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

Joint attention revisited: Finding strengths among children with autism

Differences in joint attention (JA) are prominent for some children with autism and are often used as an indicator of the disorder. This study examined the JA competencies of young children with autism who demonstrated JA ability and compared them to children with developmental delays. Method: Forty children with autism and developmental delays were matched pairwise based on mental and chronological age. Videos of children engaging in play were coded for the frequency and forms (eye contact, gestures, affect, etc.) of JA. Additionally, concurrent language was compared among children with autism (N=32) by their JA ability. Results: Children with ASD entered into JA significantly less often than children with DD but once engaged, used the forms of JA similarly. For the matched pairs there were no differences in language but the children with autism who used JA had significantly better language than children with autism who did not (even after controlling for mental age). Conclusions: There is a group of young children with autism who can use JA but do so at lower frequencies than children with DD. Possible reasons include difficulty disengaging attention and limited intrinsic social motivation to share. Adult persistence is recommended to encourage JA

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

Increasing Positive Predictive Value for Autism in Infants Using a Dynamic Systems Approach

In order to increase the ability to provide diagnosis-specific interventions as early as possible, key emergent behavioral characteristics of ASD must be differentiated from more general developmental delays during the first two years of life. Infant sibling studies may be limited in generalizability to the greater population since the majority of children with ASD do not have an affected sibling (Constantino et. al, 2010). For this reason, it is important to gain more insight into which factors, if any, could be combined to increase positive predictive value for likelihood of ASD diagnosis in a sample comprised of infants identified through screening to be at elevated likelihood of later ASD diagnosis (EL-ASD). The Dynamic Systems Theory postulates that the relative instability of one domain of development impacts the expression of another (Estes et. al, 2015). The literature suggests that early motor skills and social communication (e.g., types of vocalizations and intentionality; social gesture use) as well as ability to shift eye gaze and temperament differences (e.g., negative affect, passivity) are correlated with ASD outcomes for prodromal infants (Ozanoff et. al, 2010; Zwaigenbaum et. al, 2005; Zwaigenbaum et. al, 2015, Flanagan et. al, 2012; Paul et. al 2011; Garrido et. al, 2017; Woynaroski et. al, 2017; Colgan et. al, 2006; Crais et. al, 2009; Watson et. al, 2013; Wetherby et. al; Zwaigenbaum et. al, 2005; Zwaigenbaum et. al, 2015). This literature provides adequate evidence for the use of variables representing intentional social communication, coordination of eye gaze, motor development, and temperament as possible predictors for diagnostic outcomes from the research sample following a Dynamic Systems perspective

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

Racial Disparities in Hospitalization Due to Ambulatory Care Sensitive Conditions Among U.S. Children with Autism

Purpose This study was to investigate the factors associated with preventable hospitalization due to ambulatory care sensitive conditions (ACSCs) in children with autism. Methods Using secondary data from the U.S. Nationwide Inpatient Sample (NIS), multivariable regression analyses were conducted to determine the potential effect of race and income level on the likelihood of inpatient stays for ACSCs among autistic children. Pediatric ACSCs included three acute conditions (dehydration, gastroenteritis, and urinary infection) and three chronic conditions (asthma, constipation, and diabetes short-term complications). Results In this analysis, there were 21,733 hospitalizations among children with autism; about 10% were hospitalized due to pediatric ACSCs. Overall, the odds of ACSCs hospitalization were greater among Hispanic and Black autistic children versus White autistic children. Both Hispanic and Black autistic children from the lowest income level had the highest odds to be hospitalized for chronic ACSCs. Conclusion Inequities of access to health care among racial/ethnic minorities were most notable for autistic children with chronic ACSC conditions

Value-Added Predictors of Expressive and Receptive Language Growth in Initially Nonverbal Preschoolers with Autism Spectrum Disorders

Eighty-seven preschoolers with autism spectrum disorders who were initially nonverbal (under 6 words in language sample and under 21 parent-reported words said) were assessed at five time points over 16 months. Statistical models that accounted for the intercorrelation among nine theoretically- and empirically-motivated predictors, as well as two background variables (i.e., cognitive impairment level, autism severity), were applied to identify value-added predictors of expressive and receptive spoken language growth and outcome. The results indicate that responding to joint attention, intentional communication, and parent linguistic responses were value-added predictors of both expressive and receptive spoken language growth. In addition, consonant inventory was a value-added predictor of expressive growth; early receptive vocabulary and autism severity were value-added predictors of receptive growth

Atypical Cross-Modal Profiles and Longitudinal Associations Between Vocabulary Scores in Initially Minimally Verbal Children With ASD: Atypical Profiles and Associations Between Vocabulary Scores in ASD

We tested the relative levels (i.e., age equivalencies) of concurrent cross-modality (receptive and expressive) vocabulary and the relative strength of the longitudinal, cross-modality associations between early and later vocabulary sizes in minimally verbal preschoolers with ASD. Eighty-seven children participated. Parent-reported vocabulary was assessed at four periods separated by 4 months each. Expressive age equivalent scores were higher than receptive age equivalent scores at all four periods. Cross-lagged panel analysis was used to rule out common, but trivial, explanations for differences between the longitudinal associations of interest. Key associations were tested across intervals that varied from 8 to 12 months. In two of the three tested panels, the associations between early expressive vocabulary size and later receptive vocabulary size were stronger than the associations between early receptive vocabulary size and later expressive vocabulary size, providing evidence that is consistent with the hypothesis that expressive vocabulary size drives receptive vocabulary size in minimally verbal preschoolers with ASD

Attention-Following and Initiating Joint Attention Protocol

The protocol is designed to measure the extent to which children will follow attentional cues of the examiner, and the extent to which they will initiate joint attention in communicating with the examiner. The protocol is based on Brady, (2003), Leekam et al., (1998), and Stone et al., (1997). These types of measures have been validated as discriminating among MA-matched groups of children with autism versus DD or typical development, and have also been shown to predict future progress in language development (Mundy et al., 1986 & 1990; Rollins & Snow, 1998; Stone et al., 1997). Joint attention measures of this type have been used across the ages and functioning levels that will be represented in our investigation

A Unified Account of the Moral Standing to Blame

Recently, philosophers have turned their attention to the question, not when a given agent is blameworthy for what she does, but when a further agent has the moral standing to blame her for what she does. Philosophers have proposed at least four conditions on having “moral standing”: 1. One’s blame would not be “hypocritical”. 2. One is not oneself “involved in” the target agent’s wrongdoing. 3. One must be warranted in believing that the target is indeed blameworthy for the wrongdoing. 4. The target’s wrongdoing must some of “one’s business”. These conditions are often proposed as both conditions on one and the same thing, and as marking fundamentally different ways of “losing standing.” Here I call these claims into question. First, I claim that conditions (3) and (4) are simply conditions on different things than are conditions (1) and (2). Second, I argue that condition (2) reduces to condition (1): when “involvement” removes someone’s standing to blame, it does so only by indicating something further about that agent, viz., that he or she lacks commitment to the values that condemn the wrongdoer’s action. The result: after we clarify the nature of the non-hypocrisy condition, we will have a unified account of moral standing to blame. Issues also discussed: whether standing can ever be regained, the relationship between standing and our "moral fragility", the difference between mere inconsistency and hypocrisy, and whether a condition of standing might be derived from deeper facts about the "equality of persons"