during higher order supported joint engagement (HSJE) accounted for a significant, large amount of variance in later child verb vocabulary; R2= .26. This relation remained significant when controlling for early verb vocabulary or verb input in lower support engagement states. Other types of talk in follow-in utterances in HSJE did not correlate with later verb vocabulary. These findings are an important step towards identifying interactional contexts that facilitate verb learning in children with ASD.