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Joint Engagement, Parent Labels, and Language Development: Examining Everyday Interactions in Infant Siblings of Children with Autism

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Abstract

This study examined joint engagement, parent labels, and language development in infants with an elevated (EL) and typical likelihood (TL) for ASD. Parent–child interactions were coded for joint engagement and parent labels at 12 and 18 months, and language skills were assessed later in toddlerhood for 12 EL infants diagnosed with ASD (EL-ASD), 17 EL infants with language delay (EL-LD), 14 EL infants with no diagnosis (EL-ND), and 12 TL infants. Infants spent substantial time in supported joint engagement and received similar rates of input from parents across outcome groups. However, parents of EL-ASD infants increased the rate of labels provided in coordinated joint engagement. While labels positively predicted language for TL infants, the opposite pattern emerged for EL-ASD infants.

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Notes

  1. While the field has traditionally referred to EL infants as “high risk” (HR), this terminology conveys a view that having an autism spectrum diagnosis is inherently negative. While many individuals with autism need substantial support, many also view their autism as a positive aspect of their identity (e.g., Kenny et al., 2016; Robison, 2019). We use the terms “elevated likelihood” (EL) and “typical likelihood” (TL) here in place of the stigmatizing language predominant in the medical model of autism.

  2. EL infants were evaluated at 36 months with the exception of one EL infant who was evaluated at 24 months of age and received an ASD diagnosis prior to withdrawing from the study. This participant is included in analyses.

  3. Four infants (one in each outcome group) spent 0% of the observation at both 12 and 18 months in coordinated JE. An additional 8 infants (2 TL, 2 EL-ND, 0 EL-LD, 4 EL-ASD) at 12 months and 12 infants (1 TL, 2 EL-ND, 7 EL-LD, 2 EL-ASD) at 18 months spent 0% of the observation in coordinated JE.

  4. For both the 12-month and 18-month regressions, analyses were performed with and without controlling for concurrent expressive language. The pattern of results for each model was the same, with two exceptions: when concurrent language was not included for 18-month labels in the overall observation and for 18-month labels in coordinated JE, the EL-ND interaction terms were also significant (ps < 0.05). Additionally, post-hoc analyses rotating the reference group with and without concurrent language were equivalent unless otherwise specified, and results are presented throughout with concurrent expressive language in the model.

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Acknowledgments

This research was supported by grants from the National Institutes of Health (R01 HD054979 and R01 HD073255) to JMI. Additional support for recruitment was provided by UL1 RR024153 and UL1 TR000005 to the University of Pittsburgh Clinical and Translational Science Institute. We would like to thank Alyssa Cooper, Amanda Shields, Sydney Tan, and Alyson Menzies for their help with behavioral coding and members of the Infant Communication Lab for assistance with data collection. Special thanks to Celia Brownell and Jennifer Silk for their insightful comments and to the infants and families who participated in this research. This research was completed in partial fulfillment of the requirements for the degree of Master of Science at the University of Pittsburgh. Portions of these data were presented at the 2018 International Congress of Infant Studies, Philadelphia, PA, the 2018 Joint International Workshop “Understanding and Promoting Change from Early to Complex Skills in Typical and Atypical Development”, Bologna, Italy, and the 2021 Society for Research in Child Development virtual meeting.

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  1. Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA

    Emily J. Roemer, Elizabeth H. Kushner & Jana M. Iverson

  2. Emory University, Atlanta, GA, USA

    Elizabeth H. Kushner

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EJR jointly conceived of and designed the study, completed behavioral coding, conducted analyses and interpretation of data, and drafted the manuscript. EHK contributed to interpretation of data analyses, assisted with figures, and provided revisions and feedback on the manuscript. JMI jointly conceived of and designed the study, coordinated data collection, assisted in interpretation of data analyses, and provided revisions and feedback on the manuscript. All authors read and approved the final manuscript.

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Roemer, E.J., Kushner, E.H. & Iverson, J.M. Joint Engagement, Parent Labels, and Language Development: Examining Everyday Interactions in Infant Siblings of Children with Autism. J Autism Dev Disord 52, 1984–2003 (2022). https://doi.org/10.1007/s10803-021-05099-1

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