2022 Using father-mediated intervention to increase responsive parental behaviors and child communication in children with autism spectrum disorder: A pilot study

OBJECTIVES/SPECIFIC AIMS: Although parent involvement is recognized as an integral autism intervention component, and two-thirds of children are currently raised in 2-parent families, the majority of ASD parent research to date has focused on mother-implemented interventions, and fathers have been largely overlooked. However, fathers use interaction styles and language models that are different from mothers and may benefit children with ASD in unique ways. Thus there is a critical need in the field to expand our understanding of the potential contributions of various caregivers to communication outcomes. This investigation aimed to address this void in the research literature and contribute to clinical practice by including fathers in parent-implemented intervention, and adapting parent-implemented autism intervention to fit paternal interaction and communication styles. Specifically, this pilot study investigated the effects of a father-mediated intervention on parent use of responsive verbal and play strategies. Distal effects on child communication and pre-post changes in parental stress levels were also investigated. METHODS/STUDY POPULATION: A single subject, multiple baselines across strategies experiment was conducted with one dyad (i.e., father, child with ASD). In-home father coaching sessions were delivered weekly, targeting 4 responsive strategies (i.e., follow-in comments, follow-in directives, symbolic object play, rough-tumble play). Single subject designs are particularly suitable for autism interventions, as they allow for experimental control with participants who are from heterogeneous populations (McReynolds and Kearn, 1983). Child participant was 3 years, 1 month at the start of intervention and had previously received a received community diagnosis of ASD by a psychologist. Throughout the duration of the study, the child participant attended part-day community-based day care and received 20 hours per week of Applied Behavioral Analysis intervention both in-home and community daycare, as well as occupational therapy and speech-language therapy for 1 hour per week. The participating father was a biological parent who resided with the child continuously since birth. In addition, the father had no other formal parent training in communication intervention before participating. RESULTS/ANTICIPATED RESULTS: The results of the father-implemented intervention program yielded positive results for both father and child participant. The father quickly achieved a high level of competency using 3 of the 4 targeted strategies (i.e., follow-in comments, follow-in directives, and rough-and-tumble/physical play). Follow-in comments were used more frequently than follow-in directives and rough-and-tumble play strategies were used more frequently than symbolic play. Child use of single words increased over baseline and beginning use of multiword utterances was documented. Pre-post changes in parental stress for participating father and his spouse were not significant, however patterns of change across Parental Stress Index subscales scores were noted. DISCUSSION/SIGNIFICANCE OF IMPACT: This pilot investigation provided information regarding the treatment efficacy of a clinically relevant instructional program designed to enhance fathers’ ability to use responsive strategies to increase communicative acts or children with ASD. The results of this investigation advance clinical practice in the ASD field by providing intervention data relating to the efficacy of father-implemented instructional programs on child communication goals

Student Perspectives on Learning Language Sample Analysis Using LENA

Language sample analysis (LSA) is valuable clinical tool and an important component of comprehensive language assessment. However, LSA is underutilized in real-world practice. SLPs have identified time constraints, insufficient training, and lack of confidence in LSA skills as barriers to regular LSA implementation. Communication science and disorders (CSD) programs have opportunities to provide LSA instruction to address these barriers and prepare students to reliably, feasibly, and confidently use LSA in clinical practice. This pilot study examined CSD students’ perspectives on LSA instruction using the Language ENvironment Analysis System (LENA). Undergraduate students (n = 38) completed a series of two electronic surveys prior to and following LSA instruction using LENA. Changes in students’ self-ratings of knowledge and skills in collecting and analyzing language samples, attitudes towards studying LSA and child language development, and critical thinking skills were assessed. Significantly higher student ratings were found for all items measuring language sampling knowledge and skills following digital LSA instruction compared to baseline. In addition, student ratings of enthusiasm for and confidence in studying LSA and child language development were also significantly higher. Students’ self-ratings of critical thinking skills did not increase significantly following instruction in digital LSA. Implications for LSA teaching and learning are discussed

Father communication coaching for children with autism spectrum disorder: A single-subject study

Background and aims: Parent-mediated interventions have been shown to be effective for improving communication skills for children with autism spectrum disorder when implemented by mothers. Little is known about the efficacy of autism spectrum disorder communication interventions implemented by fathers. This study investigated the effects of a 12-week coaching program on a father’s use of responsive strategies. Targeted responsive strategies included follow-in comments, follow-in directives, responsive physical play, and responsive object play. Collateral measures of changes to child communication skills and parental stress levels were also investigated. Methods: A single subject, multiple baselines across behaviors experiment was conducted with one dyad (i.e. father and child with autism spectrum disorder). Results: Results showed that the participating father was able to quickly learn to use three of the four targeted responsive strategies (i.e. follow-in comments, follow-in directives, responsive physical play). Child’s use of single words increased over baseline level and beginning use of multi-word utterances was documented. Pre–post intervention changes in ratings of stress for the participating father and mother were noted across child and parent domains. Conclusions and implications: Findings of this pilot study may have important implications for developing much-needed parent coaching programs to enhance fathers’ use of responsive strategies and increase social communication skills for children with autism spectrum disorder

Correlates of Parent Responsiveness in the Interactions of Fathers and Mothers with Their Children with Autism Spectrum Disorders

Children with autism spectrum disorders (ASD) demonstrate early and marked deficits in communication and play abilities. Research indicates that the responsiveness of mothers plays an integral role in supporting communication development for children with ASD. Furthermore, interventions focused on increasing maternal responsiveness have been shown to be effective in improving communicative outcomes for children with ASD (McConachie & Diggle, 2007). Less is known about the relationship between the responsiveness of fathers and the social-communicative abilities of their children with ASD. However, father responsiveness has been linked to improved outcomes for children who are typically developing. To date, parent research in autism has primarily involved mothers with the implication that results will generalize to fathers. The current study investigated similarities and differences in the interaction styles of mothers and fathers and the relationship between their respective styles and child language and play skills. Parental responsiveness has also been shown to impact play development for both typically developing children and children with developmental disabilities (Cielinski, Vaughn, Seifer, & Contreras, 1995; de Falco, Esposito, Venuti, & Bornstein, 2008). In contrast, the contribution of parent responsiveness to the play development of children with ASD has not been examined. Given the deficits in play characteristic of the disorder and the strong correlations between symbolic play and language development for children with ASD, understanding the relationship between parent responsiveness and child play skills will have important implications for developing effective play-based communication intervention. The current study investigated the relationship between parent responsiveness and child play skills. Successfully involving parents in interactions with their children with ASD may be complicated in some families by parental broad autism phenotype (BAP). Parents with the BAP show characteristics similar to those found in autism without the intensity to warrant a diagnosis of autism. Nonetheless, presence of BAP characteristics may influence the ability of parents to interact with and respond to the play and language skills of their children with ASD. The current study investigated the relationship between the BAP in parents and their language and play responsiveness when interacting with their children with ASD. Findings of this study revealed that overall, mothers used more responsive verbal behaviors than fathers. However, for both fathers and mothers, verbal responsiveness was strongly correlated with the language skills of their children with ASD. Children engaged in higher symbolic level play with their fathers and mothers than with an unfamiliar adult. Comparisons between mother-child and father-child play revealed that children engaged in significantly more relational play with their mothers; they also tended to engage in more symbolic play with their fathers, although this latter comparison was not significant. In contrast to responsive verbal behaviors, mothers and fathers used similar levels of responsive play behaviors in interactions with their children with ASD. For fathers, responsiveness in play was associated with higher-level symbolic play skills for their children with ASD. Finally, for mothers but not for fathers, parent verbal and play responsiveness was found to mediate the relationship between two characteristics of the parental BAP (i.e., aloofness, rigidity) and the language and play skills of children with ASD. Results of this study provide important evidence supporting the principle that both mothers and fathers contribute to the language and play skills of their children with autism. In addition, this study provided data consistent with a mediator model of maternal responsiveness between maternal BAP and the child language and play skills of children with ASD

Fathers\u27 and Mothers\u27 Verbal Responsiveness and the Language Skills of Young Children With Autism Spectrum Disorder

Purpose: In this observational study, we examined the interactions of 16 young children with autism spectrum disorder (ASD) and their parents to investigate (a) differences in verbal responsiveness used by fathers and mothers in interactions with their children with ASD and (b) concurrent associations between the language skills of children with ASD and the verbal responsiveness of both fathers and mothers. Method: Parent verbal responsiveness was coded from video recordings of naturalistic parent–child play sessions using interval-based coding. Child language skills were measured by the Preschool Language Scale–Fourth Edition (Zimmerman, Steiner, & Pond, 2002). Results: For both fathers and mothers, parent verbal responsiveness was positively associated with child language skills. Mothers\u27 responsiveness was also significantly associated with child cognition. After controlling for child cognition, fathers\u27 verbal responsiveness continued to be significantly related to child language skills. Conclusions: Although other studies have documented associations between mothers\u27 responsiveness and child language, this is the 1st study to document a significant concurrent association between child language skills of children with ASD and the verbal responsiveness of fathers. Findings of this study warrant the inclusion of fathers in future research on language development and intervention to better understand the potential contributions fathers may make to language growth for children with ASD over time as well as to determine whether coaching fathers to use responsive verbal strategies can improve language outcomes for children with ASD

Parental Broad Autism Phenotype and the Language Skills of Children with Autism Spectrum Disorder

Father–child and mother–child interactions were examined in order to investigate concurrent associations between three characteristics of parental broad autism phenotype (i.e., aloofness, rigidity, pragmatic language deficits), parental verbal responsiveness, and language skills of children with ASD. Results for mothers indicated that aloofness and rigidity were negatively associated with both child-initiated engagement and child language skills. Maternal aloofness was also negatively correlated with verbal responsiveness to their children, but rigidity was not. Results suggest that the association between aloofness and child language are potentially mediated by maternal use of responsive verbal behaviors. Maternal pragmatic language deficits were not concurrently related to child-initiated engagement or language skills. In contrast, for fathers, aloofness and rigidity were unrelated to child-initiated engagement and language skills. Paternal pragmatic deficits were also not associated with child language, however significant positive associations were found between paternal pragmatic language deficits and frequency of child-initiated engagement. Results are discussed in reference to potential clinical implications and directions for future research

Parent couples’ participation in speech-language therapy for school-age children with autism spectrum disorder in the United States

This study examined parent couples’ participation in and satisfaction with speech-language therapy for school-age children with autism spectrum disorder in the United States. Responses from 40 father–mother couples (n = 80 parents) were examined across therapy components (i.e. parent–therapist communication, assessment, planning, and intervention). Descriptive frequencies, chi-square tests, intraclass correlations, and dyadic multilevel modeling were used to examine participation across fathers and mothers and within parent couples. Compared to mothers, fathers communicated less with therapists and participated less in assessment and planning. Fathers also had lower satisfaction than mothers with parent–therapist communication and planning. Although few parents participated in school-based therapy sessions, 40% of fathers and 50% of mothers participated in homework. However, few parents received homework support from therapists. Results are discussed in terms of clinical implications for interventionists to more effectively engage both fathers and mothers in family-centered speech-language therapy for school-aged children with autism spectrum disorder

Fathers' and Mothers' Verbal Responsiveness and the Language Skills of Young Children With Autism Spectrum Disorder

In this observational study, we examined the interactions of 16 young children with autism spectrum disorder (ASD) and their parents to investigate (a) differences in verbal responsiveness used by fathers and mothers in interactions with their children with ASD and (b) concurrent associations between the language skills of children with ASD and the verbal responsiveness of both fathers and mothers

Developing Feasible and Effective School-Based Interventions for Children With ASD: A Case Study of the Iterative Development Process

Despite an emphasis on identifying evidence-based practices among researchers and using evidence-based practices among professionals in the field of education, there are still problems with uptake and implementation in real-world settings. This lack of diffusion of practices is evident in educational programming for children with autism spectrum disorder (ASD). One solution is to use an iterative process to develop interventions in which researchers work in collaboration with the end users to test and refine interventions. However, there are very few guidelines for developing feasible and effective interventions through these iterative processes. This article provides a description of the iterative process used to develop the Advancing Social-Communication and Play (ASAP) intervention, a supplemental program designed for public preschool classrooms serving students with ASD, and examples of how data from the sequence of iterative design studies shaped the intervention development. The research team offers guidelines for other researchers looking to engage in intervention development using an iterative process in the context of partnerships with end users, including suggestions for planning and executing an intervention development grant