Look at Mommy: Attention-Related Communication in Mothers of Children at Risk for Autism

Background: When mothers interact with very young typically developing children, they simplify their speech and accompany it with a limited repertoire of concrete, informationally redundant gestures that reinforce attention to the verbal message (Iverson et al., 1999). Because Down Syndrome (DS) involves marked deficits in attention, this pattern of communicative modification is even enhanced in mothers who have a child with DS (Iverson et al. 2005).  Given that attentional difficulties are also evident in children with autism (AD; Landry & Bryson, 2004), it stands to reason that mothers of children with AD may also modify child-directed communication to direct and maintain the child’s attention and that this pattern could generalize to communication with later-born siblings of the child with AD (themselves at heightened risk, HR, for an AD diagnosis). To date, however, there is no research comparing child-directed communication of mothers with HR infants to that of mothers with low-risk infants (LR).

Objectives: Our aim was to: (1) examine and compare infant-directed communication produced by mothers of HR and LR infants; and (2) explore the extent to which such communication is aimed at focusing or redirecting the child’s attention.

Methods: Participants were 20 mothers of HR infants, 18 mothers of later-born LR infants, and their 18-month-old children.  A 10-minute sample of maternal communication, obtained during a 45 minute, videotaped, naturalistic home observation, was transcribed verbatim, and all instances of child-directed maternal gesture (e.g., pointing, nodding head “yes”), action on objects (e.g., mother hands child a cup), and behavior on the child’s body (e.g., tapping child’s arm) were identified.   Utterances were coded for (a) composition (i.e., speech only, mixed speech + gesture/action/behavior, gesture/action/behavior only); and (b) attention relatedness (i.e., focusing on or attempting to redirect the child’s attentional state).  Attention-related utterances were further classified according to whether they targeted the child’s attention or the child’s action.

Results: Mothers of HR infants produced approximately 50% fewer utterances than mothers of LR infants (M_HR = 104.6; M_LR = 163).  For both groups, most utterances consisted of speech only (M_HR = .873; M_LR = .823).  However, mothers of HR infants produced proportionately more than twice as many mixed utterances incorporating behaviors on the child’s body (M = .127) and almost twice as many attention-directing utterances (M = .290) as mothers of LR infants (M = .056; M = .169 respectively).  Finally, although the majority of attention-directing utterances for both groups focused on the child’s action, mothers of HR infants were proportionately three times more likely to focus on the child’s attention than mothers of LR infants (M_HR = .24; M_LR = .080).

Conclusions: Relative to mothers of LR infants, mothers of HR infants appear to be more sensitive to the child’s attentional focus and more likely to play an active role in directing it.  Having an older child with autism, in other words, may influence maternal behavior with later-born children, even when those children do not themselves necessarily manifest obvious autism symptomatology.