Guided Participation and Parental Tutoring in Preschool Children with Autism: A Pilot Study of Relationship Development Intervention (RDI)

ABSTRACT

The guided participation relationship between parents and children, whereby parents sensitively support the child’s emerging abilities, is central to child development. However, difficulties with intersubjective engagement characteristic of autism can make supportive interactions between parents and children more challenging. In this study, we compared dyads of parents and children with autism (n = 16) and dyads of parents and children with other developmental disabilities (n = 14) on two coding schemes, the Dyadic Coding Scales (DCS) and a Parent Scaffolding coding scheme. Consistent with expectations, the ASD group showed more difficulties in parent–child engagement on the DCS. Although autistic children were more likely to resist parental input on the Parent Scaffolding task, their parents were equally as sensitive as those in the developmental disabilities group. Child factors on the Parent Scaffolding coding scheme were associated with DCS scores. Half (n = 8) of the children with autism received an academic school year-long modified version of Relationship Development Intervention delivered in a preschool setting, and all children with autism (n = 16) were re-assessed at the end of the preschool year. The dyads who had received RDI showed improvements in parent–child engagement on the DCS, both compared to baseline and compared to the group who did not receive the intervention. No changes in Parent Scaffolding were found. The results are discussed in relation to intervention priorities for children with autism.

KEYWORDS:

• Parent–child interaction
• autism
• intersubjectivity
• intervention
• relationship-development intervention

Acknowledgments

We express our gratitude to Pediatrics Plus Developmental Preschool, a comprehensive and specialized healthcare program for children with special needs and developmental delays. Pediatrics Plus is licensed by the State of Arkansas as an Early Intervention Day Treatment (EIDT) program. Each location has classrooms specifically focused on children with ASD. The Little Rock and Conway locations served as the research setting for this study. They provided funding, space, database access, and supplemented time for interventionists to carry out the study. IRB approval was obtained through the University of Central Arkansas and by the Department of Psychology at University of York.

We are very grateful to the Foundation for Autism Research and Remediation (FARR) for a grant to the final author of this publication which was used to support purchase of materials, expenses, conference travel for presentations, and payment to naïve raters. We are also grateful to Gabriela Moreno Vera, Brandon Davis, and Erika Malfavon-Alvarez for assistance with coding.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

In this article, we use both person-first (i.e., person with autism) and identity-first (i.e., autistic person) language interchangeably for purposes of variety in the writing and to be respectful to both forms of linguistic preference.

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Notes on contributors

Fionnuala Larkin

Fionnuala Larkin, DPsychSc, is a clinical psychologist with an interest in developmental psychology and psychopathology, and in particular, bidirectional processes between parent and child that shape development. She is a Senior Lecturer in the School of Applied Psychology at University College Cork, and an associate staff member at University of York and University College Dublin. She specializes in assessment and intervention for developmental disorders in children and adults and conducts research on mind-mindedness, parent-child relationships and interaction, maternal/infant mental health and autism.

Lynne Hollaway

Lynne Hollaway, M.S. OTR/L, is a Clinical Instructor I at the University of Central Arkansas Occupational Therapy Department. She has seventeen years’ experience working with children with ASD and their families within an outpatient and preschool setting. At the time of the study, she was a certified RDI consultant and Director of Pediatrics Plus Developmental Preschool where the study was conducted. Her primary roles were administering the RDA-RV assessments, collaborating on intervention implementation, and coordinating the project with her coauthors.

Mary Garlington

Mary Garlington, M.A., BCBA, M.S., OTR/L, is an experienced occupational therapist and Board Certified Behavior Analyst (BCBA) who specializes in the treatment of children with autism spectrum disorder (ASD). She has provided school-based, community-based, and home-based services to children with ASD for the past thirteen years. She currently serves as ASD Clinical Expert for Pediatrics Plus where she provides clinical oversight for all ABA therapy services and consultation services for occupational, physical, and speech-language therapists at Pediatrics Plus. At the time of the study Mary was an RDI consultant and provided the direct RDI intervention to the children and their parents. She also administered RDA-RV assessments.

Jessica Hobson

Jessica Hobson, Ph.D., is Clinical Director of the Family Guidance and Therapy Center, Petaluma. She is a licensed clinical psychologist and Lecturer in the Psychology Department at Sonoma State University. She is a certified RDI consultant. Her clinical specialties include assessment, diagnosis, consultation, and therapy for autism spectrum disorders (ASDs). Areas of clinical and research expertise include parent-child interaction, joint attention, social communication, sensory processing, emotion regulation, neurodiversity, and twice-exceptionality. She uses mindfulness and relationship-based approaches to intervention. She has published academic papers on diverse topics in ASD including comorbid psychiatric symptoms, sensory processing differences, social anxiety, and neurocognitive profiles.