Request for Social Interaction in Prelinguistic Milieu Teaching for Young Children with Autism

Background: Prelinguistic Milieu Teaching (PMT) is an intervention that teaches early intentional communication acts composed of gestures, coordinated eye gaze, vocalizations, to increase a child’s rate and complexity of intentional communication prior to learning language. This intervention focuses on shifting function from initiating behavior request (IBR) to initiating joint attention (IJA). Few studies have showed change in IBR for social interaction from instrumental use of others into sharing the intentionality.

Objectives: To assess joint attention skills through building social routine to elicit children’s request for social interaction in PMT.

Methods: Three children with autism (age 4-5) with 5 or less functional words received PMT once a week at university clinic session. Participants were assessed using the Early Social Communication Scale (ESCS) and the Japanese MacArthur Communicative Development Inventory (JCDIs) at pre- and post-intervention. In PMT, a participant requested other’s behavior in a social routine which could not be achieved by one. When the target behavior based on ESCS at pre-intervention increased its rate in PMT, it was gradually modified into more complex behavior.

Results: Preliminary results suggest that frequency and complexity of behavior request increased across PMT, as well as joint attention skills in ESCS increased.

Conclusions: The social routine in PMT made children with autism easier to predict what would happen next after their IBR as well as to show expectation toward other’s behavior.