Responsive Parental Behaviour Predicts Joint Engagement in Toddlers with Autism Spectrum Disorder (ASD)

Background:  Parental responsivity is characterized by a constellation of behaviours including joint attention, contingent responding, emotional-affective support and language input (Warren & Brady, 2007). A positive association has been demonstrated between children’s language learning and parental responsive behaviour (Siller & Sigman, 2008). For children with autism spectrum disorders (ASDs) who display fundamental challenges in joint engagement and language, it is particularly important to understand the interaction characteristics that best facilitate increased social communication learning opportunities. 

Objectives:  The current study provides a unique examination of the association between parental responsivity and both a broad measure of children’s social behaviour (Child Behaviour Rating Scale (CBRS): Mahoney & Wheeden, 1999) and careful parceling of a hierarchy of engagement states including exclusive attention to objects and joint engagement with another person and a shared referent (Adamson, Bakeman & Deckner, 2004). The following questions were addressed: 1) is parental responsivity during parent-child play predictive of supported joint engagement? and 2) is responsivity associated with a broader measure of children’s social behavior, the CBRS?

Methods:  Eighty-five toddlers (mean age: 31 months) diagnosed with ASD and their primary caregivers (n=73 mothers; n=8 fathers, n=1 grandparent) who were participating in a larger intervention study were included. Children ranged in developmental level (MSEL score mean= 68.16 (SD= 20.41)). Ten minute videotaped parent-child interactions collected at baseline were coded for general social behaviour (CBRS), specific engagement states (adapted from Adamson et al., 2004) and parental responsivity (Mahoney et al., 1998).

Results:  Overall, mean parental responsivity was 2.66 (SD=1.13). On average, children entered into supported joint engagement 12.69 times (SD=5.8) for 18.71 seconds(s) (SD=15.20) and object engagement 22.08 times (SD=5.28) for 50.98s (SD=29.79). Responsivity was a unique predictor of the frequency (ß=.316, t= 2.98, p < .01) and longest duration (ß =.226, t=2.08, p < .05) of supported joint engagement in child initiated activities after controlling for children’s developmental level (MSEL score). Responsivity also predicted decreased duration of object engagement in parent initiated activities (ß =-.317, t(84)=-2.99, p <.01). Alongside developmental level, responsivity also predicted frequency (ß=.293, t(84)=3.33, p <.01) and longest duration of (ß=.171, t(84)=2.04, p <.05) symbol infused supported joint engagement. Further, predictive associations between responsivity and both the CBRS attention (ß =.351, t=3.47, p <.01) and initiation subscales (ß =.276, t=2.84, p <.01) were found.

Conclusions:  Findings confirm the study hypotheses that parental responsivity uniquely predicts increased child joint engagement indicating that responsivity is important across the spectrum of skills presented by toddlers with ASD. Careful delineation of object focused versus joint engagement demonstrates that responsivity is predictive of supported joint states that are associated with language learning. As such, parents who demonstrate a responsive interaction style may increase successes in facilitating child engagement. Thus, responsivity may be an important initial target in parent-mediated interventions in order to facilitate engagement and increase learning opportunities during interaction.  Yet, given the small durations of joint engagement, future research needs to investigate whether responsiveness alone is enough to increase toddlers’ joint engagement and language, or if other strategies are required.