Promoting Social Responsive Between Primary Caregivers and Children with Autism

Background:

Difficulties in the development of the capacity and desire to reference others, communicate to share subjective experiences and establish joint attention are core characteristics of autism. Evident in very young children with autism, these deficits have profound effects on the development of cognition, communication and social relating.

Objectives:  

This study involved implementation of a caregiver training program conducted over a 6-month period, derived from a developmental social pragmatic orientation, and using the Relationship Development Intervention (RDI) Program model (Gutstein, 2009). The goal was to determine whether an increase in adult-initiated declarative bids were more successful at facilitating experience-sharing and child responsiveness than bids that were imperative in nature. 

The study examined the effects of instructing caregivers to use specific communication strategies and the impact of the overall use of such strategies on children’s communication outcomes and general functioning. The research set out to examine verbal and nonverbal communication bids by caregivers when interacting with children with autism. The aim was to determine whether bids that were declarative were more successful at facilitating rate of child responding during interactions, compared to imperative bids for communication. As well as determining the rate of responding, the quality of the child response (responsiveness) was also determined as measured through experience sharing responses. 

Methods:

A nonequivalent groups quasi-experimental design, with two experimental and one comparison (control) group with pre-test and post-test measures, was used to demonstrate the feasibility of implementing a relationship-focused model, with detailed documentation of group treatment effects and individual results. Analyses of changes in pre and post-test measures were conducted for children and caregivers. A total of 16 children on the autism spectrum, aged between 3.9 and 8 years were involved in the project. The study examined the effects of instructing caregivers to communicate to invite experience-sharing by increasing their frequency of declarative communication initiations.  A comparison group received the usual program provided at the centre. The ratios of imperative to declarative communication bids of the care-givers were measured pre and post intervention, as were child social responsiveness, communication skills, adaptive functioning and measures of parental stress and coping. 

Results:  

Descriptive statistics were used to present the results where outcome measures were analysed to measure change and to assess the benefits of the intervention. Findings suggest that parents and staff were able to successfully modify their communication in the desired declarative manner, as evidenced by video-recorded play sessions, Furthermore, adult communicative adaptation appeared to correspond with increased child responsiveness. Other measures conducted at post-test, showed variable results, supporting the need for larger, controlled, longitudinal studies.  

Conclusions:  

Promoting positive caregiver and child interactions, and the implications of such exchanges, provide valuable insights. There is a compelling argument for consideration of the impact of adult communication and interactional style on the ability to influence the types of communicative functions used by children with autism. If caregivers are taught to adapt their communication style with the child with autism so that they use more declarative communication, they are likely to facilitate aspects of social-communicative development.