Mother-Child Interaction, Symbolic Play, and Productive Speech in Preschool Children with Autism

Background: Irregularities in patterns of adult-child interaction, symbolic play, and productive speech comprise major clinical signs of autism in young children. These areas have been extensively studied in relation to cognitive growth as well as to social competence (e.g., Leslie, 1987). Most previous studies targeted groups of children with autism spectrum disorder (ASD) and utilized quantitative measures to compare them to children with typical development or with mental retardation (e.g., Lord, Risi, & Pickles, 2004; Rice, Warren, & Betz, 2005; Rutter & Schopler, 1987). The present study design derived from social interaction theories, which regard the mother-child unit as a system that supports the emergence of symbolic representation (Bruner, 1975; Vygotsky, 1978; Werner & Kaplan, 1963).

Objectives: Our goal was to examine the quality of mother-child interaction, symbolic play, and speech production in preschool children with autism in order to verify possible interrelations among these domains.

Methods: Ten mother-child dyads (9 boys and 1 girl) participated in the study. Ages ranged from 37 to 51 months (M = 45 mo). All children had previously been diagnosed with ASD using the ADOS (Lord, Rutter, DiLavore, & Risi, 1999) at age 12-30 months (M = 20.9 mo). Participants demonstrated DQs above 70 on the Mullen Scales of Early Learning (1984). All children attended the same ABA intensive intervention program for at least 12 months prior to data collection (Zachor et al., 2007). Ten minutes of mother-child interaction in semi-structured situations were video-recorded and analyzed using micro-developmental analytic methods. Joint engagement measures were computed for each pair. Ten minutes of solitary play with two sets of toys were also video-recorded and scored for symbolic play levels utilizing a revised code that was initially developed by Belsky and Most (1981) and modified by Ungerer and Sigman(1981) . The solitary play recordings were also used for evaluating each child's speech production levels.

Results: All children demonstrated difficulties in establishing eye contact for social purposes, physical touch, as well as social smiles. A strong correspondence was identified between the overall joint dyadic engagement scores and children's levels of symbolic play. In dyads that maintained longer durations of triadic interaction (i.e., child-mother-object), the children demonstrated higher levels of symbolic solitary play. Levels of symbolic play were also associated with levels of speech production.

Conclusions: Speech production, socioemotional interaction, and symbolic play interrelate in interesting ways in this population. Importantly, social-emotional engagement between mothers and their young children seems related to the levels of solitary symbolic play achieved by the children. Qualitative analysis of mother-child interaction in dyads where the child has autism reveals the importance of considering socioemotional dyadic goals for early intervention. The detailed qualitative analyses in the present cross-case investigation substantiated previous findings of comparative group designs.