Children's Behavior Research Articles

Sensory processing, executive function, and behavior in children with ADHD

ABSTRACT The relationship between sensory processing, executive function, and behavior in children with Attention Deficit/Hyperactivity Disorder (ADHD) is far from clear. The aim of this study was to examine the mediating role of executive function in the relationship between sensory processing and behavior in ADHD. Sixty-three children (51 boys), aged between 7 and 14 years participated in this study. Caregivers completed the Sensory Profile 2 (SP-2), the Behavior Rating Inventory of Executive Function 2 (BRIEF-2), and the Child Behavior Checklist (CBCL) to assess sensory processing, executive function, and behavior, respectively. Positive and significant associations were found between sensory processing, executive function, and behavioral problems. In addition, positive indirect effects between sensory processing and behavior were mediated by executive function. These findings add to other evidence on neurodevelopmental disorders, suggesting that sensory processing may be a foundational aspect related to executive function, which in turn affects behavior in ADHD.

Формирование элементарных математических представлений у детей с ограниченными возможностями здоровья (с нарушением зрения)

The aim of this study is to improve the math skills of preschool children (5-7 years old) with visual impairment. In this context, it is expected that the target behavior of children with visual impairment will be changed through the creation of a specialized educational space that promotes the formation of mathematical abilities, arithmetic skills, creativity, ability to plan and organize their activities. The research group consists of 48 preschool children (5-7 years old) with visual impairments. The study was conducted in the fall of the 2023-2024 school year. During the study, the preschoolers received eight weeks of training to improve math skills. The study found that numeracy and math skills in preschool children with visual impairments had a positive effect on cognitive development, fine motor skills, and motivation to learn.

Evidence-Based Psychosocial Treatments for Disruptive Behaviors in Children: Update.

We reviewed the available evidence on psychosocial treatments for disruptive behaviors in children, as an update to Kaminski and Claussen (2017), focusing on children up to age 12 years. Search strategies, study inclusion, and treatment classification followed the procedures developed by Southam-Gerow and Prinstein (2014). Of the 44 included studies from 2016 to 2021, only 9 impacted previous results, either by increasing the level of evidence (for two treatment families) or documenting evidence for a new treatment family (four new treatment families). All three treatment families classified as Level 1: Well Established are parent-focused and now include Group parent behavior therapy + group child behavior therapy (previously classified as Probably Efficacious), in addition to Group parent behavior therapy and Individual parent behavior therapy with child participation (already classified as Well Established). Fifteen treatment families were classified as Level 2: Probably Efficacious, eight were classified as Level 3: Possibly Efficacious. Given the variability of programs in each treatment family, the evidence is for the overall treatment approach and may not apply to each program with those characteristics. Data were insufficient to examine outcomes in relation to participant characteristics. The information can be used to improve dissemination, implementation, and uptake of effective treatment, and inform research on improving access barriers.

The Bullying Concept in Scientific and Psychological Sources

From the moral point of view, a person's actions should correspond to a certain social norm. The boundaries of this norm are set by age-old patterns and perceptions. The laws and rules of ethics in force in a given socio-historical situation also have a significant impact. It is believed that “old” and “new” rules should form a solid foundation of morality. Children should be taught these rules, and then they will live without breaking the law. Everyone wants a harmonious life, and often ordinary people, “philistines”, do not think about the true, underlying causes of violent behavior. And when they encounter aggression in children and adolescents, unfortunately, they see only superficial, external manifestations in it. Thus, the behavior of children who show irritation, intemperance, rudeness, opposition, disrespect for elders is seen as a result of poor upbringing, bad influence of peers, books and films with aggressive content, etc. And these children, as a result, become the target of severe measures by adults, society in general. The article considers the old familiar problem of “aggression” in a “new” way as the bullying concept, taking into account the research of recent years. Currently, the bullying term is a universally recognized international socio-psychological term. Despite the fact that experts ignore the problem of the impact of the bullying experience on the further life and attitudes of victims, some data show the extremely adverse impact of harassing on the subsequent behavior of a person. The authors consider different points of view of the concept of “bullying”, reveal the content of the concept of “aggression”, the purposes of aggression, its types: instrumental and emotional aggression, aggression in adolescence, etc. The purpose of this research is to identify and set the main problems associated with the problem of bullying among teenagers. The object of the research is literature considering the problem of bullying, its types. The following methods were used: theoretical (analysis of psychological, pedagogical and scientific and methodological literature on the studied problem, content analysis of modern literature; study of sources determining the characteristics of adolescent development.

Investigating the impact of an AI-based play activities intervention on the quality of life of school-aged children with ADHD

BackgroundAttention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that not only impacts children's behavior, learning, and social interactions but also their quality of life. Advances in artificial intelligence (AI) may provide new opportunities to improve the ADHD symptoms and quality of life of children with ADHD, especially through customized play activities that address their specific needs. AimsThis study examined the impact of AI-based play activities on the quality of life of 61 Saudi children aged between 8 and 12 years who had an ADHD diagnosis. MethodsAI-based play activities intervention consisted of twelve 45-minute sessions, delivered to the experimental group over four weeks (three sessions per week). The control group did not receive any intervention. Children and parents completed the Pediatric Quality of Life Inventory (PedsQL) at pre-test, post-test and follow-up. Results and outcomesThe experimental group exhibited significant improvements in all dimensions and total scores of PedsQL, with moderate to large effect sizes. These improvements were not observed in the control group. The beneficial effects of the AI-based play activities were maintained at the 7-weeks follow-up. ConclusionsAI-based play interventions may enhance quality of life for children with ADHD, with sustained improvements observed after 7-weeks. Incorporating such interventions into educational and therapeutic settings could improve behavioral, social, and cognitive ADHD symptoms. Future research should explore broader applications and long-term effects of AI-based play activities interventions.

학교폭력 가해자에 대한 경찰다이버전 정책 기반 다중체계치료 사례연구

Objectives This purpose of the study was conducted to explore the effectiveness of Multisystemic Therapy for school violence perpetrators as part of the police diversion policy. Methods The subject of the study was a 14-year-old male student who was reported to have school violence, which is extortion and intimidation, and was released on the condition of participating MST. In accordance with the multisystemic therapy manual, five key goals were derived by analyzing risk factors for adolescents' problematic behaviors through evaluation of various systems surrounding him. An intervention strategies were established to achieve the core goals(i.e., stop smoking and alcohol, controlled use of SNS, making pro-social friends, stay away from delinquents, promoting positive parenting skills of parents). The essential parts of MST as like the therapy team, the visiting service, and weekly supervision were implemented. In order to measure pre-post changes, Children Behavior Checklist 6-18, the Parenting Stress Index, the Parenting Attitude Test, and the MMPI-A were conducted. The package of scales was implemented at 3 points as pre-time, post-time, and 8 months follow-up. Results First of all, the level of the externalization problem scale of CBCL 6-18, which was at the clinical range at the pre-test, recovered to the level of the normal range in the post-test, and these results were maintained even at the 8 months follow-up. Regarding MMPI-A, the score was lowered by nearly 2 standard deviations in the scale of Pd compared to pre-test. Then, parenting stress decreased and positive parenting attitudes of parents increased. In addition, all the five core goals were achieved. Conclusions The results of this study showed that multisystemic therapy for school violence perpetrator can help decrease adolescents’ problematic behaviors including school violence.

Participatory Design of an Embodied Mixed Reality Experience Aimed to Assessing Individual and Collaborative Behaviors of Children

This study is part of a broader project exploring the integration of Mixed Reality (MR) in fostering prosocial behaviors among children, particularly focusing on interpersonal synchrony (IPS) and its impact on collaboration. IPS, the coordination of rhythmic movements among individuals, has been associated with improved group cohesion and prosocial behaviors, such as collaboration. Traditional assessments of prosociality typically involve structured play activities for dyads, making them difficult to adapt to other settings. To address these limitations, this research aims to design a flexible embodied MR experience that allows children to choose between collaborative or individual engagement, reflecting the natural dynamics of children's play interactions. For this purpose, we conducted an embodied participatory design (PD) and usability study with 50 children aged 8-10 years. We provide a detailed account on how the PD process was orchestrated and an evaluation of user-system interaction, children's perceptions of play modes, and experience satisfaction. The results show how the MR experience, codesigned with children, supports a free play environment, allowing children to choose their preferred play mode. This study highlights the potential of MR in psychological research and child development, providing a new avenue for assessing individual and collaborative behaviors in larger groups of children.

Association between snack intake behaviors of children and neighboring women: A population-based cross-sectional analysis with spatial regionalization

BackgroundAccumulated evidence indicates that neighborhood environments affect children's health behaviors. However, measuring neighborhood environments remains challenging because there exist strengths and weaknesses both in objective and perceived environment measures. Drawing on a recent conceptual model of how environment, perception, and behavior interact, we hypothesized that neighbors' behavioral similarities indicate the combined influence of physical and social environmental opportunities on specific behaviors. We then examined how these similarities (i.e. the behavioral tendencies of children's adult neighbors) relate to children's obesogenic dietary behaviors. MethodsWe used data for 2275 women and 821 elementary schoolchildren from a 2012–2013 population-based survey in greater Tokyo, Japan. Snack intake was defined as the total consumption of various types of snacks, estimated using a validated self-administered diet history questionnaire. Spatial regionalization, a type of spatial clustering, was used to empirically identify segments that could effectively differentiate regional variation in women's snack intake behaviors. We conducted multiple regression analysis to assess the cross-sectional association between children's snack intake and the mean snack intake of neighborhood women, adjusting for mother's intake. ResultsA 1-g increase in the mean snack intake of neighborhood women was associated with a 0.23-g (95% confidence interval: 0.00–0.45) increase in children's intake, while a 1-g increase in mother's intake was associated with a 0.34-g (95% confidence interval: 0.26–0.41) increase in children's intake. DiscussionThe results suggest that the out-of-home physical and social neighborhood environments may have non-ignorable associations with children's dietary behaviors by offering behavioral opportunities in addition to maternal influence.

Online Parenting Programs for Children's Behavioral and Emotional Problems: a Network Meta-Analysis.

Online parenting programs to support parents of children with behavioral problems and emotional problems have become widely available in recent years. Research has consistently shown their positive effects on child development, parents' adaptive parenting practices, and parents' mental health. However, knowledge is lacking on which type of content is more suitable to be delivered online. Our work addresses this knowledge gap by conducting traditional and network meta-analyses to improve our understanding of (1) how effective online parenting programs are to improve children's behavior and emotional problems, and (2) what clusters of components are most likely to yield the strongest effects. Following the PROSPERO preregistration, we systematically searched PsycINFO, MEDLINE, Web of Science, and Cochrane. Of the 8292 records retrieved, 28 records on 27 randomized controlled trials (N = 5,312) met the inclusion criteria. Results show moderate effect sizes of online parenting programs on reduced child behavioral and emotional problems, parents' ineffective parenting practices, and parents' mental health problems. Online programs adopting a learning theory perspective, either with or without additional parental self-care and parents as therapist approaches, are most likely to yield the strongest effects on child behavioral problems. Online programs adopting a learning theory perspective, parental self-care and parents as therapist approaches, with or without additional relationship perspectives, are most likely to yield the strongest effects on child emotional problems. Online parenting programs seem promising tools for improving child behavioral and emotional problems. Future research should identify the circumstances that allow parents and children to benefit more from specific components in these programs.

The Spiritual Education Value and Practical Approaches of Early Childhood Dance

Early childhood dance is an art activity for young children created according to the characteristics of their physical and mental development, which is characterized by intuitive image, sociality, and children's fantasy. It is characterized by intuitive image to show the form of all things for young children, which shows the knowledge of truth; young children shape their good character in the collective dance environment of cooperation and communication, which is for the sake of goodness; and young children experience the charm of dance art in the dance world of children's fantasy, which is for the sake of cultivating beauty. The truth, goodness and beauty it contains can nourish young children's hearts and promote the formation of positive psychological qualities in young children, which is an important way to educate young children. In this sense, educators should fully explore the value of early childhood dance according to the level of physical and mental development of young children, so as to achieve the dance wisdom - to promote the development of young children's cognitive ability, to dance ideology - to enhance the quality of young children's will, to dance and express their feelings. --Cultivate young children's positive emotions and feelings, nurture children's personality, and guide children's pro-social behavior. To realize dancing to nurture the heart and dancing to nurture people, and to promote the comprehensive and harmonious development of young children's body and mind.

PENDAMPINGAN SOCIAL BEHAVIOUR TERAPHY DAN CLASSICAL CONDITIONING TERAPHY PADA KOMUNITAS PEDULI ANAK AUTIS

The purpose of this service is to provide support and assistance to children with autism through the implementation of Social Behavior Therapy and Classical Conditioning Therapy. The methods used in implementing this service involve counseling based on counseling service cards, seminars, workshops, and pre-tests and post-tests to measure the effectiveness of the program. The results of the service showed that 85% of parents and caregivers were satisfied with the program, and there was a significant increase in the social skills and adaptive behavior of children with autism. The sustainability of this program is supported by intensive training for caregivers and parents, which ensures consistent application of therapy. This program is expected to be a model for other communities in implementing behavioral therapy for children with autism, creating a more supportive and inclusive environment for them in the future.

The impact of children’s dental anxiety on dentists

INTRODUCTION. According to statistics, medical workers and, in particular, dentists are exposed to stressful factors in the workplace on a daily basis. Due to the specifics of their daily activities, pediatric dentists experience a great emotional burden, especially when treating children who are not adapted to dental care, which leads to the development of an emotional burnout syndrome among specialists. AIM. To determine the effect of children’s dental anxiety on emotional stability during admission and psychoemotional status after admission by dentists with emotional burnout syndrome.MATERIALS AND METHODS. The study involved 76 pediatric dentists and 68 patients aged 6–7 years. The psychoemotional state of dentists was assessed using the Maslach Burnout Questionnaire and a Visual Analog Scale. The behavior of children at the dental appointment was recorded according to the evaluation scale of the behavioral profile of the Melamed.RESULTS. According to the results of the Maslach questionnaire, burnout syndrome of varying severity was detected in all specialists. Deterioration of the psychoemotional state after receiving a patient who was not adapted to dental treatment was observed in 16%.CONCLUSIONS. The study shows that in order to prevent burnout syndrome in pediatric dentists, it is necessary to reduce professional stress through methods of adapting children to treatment, correcting patient behavior and reducing dental anxiety.

Thumbtack needle at front-mu points for abnormal behavior in children with autism spectrum disorders

To compare the clinical effect of thumbtack needle at front-mu points combined with conventional rehabilitation training and simple conventional rehabilitation training in the treatment of autism spectrum disorders (ASD). A total of 40 children with ASD were randomly divided into a combination group (20 cases, 3 cases dropped out) and a conventional rehabilitation group (20 cases, 3 cases dropped out). Conventional rehabilitation training i.e. language-cognition training and comprehensive education training was adopted in the conventional rehabilitation group, once a day, 5 days a week. On the basis of the treatment in the conventional rehabilitation group, thumbtack needle was applied at Zhongwan (CV 12), bilateral Tianshu (ST 25) and Guanyuan (CV 4) in the combination group, the needles were retained for 3 days each time, 3-day interval was taken between each treatment, for 5 times per month. One-month treatment was as one course and a total of 3 courses were required in both groups, with 10-day break between each course. Before and after treatment, the scores of autism behavior checklist (ABC), childhood autism rating scale (CARS), TCM spleen-stomach symptoms and Achenbach child behavior checklist (CBCL) were observed, and the serum ratio of glutamate and gamma-aminobutyric acid (Glu/GABA) was measured. After treatment, the scores of ABC, CARS and CBCL were decreased compared with those before treatment (P<0.05, P<0.01) in both groups, the TCM spleen-stomach symptoms score was decreased compared with that before treatment (P<0.05) in the combination group; the changes in the scores of ABC, CARS, TCM spleen-stomach symptoms and CBCL, as well as the serum Glu/GABA in the combination group were lager than those in the conventional rehabilitation group (P<0.05, P<0.01). Both thumbtack needle at front-mu points combined with conventional rehabilitation training and simple conventional rehabilitation training can effectively treat ASD, the combination treatment has superior effect on improving the abnormal behavior, spleen-stomach symptoms and balance of nerve impulse and inhibition.

The impact of a positive discipline group intervention on parenting self-efficacy among mothers of young children.

Instilling healthy behaviors in early childhood is crucial as they can have lifelong impacts. However, many Chinese mothers lack effective parenting strategies, resulting in low self-efficacy. Positive Discipline, a non-punitive and non-indulgent approach, can help enhance maternal parenting self-efficacy and promote healthy lifestyle behaviors in children. This study explores the impact of a Positive Discipline group intervention on the parenting self-efficacy of Chinese mothers and how it can contribute to promoting diet and healthy lifestyle behaviors in early childhood. We randomly selected 70 mothers with low parenting self-efficacy from a kindergarten in China, dividing them into an intervention group (35 participants) and a control group (35 participants). The intervention group received a 6-week Positive Discipline intervention, while the control group received no intervention. The intervention aimed at helping mothers nurture their children in a kind and firm manner. We used paired samples t-tests and independent samples t-tests to compare changes in parenting self-efficacy scores before and after the intervention. Results showed that the intervention group's parenting self-efficacy scores significantly improved after the intervention, from an average score of 25.00 ± 4.08 to 36.29 ± 2.99 (p < 0.05, Cohen's d = 3.156). Significant improvements were observed in areas like "believing their parenting style benefits their child's growth" and "knowing how to effectively parent their children." The control group's average scores showed no significant changes between pre- and post-intervention (pre: 25.07 ± 5.33; post: 24.86 ± 5.75, p > 0.05, Cohen's d = 0.076). Furthermore, 3 months post-intervention, the intervention group's scores remained significantly higher than pre-intervention (p < 0.05), demonstrating the intervention's lasting effect. This study demonstrates that the Positive Discipline group intervention significantly enhances parenting self-efficacy in Chinese mothers, promoting healthy lifestyle behaviors in early childhood. Providing continuous support and guidance to mothers can help solidify their parenting confidence, ensuring long-term intervention success. Future research should explore how group interventions can effectively integrate healthy behaviors into early childhood routines and impact children's diet and lifestyle behaviors.

Individual Participant Data Meta-Analysis: Individual Differences in Mediators of Parenting Program Effects on Disruptive Behavior.

Although parenting programs are the most widely used approach to reduce children's disruptive behavior, there is a notable lack of understanding of the exact changes in parenting that underlie their effects. Challenges include the frequent use of composite measures of parenting behavior, and insufficient power to detect mediation effects and individual differences in these in individual trials. We pooled individual participant data from 14 European randomized controlled trials of social learning-based parenting programs to examine which specific parenting behaviors best explain program effects. Participants were 3,252 families with children aged 1 to 13 years. As putative mediators, we included parental use of praise, tangible rewards, physical discipline, harsh verbal discipline, and not following through on discipline. Additionally, we explored whether subgroups of families showing different mediational pathways exist. Changes in parenting partially mediated program effects, with all included parenting behaviors, except parental use of praise, serving as unique mediators. Less harsh verbal discipline and increased following through on discipline were the strongest mediators. We identified three subgroups with distinct responses to parenting programs. Most families benefited, partly through increased following through on discipline; those with the least or most difficulties were more likely to benefit less, or not at all. Our findings offer insight into the specific parenting behavior changes key to reducing disruptive child behavior, while highlighting the need for innovative research methodologies to gain a deeper understanding of individual differences in parenting program benefits and mechanisms.

Age-adapted painting descriptions change the viewing behavior of young visitors to the Rijksmuseum

Children learn about art by actively engaging with their surroundings. This makes museums potentially rich environments for learning and development. Yet, the descriptions of paintings on show are usually written for adults rather than younger visitors. This study uses mobile eye tracking to examine how painting descriptions tailored for children influence their eye movements when viewing paintings at the Rijksmuseum - the national museum of The Netherlands. Our findings underscore the importance of adapting information specifically for children, rather than simply providing them with adult-oriented museum materials. Children who received information tailored to their developmental level showed increased glance durations to areas highlighted in the descriptions. Strikingly, the behavior of children provided with painting descriptions intended for adults was no different from their behavior when they received no information at all.

Pemberdayaan Siswa SD Tentang Keterampilan Cuci Tangan di Purbowangi Buayan Kebumen

Introduction: Efforts to change health behavior to support an increase in levels are carried out through a Clean and Healthy Living Behavior development program, one of which is washing hands. The low level of parental behavior in training children to wash their hands with soap before and after eating is the reason why it is important to wash their hands. Objective: The purpose of this service was to empower students to improve hand washing skills for students at Elementary School 4 Purbowangi Kebumen. Method: This public service was conducted by providing counseling using the correct hand washing demonstration method to 94 students, the activity steps include: the staff observes the hand washing skills of students before being given treatment (pretest), then provides counseling using a demonstration method about hand washing. The next step is for the service to observe the hand washing skills of students after being given treatment (posttest). Result: The results of this community service activity showed that the majority of participants were male, 51 students (54.3%), 33 (35.1%) aged at most 10 years. Hand washing skills before and after being given the intervention improved. This is evident from the results of the average hand washing skill before the demonstration was 41.0904 (poor) and the average hand washing skill after the demonstration was 96.2234 (very good). Conclusion: Activities to empower elementary school students regarding hand washing skills went smoothly and was able to improve the skills of all students in washing their hands.

Developmental changes in how pedestrians cross streets in single- vs. dual-lane traffic conditions.

Pedestrian injury is a leading contributor to childhood deaths. This study compared the crossing behaviors of children with adults when crossing in virtual single-lane vs. two-lane traffic conditions. Using a fully immersive virtual reality system, children 7-10 years and adults crossed streets with traffic in one lane (near lane) or in two lanes (near and far lane) with 0 offset so cars from opposing directions arrived at the child's crossing line at the same time. On each trial, pedestrians made a decision on when to cross and then completed the crossing, with measures of attention and crossing behaviors automatically recorded by the system as they did so. In comparison to crossing a single lane of traffic, crossing two-lane roads increased injury risk for all pedestrians, though children experienced significantly greater risk than adults. Children predominantly crossed by stopping before entering the far lane, whereas adults showed greater synchronization of self-movement to traffic flow and more often crossed both lanes without stopping. Children experience more high-risk outcomes than adults when crossing single-lane roads. Crossing two-lane roads elevates risk for pedestrians of both ages, though this risk is significantly greater for child than adult pedestrians. The predominant strategy used to cross two lanes of traffic shows significant developmental changes. Implications for injury prevention are discussed.

A Growth Mindset Scale for Young Children (GM-C): Development and validation among children from the United States and South Africa.

Beliefs about the malleability of intellectual ability-mindsets-shape achievement. Recent evidence suggests that even young children hold such mindsets; yet, no reliable and valid instruments exist for measuring individual differences in young children's mindsets. Given the potential relevance of mindsets to children's achievement-related behavior and learning, we developed and tested the psychometric properties of the Growth Mindset Scale for Children (GM-C). Among other psychometric properties, we assessed this instrument's (a) factor structure, (b) measurement invariance, (c) internal consistency, (d) temporal stability (test-retest reliability), (e) concurrent validity, and (f) cross-cultural robustness in samples of US children (Study 1; N = 220; ages 4 through 6; 50% girls; 39% White) and South African children (Study 2; predominantly grades 4 and 5; N = 331; 54% girls; 100% non-White). The GM-C scale exhibited four factors, representing beliefs about the instability of low ability, the malleability of low ability, the instability of high ability, and the malleability of high ability. The GM-C scale also demonstrated invariance across age, acceptable internal consistency (αs between .70 to .90), and moderate temporal stability over approximately one month (rs between .38 to .72). Concurrent validity was supported by significant relations between children's scores on the subscales about low ability and their goal orientations (Studies 1 and 2), challenge-seeking behavior, and achievement in math and English (Study 2). These findings suggest that the GM-C scale is a promising tool for measuring mindsets in young children. We offer practical recommendations for using this new scale and discuss theoretical implications.

Cultivating the imagination: Caregiver input during pretend play with toddlers at elevated likelihood for autism.

Toddlers with autism spectrum disorder (ASD) may exhibit less pretend play than their neurotypical counterparts. Previous research suggests that caregivers' input during play influences children's play behavior, and children's behavior may in turn prompt caregivers of differently developing children to talk about play in different ways. Caregiver input about pretend play during toy play at home was examined at 18- and 36-months in toddlers with an older sibling with ASD, who are at elevated likelihood (EL) for ASD (n = 40), and toddlers with typical likelihood (TL) for ASD (n = 12). EL toddlers were classified into three outcome groups: EL-ASD (n = 10), EL-no diagnosis (EL-ND; n = 14), or EL-language delays (EL-LD, n = 16). Caregiver utterances were categorized according to the types of pretend and non-pretend play suggested (e.g., pretending with inanimate objects vs. using objects for their intended function). Pretend utterances were further categorized as related or unrelated to the child's own actions. All caregivers produced proportionately more utterances about complex types of pretend play over time. At 36 months, caregivers of autistic toddlers produced proportionately fewer pretend play utterances, and proportionately fewer pretend play utterances were related to EL-ASD toddlers' actions compared to their neurotypical peers. These findings highlight bidirectional effects between caregivers and toddlers during play. While EL-ASD toddlers may provide less frequent opportunities for caregivers to talk about complex types of pretend play, the current study highlights caregivers' high levels of attunement to their toddlers' play skills.