ABSTRACT
The proposed project will lead to an understanding of how common caregiver interaction strategies facilitate
moment-to-moment changes in reciprocal communication and how child characteristics are associated with
this relationship. Acquiring spoken language by age 5 is a key predictor of lifelong communication outcomes
and an estimated one-third of autistic children who have not met this benchmark, also commonly classified as
minimally verbal, experience significant difficulties that impact daily living and quality of life long-term. Because
reciprocal communication sets the stage for successful social interactions and language learning, promoting
reciprocity is an important goal for both development and intervention in nonspeaking children. While many
intervention approaches leverage parent-child synchrony and turn-taking to support communication, our
understanding of how specific behaviors influence reciprocity is primarily limited to summary-level measures
and often uses third-party subjective ratings. In contrast, the key innovation in this proposal is investigating
interaction dynamics on two timescales – at the interaction level and at the moment-to-moment level.
Analyzing the interaction at the moment-to-moment level allows for a more direct temporal link between
commonly used caregiver strategies and changes in reciprocity than summary-level measures can provide.
The proposed study will utilize a cohort observational design and a sequential analysis approach to
address two specific aims: to evaluate the influence of caregiver strategies on moment-to-moment changes in
reciprocal interaction in nonspeaking autistic children and to determine the impact of individual child
characteristics on the relationship between caregiver behavior and reciprocal interchanges. These aims will
test the working hypothesis that caregiver imitation and multimodal communication are more likely to elicit
communication interchanges with their child than expected by chance, and that child receptive language is
associated with the relationship between these strategies and occurrence of interchanges. Multimodal
communication and imitation strategies are commonly employed by caregivers and recent work has shown that
they lead to increased engagement in younger autistic children. This highly quantitative approach builds on
prior work by addressing the influence of timing and coordination during interaction, which are known to be
impacted in autism. By analyzing the play interactions of 4–6-year-old children, we will gain more insight into
the nature of reciprocal communication dynamics at a critical juncture in children's communication
development – during the shift from preverbal to minimally verbal status. This knowledge will move the field
toward identifying specific mechanisms of social interaction in nonspeaking children and refine intervention
strategies for this population. Future work can extend this approach to increase our understanding of how
caregiver strategies influence behavior and for whom they are most effective.
