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Parent Strategies for Improving Joint Engagement and Language in a Diverse Sample of Limited Language Preschoolers with Autism Spectrum Disorder

Abstract

Children’s early language, communication, and social skills are often learned through social interactions with their caregivers. Being jointly engaged with caregivers provides the referential context for children to learn these early skills; however, many children with autism spectrum disorder (ASD) are impaired in their ability to share experiences with others and can thereby miss out on crucial opportunities for language and social development. There are many interventions for young children with ASD that teach children to share attention with others, from those that are more adult-driven and structured (e.g., Discrete Trial Training (DTT)) to child-led and naturalistic (e.g., Joint Attention, Symbolic Play, Engagement, and Regulation (JASPER)). Training parents in intervention strategies is effective for improving a wide range of children’s outcomes. This study aimed to: a) examine changes in parents’ use of four ABA-based strategies during parent-child free play interactions over the course of intervention (entry, 2 months into the intervention, 4 months into the intervention, and exit) and b) explore the relationship between parents’ use of strategies and children’s joint engagement and language outcomes over time. The current study was a secondary data analysis of a randomized controlled trial that compared two different interventions for children with ASD. Children (n=156) with limited expressive language ability received either 6 months of DTT or JASPER from an interventionist. In the last 8 weeks of intervention, parents received weekly parent training in whichever intervention their children were randomized to. Parent strategies (responsiveness, pacing, prompting, and environmental arrangement), child joint engagement, and child language were coded from a 10-minute free-play assessment that was collected at each timepoint. Results indicated that parents increased in their appropriate use of parent strategies over time. Parents’ pacing and environmental arrangement were related to children’s joint engagement across time and across treatment groups, while only parents’ pacing was related to children’s language outcomes. Implications for parent-child interactions and for parent trainings within early intervention contexts are discussed.

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