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Caregivers of autistic toddlers learn multicomponent Naturalistic-Developmental-Behavioral-Interventions (NDBIs) with high levels of fidelity. However, little thought has been given to the impact of NDBIs on characteristics of caregiver-child interactions (CCXs) that facilitate child language development, but are not directly targeted by NDBIs, such as linguistic diversity and complexity. This study compared the linguistic input of 111 caregivers who learned either responsive or directive NDBI strategies over an 8-week period. Caregivers’ number of different words (NDW), mean length of utterance in words (MLUw), and fidelity using taught strategies were measured during 10-minute CCXs. After intervention, caregivers who learned responsive strategies had significantly lower NDW and MLUw than those who learned directive strategies, and their fidelity of strategy use was negatively associated with NDW and MLUw. This association seems to be driven by two strategies: modeling appropriate language and pacing. This suggests that these strategies may have a negative consequence on caregiver linguistic diversity and complexity, pointing to ways that clinicians may individualize NDBIs to target competing goals for unique children and families.
Funding provided by the National Institute of Health (NCT02632773). |
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