Social Communication In Children Research Articles

Caregiver strategies before intervention moderate caregiver fidelity and maintenance in RCT of JASPER intervention with autistic toddlers

AbstractBackgroundInterventions facilitated by caregivers have gained popularity among those caring for young children with autism. Instructing caregivers on specific techniques to foster social communication skills in their at‐risk or diagnosed autistic children has the potential to alleviate concerns about their children's development. Moreover, it can offer a more intensive early intervention compared to what community providers alone can deliver. This study seeks to explore the correlation between caregiver strategies employed prior to participating in a caregiver‐mediated intervention and the caregiver's fidelity to the intervention, as well as its sustainability during the follow‐up period and child outcomes. This study constitutes a secondary analysis of a randomized controlled trial that compared the joint attention, symbolic play, engagement, and regulation (JASPER) and Psychoeducational Education Intervention (PEI), revealing significant advancements in children's social communication skills with the JASPER intervention.MethodsEighty‐six children (average age 31.5 months) with ASD and their primary caregivers enrolled in the two armed randomized trial evaluating the effect of JASPER versus PEI. Generalized linear mixed models were used to model the longitudinal trajectories of the outcomes.ResultsResults indicated that caregivers in the JASPER intervention made more gains in overall JASPER strategies and individual domain strategies (environment, prompt, communication, mirrored pacing) compared to the caregivers in PEI (p's < 0.01) from baseline to exit. While both groups regressed some in overall and subdomain strategies at follow‐up, caregivers in the JASPER intervention maintained more overall, and specifically in communication, and mirrored pacing strategies compared to PEI group (p's < 0.05). Further, baseline caregiver strategies moderated the treatment effect of child's joint attention skills from exit to follow‐up (p = 0.002), where JASPER dyads with high caregiver strategy use at baseline continued to improve in JA skills post exit, whereas all other children did not.ConclusionIn summary, understanding caregiver style of interaction before intervention on caregiver fidelity and maintenance from exit to follow up and child progress is important to improving intervention uptake and child outcomes.

Examining variability in Naturalistic Developmental Behavioral Intervention strategy use in caregivers of children with autism spectrum disorders.

Naturalistic Developmental Behavioral Interventions (NDBIs) for young children with autism spectrum disorder commonly involve caregiver-mediated approaches. However, to date, there is limited research on how caregivers' skills change, and, in turn, impact child outcomes. We evaluated the NDBI strategy use of 191 caregivers prior to participation in NDBIs (or control groups) across multiple randomized controlled trials, using the Measure of NDBI Strategy Implementation, Caregiver Change (MONSI-CC). Clustering analyses were used to examine caregiver variability in NDBI strategy use at intervention entry. Generalized Linear Mixed Models were used to examine changes in caregiver strategy use over the course of intervention and its impact on changes in children's social communication. Using clustering analysis, we found that caregivers' baseline skills fit four profiles: limited, emerging, variable, and consistent/high, with few demographic factors distinguishing these groups. Caregivers starting with limited or emerging skills improved in their strategy use with intervention. Caregivers starting with more skills (consistent/high or variable) maintained higher skills over intervention. Children of caregivers in these groups who received target NDBIs improved in their social communication skills. Results suggested that caregiver skills improve through participation in NDBIs and may directly contribute to their children's outcomes, although more research on mediating factors is needed. Individualized approaches for caregivers and their children starting with differing skill profiles at intervention entry may be warranted.

The Efficacy of Music Therapy Programs on the Development of Social Communication in Children with Autism Spectrum Disorder: A Systematic Review

Autism spectrum disorder (ASD) in children is characterized by difficulties in social communication and restricted repetitive behavior patterns. Music therapy appears to have beneficial effects in the area of social interaction and communication. The aim of this systematic literature review is to investigate the effectiveness of music therapy programs on the development of social communication among preschool- and school-aged children with ASD. For this purpose, a detailed study of the relevant literature that has been published in the last decade in peer-reviewed scientific journals was conducted. Web of Science, Springer Link, PsyINFO, and ERIC databases were searched, and according to the eligibility and exclusion criteria, 12 studies were finally selected from the 167 initially found. From the analysis of the results, the following categories were defined to contribute to enhancing social communication: (a) improvisational music therapy; (b) joint attention and eye contact; (c) therapeutic relationship, synchronization, and attunement; (d) imitation; (e) understanding and interaction; (f) family-centered music therapy; and (g) language and socioemotional adjustment. The results of the review were mixed, as music therapy appeared to have a positive effect on improving the social communication of children with ASD, but a general conclusion could not be drawn about the degree of its effectiveness compared to the standard treatments that children usually receive. In the future, further research in this field, especially on the improvisational music Therapy technique, is recommended. Moreover, an increased focus on the development of a common methodological practice regarding the sample selection process and measurement tools is suggested.

Research on the Present Situation and Cultivation Strategy of Children's Social Communication Ability from the Perspective of Family-Kindergarten Coeducation

Family and kindergarten are the most vital places for children's life and education. Only by implementing family-kindergarten coeducation can we create a better growing environment for children and empower their peer communication. This study found three main problems, including children's poor peer communication ability, parents' insufficient sense of responsibility, and the severely limited development of family-kindergarten coeducation. Based on the above problems, this study puts forward that teachers should conduct targeted guidance according to the social communication needs of children in different age classes. Parents should improve their educational awareness and scientifically guide children to establish correct communication concepts. Meanwhile, kindergarten takes a dual approach to break through the communication barriers of family-kindergarten coeducation.

Do Caregiver Perceptions of the Virtual More Than Words® Program Differ Based on Autistic Children's Attributes?

More Than Words® (MTW) is a caregiver-mediated intervention program led by a speech-language pathologist (SLP) who teaches caregivers strategies to support their autistic child's early social communication and play development. The program includes group sessions composed of multiple families with children of varying profiles. We explored whether caregiver experiences and perceived outcomes of the virtual MTW program differed depending on the child's age and social communication stage. As part of a program evaluation of virtual MTW delivered to over 2,000 families in Ontario, Canada, between 2020 and 2021, we randomly selected 31 families across four social communication stages and two age groups using stratified sampling (n = 4, in all but one subgroup). The Final Reflection and Evaluation form was analyzed both qualitatively and quantitatively, and a modified RE-AIM framework guided our analyses, including theme development. Child attributes did not appear to impact caregivers' experiences, but perceived child skill improvements varied by children's social communication stage. The majority of caregivers reported changes in how they interact with their child. Four themes emerged: (a) perceived child skill improvements differed by social communication stage, (b) caregivers gained new knowledge and strategies regardless of child attributes, (c) SLPs effectively managed families' individual needs, and (d) program components were appropriate for a variety of families. Findings suggest that the content taught in the MTW program was relevant for a variety of children, including those beyond the program's intended age of 5 years and under. Grouping families of children with varying profiles does not appear to negatively influence caregivers' experiences or perceived outcomes. https://doi.org/10.23641/asha.25237009.

Enhancing children's emotional regulation and social communication through group intervention – evidence of impact in an Irish outpatient Child and Adolescent Mental Health Service

In the last decade, Child and Adolescent Mental Health Services (CAMHS) have observed an unprecedented rise in young children presenting with suicidal ideation, needing urgent assessment and treatment. Once stabilised, CAMHS professionals often refer these children to speech and language therapists (SLTs) for assessment of and support for their social-emotional skills. The Secret Agent Society (SAS) is an evidence-based intervention for children with significant emotional regulation and social communication challenges. No published peer-reviewed evidence exists for the use of SAS for children with moderate-severe mental health disorders. This study aimed to evaluate the efficacy of SAS in an Irish outpatient CAMHS. Fifty-one children (30 boys, 21 girls) aged 8–12 years (mean age 10:11) with diagnoses of attention deficit hyperactivity disorder, anxiety disorder and/or autism attended the 14-week programme. Questionnaires were completed by children, their parents (51 mothers, 45 fathers) and teachers pre-intervention, post-intervention and at 3- and 6-month follow-up. Statistically significant improvements were made in children's social communication ( F (1.985, 99.273) = 24.900, p < 0.001) and emotional regulation ( F (1.787, 89.358) = 27.302, p < 0.001) across home and school settings. Children's knowledge of emotional regulation strategies also significantly improved. Treatment gains were maintained up to 6-months post-intervention. Results provide preliminary evidence for the efficacy of SAS in an Irish outpatient CAMHS. A cost–benefit analysis would determine the feasibility of offering SAS in other outpatient community services. SLTs have a vital role to play in delivering intensive social-emotional skills support for children with complex diagnostic profiles within CAMHS and other specialised multi-disciplinary teams.

Role of autonomic, nociceptive, and limbic brainstem nuclei in core autism features.

Although multiple theories have speculated about the brainstem reticular formation's involvement in autistic behaviors, the in vivo imaging of brainstem nuclei needed to test these theories has proven technologically challenging. Using methods to improve brainstem imaging in children, this study set out to elucidate the role of the autonomic, nociceptive, and limbic brainstem nuclei in the autism features of 145 children (74 autistic children, 6.0-10.9 years). Participants completed an assessment of core autism features and diffusion- and T1-weighted imaging optimized to improve brainstem images. After data reduction via principal component analysis, correlational analyses examined associations among autism features and the microstructural properties of brainstem clusters. Independent replication was performed in 43 adolescents (24 autistic, 13.0-17.9 years). We found specific nuclei, most robustly the parvicellular reticular formation-alpha (PCRtA) and to a lesser degree the lateral parabrachial nucleus (LPB) and ventral tegmental parabrachial pigmented complex (VTA-PBP), to be associated with autism features. The PCRtA and some of the LPB associations were independently found in the replication sample, but the VTA-PBP associations were not. Consistent with theoretical perspectives, the findings suggest that individual differences in pontine reticular formation nuclei contribute to the prominence of autistic features. Specifically, the PCRtA, a nucleus involved in mastication, digestion, and cardio-respiration in animal models, was associated with social communication in children, while the LPB, a pain-network nucleus, was associated with repetitive behaviors. These findings highlight the contributions of key autonomic brainstem nuclei to the expression of core autism features.

Effect of Bullying and Aggression on Social Communication of Children who Stutter

Background: Bullying and aggression in school settings have a profound impact on children, especially those with communication challenges like stuttering. Previous research has indicated that children who stutter may face increased risks of bullying, leading to adverse social, psychological, and academic outcomes. Objective: The primary objective of this study was to investigate the relationship between bullying, aggression, and social communication skills in children who stutter, and to understand the prevalence and impact of bullying on this particular group. Methods: In this cross-sectional study, data were collected from 385 stuttering adolescents aged 10-18 years, alongside their parents, at Eman Clinic, Children's Hospital, and GHQ Hospital in Faisalabad. The study utilized the Olweus Bullying Victim Questionnaire (OBVQ) and the Bus Perry Aggression Questionnaire to assess bullying and aggression. The Social Communication Questionnaire (SCQ) was employed to evaluate social communication skills. Data analysis was performed using SPSS version 25, focusing on descriptive statistics and correlation analysis. Results: The age distribution of respondents showed 38.2% (150) in the 10-12 age group, 34.6% (136) in the 13-15 age group, and 25.2% (99) in the 16-18 age group. Regarding gender, 59.0% (232) were female and 39.0% (153) were male. The correlation analysis revealed a significant positive correlation between bullying and aggression (r = .435, p < .000), while the relationships between bullying and SCQ (r = -.046, p = .371), and aggression and SCQ (r = .051, p = .323) were not statistically significant. Conclusion: The study highlights a significant correlation between bullying and aggression in stuttering adolescents, suggesting that as bullying increases, so does aggression. However, the impact of bullying and aggression on social communication skills was less clear, indicating a need for further research. These findings underscore the necessity of developing supportive measures in educational and healthcare settings for stuttering children to combat bullying and its adverse effects.

The bidirectional relationship between emotion regulation and social communication in childhood: A systematic review

AbstractEmotion regulation (ER) refers to the ability to regulate emotional reactions in response to stimuli. Social communication involves the knowledge and skills to engage in social interactions. Both processes develop in the first years of life and form the foundation for later functioning. Literature suggests a bidirectional relationship between ER and social communication; however, the majority of research examines these constructs independently. This review provides an in‐depth examination of research that has measured the relations between ER and social communication in children from 2 years of age and onwards. Findings revealed an age‐related pattern, where ER was related to later social communication and vice versa. However, there was no consensus regarding direct relationship(s) between ER and social communication due to heterogeneity among studies when defining and measuring these constructs. This review illustrates the importance of understanding the pathways between ER and social communication and may inform future studies, both in typical and atypical development.

Preliminary Outcomes and Adaptation of an NDBI for Spanish-Speaking Families

Naturalistic, Developmental, and Behavioral Interventions (NDBIs) are an empirically supported intervention approach for young autistic children and their families. Spanish-speaking (SS) Latinx families have been underrepresented in autism intervention research, limiting our understanding of whether NDBIs are aligned with Latinx family values and belief systems. This study piloted a parent-mediated NDBI, Project ImPACT, within outpatient services for SS Latinx families. We aimed to examine the preliminary impact of Project ImPACT on family and child outcomes while using the Ecological Validity Model to evaluate program adaptations made by bilingual clinicians. Results from 15 families indicated good treatment completion and high satisfaction, alongside significant increases in child social communication skills and parent self-efficacy in supporting their child’s development. Mixed-methods data examining program adaptations indicated the need to provide additional information related to autism, bilingual language development, and service navigation, as well as adaptations to language and metaphors used in the program.

Autistic Children's Irritability During Social Communication Assessments.

Accurate measurement of autistic children's social communication is critical for assessing skills, setting intervention goals, evaluating change over time, determining service eligibility, and determining classroom placement. There are various types of assessments, some of which use specific tasks to elicit social communication. Structured tasks may frustrate children, inadvertently elicit irritability, and have a cascading effect on their ability to communicate. To date, no studies have evaluated how differing types of social communication assessments may exacerbate children's irritability and impact assessment scores. We examined the extent to which (a) social communication assessment type (structured vs. naturalistic) impacts autistic children's irritability and (b) child irritability is associated with social communication scores. Autistic toddlers (n = 114, Mage = 33.09 months, SD = 6.15) completed the Communication and Symbolic Behavior Scales (CSBS; structured) and a 10-min play-based mother-child interaction (MCX; naturalistic). Child irritability was scored on both assessments using a global rating scale of 0-15. Child irritability during the CSBS was significantly higher than during the MCX (V = 4892, p < .001, r = .68). Higher irritability was associated with lower CSBS social communication scores (B = -0.05, p = .03), but not MCX scores (B = 0.04, p = .13; Theil's F = 6.92, p = .009). Our findings suggest that the CSBS may pose unique challenges for autistic children, as it led to higher rates of irritability and negatively affected children's social communication scores. Evaluating the association between assessment type and irritability supports the complete characterization of autistic children's experience during assessments and clinicians in obtaining a more representative measure of social communication.

Addressing disruptive behaviors within naturalistic developmental behavioral interventions: Clinical decision-making, intervention outcomes, and implications for practice.

Naturalistic developmental behavioral interventions are a common and well-researched type of intervention for young autistic children that focus on supporting social communication. These interventions often do not include formal guidelines on how to address disruptive behaviors, even though they are common among autistic children. This study measured how often clinicians delivering a specific naturalistic developmental behavioral intervention, Project ImPACT, adapted how they delivered the program to address disruptive behavior, and how these adaptations related to children's social communication outcomes at the end of their participation in the intervention. We also spoke with clinicians about how they address disruptive behavior and emotion regulation during their sessions. In this study, clinicians adapted Project ImPACT to address disruptive behaviors in about one-third of all sessions. These adaptations did not affect children's social communication outcomes. Clinicians discussed how they felt social communication, disruptive behavior, and emotion regulation are linked to one another and that they often try to integrate intervention strategies to address each of these areas. However, they note that a clinicians' approach to addressing disruptive behavior might vary depending on their level of training and experience. These results indicate several future directions for supporting clinicians in addressing behavior and regulation effectively within these types of interventions.

Relative Efficacy of Self-directed and Therapist-assisted Telehealth Models of a Parent-mediated Intervention for Autism: Examining Effects on Parent Intervention Fidelity, Well-being, and Program Engagement.

Although there is growing interest in telehealth to deliver parent-mediated intervention for autistic children, empirical evaluations are limited, and little is known regarding the relative benefits of self-directed and therapist-assisted telehealth interventions. This study examined the effect of self-directed and therapist-assisted ImPACT Online on parent learning and well-being, moderators of treatment, and predictors of program engagement. Sixty-four young autistic children and their primary caregiver participated. Children were matched on age and developmental quotient and randomly assigned to a therapist-assisted, self-directed, or resource support control group. Participants were assessed at intake, after 6 months (post), and at a 3-month follow-up. There was a significant treatment effect for parent learning for the therapist-assisted but not self-directed program; when analysis was limited to parents who completed the program, treatment effects were observed for both groups. There were no treatment effects for parent self-efficacy or parenting stress; however, there was an effect on parents' perception of their child's positive impact. Parenting stress did not moderate the effect of group on parent outcomes. Parent age, program satisfaction, and therapist assistance were all significant predictors of parent program engagement. This study supports the efficacy of therapist-assisted telehealth parent-mediated intervention for teaching parents intervention strategies to support their child's social communication and improving their perceptions of their child's positive impact, and suggests that self-directed programs may be beneficial for parents who fully engage with the program.

Brief Report: Telehealth Music-Enhanced Reciprocal Imitation Training in Autism: A Single-Subject Feasibility Study of a Virtual Parent Coaching Intervention.

Telehealth delivery increases accessibility of parent-mediated interventions that teach parents skills and support autistic children's social communication. Reciprocal Imitation Training (RIT), an evidence-based Naturalistic Developmental Behavioral Intervention (NDBI) focused on imitation skills, a common difficulty in autism, holds promise for telehealth-based parent training. Imitation is also a core component of musical play during childhood and the affordances of musical play/song naturally shape parent-child interactions. We evaluate the feasibility of a music-based, telehealth adaptation of RIT-music-enhanced RIT (tele-meRIT)-as a novel format for coaching parents in NDBI strategies. This single-subject, multiple baseline design study included 4 autistic children (32-53months old) and their mothers. Parent-child dyads were recorded during 10-min free play probes at baseline, weekly tele-meRIT sessions, and one-week and one-month follow-up. Probes were coded for parents' RIT implementation fidelity, parent vocal musicality, and children's rate of spontaneous imitation. No parent demonstrated implementation fidelity during baseline. All parents increased their use of RIT strategies, met fidelity by the end of treatment, and maintained fidelity at follow-up. Parent vocal musicality also increased from baseline. Intervention did not consistently increase children's imitation skills. A post-intervention evaluation survey indicated high parent satisfaction with tele-meRIT and perceived benefits to their children's social and play skills more broadly. Implementing tele-meRIT is feasible. Although tele-meRIT additionally involved coaching in incorporating rhythmicity and song into play interactions, parents achieved fidelity in the RIT principles, suggesting one avenue by which music can be integrated within evidence-based parent-mediated NDBIs.

The Effectiveness of Telemedicine in Coaching Parents of Autistic Children Using Naturalistic Developmental Early Interventions: a Rapid Review

AbstractEvidence on the effectiveness of telemedicine in coaching parents of autistic children using naturalistic developmental early interventions is limited. This review aimed to examine the literature on the effectiveness of telemedicine on children’s social communication following parent-mediated naturalistic developmental early interventions. A total of nine studies were identified. Intervention characteristics, outcomes, and research quality were assessed. Findings suggest insufficient evidence for the effectiveness of telemedicine on child social communication. All the included studies were at high risk of bias in at least one quality indicator of the risk of bias tools. More high-quality research is required to examine the effectiveness of telemedicine applications on child social communication to support access and continuity of early intervention services.

Possible disrupted biological movement processing in Developmental Coordination Disorder

AimThere is emerging evidence that the Mirror Neuron System (MNS) might contribute to the motor learning difficulties characteristic of Developmental Coordination Disorder (DCD). This study aimed to identify whether MNS activity differed between children with and without DCD during action observation, action execution and during a non-action baseline. MethodsElectroencephalography (EEG) was used to measure mu rhythm (a proxy for MNS activation) in 8-12-year-old children either with (n = 20) or without (n = 19) a diagnosis of DCD. The mu rhythm was recorded at rest and during five experimental conditions: (1) observation of gross motor and (2) fine motor actions; (3) execution of gross motor and (4) fine motor actions; and (5) non-biological movement. To address whether potential co-occurring traits of other neurodevelopmental conditions were associated with differences in mu rhythm, parents reported their child's attention and social communication skills. Mixed and repeated measure ANOVAs were conducted to examine differences in mu desynchronization and mu power respectively. ResultsThe non-DCD group showed greater mu rhythm desynchronization than children with DCD (i.e., more MNS activity), with both groups demonstrating increasing desynchronization from observation of fine actions to execution of gross actions. However, we also found that the children with DCD had less mu power during the non-biological movement condition than the non-DCD children, although mu power did not differ between groups during the resting condition. Correlations between mu desynchronization and children's attention and motor skills showed that poorer attention and motor abilities were associated with reduced MNS activity. ConclusionCompared to children without DCD, the MNS in children with DCD did not distinguish between biological and non-biological movement. It is possible that the reduced specificity of the MNS in children with DCD is an underlying factor in the motor impairments observed in the disorder. The differential MNS activity could reflect broader atypical activity in perceptual networks that feed into the MNS in DCD.

Evaluation of the social communication of children up to 12 years old with Autism Spectrum Disorder in a Psychosocial Care Center

Objective: To characterize social communication in children up to 12 years old diagnosed with Autistic Spectrum Disorder (ASD) treated at the Child Psychosocial Care Center (CAPSi) in Mossoró/RN. Methods: Exploratory, descriptive, quantitative, cross-sectional study conducted at CAPSi in Mossoró/RN. The data collection was based on the application of questionnaires to parents/guardians to characterize their socioeconomic conditions and their perception of their children. The Language Development Assessment (LDA) instrument for children was used, developed to assess the acquisition and development of language content (semantics) and structure (morphology and syntax). The questionnaires were coded, and the data were tabulated for further statistical analysis. Results: 33 children and 73 parents/guardians were studied. Most parents/guardians were female (95.9%), aged 30-39 years (mean age 37.6 years predominantly), with a partner (60%), with high school education (45%), and monthly income around one minimum wage (76.7%), having positive attitudes toward their children and noticing difficulties in their communication. In applying the questionnaire to the children, 63.7% presented results within the normal range, while 3% presented mild and 33.3% severe language alterations. Conclusion: Children with ASD attending CAPSi have language disorders in the pragmatic sublevel, and more than half of the participants did not have morphosyntactic and semantic changes.

Neuropsychological profile of children with Autism Spectrum Disorder and children with Developmental Language Disorder and its relationship with social communication

Objective The objective of this study was to probe neuropsychological mechanisms of social communication in children with Autism Spectrum Disorders (ASD) and children with Developmental Language Disorders (DLD). Due to overlap of symptoms that include social dysfunction, diagnostic boundaries between these two developmental disorders remain unclear. This study hypothesizes that these two groups of children differ in the characteristics and in the underlying mechanisms of their social issues. Method This study examines a wide range of neuropsychological domains in search of a relationship with social communication. A total of 75 children with ASD and 26 children with DLD are included. A cross-battery assessment of neuropsychological functions is conducted, and social communication is evaluated using the Social Responsiveness Scale (SRS). Results The neuropsychological profile for the ASD group differs from the DLD group, with the former demonstrating higher scores on Visual Processing and Comprehension, whereas the DLD group scores higher on Fluid Reasoning, Visual Processing and Processing Speed. Correlation analysis reveals that the association between neuropsychological domains and social communication differs between the groups. Discussion Children with ASD and DLD clearly have distinctive neuropsychological profiles—their strengths and weaknesses are not equivalent. Such results motivate broad assessment of neuropsychological functions, as this assists in differentiating ASD from DLD for theragnostic purposes.

Verbal Responsiveness in Parents of Toddlers With and Without Autism During a Home Observation.

This study examined patterns of verbal responsiveness in parents of toddlers (Mage = 20months) later identified with autism (n = 121), developmental delay (n = 46), or typical development (n = 44) during an hourlong home observation. Parent verbal responsiveness (PVR) was compared using MANOVA across groups and by child expressive language phase. Multiple regression analyses controlling for child age and maternal education were employed to examine the extent to which PVR predicted variance in concurrent child social communication and prospective language skills. Parents provided synchronous responses approximately 90% of the time. Parents of children with autism and developmental delay used smaller proportions of responses that added linguistic information (i.e., expansions and follow-in directives for language) than those of children with typical development. Parents of children in the preverbal phase were more likely, on average, to affirm their children's acts of intentional communication or provide a follow-in directive for action that did not necessitate a verbal response than to expand or elicit language. Regression results indicated that parental use of expansions and follow-in directives for language made significant contributions to child language outcomes. The patterns we observed may reflect parents' attunement to their child's developmental level. Responsiveness to a child's focus of attention is vital in the earlier stages of language learning; however, results point to the potential importance of parental expansions and follow-in directives for promoting language development across groups in this sample. Directions for intervention research targeting PVR and language skills in toddlers with autism and developmental delays are discussed.

Paediatric autism communication therapy improved long-term child outcomes

Paediatric autism communication therapy impoved long-term child outcomes Paediatric Autism Communication Therapy is currently the only scientifically evidenced early social communication intervention to demonstrate long-term improved child social communication outcomes into middle childhood. Despite Autism being an enduring condition affecting 2% of people globally, evidenced intervention to improve the developmental impairments is limited. Paediatric Autism Communication Therapy (PACT) is currently the only scientifically evidenced early social communication intervention to demonstrate long-term improved child social communication outcomes into middle childhood. The PACT intervention has shown long-term improvement of autism core symptoms within randomised clinical trials (RCTs). PACT relatively low-intensity approach is referenced in UK national guidance for the new autism care pathway from pre- to post-diagnosis and education support.