Emotion Coregulation in Mother-Child Dyads: A Dynamic Systems Analysis of Children with and without Autism Spectrum Disorder

Few studies have investigated patterns of emotion coregulation in families of children with Autism Spectrum Disorder (ASD) or contrasted the ways in which their emotion coregulation patterns differ from families of typically developing (TD) children. To address this gap, we used a dynamic systems approach to compare flexible structure and emotional content of coregulation between mothers and children (3-7 years) with ASD (n = 47) and TD children (n = 26). Mother-child play interactions in the home were videotaped and emotion-engagement states were coded in micro-level 5-s intervals based on behavioral and affective expressions. Analyses indicated that mother-child dyads in the ASD group spent more time than dyads in the TD group in mismatched emotion-engagement states (e.g., child negative/mother positive), and children with ASD spent more time than TD children engaged exclusively with objects. Mother-child dyads in the TD group stayed longer in mutual positive engagement states. Compared to dyads in the TD group, mother-child dyads in the ASD group exhibited greater flexibility (i.e., a wider range of emotional-engagement states, more frequent changes in states, and less time in each state). These findings suggest that mothers and their children with ASD do not sustain dyadic positive engagement patterns in a low-stress environment. Findings confirmed the preference of children with ASD for objects over social partners, even when they are at home with their mothers, and elucidated a challenging mother-child interactional style. Results have implications for mother-child interventions aimed at regulating negative emotional states and sustaining positive ones in families raising children with ASD

Strategies to Engage Underrepresented Parents in Child Intervention Services: A Review of Effectiveness and Co-occurring Use

The purpose of this review was to estimate the impact of parent engagement strategies tested with underrepresented families of young children with social, emotional, or behavioral disorders, and describe the combinations in which these strategies are commonly used together. We conducted a systematic review using the PracticeWise Engagement Coding System to identify which strategies had the strongest empirical support for engaging underrepresented (i.e., minority race or ethnicity, or low income) families receiving psychosocial services for their children. Social network analyses were used to identify the frequency of strategy use and how strategies were combined to engage underrepresented families. Linear regression was used to estimate the impact of each strategy on parent engagement, using attrition as a proxy for non-engagement. Thirty-five studies met inclusion criteria. Parent attrition was predicted by larger sample sizes, lower maternal education, interventions that were more community or home-based, less therapist monitoring, positive reinforcement from therapists, and more pairing families with peers. Social network analyses suggested that more effective strategies were more frequently implemented alone and less effective strategies were commonly combined with each other. Our findings suggest that researchers and practitioners require guidance in selecting engagement strategies to reduce attrition of underrepresented families in treatment. Although we identified promising strategies for improving parent engagement in treatment for underrepresented children with social, emotional, or behavioral disorders, the frequent combining of engagement strategies in research means that there is little data on the independent effects of interventions to increase parent engagement for this population

It's who you know: Caregiver social networks predict service use among under-resourced children with autism

Background: Numerous studies have shown that racial/ethnic minority and under-resourced families face barriers that delay timely access to autism services. These barriers include lack of resources and information about autism, financial hardship, mistrust in the service system, cultural and language mismatch, and other factors that have yet to be identified. Method: The current study aimed to examine additional caregiver and system-level factors that could be associated with early service access using a diverse sample from four study sites (Los Angeles, CA; Philadelphia, PA; Sacramento, CA; and Rochester, NY). Partnering with community agencies that serve traditionally underrepresented groups, the research team recruited 118 caregivers of young children with autism who were low-income, English, Spanish or Korean speaking and had not accessed autism-specific services. Results: Regression analyses revealed that the total number of services accessed were associated with caregiver social network size (p = 0.011) but not by race, autism knowledge and caregiver agency. Among families receiving at least one non-autism specific service, a marginally significant interaction effect of site and primary language on total services received was observed (p = 0.06). Conclusion: Findings suggest that caregivers’ social network connections are crucial in early service access, and future interventions could target increasing social networks to improve families’ service engagement. More attention for non-English speaking families, especially those living in areas with few supports in their native languages, is needed

Estudo longitudinal da atenção compartilhada em crianças autistas não-verbais Longitudinal study of joint attention in non-verbal autistic children

OBJETIVO: identificar e caracterizar as habilidades e o desenvolvimento da Atenção Compartilhada de crianças autistas, não-verbais, pela observação de comportamentos comunicativos. MÉTODOS: a pesquisa envolveu cinco meninos, entre 5a,9m e 8a,6m, com diagnóstico de Transtorno Autista (DSM-IV, 2002), filmados em dois momentos, com intervalo de 4 meses. Neste período, as crianças foram submetidas à intervenção fonoaudiológica baseada na estimulação da Atenção Compartilhada. Cada gravação era de 15 minutos e envolvia uma criança ou um grupo de 2-3 crianças com a terapeuta, em situações de interação não-dirigida e semi-dirigida, na escola onde estudavam. Foram observados e registrados comportamentos referentes às habilidades de Atenção Compartilhada. O material utilizado envolveu instrumentos musicais de percussão. Os dados foram analisados considerando-se o tempo, a interação e o(s) interlocutor(es). RESULTADOS: o comportamento olhar apresentou maior crescimento em cada um dos sujeitos. A análise dos dados revelou que os sujeitos apresentaram tendências qualitativas de evolução da habilidade de compartilhar a atenção, revelando um significado clínico importante, apesar da não ocorrência de significância estatística. Cada sujeito apresentou características e evolução dos Comportamentos Comunicativos relativos à Atenção Compartilhada de maneira individualizada. Após o período de intervenção fonoaudiológica, verificou-se aumento quantitativo dos comportamentos observados nos cinco sujeitos, principalmente na interação criança-terapeuta. CONCLUSÕES: o olhar é um importante patamar para o desenvolvimento dos outros comportamentos em direção à Atenção Compartilhada. A interação adulto-criança favorece o surgimento de comportamentos comunicativos e o compartilhar. A terapia fonoaudiológica focada nas habilidades de Atenção Compartilhada parece contribuir positivamente para o desenvolvimento da comunicação das crianças autistas.<br>PURPOSE: to identify and characterize abilities of Joint Attention of non-verbal autistic children through the observation of communicative behaviors. METHODS: the research involved 5 boys, between 5,9 and 8,6-year old, diagnosed as Autistic Disorder (DSM IV, 2002), recorded in two instances with a four months interval. Meanwhile, the children were submitted to a language therapy mediation based on Joint Attention stimulation. Each recording was 15 minutes long and involved one child or group of 2-3 children with the therapist within non-directed and semi-directed interaction situations, at school where they studied. We observed and registered behaviors regarding Joint Attention abilities. The used material involved percussion instruments. Data were analyzed in relation to time, interaction and interlocutor. RESULTS: the gaze behavior showed the greatest growth in each subject. Data analysis revealed that the subjects showed qualitative trends for evolution of the Joint Attention ability revealing important clinical meaning although there was lack of statistical significance. Each subject showed characteristics and evolution of the communicative behaviors regarding Joint Attention in an individualized manner. After the period of language therapy intervention, we observed a quantitative behavioral growth in the 5 subjects, specifically under child-therapist interaction. CONCLUSIONS: the gaze behavior is an important step for the development of others behaviors toward Joint Attention. The adult-child interaction situation facilitates the appearance of communication behaviors and sharing. Language therapy with focus on the Joint Attention abilities seems to contribute positively for communication development of autistic children