Infants at Elevated Likelihood of Autism Spectrum Disorder: Language Development Patterns and Caregiver Coaching Strategies

This dissertation is composed of two manuscripts that study the early development of infants at an elevated likelihood of an autism spectrum disorder diagnosis (EL-ASD). In the first manuscript, the language profiles (i.e., receptive dominant, expressive dominant, balanced) and the predictors of the language profiles are examined in infants at EL-ASD. Results indicated that there were no differences in the frequencies of the profiles demonstrated by children at EL-ASD when compared to children at lower likelihood of an ASD diagnosis. Neither response to joint attention nor parent responsiveness were predictors of the difference between receptive and expressive language scores within this sample. Similarly, ASD-related social communication features and restrictive and repetitive behavior features were also not significantly correlated with the language difference scores. However, the language scores themselves were significantly associated with these variables. The results suggest that while the language difference scores may not relate to response to joint attention, parent responsiveness, or ASD features (social communication or restricted and repetitive behaviors) in infants at EL-ASD, there is a relationship between these skills and features and the language scores of infants within this sample. The second manuscript is focused on coaching behaviors demonstrated by interventionists in a parent-mediated intervention for infants at EL-ASD. In this study, we investigated the frequency of the coaching behaviors used by the interventionists, the relationship between the use of coaching behaviors and parent education levels, and the relationship between the use of coaching behaviors and the change in parent responsiveness to their infants’ attentional and communication cues. Results indicated that the joint interaction and child-focused behaviors were demonstrated most frequently by interventionists. Guided practice, caregiver practice, and problem solving were implemented less frequently. The use of the joint interaction coaching behavior was positively associated with parent education levels, whereas the use of the child-focused behavior was negatively associated with parent education levels. More information sharing by the interventionist predicted a greater change in parent responsiveness, whereas more child-focused behaviors predicted less change in parent responsiveness. These results suggest the need for professional development that facilitates the implementation of coaching behaviors often used less frequently.Doctor of Philosoph

Parent coaching behaviors used within an Adaptive Responsive Teaching intervention

The coaching service delivery model is often implemented within parent mediated interventions for infants at an elevated likelihood of autism spectrum disorder. However, less is known about the exact coaching behaviors used within intervention sessions. Therefore, we examined the coaching behaviors implemented within the Adaptive Responsive Teaching intervention. We also investigated the associations between coaching behaviors and parent education levels and the associations between the coaching behaviors and a parent outcome, i.e., parent responsiveness. Results indicated that the interventionists demonstrated joint interaction and child-focused behaviors the most frequently. The interventionists much less frequently demonstrated guided practice, caregiver practice, and problem solving behaviors. The use of joint interaction behaviors was positively associated with parent education levels, whereas, the use of child-focused behaviors was negatively associated with parent education level. More information sharing by the interventionists predicted a greater change in parent responsiveness, whereas more child-focused behaviors predicted less change in parent responsiveness

Using an Electronic Delphi Method to Identify Core Components of Expressive Language Interventions for Autistic Preschoolers

Our research study aims to identify an initial set of active ingredients or core strategies of evidence-based practices (EBPs) that support the expressive language of autistic preschoolers. In addition, we plan to create an initial set of dosage recommendations for these active ingredients to guide practitioners and support future efficacy evaluations. To achieve these aims, we will asynchronously and virtually convene a panel of early childhood ASD research and practice experts. The panel will complete a series of questionnaires to identify and define a set of core EBP components of expressive language interventions and dosage recommendations. Through these iterative questionnaires, we aim to have a consensus decision