Emotional Availability and Play in Mother–Child Dyads with ASD: Changes during a Parental Based Intervention
Abstract
:1. Introduction
1.1. Affective Quality in Mother–Child Dyads with ASD
1.2. Cognitive Elements in Mother–Child Dyads with ASD: The Role of Play
1.3. Parental Involvement during Intervention with Children with ASD
1.4. Aims and Hypotheses
- In line with previous findings that include caregivers into the therapeutic setting [55,56,57], and in line with the theoretical framework of the implemented intervention that focuses on the syntonization between adult and child’s needs, we expect that mothers will increase their awareness of timing during the interaction with the child, catching child’s signals and respecting his/her time given the possibility for parents to experiment themselves in functional interaction with their children.
- Further, considering that during intervention therapists provide caregivers appropriate hints and suggestions to interact and play with their children in a functional way, we also predict that mothers will increase their general levels of Emotional Availability, especially considering structuring and non-intrusiveness scales.
- With respect to the child, in line with previous findings that depicted positive change in child socio-communicative behaviors [78,79,80,81] we expect to find improvements in the child’s level of responsiveness and in the use of different communicative strategies (e.g., eye-contact looking, body positioning, verbal involvement) to involve the caregiver during an interactive exchange.
- In particular, we expect that during the intervention children will increase their level of symbolic play, consequently decreasing their level of exploratory play during the interaction with the caregiver, given that the intervention focuses also on a specific work on cognitive abilities necessary to be able to play with more advanced skills.
- We further expect that mother and child scores will be more related after intervention, indicating an increased adaptation by the adult to the child’s level of play.
- Considering the child, we expect that the communicative aspects of the child in interaction with the caregiver may impact on the child’s scales of Emotional Availability, given the impact of verbal and non-verbal communicative aspects on dyadic functional relationships.
- Further, on the basis of previous literature that reported that higher levels of parental stress may impact on adult interactive modalities considering children with typical development [82] and children with ASD [83], we want to investigate the parental stress with respect to the adult Emotional Availability, and the specific stress dimensions that may impact on parent’s modalities during the interplay with the child.
2. Materials and Methods
2.1. Participants
2.2. Procedure
2.3. ODFLab Parental Based Intensive Intervention
2.4. Measures
2.4.1. Griffiths Mental Development Scales
2.4.2. Autism Diagnostic Observation Schedule-2
2.4.3. Emotional Availability Scales
2.5. Play
2.6. Parental Stress Index-Short Form
2.7. Statistical Analysis
3. Results
3.1. Longitudinal Changes: Emotional Availability Scales
3.1.1. Adult’s Scales
3.1.2. Child’s Scales
3.2. Longitudinal Changes: Play Skills
3.3. Linear Mixed Models
3.3.1. Parents’ Structuring Ability is Linked to Chronological Age and Their Perception of Having a Difficult Child
3.3.2. Parents’ Non-Intrusiveness is Linked to Child’s Language Ability
3.3.3. Child’s Symbolic Play Level is Predictive of Child’s Language Ability
3.3.4. Child’s Responsivity is Linked to Child’s Language Ability
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Mean (SD) | ||
---|---|---|
T1 | T2 | |
Child Chronological Age (months) | 37.793 (9.108) range (22–55) | 55.500 (13.063) range (32–81) |
Child Mental Age (months) | 26.750 (7.006) range (15–43) | 40.760 (11.296) range (23–63) |
Parental Age (years) | 38.071 (4.799) range (27–45) | 39.996 (5.071) range (27–46) |
Socio Economic Status | 35.214 (13.600) range (14.5–59.5) | 35.600 (14.361) range (14.5–66.0) |
T1 M(SD) | T2 M(SD) | p-Value-r2 | BF | |
---|---|---|---|---|
Ados Social Affect | 12.931 (2.939) | 11.357 (2.599) | T (27) = 3.827, p = 0.0007; r2 = 0.352 | BF = 46.309 |
ADOS Restrictive and Repetitive Behabiors | 3.552 (1.824) | 3.500 (1.876) | T (27) = 0; p-value = 1; r2 = 0 | BF = 0.200 |
Ados Total Score | 16.700 (3.809) | 14.893 (3.370) | T (27) = 2.718; p = 0.011; r2 = 0.215 | BF = 4.146 |
ADOS Comparison Score | 6.407 (1.394) | 5.786 (1.101) | T (25) = 2.476; p = 0.020; r2 = 0.197 | BF = 2.606 |
GMDS-General Quotient | 71.964(13.675) | 75.037(21.636) | T (26) = −1.311, p = 0.201, r2 = 0.062 | BF = 0.439 |
GMDS–Language and Communication Scale | 54 (23.764) | 69.84 (37.121) | W = 77.5, p = 0.023; r2 = 0.458 | BF = 6.671 |
Adult Sensitivity | Adult Structuring | Adult Non-Intrusiveness | Adult Non-Hostility |
---|---|---|---|
Affect | Provides appropriate guidance and suggestions | Follows child’s lead | Adult lacks negativity in face or voice |
Clarity of perceptions and appropriate responsiveness | Success of attempts | Non-interruptive ports of entry into interaction | Lack of mocking, ridiculing, or other disrespectful statement and/or behavior and general demeanor |
Awareness of timing | Amount of structure | Commands, directives | Lack of threats of separation |
Flexibility, variety, and creativity in modes of play or interaction | Limit setting proactively | Adult talking | Does not lose cool during low and high challenge/stress times |
Acceptance | Remaining firm in the face of pressure | Didactic teaching | Frightening behavior/tendencies |
Amount of interaction | Verbal vs. non-verbal structuring | Physical vs. verbal interferences | Silence |
Conflicts situations | Peer vs. adult role | The adult is made to “feel” or “seem” intrusive | Themes or plat themes hostile |
Child Responsiveness | Child Involvement | ||
Affect/emotion regulation, organization of behavior | Simple initiative | ||
Responsiveness | Elaborative initiative | ||
Age-appropriate autonomy seeking and exploration | Use of adult | ||
Positive physical positioning | Lack of over-involvement | ||
Lack of role reversal/over-responsiveness | Eye contact, looking | ||
Lack of avoidance | Body positioning | ||
Task oriented/concentrate | Verbal involvement |
Mean (SD) | p-Value–R2 | Bayes Factor | ||
---|---|---|---|---|
T1 | T2 | T1–T2 | T1–T2 | |
Total Sensitivity | 4.552 (0.588) | 4.914 (0.669) | p = 0.002 ** r2 = 0.596 | BF = 25.097 |
Sensitivity 3: Awareness of timing | 1.966 (0.421) | 2.207 (0.412) | p = 0.0262 * r2 = 0.454 | BF = 2.952 |
Sensitivity 6: Amount of interaction | 1.0690 (0.604) | 2.138 (0.516) | p < 0.001 *** r2 = 0.669 | BF > 100 |
Total Structuring | 4.276 (0.560) | 5.121 (0.529) | p < 0.0001 *** r2 = 0.892 | BF > 100 |
Structuring 1: Appropriate guidance | 4.103 (0.724) | 5.034 (0.731) | p < 0.0001 *** r2 = 0.795 | BF > 100 |
Structuring 2: Success of attempts | 4.103 (0.724) | 4.552 (0.985) | p = 0.003 ** r2 = 0.559 | BF = 23.42 |
Structuring 3: Amount of structure | 1.690 (0.541) | 2.138 (0.516) | p < 0.001 *** r2 = 0.641 | BF > 100 |
Structuring 5: Remaining firm during pressure | 2.310 (0.471) | 2.552 (0.506) | p = 0.023 * r2 = 0.433 | BF = 2.952 |
Total Non–Intrusiveness | 4.466 (0.654) | 5.345 (0.769) | p < 0.0001 *** r2 = 0.886 | BF > 100 |
Non–Intrusiveness 1: Follows child’s lead | 4.379 (0.775) | 4.931 (0.961) | p = 0.019 * r2 = 0.504 | BF = 5.069 |
Non-Intrusiveness 2: Non-interruptive entry in interaction | 4.552 (0.783) | 5.103 (1.113) | p = 0.014 * r2 = 0.549 | BF = 7.699 |
Non-Intrusiveness 6: Physical vs. verbal interferences | 2.103 (0.409) | 2.310 (0.471) | p = 0.019 * r2 = 0.454 | BF = 4.031 |
Non-Intrusiveness 7: The adult is made to feel intrusive | 2.172 (0.602) | 2.552 (0.506) | p = 0.003 ** r2 = 0.586 | BF = 30.755 |
Total Non–Hostility | 5.431 (0.578) | 5.379 (0.883) | p = ns | BF = 0.210 |
Mean (SD) | p-Value–R2 | Bayes Factor | ||
---|---|---|---|---|
T1 | T2 | T1–T2 | T1–T2 | |
Total Responsiveness | 3.552 (0.817) | 4.034 (0.844) | p < 0.001 ** r2 = 0.716 | BF > 100 |
Responsiveness 1: Emotional regulation of affect and behavior | 3.241 (0.872) | 3.552 (1.088) | p = 0.022 * r2 = 0.432 | BF = 2.880 |
Responsiveness 2: quantity of responsiveness | 3.069 (1.163) | 3.655 (1.143) | p = 0.001 ** r2 = 0.675 | BF = 21.431 |
Responsiveness 4: Positive physical positioning | 1.724 (0.649) | 2.000 (0.535) | p = 0.036 r2 = 0.479 | BF = 1.836 |
Responsiveness 7: Task orientation-concentration | 1.448 (0.686) | 1.828 (0.539) | p = 0.003 ** r2 = 0.566 | BF = 30.755 |
Total Involvement | 3.138 (0.823) | 3.379 (0.690) | p = 0.02 * r2 = 0.613 | BF = 24.648 |
Involvement 2: Elaborative initiative | 1.655 (0.974) | 1.828 (1.071) | p = 0.036 * r2 = 0.425 | BF = 2.313 |
Involvement 3: Use of adult | 1.448 (0.632) | 1.690 (0.660) | p = 0.010 * r2 = 0.491 | BF = 7.206 |
Involvement 5: Eye–contact looking | 1.310 (0.604) | 1.586 (0.733) | p = 0.024 * r2 = 0.435 | BF = 2.776 |
Involvement 6: Body positioning | 1.759 (0.689) | 2.069 (0.593) | p = 0.009 ** r2 = 0.471 | BF = 4.698 |
Involvement 7: Verbal involvement | 1.517 (0.688) | 2.069 (0.651) | p < 0.0001 *** r2 = 0.742 | BF > 100 |
Mean (SD) | p-Value-R2 | Bayes Factor | ||
---|---|---|---|---|
T1 | T2 | T1–T2 | T1–T2 | |
Child Exploratory Play | 0.194 (0.0715) | 0.133 (0.095) | p = 0.007 ** r2 = 0.234 | BF = 6.319 |
Child Symbolic Play | 0.0721 (0.0833) | 0.125 (0.115) | p = 0.014 * r2 = 0.197 | BF = 3.449 |
Adult Exploratory Play | 0.1666 (0.090) | 0.0126 (0.087) | p = ns | BF = 0.837 |
Adult Symbolic Play | 0.160 (0.102) | 0.148 (0.124) | p = ns | BF = 0.231 |
Beta | T | P-Value (T) | Wald F | P-Value (W) | Chi 2 (Baseline Model) | Marginal R2 | BIC | |
---|---|---|---|---|---|---|---|---|
Model 1: Structuring | X2 (6) = 9.364, p = 0.009 | 0.485 | 55.365 | |||||
Intercept | 1.900 | t(25,474) = 2.340 | p = 0.027 | F (27.315) = 5.344 | p = 0.029 | |||
Predictor 1: time | 0.718 | t(12.196) = 9.954 | p < 0.0001 | F (14.543) = 96.451 | p < 0.0001 | |||
Predictor 2: Psi–Difficult Child | 0.016 | t(24.079) = 2.255 | p = 0.034 | F (26.096) = 4.531 | p = 0.043 | |||
Age caregiver | 0.050 | t(21.529) = 2.510 | p = 0 0.020 | F (23.798) = 6.226 | p = 0.020 | |||
Model 2: Non Intrusiveness | X2 (5) = 26.709, p < 0.0001 | 0.400 | 101.400 | |||||
Intercept | 4.090 | t(46.979) = 21.277 | p < 0.0001 | F (47.394) = 429.756 | p < 0.0001 | |||
Predictor 1: Time | 0.771 | t(26.111) = 7.045 | p < 0.0001 | F (28.052) = 48.834 | p < 0.0001 | |||
Predictor 2: GMDS–Language and Communication | 0.008 | t(50.000) = 2.677 | p = 0.010 | F (50.000) = 6.610 | p = 0.013 | |||
Model 3: language and communications scale | X2(5) = 16.218, p = 0.0003 | 0.164 | 508.120 | |||||
Intercept | 47.218 | t(41.660) = 8.046 | p < 0.0001 | F (41.157) = 63.895, | p < 0.0001 | |||
Predictor 1: Time | 8.186 | t(29.848) = 1.526 | p = 0.138 | |||||
Predictor 2: Child symbolic play | 104.376 | t(46.240) = 2.810 | p = 0.008 | F (45.987) = 7.321, | p = 0.010 | |||
Model 4: child Responsiveness | X2 (5) = 10.086, p = 0.001 | 0.260 | 118.020 | |||||
Intercept | 2.947 | t(46.702) = 13.129 | p < 0.0001 | F (47.260) = 163.592 | p < 0.0001 | |||
Predictor 1: Time | 3.22 | t(25.642) = 2.504 | p = 0.019 | F (28.093) = 28.093 | p = 0.019 | |||
Predictor 3: GMDS-Language and communication scale | 0.011 | t(49.983) = 3.389 | p = 0.001 | F (49.986) = 10.590 | p = 0.002 |
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Perzolli, S.; Bertamini, G.; de Falco, S.; Venuti, P.; Bentenuto, A. Emotional Availability and Play in Mother–Child Dyads with ASD: Changes during a Parental Based Intervention. Brain Sci. 2020, 10, 904. https://doi.org/10.3390/brainsci10120904
Perzolli S, Bertamini G, de Falco S, Venuti P, Bentenuto A. Emotional Availability and Play in Mother–Child Dyads with ASD: Changes during a Parental Based Intervention. Brain Sciences. 2020; 10(12):904. https://doi.org/10.3390/brainsci10120904
Chicago/Turabian StylePerzolli, Silvia, Giulio Bertamini, Simona de Falco, Paola Venuti, and Arianna Bentenuto. 2020. "Emotional Availability and Play in Mother–Child Dyads with ASD: Changes during a Parental Based Intervention" Brain Sciences 10, no. 12: 904. https://doi.org/10.3390/brainsci10120904
APA StylePerzolli, S., Bertamini, G., de Falco, S., Venuti, P., & Bentenuto, A. (2020). Emotional Availability and Play in Mother–Child Dyads with ASD: Changes during a Parental Based Intervention. Brain Sciences, 10(12), 904. https://doi.org/10.3390/brainsci10120904