Mother-Child Engagement: The Co-Construction of Narratives in Intervention Contexts for Young Children with Autism

Background: Parents and young children create and sustain narrative interactions in their participation in socially engaged contexts in everyday interactions. In clinical interactions these narratives can be contrived in order to maximize social interactions, and are most evident in young children diagnosed with autism. In clinical interactions, narratives can be considered a ‘window' into the development of conversational practice. Development of narrative practice involves the triadic coordination of attention between self, other and events—a hallmark of difficulty for young children with autism (Adamson, 1995; Tomasello,1995; Trevathen & Aitken, 2001). While narrative development includes ordering experience that is dialogic, dynamic, and includes affective engagement, few studies have delineated the parent's role in interaction contexts or the trajectory of narrative development. Objectives: This paper examines the conversational narrative chains of mother-child interactions in clinical interaction interventions with their young children recently diagnosed with autism. The purpose of this paper is twofold: (1) to investigate the development, co-construction, and trajectory of narratives in mother-child interactions in an in-home intervention; and (2) to further our understanding of the development of narrative and conversational “moves” or practices in the context of engagement. Methods: Fifteen dyadic mother-child interactions were videotaped over a period of sixteen weeks. Children were between 25-44 months of age with a mean age of 32.5 months, and were matched on developmental ages on the Mullen Scales of Early Learning. All videotaped interactions were transcribed verbatim for mother and child interactions involving specified play routines. Specific narrative structures were coded to examine the use of questions, statements, or stories, and function to initiate, confirm, disconfirm, or elaborate in the clinical contexts of the interaction. Rating scales (Mahoney, Boyce & Spiker, 1996; 1999; Mahoney & Wheeden, 1998; 1999) were used to code maternal sensitivity, responsivity, and reciprocity as well as child persistence, interest, cooperation, initiation, joint attention and affective engagement. Results: A mixed-method approach was used to analyze the conversational structures over the sixteen week intervention. Exemplars of the dyadic narratives are described as thematic routines developed over the intervention period. Each dyad developed and sustained interaction stories that were created in the conversational practices. Maternal sensitivity and reciprocity were significantly correlated with the child's joint attention and initiation of conversation from pre-intervention to post-intervention ratings. Further, results from a Wilcoxon Signed Ranks text showed a significant increase in observed child joint attention (z = -2.23, p=.03), a significant increase in the proportion of maternal praise (z= -1.93, p =.05) to their child from the total verbalizations during the mother-child structured play contexts, and a significant decrease in the proportion of maternal commands (z = -.77, p=.05) from the pre-intervention to post-intervention assessment. Conclusions: These results provide evidence that engagement routines should be established in the context of meaningful activities that are dynamic in nature in order to understand narrative trajectories. Further, engagement appears to be a mediator for reciprocity, sensitivity, and embedded in the quality of the intervention in mother-child interactions that facilitate and sustain the narrative development and structure.