Compliance in Toddlers with Autism Spectrum Disorder: Exploring the Effects of Treatment and Caregiver Requests
Children’s ability to comply with caregiver requests is considered to be the earliest indication of self-regulation processes in early childhood and is related to a host of positive future outcomes including social competence, mental health and less parenting stress. The ability to comply with requests may be especially important for children with ASD, who are already pre-disposed to core deficits in social-communication that may make caregiver-child interactions more challenging. Although compliance to caregivers’ requests has been studied in children with autism, studies have largely neglected exploring these constructs amongst very young children with ASD. There is also a scarcity of research exploring the effect of early caregiver-mediated intervention on compliance in very young children with autism, an area that warrants more study given the importance of children’s compliance for future outcomes. This study is a secondary data analysis of existing data collected as part of a larger randomized controlled efficacy trial of a naturalistic, parent-mediated social-communication intervention for children with (ASD). The aims of this study are to characterize the use of caregiver requests and children’s compliance at entry to the study, explore the effects of treatment on caregiver’s use of requests and children’s compliance to caregivers’ requests over time. Caregiver’s requests and children’s compliance were coded using videos of dyads completing a clean-up task at three timepoints: entry, exit and 3-month follow-up. Caregiver-mediated intervention (JASPER) increased children’s compliance with caregivers’ direct requests, but no effect was detected for the effect of treatment on children’s compliance with caregivers’ indirect requests and caregivers’ total requests over time. No treatment effect was found for caregivers’ use of direct and indirect requests for participants in either condition. Implications for the contributions of caregiver-mediated treatment and caregivers’ use of requests on the development of compliance in very young children with ASD are discussed.