Date of Award

Summer 8-7-2018

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Kathleen Baggett

Second Advisor

Dr. Brian Barger

Abstract

INTRODUCTION: Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting 1 in 59 children in the United States (Centers for Disease Control and Prevention [CDC], 2018). Parent-mediated early interventions, which aim to support parent facilitation of toddler social communication, are a major of focus of research (Green et al., 2017). Systematic review of the literature revealed that, out of 27 studies of parent-mediated interventions to improve toddler social communication outcomes, only seven (25.9%) used a measure designed to assess both parent and child behavior during observed parent-child interaction. Measures reported in this literature are of limited relevance for community early childhood practitioners due to high level of training and burden required for administration and scoring. To address this limitation, secondary coding and analysis of parent-child interaction video data from a recently published study (Schertz, Odom, Baggett, & Sideris, 2017) was conducted. Using a practical and psychometrically sound indicator of parent-child interaction, the aim was to provide an empirical example of how results of an indicator of parent-child interaction could be applied by practitioners via a data-based approach for monitoring progress of parent support of toddler social behavior among dyads participating in community parent-mediated intervention services. Analyses were conducted to examine parent support behaviors in relation to the general outcome of child social behavior toward their parents and address the following research questions: What is the mean, median, range, and standard deviation of parent positive support behavior and child social behavior in a sample of toddlers with ASD? Is parent positive support behavior significantly and positively related to child social behavior? Do children whose parents engage in high levels of support behavior demonstrate more positive social behavior in contrast to children whose parents engage in low levels of support behavior?

METHOD Direct observation of parent-child interaction was conducted using the Indicator of Parent Child Interaction-2 (IPCI-2), within a sample of parents and toddlers from a randomized controlled trial of a parent-mediated early behavioral intervention focused on improving outcomes for toddlers with ASD (Schertz et al., 2017). Videos were coded from 10-minute parent-child free-play sessions recorded in the family homes. Two independent coders established interobserver agreement at 92.5%. Descriptive statistics were provided of caregiver support behavior (facilitator) and child engagement with parents. To quantify the strength of the relationship between parent and child behavior, correlation, and bivariate regression analyses were conducted between caregiver facilitators and child engagement.

RESULTS: Caregivers overall obtained a mean facilitator score of 217.9 (SD= 59.8, range=285) and mean child engagement score of 126.37 (SD= 40.0, range= 190). Overall caregiver facilitator and overall child engagement variables showed highly significant strong correlations, r=.747, p

DISCUSSION: This study highlights the relevance of practical application of a practitioner measure to assess parent-child interaction. Results demonstrate that an applied observation measure, with high interobserver agreement, can be use used to capture targeted parent behaviors key to promoting social communication in toddlers with ASD.

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