A parent-report instrument, the First Year Inventory (FYI), was developed to assess behaviors in 12-month-old infants that suggest risk for an eventual diagnosis of autism. The target behaviors were identified from retrospective and prospective studies. FYIs were mailed to 5,941 families and 25% (N = 1,496) were returned, with higher return rates for white families and for families with greater educational attainment. Ad hoc groups of questions afforded measurement of eight specific constructs, which were combined to establish a general risk index. Boys had higher risk scores than did girls. Maternal race and education influenced answers. A small percentage of infants appeared to be at notably elevated risk. Large-scale longitudinal research is warranted to determine whether the FYI can predict an eventual diagnosis of autism.
This study examined the development of deictic and representational gestures in 12 typically developing children from 6 to 24 months of age. Gestures were categorized into J. Bruner's (1981) 3 broad (and 8 specific) communicative functions: behavior regulation (i.e., requesting objects, requesting actions, protesting), joint attention (i.e., commenting, requesting information), and social interaction (i.e., representational gestures, attention seeking, social games). Ongoing parental completion of researcher-created gesture recording forms and monthly researcher observational confirmation were used to capture the emergence and consistent use of targeted gestures. Within each specific functional category, a hierarchy of development was documented for the gestures and behaviors used to signal that intent. This study provides rich detail as to the order of emergence of common deictic and representational gestures and their relationship to other preceding and concomitant behaviors that children use to signal their intentions. Furthermore, the results document younger ages of emergence, in comparison with previous studies, for most of the targeted gestures and provide insight into the controversy in the literature regarding the relative emergence of declarative and imperative gestures.
Theoretically, interventions initiated with at-risk infants prior to the point in time a definitive autism spectrum disorder (ASD) diagnosis can be made will improve outcomes. Pursuing this idea, we tested the efficacy of a parent-mediated early intervention called Adapted Responsive Teaching (ART) via a randomized controlled trial with 87 one-year-olds identified by community screening with the First Year Inventory as at-risk of later ASD diagnoses. We found minimal evidence for main effects of ART on child outcomes. However, ART group parents showed significantly greater increases in responsiveness to their infants than control group parents. Further, significant indirect (mediation) effects of assignment group on multiple child outcomes through changes in parent responsiveness supported our theory of change.
This study examined the (a) feasibility of enrolling 12-month-olds at risk of ASD from a community sample into a randomized controlled trial, (b) subsequent utilization of community services, and (c) potential of a novel parent-mediated intervention to improve outcomes. The First Year Inventory was used to screen and recruit 12-month-old infants at risk of ASD to compare the effects of 6–9 months of Adapted Responsive Teaching (ART) versus referral to early intervention and monitoring (REIM). Eighteen families were followed for ~20 months. Assessments were conducted before randomization, after treatment, and at 6-month follow-up. Utilization of community services was highest for the REIM group. ART significantly outperformed REIM on parent-reported and observed measures of child receptive language with good linear model fit. Multiphase growth models had better fit for more variables, showing the greatest effects in the active treatment phase, where ART outperformed REIM on parental interactive style (less directive), child sensory responsiveness (less hyporesponsive), and adaptive behavior (increased communication and socialization). This study demonstrates the promise of a parent-mediated intervention for improving developmental outcomes for infants at risk of ASD in a community sample and highlights the utility of earlier identification for access to community services earlier than standard practice.
Fathers of children with autism spectrum disorders (ASD) are underrepresented in both early intervention and research. However, fathers have unique interaction styles that make important contributions to the language and symbolic play development of typically developing children. Fathers may make similar contributions to the development of their children with ASD, who struggle with social-communicative deficits, particularly in the areas of language and symbolic play. This article provides a theoretical rationale for enhancing father—child involvement in early autism intervention that may lead to improved outcomes in child communication and symbolic play and have cascading benefits for families in reducing stress and enhancing coping mechanisms. To support this rationale, systematic reviews of the literature were conducted to (a) identify the extent of father involvement in parent training programs for children with autism, (b) identify the contributions of parents to the symbolic play outcomes of their children with ASD and other disabilities, and (c) examine differences in stress and coping experienced by mothers and fathers of children with ASD. Finally, possible barriers to father participation in early autism intervention are discussed and recommendations are offered for making parent-implemented early intervention for children with ASD more amenable to fathers.
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