The behaviours of parents of children with autism predict the subsequent development of their children's communication.
Siller M and Sigman M.
Journal of Autism and Developmental Disorders 32(2): 77-89. 2002
Bottom Line Does the way in which parents interact with their child affect their child’s language development?
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Question: Does a parent's behaviour predict his/her child's later communication skills?
Background: Although estimates differ, between 50% and 72% of children with autism will later develop some language. It has been thought that IQ determines whether children with autism will go on to develop the ability to communicate verbally, as children with higher IQs are more likely to be verbal, although the relationship is not perfect. There has, however, been an element missing from the studies done thus far. All children, whether they are typically developing, developmentally delayed, or have an autistic disorder, benefit from a type of parental care that best promotes their intellectual, emotional, and social growth and development. Parents need to know what knowledge and skills are needed for this task. This is a study that looked at features of parent-child interaction that tend to enhance child language development.
Design: Time series, with follow up at 1, 10, and 16 years. Current data is from the 16 year time.
Participants: There were three groups of participants: typically developing children, developmentally delayed children, and children with autism as diagnosed with the ADI-R (the best diagnostic instrument available). At the first assessment they were matched for chronological age, mental age, language age level, intelligence, and maternal education, with no significant difference found amongst the groups for mental age, language level, or maternal education. The children with autism and the children with developmental delay were not significantly different from each other, but they did differ from the typically developing children for chronological age and IQ. The typically developing children had average IQs and were considerably younger, to match the developmental stage of the other participants.
Setting: The UCLA Neuropsychiatric Institute.
Assessment of prognostic factors: At the initial assessment the children were given the Early Social Communication Scale and were videotaped in interaction with their primary caregiver (usually their mother) to demonstrate the quality of the interaction. Language skills were assessed at 16-year follow up.
Main Outcome Measures: Age equivalent scores for child's language, the gain in language scores over 1, 10 and 16 years, caregiver behaviours and verbalizations during the videotaped interaction with the child.
Main Results: Children whose caregivers were most "in synch" with them and least demanding that they follow the caregivers' interests or leads in play had better language skills at time 3 (16-year follow up).
Conclusions: It is important to know how parents can produce the best outcome for any child. In this case, "sensitivity," or the ability to pick up on and interpret a child's cues and signals and respond empathetically, is important for later child language development. Caregivers who let the child lead the interaction, who commented on the child's activities, named the objects the child attended to, and generally engaged the child in play according to the child's interests, had children who later showed better verbal skills compared with children whose caregivers showed fewer of these behaviours.
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Commentary Joint attention is a form of nonverbal communication that is thought to be important for the development of verbal communication skills in typically developing children. The term refers to behaviours that we use to direct another person to the focus of our attention (e.g., pointing, looking back and forth between an object and another person). Children with autism generally have poorly developed joint attention and verbal communication skills. It is known, however, that the way that parents interact with their children during play can help the development of this important skill. In their study, Siller and Sigman examined how a parent's play style affects the development of joint attention and language skills in children with autism. Overall, the study found that children whose parents were more "in synch" with their play made greater gains in joint attention at one-year follow up. Play interactions were considered to be synchronized if the parents' words and behaviours were directed to the child's focus of attention instead of directing them to do something else (e.g., play with a different toy). Similarly, parents whose comments were undemanding, for example, talking about what the child is doing with a toy, rather than demanding, such as telling the child do something different, had children who made more improvements in language over a 16-year follow up. In this study, better outcomes were clearly seen in children whose parents were more responsive and in-tune with their children during play. That is, the children of parents whose comments and behaviours were directed to the focus of the child's play made more gains than parents who were more demanding. The findings are important because they suggest that parents can make a difference by simply showing an interest in their child's play through their words and behaviour. Many children with autism spend hours every week in highly structured and directive learning environments. It is important to know that learning can also take place in more relaxed interactions with parents. More controlled research on this topic would be helpful to both parents and clinicians. Beth A. McConnell, Ph.D.
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