Predictors of Change in Play-Based Communication and Behavior Intervention for High-Risk ASD: The Role of Mother-Child Dyadic Synchrony.

Linyan Fu,Yun Da,Chunyan Li,Jiao Weng,Xiang Xiao,Min Feng,Ting Xiao,Junli Fu,Nana Qiu,Xiaoyan Ke

doi:10.3389/fped.2020.581893

Abstract

Background: Interindividual variability is important in the evolution of adaptative profiles of children with ASD having benefited from an early intervention make up for deficits in communication, language and social interactions. Therefore, this paper aimed to determine the nature of factors influencing the efficacy variability of a particular intervention technique i.e., “Play-based communication and behavior intervention” (PCBI).Methods: The participants comprised 70 13–30-month-old toddlers with ASD enrolled in PCBI for 12 weeks. The Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the efficacy of PCBI. Video recordings of 5 min of free-play before and after PCBI were used to examine behaviors of mothers and children and parent-child dyadic synchrony. Hierarchical multiple regression analyses and machine learning algorithms were performed to explore the effect of these potential predictors (mothers' factors, children's factors and videotaped mother-child interaction) of intervention efficacy.Results: The hierarchical regression analysis and the machine learning algorithms indicated that parenting stress, level of completion of training at home and mother-child dyadic synchrony were crucial factors in predicting and monitoring the efficacy of PCBI.Conclusions: In summary, the findings suggest that PCBI could be particularly beneficial to children with ASD who show a good performance in the mother-child dyadic synchrony evaluation. A better dyadic mother-child synchrony could enhance the PCBI efficacy through adapted emotional and behavioral responses of the mother and the child and has a beneficial influence on the child's psychological development.

Highlights

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication and restricted/repetitive behavior or interests [1]
We used video-recorded motherchild interactions to investigate the behaviors of children and mothers and found a significant gain in the level of child positive engagement and a reduction in child-object engagement
Previous studies have demonstrated that children with ASD have unstable structures of dyadic interactions and may have difficulty sustaining positive emotional states [18]

Summary

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication and restricted/repetitive behavior or interests [1]. The first 2 years after birth is a critical period marked by the rapid development of cognition and language [3, 4]. Children later diagnosed with ASD may present some deficits in these abilities [5], and the gap between these children and typically developing peers widens at 3–5 years of age [6]. Studies have shown that early intervention is efficacious in modifying cognitive and social-communicative outcomes and potentially improving developmental trajectories in toddlers with ASD [4, 7]. Interindividual variability is important in the evolution of adaptative profiles of children with ASD having benefited from an early intervention make up for deficits in communication, language and social interactions. This paper aimed to determine the nature of factors influencing the efficacy variability of a particular intervention technique i.e., “Play-based communication and behavior intervention” (PCBI)

Objectives

Methods

Results

Discussion

Conclusion