Developmental Social Pragmatic Parent Coaching Intervention Increases Language-Promoting Utterances in Parents of Children with ASD.

Background: Developmental Social Pragmatic (DSP) parent-coaching interventions can be effective in promoting communication skills of children with Autism Spectrum Disorder (ASD), however the specific features of such interventions that underlie developmental change are not well understood. DSP models embrace teaching functional skills in a sequence following a typical developmental trajectory, and work within natural contexts. Another component of DSP treatment models is a focus on social communication and the function of language rather than the form. Despite the known impacts of parent language functions on child language development, there is a paucity of knowledge concerning how functions of parental language may change with treatment, and how these changes might interact with language learning in children with ASD.

Objectives:  To compare parent language use between a Developmental Social Pragmatic (DSP) Parent Coaching treatment group and a community treatment group, pre- and post-therapy, as a first step toward better understanding how adult language supports functional language use in children with ASD.

Methods:  Forty-one parent-child dyads were randomly assigned to either a DSP treatment group (n=21) or waitlist, community treatment (CT) group (n=20). All children were between 2.0-4.11 years old at study onset and were diagnosed with ASD using the ADOS and ADI. The treatment group received 2 hours per week of DSP therapy from SLPs and OTs, while the CT group sought a variety of other forms of community based therapy (e.g. ABA, SLP, OT, Specialized Education Programs) independently, averaging 3.6 hours per week.

Twenty-five-minute parent-child interactions were videotaped pre-treatment and post-treatment, 12 months apart, and transcribed in CHILDES. The main communicative function of each parent utterance was coded by two blind coders. Six language functions were classified as either language promoting (commenting, open ended questions, responding) or non-language promoting (prompting, directing, and asking questions for which there was only one correct answer; Talbott et al., 2015). The proportion of language promoting and non-language promoting utterances was analyzed using a mixed MANOVA with follow up MANOVAs for individual functions within each category. Paired and independent t-tests examined between and within group effects.

Results: There were significant time by group interactions for both language promoting (p<.001) and non-language promoting utterances (p=.001). Analyses for individual functions indicated significant group×time interactions for directives (p=.008), prompts (p=.029), and responses (p=.002). The DSP parent group significantly increased their responses and decreased their directives and prompts from pre- to post-therapy, while the CT group showed no change over the year. While the groups did not differ in any function use pre-treatment, the CT group used significantly fewer responses and more directives than the DSP group post-treatment.

Conclusions: Results of this study offer support for parent-implemented interventions, suggesting that parents have the potential to apply strategies obtained from coaching in the facilitation of communication with their children. Future analysis will examine the interaction between parent and child language use.