A Comparison of Maternal and Clinician Perception of Communication in Toddlers with Autism

Purpose: Caregiver instruction in responsive communication strategies for toddlers with autism spectrum disorder (ASD) relies on assumptions that caregivers interpret behaviors in alignment with clinician communication targets. The purpose of this study was to identify child behavioral forms that are predictive of alignment in identification of child communication between clinical researchers and mothers of young children with ASD. Methods: Participants were 33 mothers and their children with ASD between 18 and 48 months of age. Parent identification of child communication (PICC) was assessed using a procedure in which mothers and clinical researchers each independently identified child communication in the same 10, one-minute video clips of each mother’s child. Endorsed communicative acts were coded for the presence of conventional forms (e.g., vocalization) and potentially communicative forms (e.g., body movement). Multilevel logistic regressions, fit with Bayesian inference, were conducted to predict classification of maternal endorsements of child communication based on the presence of conventional and potentially communicative forms as either an aligned (i.e., act endorsed by mother and researcher as communicative) act or an overattribution (i.e., act endorsed by mother but not researcher). Results: The presence of vocalization, verbalization, and gesture each significantly predicted increased likelihood of alignment; the presence of eye contact did not. Although repetitive-sensory behaviors significantly increased likelihood of overattribution, affect shifts and body movements each significantly reduced likelihood of overattribution, and hand activity was not significantly predictive of overattribution. Conclusions: Misalignment in mother-clinician identification of communication may be in part due to mothers’ endorsement of behavioral forms that are not traditionally classified as part of a child’s communication repertoire. Findings emphasize the need to work towards designing communication interventions that consider the ways in which clinicians and parents of children with ASD each bring their own interpretive frameworks to the early intervention experience.