Date of Award

5-31-2018

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Clinical Psychology

First Advisor

Alice S. Carter

Second Advisor

Abbey Eisenhower

Third Advisor

Angel Fettig

Abstract

Requesting deficits are an early social communication risk factor for ASD in toddlers (Barbaro & Dissanayake, 2009) and are successfully targeted through intervention (Leung, 1994). Currently, evidence-based interventions address a number of social communication deficits. However, little is known about how specific interactional strategies (i.e., ways interventionists interact with children to initiate or respond to behavior while working towards treatment goals) function individually, and in combination, on specific target behaviors. The current study evaluated two interactional strategies: positive affective engagement (consistently high versus low with contingent high) and expectant pausing (long versus short) on child requesting behaviors. As part of a larger screening study, children were recruited and randomized to one of four conditions (positive affective engagement by expectant pausing) following confirmation of an ASD diagnosis made with gold-standard assessment tools and clinical judgment (n=58, M=28.24 months [4.61]). Examiners administered 5 trials within each assigned condition using hierarchical prompting with a novel toy in an attempt to elicit requests. Child interest (no interest, moderate interest, high interest) was examined as a potential moderator of child requesting. Child expressive language and ASD symptom severity were considered as covariates of child requesting. Generalized estimating equation (GEE) analyses revealed a three-way interaction between positive affective engagement, child interest in materials, and trial number. In high child interest trials, in which children were randomized to the consistently high engagement versus the low with contingent high engagement condition, children were more likely to request in earlier trials than in later trials. In contrast, in medium child interest trials, in which children were randomized to the low with contingent high engagement versus the consistently high engagement condition, children made more requests independent of trial number. Low child interest trials rarely resulted in requesting behaviors, irrespective of engagement condition. Pause length was not associated with requesting. A major finding to emerge from this study is that a child’s level of interest in materials is an important consideration when attempting to elicit a request. Findings provide evidence that examiner use of engagement approach matters and may need to vary based on a child’s current level of interest in intervention materials/activities.

Comments

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