Otizmli Küçük Çocuklar ve Ebeveynlerinde Katılım: Çoklu Olgu Çalışması

This qualitative multiple-case study comprehensively examined the circumstances that supported and hindered social engagement in the three toddlers with autism when they interacted with their mothers. Directive actions of mothers for controlling and teaching purposes and requesting actions of toddlers resulted in instrumental engagement during which power struggles were sometimes observed. The findings indicated that social engagement was established when one interacting partner’s social initiation was accepted with a social response from the other partner. Those socially engaged moments were first built upon the toddlers’ individual interests but maintained only by continuous back-and-forth responses from both mothers and toddlers manifesting a transactional sequence during which the schema of their interaction continuously changed, adapted, and developed. This finding revealed that social, rather than instrumental, engagement may lead, possibly, to a sense of joy in these children while interacting with their mothers. One further approach related to this finding can be concentrating on the child’s social motivation (e.g., having fun), rather than non-social motivation (e.g., receiving a favorite snack or toy) while interacting. Such an approach can be a promising avenue for optimally encouraging social purposes of engagement in toddlers with autism.Otizmli üç küçük çocuğun anneleri ile etkileşimleri sırasında onların sosyal katılımlarını destekleyen ve engelleyen koşullar çoklu olgu çalışmasıyla incelenmiştir. Annelerin kontrol ve öğretim amaçlı yönergeler içeren davranışları ve otizmli küçük çocukların rica içeren davranışları zaman zaman güç savaşlarının gözlendiği araçsal katılım ile sonuçlanmıştır. Bulgular, etkileşim partnerinin sosyal güdüyle başlattığı davranışına diğer etkileşim partnerinin sosyal güdüyle cevap vermesi ile sosyal katılımın kurulabildiğini göstermiştir. Sosyal amaçlı katılım başlangıcının otizmli küçük çocuğun bireysel ilgi alanları üzerine kurulabilmesi ve yalnızca her iki etkileşim partnerinin süregelen sosyal amaçlı cevapları ile korunabilmesi, sosyal amaçlı etkileşimlerde eylemlerarası (transactional) bir sıranın var olduğunu göstermiştir. Eylemlerarası sıra boyunca iki partner arasındaki etkileşim resminin sabit kalmadığı, sürekli değiştiği, uyum sağladığı ve geliştiği gözlenmiştir. Bu bulgular, otizmli küçük çocukların anneleri ile etkileşimlerinde, araçsal olmaktan ziyade sosyal amaçlı katılım anlarından muhtemelen keyif aldıklarının göstergesi olabilir. Bu nedenle, bir sonraki adımda otizmli küçük çocukların ebeveynleri ile etkileşimleri sırasında (çocuğa sevdiği atıştırmalığı veya oyuncağı vermek gibi), sosyal olmayan motivasyonlar yerine, (çocuğun keyif alması, eğlenmesi gibi) sosyal motivasyonlara odaklanmak faydalı olabilir. Böyle bir yaklaşım otizmli küçük çocuklarda sosyal amaçlı katılımı desteklemenin en umut verici yolu olabilir

Engagement between parents and toddlers with autism: a qualitative multiple-case study

This qualitative multiple-case study comprehensively examined the circumstances that supported and hindered social engagement in the three toddlers with autism when they interacted with their mothers. Directive actions of mothers for controlling and teaching purposes and requesting actions of toddlers resulted in instrumental engagement during which power struggles were sometimes observed. The findings indicated that social engagement was established when one interacting partner's social initiation was accepted with a social response from the other partner. Those socially engaged moments were first built upon the toddlers' individual interests but maintained only by continuous back-and-forth responses from both mothers and toddlers manifesting a transactional sequence during which the schema of their interaction continuously changed, adapted, and developed. This finding revealed that social, rather than instrumental, engagement may lead, possibly, to a sense of joy in these children while interacting with their mothers. One further approach related to this finding can be concentrating on the child's social motivation (e.g., having fun), rather than non-social motivation (e.g., receiving a favorite snack or toy) while interacting. Such an approach can be a promising avenue for optimally encouraging social purposes of engagement in toddlers with autism

Mediating Parent Learning to Promote Social Communication for Toddlers with Autism: Effects from a Randomized Controlled Trial

A randomized controlled trial was conducted to evaluate effects of the Joint Attention Mediated Learning (JAML) intervention. Toddlers with autism spectrum disorders (ASD) aged 16 to 30 months (n=144) were randomized to intervention and community control conditions. Parents, who participated in 32 weekly home-based sessions, followed a mediated learning process to target preverbal social communication outcomes (social visual synchrony, reciprocity, and responding and initiating forms of joint attention) throughout daily interactions. The analysis found post-intervention effects for all outcomes, with all except initiating joint attention sustaining six months post-intervention. Findings support the value of very early intervention targeting explicitly social functions of preverbal communication and of promoting active engagement in the learning process for both toddlers and parents

Designing Studies to Evaluate Parent-Mediated Interventions for Toddlers With Autism Spectrum Disorder

Given recent advances in science, policy, and practice of early identification in autism spectrum disorder (ASD), questions about the effectiveness of early intervention have far-reaching service and policy implications. However, rigorous research evaluating the efficacy and effectiveness of intervention programs for toddlers with ASD faces a multitude of novel scientific challenges. The Autism Speaks Toddler Treatment Network (ASTTN) was formed in 2007 to provide an infrastructure for ongoing communication between the investigators of eight research projects evaluating parent-mediated interventions for toddlers with ASD. The present article describes and compares the research studies of the ASTTN; highlights specific challenges with regard to research design, participants, recruitment, eligibility criteria, enrollment, and intervention approach; and outlines practical considerations that may guide the next generation of parent-mediated intervention studies involving toddlers with ASD