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Systematically Observing Changes in Joint Engagement During Parent-Child Interactions

Thursday, 2 May 2013: 15:30
Auditorium (Kursaal Centre)
L. B. Adamson1, R. Bakeman2 and D. L. Robins3, (1)Georgia State University, Atlanta, GA, (2)Psychology, Georgia State University, Atlanta, GA, (3)Department of Psychology, Georgia State University, Atlanta, GA
Background: Joint attention deficits characterize young children with ASD and motivate many early interventions.  Although parent reports and experimenter-implemented assessments can measure joint attention skills, additional information about how these skills manifest during interactions is crucial for detailing treatment effects.  Especially when intervention involve parents, it is essential to monitor not only changes in joint engagement but also in child and parent communicative acts and in shared topics.

Objectives: To develop a brief observational protocol to view parent-child communication that can efficiently produce reliable data about children’s joint engagement and related aspects of social interaction for use in research, including intervention studies, that monitors developmental trajectories.

Methods: The Communication Play Protocol (CPP) provides a stable frame for observing interactions by using the conceit of a Play to invite a parent (as supporting actor) to entice the child (the star) to enact scenes whose plots sample communicative functions including interacting, requesting, and commenting.  To date, several hundred CPPs have been performed in studies that trace the typical developmental course of joint engagement, compare typical and atypical trajectories including those of young children with ASD, and assess the effect of early language interventions.  Data have been extracted from videorecords using methods including state coding, language transcripts, and, most recently, validated rating items.  Our current rating battery includes 16 items about forms of joint engagement (total, supported, coordinated, symbol-infused), child communicative acts (e.g., expressive language, initiating and responding to communication), parent actions (e.g., scaffolding, following child’s focus, symbol highlighting), and topic characteristics (e.g., scope of shared topic).

Results:  Drawing on our on-going large-scale longitudinal study of toddlers who screen positive for ASD on the M-CHAT-R, we document that the CPP rating items detail the pervasive effect of ASD on joint engagement.  Screen-positive children subsequently diagnosed with ASD differ significantly from TD children on all items, and differ from screen-positive children who were not diagnosed with ASD on all child items except one (coordinated joint engagement) but on none of the parent items.  Change over time is evident in significant differences on all items from pre-diagnosis (at on average 24 months) to a 6-month follow-up.  Once trained, raters masked to child status generate reliable data quickly.  But because the full CPP takes over 45 min to administer, we asked if a CPP with only 3 scenes, one each for interacting, requesting, and commenting, could produce the same results.  It does, with correlations between versions uniformly high (96% above .80) and results related to group and age differences remaining essentially the same.

Conclusions :  The CPP, even an abbreviated 15 min version, coupled with rating items generates information about joint engagement and associated communication during parent-child interactions that is sensitive to diagnostic differences and change over time.  Discussion includes consideration of applying the abbreviated CPP to monitor changes in interactions due to treatment, expanding the rating battery to include intervention-specific items, and using additional data capture procedures to gain more refined evidence related to the quality of low rate phenomena such as coordinated joint engagement.

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