Measuring change in parent child communicative interaction during pre-school treatment for autism

Background: Comprehensive parent training studies generally define the specific intervention, measure moderating variables such as child ability or parent education, and relate these to child outcome variables. Despite a number of studies reporting positive gains from communication focussed parent training programmes, there is a lack of intervention trials which analyse change in parent and child dyadic interaction as a mediator of outcome. No adequate standardised dyadic interaction measure of this kind exists in the autism literature. 
The Parent Child Interaction (PCI) measure was developed during a pilot RCT of a parent-mediated communication intervention for pre-school autism (Aldred et al 2004). It integrates measures of synchronous and asynchronous parental communication acts (Shapiro et.al. 1987); semantic contingency of parental verbal responses from (Conti-Ramsden 1990); and duration of shared attention (Watson, 1998).

Objectives: To investigate change in parent-child interaction during preschool parental intervention.
To relate any change to overall change in child autism symptomatology and communication functioning.

Methods: Detailed PCI data on 28 children 2-5yrs diagnosed with core autism included in the pilot RCT were analysed using 2 group pre-post comparisons and regression analysis to investigate change effects.

Results: The study found significant relative improvements in parent adapted communication and child communication initiation which correlated with standardised measures showing significant improvements in autism-specific symptoms on standardised tests following a 12 month intervention.

Conclusions: The results suggest utility of this PCI video measure. The converging PCI process measure and standardised child and parent results suggest a relationship between changes in parent adapted communication targeted in therapy and gains in child reciprocal social interaction, language and communication initiation.