Interactions Between Young Children with Autism Spectrum Disorder and Their Caregivers

Background:

In research with young children with autism spectrum disorder (ASD), observing caregiver-child interactions provides an opportunity to assess children’s social-communication behaviors and caregivers' parenting styles. One assessment used, the Indicator of Parent Child Interaction (IPCI), an Individual Growth and Development indicator (IGDI) has been used frequently in educational assessment with infants and toddlers, but less so in research with young children with ASD. The current study examined parent-child interactions with the IPCI with a group of toddlers with ASD.

Objectives:

Our specific aims include:

1. To examine caregiver interaction behaviors as measured by the IPCI.
2. To examine child interaction behaviors as measured by the IPCI.
3. To identify caregiver and child characteristics that may affect their interaction behaviors.

Methods:

Thirty-three young children with or at risk for ASD, as determined by the Modified Checklist for Autism in Toddlers (M-CHAT), participated in the IPCI with a primary caregiver as part of a larger intervention study. Children ranged in age from 17 to 42 months old, with a mean of 24 months. Primary caregivers were mostly female and ranged in age from 25 to 52 years, with a mean of 35 years old. The IPCI consists of four semi-structured parent-child activities (free play, looking at books, distraction task, and dressing), similar to those that might be observed in daily family routines. Episodes were videorecorded for a total of ten minutes and coded in 30-second intervals on 6 caregiver interaction behaviors (warmth and acceptance, descriptive language, follows lead, maintaining/extending, harsh/critical, and restrictions) and 6 child interaction behaviors (positive feedback, sustained engagement, follow through, irritable/fuss/cry, external distress, and frozen/watchful). Children were also assessed on the Mullen Scales of Early Learning from which a mental age score was calculated.

Results:

Caregivers engaged in descriptive language with their children in over half of the intervals (M=10.42, SD=5.20). In almost half of intervals, caregivers were observed following the child’s lead (M=8.06, SD=4.39). No harsh or critical caregiving behaviors were observed. Children demonstrated sustained engagement in play with a toy for approximately half of the intervals (M=10.36, SD=3.87); however, children displayed positive affect such as smiling at their caregiver in only about 5% of the intervals (M=1.15, SD=2.25). No children demonstrated frozen/watchful behavior. Parents’ use of descriptive language and children’s engagement were positively correlated with children’s mental age scores (r=.417, p<.05; r=.375, p<.05, respectively).

Conclusions:

Findings from this descriptive study provide valuable information about caregivers’ and children’s behaviors during interactions across several different activities. In particular, caregivers used descriptive language over half of the time with their toddlers, and more so when toddlers had higher cognitive skills. Furthermore, children with higher cognitive scores demonstrated more engagement in activities with caregivers than children with lower scores. Future research will examine how aspects of caregiver-child interactions may change over time as related to an intervention to enhance interaction quality.