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The Contribution of Two Categories of Parent Verbal Responsiveness to Later

Language for Toddlers and Preschoolers on the Autism Spectrum
Article in American Journal of Speech-Language Pathology · February 2013

DOI: 10.1044/1058-0360(2012/11-0004) · Source: PubMed
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The Contribution of Two Categories of Parent Verbal

Responsiveness to Later Language for Toddlers and
Preschoolers on the Autism Spectrum
Eileen Haebig,
University of Wisconsin
Andrea McDuffie, and
MIND Institute, University of California Davis
Susan Ellis Weismer
University of Wisconsin
Abstract
Purpose—Longitudinal associations between two categories of parent verbal responsiveness and

language comprehension and production one year later were examined in 40 toddlers and
preschoolers with a diagnosis of an autism spectrum disorder (ASD).
Method—Parent-child play samples using a standard toy set were digitally captured and coded
for child engagement with objects and communication acts and for parent verbal responses to play
and communication.
Results—After controlling for parent education, child engagement and initial language level,
only parent directives for language that followed into the child's focus of attention accounted for
unique variance in predicting both comprehension and production one year later. A series of
exploratory analyses revealed that parent comments that followed into the child's focus of
attention also accounted for unique variance in later comprehension and production for children
who were minimally verbal at the initial time period.
Conclusions—Child developmental level may warrant different types of linguistic input to
facilitate language learning. Children with ASD who have minimal linguistic skills may benefit
from parent language input that follows into the child’s focus of attention. Children with ASD
who are verbally fluent may need more advanced language input to facilitate language
development.
Keywords
autism spectrum disorder; parent responsiveness; parent-child interactions
According to a social interactionist approach to language development, children acquire

language through ongoing interactions with conversational partners in everyday contexts
(Bohannon & Bonvillian, 2005). For children who face language learning challenges, as do
children with ASD (American Psychiatric Association, 1994), the contribution of the parent
may be especially important in determining the progression of language acquisition.
Previous research has provided support for the role of contingent verbal input from parents
in supporting language development for children at risk for or experiencing developmental
delays (Brady, Marquis, Fleming, & McLean, 2004; Mahoney, Boyce, Fewell, Spiker, &
Wheeden, 1998; Landry Smith, & Swank, 2006; Yoder & Warren, 1999), including children
with ASD (McDuffie & Yoder, 2010; Siller & Sigman, 2002, 2008). This study extends the
current literature by examining the longitudinal associations between two broad categories
Haebig et al. Page 2
of responsive verbal input provided by parents and language skills 12-months later in a
group of toddlers and preschoolers with a diagnosis of an autism spectrum disorder (ASD).
The hallmark of parent responsiveness is that parents follow into the child’s focus of
attention and respond contingently to child acts of play and communication. Parent verbal
responsiveness, according to certain theoretical perspectives, is thought to facilitate word
learning by providing adult labels that map directly onto the object or activity to which the
child is attending (Baldwin, 1995; Tomasello & Farrar, 1986). When parents follow into the
child’s focus of attention, they assume the burden of ensuring that both the child and parent
are jointly focused on the same referent, creating a state of shared engagement during which
parental language input is more likely to be attended to and learned from by the child (e.g.,
supported joint engagement; Adamson, Bakeman, & Deckner, 2004).
Joint Attention in Children with Autism

Following into the attentional focus of a communication partner, often termed attention
following or responding to joint attention, represents a core deficit in children with ASD
(Leekam, Hunnisett, & Moore, 1998; Mundy, Sigman, Ungerer, & Sherman, 1986). Indeed,
many correlational studies have replicated the predictive association between attention
following and later language development for children with ASD (McDuffie, Yoder, &
Stone, 2005; Mundy, Sigman, Ungerer, & Sherman, 1986; Sigman & Ruskin, 1999; Siller &
Sigman, 2008). Theoretically, the process of attention following allows children to learn the
meanings of new words when the adult’s referential focus does not correspond with the
child’s. When there is a discrepancy between the adult’s focus of attention and that of the
child, the child must notice and respond to adult cues, such as gaze shifts and pointing
gestures, to correctly identify the adult’s intended referent. Only then can a correct mapping
between novel label and object referent be established. Relative to children with cognitive
delays without ASD, experimental studies have shown that children with ASD produce more
incorrect mappings between novel labels and objects because they utilize their own focus of
attention, rather than that of the speaker, when acquiring new words (Baron-Cohen,
Baldwin, & Crowson, 1997; Preissler & Carey, 2005). Thus, children with ASD often need
increased scaffolding during the process of word acquisition. Parent verbal responsiveness
can potentially provide needed support to help the child correctly associate new labels with
their referents.
The Role of Parent Responsiveness

Parent responsiveness may be defined as a broad category of behaviors through which
parents provide prompt, affectively positive, and contingent responses to child acts of
communication and play (Landry, Smith, Miller-Loncar, & Swank, 1997; Tamis-Lemonda
& Bornstein, 2002). Parents who consistently use responsive verbal language input may
decrease the cognitive and affective demands on the child to coordinate attention to both
people and objects (Adamson, Bakeman, & Deckner, 2004). Two categories of parent verbal
responsiveness were examined: responsiveness to the child’s focus of attention and
responsiveness to child communication acts.
Responsiveness to the child’s focus of attention

Verbal input that follows into the child’s focus of attention provides labels for objects and
events to which the child is actively attending. The facilitative role of follow-in verbal input
from parents was considered by Tomasello and Todd (1983) who examined the relationship
between early joint attention and language development in typically developing one-year-
olds. These children learned more object labels when mothers followed into and talked
about their child’s focus of attention (Tomasello & Todd, 1983; Landry et al., 1997). In fact,
within episodes of joint attention, the frequency of labels provided by mothers predicted the
child’s later spoken vocabulary (Tomasello & Farrar, 1986). This study assessed three types
of parent verbal responses to the child focus of attention: follow-in commenting, follow-in
directives, and parent descriptions of their own actions.
Follow-in comments are statements that describe objects within the child’s focus of attention
or with which the child is actively engaged, without conveying an expectation that the child
respond to the parent or change his or her current activity. Previous research indicates that
follow-in comments predict later language for children with ASD (McDuffie & Yoder,
2010; Siller & Sigman, 2002, 2008). In contrast, follow-in directives – while relating to the
child’s ongoing attentional focus – convey an expectation that the child change his or her
ongoing activity in some way (e.g., “Throw the ball.”). We consider these types of directive
utterances to be follow-in directives for behavior. While Siller and Sigman (2002) found no
correlation between follow-in directives for behavior and later language, McDuffie and
Yoder (2010) found that follow-in directives for behavior and follow-in comments each
contributed unique variance to predicting later vocabulary for a group of toddlers with ASD
who produced, on average, less than ten spoken words at the initial study visit.
Following the reasoning of McCathren, Yoder, and Warren (1995), McDuffie and Yoder
(2010) suggest that follow-in directives have the potential to facilitate a mapping between
labels and objects or events in a manner similar to follow-in comments, presumably because
these types of directives also refer to the child’s current focus of attention. However,
McDuffie and Yoder (2010) only assessed follow-in directives aimed at changing the child’s
behavior. Thus, the role of follow-in directives for language (e.g., “What color is that car?”)
in supporting later language requires additional clarification. Follow-in directives, which
maintain shared focus between parent and child, should be distinguished from redirects; that
is, directives which seek to change the child’s focus of attention to correspond to that of the
adult. Redirects have been shown to be negatively or nonsignificantly associated with later
language (McCathren, Yoder, & Warren, 1995; McDuffie & Yoder, 2010).
Finally, parents’ descriptions of their own actions also can be considered to provide
linguistic information about actions that parents are modeling within the child’s focus of
attention. If children are actively attending to the parent models, it should be possible to
make an association between the parents’ actions and the verbal language parents are
producing. No previous study, however, has evaluated the contribution of parents’
descriptions of their own actions to later language for children with ASD. Examination of
this relationship is important as it is likely that parents often may use descriptions of their
own actions while engaged in play with their child.
Responsiveness to child communication acts

Child acts of nonverbal and verbal communication clearly indicate the child’s focus of
attention to the adult. Two types of parent responses to child communication acts were
examined, linguistic mapping (Yoder & Warren, 2001) and expansions (Scherer & Olswang,
1984). The adult may respond to nonverbal communication acts by linguistically encoding
the child’s presumed message (McDuffie, Yoder, & Stone, 2005; Siller & Sigman, 2002;
Yoder & McDuffie, 2006) or may respond to verbal communication acts by providing
additional semantic or grammatical information. During linguistic mapping, the adult
provides a noun, verb or function word that corresponds to the object, action or event about
which the child is communicating. In a similar manner, expansions provide opportunities for
children to hear developmentally advanced language forms that map directly onto the child’s
own productions. In addition to providing follow-in language input, linguistic mapping and
expansions acknowledge the child’s attempts to communicate and may encourage the child
to communicate more frequently in subsequent interactions. Yoder and Warren (1999) found
that maternal linguistic mapping mediated the relationship between child intentional
communication and later language for a group of children with developmental delays. For a
group of minimally verbal children with ASD, McDuffie and Yoder (2010) found that
parent expansions were a unique predictor of later vocabulary size, even after controlling for
the frequency of child communication acts.
In summary, certain categories of parent language provided in the context of parent-child

interactions (i.e., verbal responsiveness to the child’s focus of attention and verbal
responsiveness to child communication acts) have been found to facilitate later language for
children with ASD. It is important, however, to acknowledge that opportunities for parent’s
to provide responsive verbal language input is somewhat reliant upon child behaviors (i.e.,
child active engagement and communication acts). As several studies have shown, children
with ASD may display a restricted repertoire of play behaviors leading to less productive
engagement with objects (McDuffie, Lieberman, & Yoder, 2011) and may initiate
communication acts less frequently than children who are typically developing as well as
children with other developmental delays (Mundy, Sigman, Ungerer, & Sherman, 1986).
Thus, parents may face challenges in having sufficient opportunities to provide responsive
verbal language input that responds to child engagement or communication acts. Clinically,
this line of research is important as it can inform the content of parent mediated intervention
programs which encourage parents to use empirically based language facilitation strategies
when interacting with their children.
The extant literature provides only three published studies examining the relationship
between parent verbal responsiveness and subsequent language development for children
with ASD (McDuffie & Yoder, 2010; Siller & Sigman, 2002, 2008). Moreover, two of those
studies (Siller & Sigman, 2002, 2008) did not examine the role of parent verbal responses to
child communication acts in facilitating later language. In addition, Siller and Sigman
(2008) used a composite metric to represent parent responsiveness. This variable included
all maternal utterances that were synchronized with the child’s focus of attention (i.e., both
follow-in comments and follow-in directives) while another variable included only maternal
utterances that were synchronized with the child’s focus of attention and action (i.e., follow-
in comments). Thus, Siller and Sigman (2008) did not independently evaluate the role of
follow-in directives in predicting either language levels or rate of growth in language over
time. In addition, McDuffie and Yoder (2010) examined language outcomes after only 6
months in time using a parent report measure of vocabulary comprehension and production.
McDuffie and Yoder (2010) also used a composite variable that collapsed across parent
descriptions of their own actions and follow-in comments and only coded follow-in
directives for behavior and did not examine the potential contribution of follow-in directives
for language. We expanded upon these previous studies by using a more nuanced and
inclusive coding scheme and by examining longitudinal associations between parent

language input and child language outcomes over a period of one year.
Research Questions
The following research questions were addressed in a group of toddlers and preschoolers on
the autism spectrum:
1. Does parent language input that follows into the child’s focus of attention
significantly predict gains in expressive and receptive language one year later?
2. Does parent language input that responds to child communication acts significantly
predict gains in expressive and receptive language?
Method
Overview of Design and Procedures
This study utilized a longitudinal design. Parent responsivity was coded from videotapes of
naturalistic parent-child play samples collected at Time 1 (the initial annual visit of a larger
study). Autism status as well as language and cognitive ability were measured at Time 1 and
are reported in this paper to provide descriptive information about the participants. Although
children in the sample demonstrated a range of performance on standardized measures of
language and cognition, the mean performance on all measures was in the below-average
range. The difference scores (i.e., difference of raw scores between Time 1 and Time 2, on
average 12 months later) from standardized tests of language comprehension and production
served as the outcome measures. Parent education was taken into account in all analyses.
Participants
Forty parent-child dyads were selected at random from participants in a larger study
examining trajectories of language development in toddlers and preschoolers with ASD.
Participants in the larger study were recruited from Wisconsin. All 40 toddlers and
preschoolers received a clinical diagnosis of an autism spectrum disorder from an
interdisciplinary team of experienced professionals which was led by a licensed
psychologist. Of the 40 participants selected, 33 were males. The age range of the
participants at Time 1 was from 24–39 months. All children came from families of native
English speakers. Thirty-four of the children were Caucasian, one was Hispanic, two were
African American, and three were classified as “other” with respect to racial/ethnic
background. Descriptive characteristics of the participants are presented in Table 1.
Parents who participated in the play sample procedure consisted of 33 mothers and 7 fathers.
Parent education ranged from 12 years to 19 years, with an average of 14 years (SD = 2.04).
Assessments and Measures

Autism Status—All participants received a best estimate clinical diagnosis of either
autism (n=17) or autism spectrum (n=23) from a licensed psychologist who utilized multiple
sources of information including cognitive and language testing, as well as either the
original or toddler version of the Autism Diagnostic Observation Schedule (ADOS–G; Lord
et al., 2000; ADOS-T; Luyster et al., 2009) and the Autism Diagnostic Interview-Revised
(ADI-R; Le Couteur, Lord, & Rutter, 2003). The ADI-R and ADOS represent the current
gold standard for assigning a diagnostic classification of autism for research purposes.
The ADOS consists of a series of activities and materials, presented with systematic prompts
and used to elicit a sample of an individual’s social and communication behaviors. There are
four ADOS modules, each designed for a particular developmental and language level,
ranging from no expressive language in preschool-aged children to verbally fluent adults.
This system of organization allows the observation to take place within the context of an
interaction appropriate for the individual’s expressive language level. The revised ADOS
diagnostic algorithms were used, as specified by Gotham and colleagues (Gotham, Risi,
Dawson, Tager-Flusberg, Joseph, Carter, et al., 2008; Gotham, Risi, Pickles, & Lord, 2007).
These module-specific algorithms consist of a Social Affective domain (comprised of items
representing reciprocal social interaction as well as communication) and a Restricted,
Repetitive Behaviors domain. Scores for these domains are summed and the total score is
compared to thresholds resulting in an ADOS classification of autism, autism spectrum, or
nonspectrum. To provide additional descriptive information about the participants, autism
severity scores were calculated from ADOS total score according to Gotham, Pickles, and
Lord (2009) and based upon each participant’s chronological age, language status, and
ADOS module the participant had received. ADOS severity scores range from 1 to 10, with
scores of 1 - 3, 4 - 5, and 6 - 10 indicating mild, moderate and severe degree of autistic
impairment, respectively (Gotham et al., 2009). The diagnosis of an autism spectrum
disorder includes individuals who function along a continuum of abilities. To adequately

represent this population, participants were not excluded based upon scores from language
or cognitive measures.
Language and Cognition—The MacArthur-Bates Communicative Development

Inventory (CDI; Fenson et al., 2007) is a widely used parent report instrument used to assess
vocabulary comprehension and production. The Words and Gestures subscale (CDI:WG)
contains a vocabulary checklist of 396 words typically acquired by children exposed to
American English between 8 and 16 months of age. The Preschool Language Scales, 4th
edition (PLS-4; Zimmerman et al., 2002) is a standardized test of receptive and expressive
communication abilities in children ranging from 2 weeks through 6 years of age. Difference
scores, computed using Time 1 and Time 2 raw scores for the Auditory Comprehension and
Expressive Communication subscales of the PLS, were used as the outcome measures in all
analyses. Although it may be difficult to capture change with a standardized measure of
global language ability, use of the PLS-4 provided a metric of language comprehension and
production that was independent of the contribution of the parent. In order to utilize a more
sensitive measure of change over time, raw scores from the PLS-4 were used rather than age
equivalent or standard scores. Nonverbal cognitive level was assessed with the Visual
Reception Subscale of the Mullen Scales of Early Learning (MSEL; Mullen, 1995). The
MSEL provides a measure of cognitive functioning for infants and children ranging in ages
from birth to 68 months.
Procedures
A 15 minute parent-child play session was completed at the first visit. During this play
session, the child and a parent engaged in play with two different toddler toys (Mr. Potato
Head and a Fisher-Price farm set) that were provided by the research team. Before each play
sample, the parent was instructed to play with the child as he/she normally would. A student
research assistant recorded the play sessions with a hand-held digital video recorder.
Coding and Reliability

Play session videos were coded with ProcoderDV (Tapp, 2003). A frequency based coding
procedure was used to code the beginning ten minutes of each parent-child play sample. The
following child and parent variables were coded: child engagement, parent verbal responses
to the child’s focus of attention, child communication acts, and parent verbal responses to
child communication acts. The following paragraphs provide details of the coding process.
Additional details and the coding manual are available from the first author. After coding,
data files were exported into MOOSES software (Tapp, Wehby, & Ellis, 1995) for
calculation of cumulative frequencies.
Responsiveness to the Child’s Focus of Attention—Parent responsiveness to the

child’s focus of attention can be considered part of a transactional process in that the child’s
active engagement with toys sets the occasion for the parent to provide language that
describes the child’s focus of attention. Thus, coding this category of parent verbal
responsiveness required a two-step process: a) intervals of child engagement were identified
in the play session video; and b) parent verbal responses that were relevant to the child’s
focus of attention were coded.
Child engagement: During the first pass through the media file, each 1-second interval was
coded for child active engagement with objects using a mutually exclusive and exhaustive
coding system. Intervals were coded as engaged, not engaged, or uncodable. One-second
intervals coded as engaged displayed the child actively manipulating an object or visually
attending to an object. Active manipulation of an object was defined as purposeful
movement of the object and did not include passive holding. Attention to an object was
evident if the child looked at an object or verbalized about an object. The child also was
considered to be actively engaged if he/she visually attended to the parent’s use of an object.
Verbal responses to the child’s focus of attention: During the second pass through the
media file, instances of parent verbal responsiveness to the child’s focus of attention were
identified and coded. Verbal responsiveness to the child’s focus of attention included four
subtypes of parent spoken utterances: a) follow-in comments; b) parents describe their own
action; c) follow-in directives; and, d) three control variables (redirects, introductions, and
other talking). Intervals with continued talking, no talking, or containing unintelligible
parent utterances were identified. Each parent utterance was counted only a single time even
if the utterance continued across subsequent intervals.
Follow-in comments: The parent was considered to use a follow-in comment if the parent
utterance was produced while the child was actively engaged and the comment described the
child’s focus of attention. A follow-in comment did not: a) follow a child communication
act; b) tell the child what to do; or, c) request the child to communicate about his/her focus
of attention. For example, the parent could say “You’re pushing the tractor” or “There’s the
cow, moo moo.”
Parent describes his or her own actions: A parent was credited with describing his or her
own action if the parent performed a play action and described this action to the child while
the child was attending to what the parent was doing. This type of parent verbal utterance
had to be accompanied by a play model; that is, the parent had to demonstrate an action with
the toys to which the child was attending (e.g., “Eyes on” as the parent puts the eyes on Mr.
Potato Head).
Follow-in directives: Parent directives consisted of parent linguistic input that directed the
child: (a) to change his/her behavior; or, (b) to communicate in response to a question.
Therefore, follow-in directives included two subtypes of utterances: follow-in directives for
behavior (i.e., requests to change a play behavior or toy; e.g., “push the tractor”) and follow-
in directives for language (i.e., requests to label an object; e.g., “What’s this?” or “What
does the cow say?”).
Control Variables: Control variables were included to demonstrate that not all types of
parent verbal utterances would be supportive of language growth. Verbal redirects,
introductions, and other talking (utterance that did not provide linguistic information about
the child’s focus of attention, were not directed toward the child, or did not serve as a
redirect or introduction; e.g., “oh” or “mm hm”) were used as control variables.
Responsiveness to Child Communication Acts—Coding this category of parent

verbal responsiveness required a two-step process: a) acts of child gestural or verbal
communication were identified in the play session video; and b) parent verbal utterances
provided subsequent to (within 3 seconds) the child communication act were coded.
Child communication acts: Child acts of intentional communication were identified during
the first pass through the media files. Child communication acts were defined using the
conventions from the Communication and Symbolic Behavior Scales: Developmental
Profile (CSBS DP) by Wetherby and Prizant (2002). Intentional communication acts could
be verbal (i.e., a word or sign) or nonverbal (i.e., communicative gesture or a vocalization

with eye gaze). Once child acts of intentional communication were identified, they were
categorized as verbal or nonverbal communication acts.
Verbal responses to child communication acts: Following the identification of child acts
of intentional communication, the coder determined if a parent verbal response followed
each child communication act within 3 seconds of the child act. Assuming that a child
produced a nonverbal communication act, a parent verbal response was coded as linguistic
mapping if the adult labeled a referent or action that was implied by the child’s
communication act (e.g., child reaches for the toy cow while shifting eye gaze to the parent
and the parent says “want cow”). Additionally, assuming that a verbal act of child
intentional communication had occurred, a parent verbal response that expanded the child’s
verbal communication act also was recorded (e.g., child says “hat” and the parent expands
the child’s communication act by saying “blue hat”).
Refer to Tables 2 and 3 for examples of coded variables and Table 4 for means, ranges and
standard deviations for all coded variables.
Reliability—Reliability was computed by having a separate coder independently recode 20

percent of the play samples which were randomly selected. The primary coder trained the
reliability coder through coding of practice videos and a series of consensus discussions.
Interobserver reliability was computed using intraclass correlation coefficients (ICC).

Intraclass correlation coefficients reflect the proportion of the variability in the reliability
sample that is due to between-participant variance in true score estimates of the behavior of
interest (Shavelson & Webb, 1991). Values of 0.6 are considered acceptable with g-
coefficients (Suen & Ary, 1989). Reliability between the two coders was .77 for “other
talking” and between .956 and 1.0 for all other categories of coded behavior.
Data Analysis
Preliminary data analysis examined bivariate correlations between the Time 1 predictor
variables (follow-in comments, follow-in directives, parent descriptions of his or her own
action, linguistic mapping, and expansions), the covariates (child engagement, child verbal
and nonverbal communication acts, and parent education), control variables (redirects,
introductions, and other talking) and difference scores computed from the language
measures at both time points (i.e., Time 2 PLS-4 Auditory Comprehension (AC) raw scores
minus Time 1 PLS-4 Auditory Comprehension raw scores; Time 2 PLS-4 Expressive
Communication (EC) raw scores minus Time 1 PLS-4 Expressive Communication (EC) raw
scores). Difference scores were used to assess the change, or growth, in language scores
over time. This is necessary given the high degree of intercorrelation between language
scores at both time points (i.e., for comprehension, r = .788 p < .001; for production, r = .686
p < .001) and, therefore, needs to be accounted for. These preliminary analyses were
followed by a series of hierarchical multiple regression analyses aimed at identifying unique
predictors of later language. Significant predictors from each category of parent
responsiveness were entered together as predictors of either comprehension or production
difference scores to determine a final regression model. In order to control for engagement
when evaluating parent variables that responded to the child’s focus of attention, a
proportion was created using the parent responsiveness variable as the numerator and child
engagement as the denominator (e.g., follow-in directives for language divided by child
engagement). In order to control for the contribution of child communication acts when
evaluating the contribution of parent verbal responses to child communication acts, a
proportion was created using a parent responses to child communication acts as the
numerator and child communication acts as the denominator (e.g., parent expansions divided
by child verbal communication acts). Based on previous research, we expected the coded
parent responsive variables to positively relate to language gains; therefore, all analyses
were one-tailed.
Results
Bivariate Correlations
Parent Responses to Child’s Focus of Attention—Examination of bivariate
correlations between parent responses to the child’s focus of attention measured at Time 1
and difference scores for language comprehension (PLS-4 AC) and production (PLS-4 EC)
revealed that follow-in comments were not significantly correlated with language gains.
Despite this, significant correlations were found between language comprehension
difference scores and parent descriptions of his or her own actions (r = −.30) and parent
follow-in directives for language (r = .66; all ps < .05, one-tailed). The negative association
between parent descriptions of his or her own actions and later language comprehension was
unexpected. Only parent follow-in directives for language were significantly associated with
language production difference scores (r = .67, p < .05, one-tailed). The association between
parent redirects and language comprehension difference scores was in the expected direction
but failed to reach significance (r = −.232, p = .075, one-tailed); almost no association was
observed for parent redirects and child language production (r = −.083, p = .306, one tailed).
Parent Responses to Child Communication Acts—Bivariate correlations were

examined between parent responses to child communication acts at Time 1 and difference
scores for language comprehension (PLS-4 AC) and production (PLS-4 EC). Significant
bivariate correlations with comprehension were found for expansions (r = .51, p < .001, one-
tailed). No significant bivariate correlations were found for language production. (See Table
5 for a summary of all bivariate correlations).
Hierarchical Multiple Regressions—Parent behaviors that emerged as significant

correlates of language gains in the previous analyses were entered as predictors into a series
of hierarchical multiple linear regression analyses to identify parent behaviors that
accounted for unique variance in explaining language gains. We included follow-in
comments even though they were not significant correlates of either comprehension or
production difference scores because of our hypotheses about the importance of this specific
variable. The analyses controlled for parent education and, as previously described,
engagement and child communication acts were controlled for through the creation of
proportions.
Parent variables that responded to the child’s focus of attention—After

controlling for parent education, parent follow-in directives for language accounted for
significant and unique variance in predicting language comprehension (t = 3.67, p < .001,
one-tailed, B = 232.28, β =.59, R2 change = .34) and language production (t = 3.10, p = .
003, one-tailed, B = 131.43, β =.47, R2 change = .22), over and above the contribution of
follow-in comments and expansions. Contrary to our expectations, follow-in comments
emerged as a negative predictor of language gains for both comprehension (t = −2.231, p = .
018, one-tailed, B = −66.157, β = 29.659, R2 change = .09) and production (t = −2.312, p = .
016, one-tailed, B = −45.862, β =19.834, R2 change = .09).
Parent variables that responded to child communication acts—After controlling

for parent education and child verbal communication acts, parent expansions did not
significantly contribute to language gains for comprehension, despite significant positive
bivariate associations with language comprehension difference scores.
Exploratory Analysis
Because the expected pattern of associations with later language was not observed for parent
follow-in comments or expansions, exploratory analyses were undertaken. It was noted that
there was considerable variability in Time 1 language abilities within the sample of 40
toddlers. The observation of such diversity in language development corresponds with
descriptions in the literature suggesting that children with ASD represent a heterogeneous
group in the domain of language development (Lord, Risi, & Pickles, 2004).
Previous intervention research has noted that initial child characteristics often moderate the
effectiveness of intervention approaches. Carter and colleagues (2011), for example, found
that child outcomes following a parent-implemented language intervention for young
children with ASD were moderated by child object interest at the pre-treatment (Carter,
Messinger, Stone, Celimli, Nahmias, & Yoder, 2011). Children with lower levels of object
interest at Time 1 demonstrated language growth, whereas children with higher levels of
object interest exhibited attenuated language growth. Child object interest also impacted the
effectiveness of different approaches in a randomized comparison of two types of
communication interventions (Yoder & Stone, 2006). As initial developmental abilities
seem to play a role in language learning (Carter et al., 2011; Yoder & Stone, 2006), it was
reasoned that children at different stages of language development might respond
differentially to specific types of responsive verbal input from parents. This analysis
approach would involve splitting the participant sample into two groups and conducting a
regression analysis to determine if there is an interaction between responsiveness (i.e.,

parent use of follow-in comments) and group (high language, low language).
It was decided that the ADOS administration at Time 1 would provide an objective metric,
independent of maternal influence, of the amount of functional spoken language each child
used at Time 1. For purposes of the exploratory analysis, children were included in a
Minimal Expressive Language Group (n=22; Autism = 6 ASD = 16) if they received the
ADOS Toddler Module, or ADOS Module 1 and received a score of 3 or 8 on Item A1,
Overall Level of Language. These scores indicate that the child produced fewer than 5
words during administration of the ADOS. Children were included in a Verbally Fluent
Group (n=18; Autism = 11 ASD = 7) if they received the ADOS Toddler Module, or ADOS
Module 1 and received a score of 1 or 2 on Item A1. These scores indicate that the child
produced at least five recognizable single words or occasionally or regularly produced
utterances with at least two words during the ADOS administration. In addition, children
who received the ADOS Module 2 were included in the Verbally Fluent Group. These
children are considered to have the ability to use flexible phrases of at least three words on a
regular basis. The MEL subgroup consisted of 17 male and 5 female children and 18
mothers and 4 fathers. The VF subgroup was made up of 16 male and 2 female children and
15 mothers and 3 fathers. Parent education did not differ significantly between the two
subgroups (t(38) = −.619, p= .540, two-tailed). In order to further describe the language
ability of participants in these subgroups, we examined expressive vocabulary as reported by
parents on the CDI-WG subscale completed at Time 1. Mean expressive vocabulary sizes
were 7.09 (SD=9.04, Range 0–37) and 126.33 (SD=112.06, Range 9–384) for the MEL and
VF subgroups, respectively, generally corresponding to the assigned subgroup classification.
The following variables were entered into the regression analysis examining the contribution
of follow-in comments to difference scores in comprehension and production: parent
education, Group (VF, MEL), follow-in comments, and Group x Follow-in comments
interaction term. To compute the interaction term, the ratio variable for follow-in comments
was grand mean centered and Group was dummy coded (see Cohen, Cohen, West & Aiken,
2003; p. 261). Grand mean centering is recommended to reduce collinearity between the
variables that comprise the product term.
Results of the Regression analyses revealed a significant interaction between Group and
parent use of follow-in comments in predicting language comprehension (t = −2.50, p = .
009, one-tailed, B = −105.66, β = 42.32, R2 change = .10) and language production (t =
−2.54, p = .008, one-tailed, B = -91.38, β = 35.97, R2 change = .11). As Figure 1 depicts,

children with minimal expressive language benefited from parent use of follow-in comments
after accounting for parent education and child engagement, while children who were
verbally fluent at the initial visit did not (also see Table 6).
Discussion
The goal was to examine the contributions of specific categories of parent verbal
responsiveness to later language outcomes, for a group of young children with diagnoses on
the autism spectrum. The types of responsiveness that were examined were based upon
social interactionist theories of early language learning and previous empirical findings
which suggested the types of parent verbal input that should facilitate early language
development in children who are challenged in using attention following (i.e., response to
joint attention). The most interesting finding of this study was that the relationship between
parent linguistic input and later language gains may differ according to the child’s stage of
language development.
Responsiveness to the Child’s Focus of Attention

Follow-in Commenting—Although parent follow-in comments (i.e., comments that

describe the child’s focus of attention without placing demands on the child) were not found
to significantly predict later language for the full participant group, the follow-up
exploratory analysis revealed an interaction between initial child language levels and parent
use of follow-in comments. That is, children who were minimally verbal (in this case, who
use less than 5 spoken words during administration of the ADOS), had better language
outcomes one year later when their parents used more follow-in comments. Children who
could be considered verbally fluent (in this case, who used more than 5 spoken words or
talked in multiword utterances), did not benefit from parent use of this type of verbal input,
and in fact, showed attenuated language growth.
The positive association between parent follow-in comments and later language in the
subgroup with minimal expressive language replicates and adds support to the findings of
McDuffie and Yoder (2010) and Siller and Sigman (2002). Furthermore, it appears that
participants in the McDuffie and Yoder (2010) study, who are described as having fewer
than 10 words during a conversational language sample, had similar language levels to the
participants in the MEL subgroup. Conversely, the verbally fluent subgroup, who all were
producing flexible (i.e., non-stereotyped) phrase speech and who had an average spoken
vocabulary size of 126 words according to parent report, were more competent
communicators and may have benefited more from advanced linguistic input from their
parents, rather than follow-in commenting. Furthermore, it is possible that parents were
providing labels for objects that the verbally fluent subgroup already knew and did not
provide sufficient novel verbal information, which may have contributed to the finding of
attenuated growth. Carter and colleagues (2011) suggested that children with ASD with
more severe impairments also differentially responded to parent input. Like Carter et al.
(2011), our findings suggest that distinct categories of parent language input may support
language growth dissimilarly for children at different stages of language acquisition.
Children with lower linguistic abilities produce limited nonverbal and verbal communication
acts and therefore have fewer ways of eliciting language-facilitating verbal input from their
parents. This highlights the importance of having parents who talk about the child’s focus of
attention (i.e., follow-in commenting). Indeed, this subgroup of children had an average
spoken vocabulary size of less than 8 words according to parent report. Parent follow-in
commenting, in particular, is not contingent upon child communication acts and does not
require the child to make an active contribution to the language learning process; instead, the
parent actively coordinates his or her own focus of attention and verbal content to match the
child’s focus. Therefore, parent descriptions of their child’s focus of attention may optimally
support language development for minimally verbal children on the autism spectrum.
Parent descriptions of his or her own behavior—While McDuffie and Yoder (2010)
used a composite variable that included parent descriptions of his or her own actions within
the category of parent follow-in comments, the present study examined these two categories
of verbal responsiveness separately. We did expect that parent descriptions of his or her own
actions while the child was attending to the parent would positively relate to language gains
over time. However, we did not find that parent descriptions of his or her actions were
related to language gains for this group of children. We speculate that it is not necessarily
the case that children will process language input that encodes what the parent is doing, even
if it appears that the child is attending to such input. It seems plausible that children with
ASD have a more difficult time mapping labels to objects which they are not manipulating
themselves and to actions they are not performing even if the child seems to be attending to
the action that another person is performing. In addition, while children were judged to be
engaged in the interaction during the intervals within which parent descriptions of his or her
own actions were observed, it may be difficult to gauge a child’s actual degree of
engagement unless the child is actively manipulating an object.
Follow-in directives for language—One difficulty in interpreting the contribution of

directives to later language is that previous research often has not distinguished between
different types of directives (e.g., redirects, introductions, directives for behavior, and
directives for language; McCathren, Yoder, & Warren, 1995). We tested the contribution of
four specific types of directives: redirects, introductions, follow-in directives for behavior,
and follow-in directives for language.
Follow-in directives for language were significantly and positively associated with later
language. Although we found follow-in directives to be facilitative, there remain conflicting
suggestions in the literature concerning the contribution of directives to later language.
Some propose that use of questions may limit the child to a yes/no response or to producing
a label which the child already knows (Whitehurst, Falco, Lonigan, Fischel, DeBaryshe,
Valdez-Menchaca, & Caulfield, 1988). Conversely, others have suggested that questions
serve as a means to intellectually stimulate children and, by conveying the expectation that
the child should respond to the adult, to encourage the child’s participation in a
conversational exchange (McDonald & Pien, 1982). Follow-in directives for language can
scaffold child engagement with both people and objects (Yoder, Davies, Bishop, & Munson,
1994). In fact, Yoder and colleagues (1994) found that children with developmental delays
were more than twice as likely to continue a topic after an adult produced a follow-in
directive for language than in response to a follow-in comment. Follow-in directives for
language may act to promote continuation of the child’s focus of attention because they are
contingent upon the child’s current focus of attention. In addition, follow-in directives for
language may prompt the child to use a known word to label a different exemplar of a
referent, or to use the word in a different context. This type of generalization may be
especially important for children with ASD whose speech is often context bound and for
whom words are often not used flexibly (Yoder & McDuffie, 2006). Also, follow-in
directives for language may provide a technique that encourages reciprocal exchanges and
sharing of attention in children with ASD, a prompt that is needed given these children’s
known deficits in initiating joint attention (Mundy et al., 1986). Parent questions that elicit a
word that is within the child’s lexicon can be followed with a semantic or grammatical
expansion of the child’s prompted response (Scherrer & Olswang, 1984; Whitehurst et al.,
1988). This point is especially meaningful for our verbally fluent subgroup, who likely had a
sufficient amount of verbal skills to successfully respond to parent follow-in directives for
language. Children who have minimal expressive abilities also may benefit from directives
for language because parents can ask questions to prompt nonverbal communication acts
and then linguistically map, or verbally state the child’s nonverbal message (e.g., “Where is
Mr. Potato Head’s nose?” child points, “There’s his nose!). Thus, because follow-in
directives for language can be used to facilitate language in both verbally fluent and
minimally verbal children, it is not surprising that positive associations were seen for the
entire participant group.
Follow-in directives for behavior—Because children with ASD have restricted and
repetitive behaviors and limited play skills (Tager-Flusberg, Joseph, & Folstein, 2001),
parents may have infrequent opportunities to use diverse lexical input when providing
follow-in comments that describe the child’s focus of attention. Based on the findings of
McDuffie and Yoder (2010), it was hypothesized that follow-in directives for behavior
would be facilitative of language acquisition because they instruct the child to play with a
toy in a new way, or extend current play actions to a new toy. Contrary to our expectations,
we did not find a positive association between follow-in directives for behavior and later
language. Directives that instruct the child to change his/her behavior may be at odds with
the child’s intended actions and therefore, the child may be less likely find this type of
parent verbal input to be meaningful.
Responsiveness to Child Communication Acts

Linguistic Mapping—While there is both theoretical and empirical support for the
facilitative role of linguistic mapping in supporting language in children with other types of
developmental delay (e.g., Yoder & Warren, 1999), researchers have not yet demonstrated
that children with ASD can benefit from this type of responsive input. A significant positive
correlation between linguistic mapping and later language was observed for the combined
participant group for language comprehension. However, after controlling for parent
education, and accounting for initial child language and frequency of child nonverbal
communication acts, linguistic mapping failed to emerge as a significant predictor of later
language. Upon closer examination, it was clear that the opportunity for linguistic mapping
was extremely limited in both groups. On average, the combined group of participants
produced less than one nonverbal communication act every two minutes during the play
sample. In addition, only 26 of the 40 parents ever produced an act of linguistic mapping,
with 11 parents producing only one instance of this type of response. Thus, children may not
have been exposed to sufficient quantities of linguistic mapping to make a positive
contribution to later language.
Expansions—Positive bivariate associations with later language comprehension and

expansions were detected, a finding in agreement with previous work (e.g., McDuffie and
Yoder, 2010). However, such an association did not persist after controlling for parent
education, initial child language and child verbal communication acts. The opportunity to
expand child utterances is dependent on the verbal communication acts produced by the
child. These opportunities also were extremely limited given low frequency of child verbal
communication acts. On average, the combined group of participants produced one to two
verbal communication acts every minute during the play sample, but there was a large range
in performance with about half of the children producing three or less verbal communication
acts in the entire play sample.
Lack of a positive association between parent expansions and later language in children with
ASD also may be related to limitations in attention and motivation (Dawson et al., 2004;
Lovaas, Koegel, & Schereibman, 1979). These deficits may impede children’s ability to
compare their own communicative productions with the parents’ more linguistically
advanced model. Young children with autism learned linguistic skills better in adult recast
and prompted child imitation conditions than in adult recast alone conditions (Koegel, Lyons
& Koegel, in preparation). Although children with ASD can learn through their interactions
with others, they may benefit more from direct prompting than linguistic mapping and
expanding alone. Therefore, both direct prompts for language, such as follow-in directives
for language and direct prompts for imitations may be required with this population.
Limitations of the Current Study

Several limitations must be acknowledged. A large number of variables were investigated
given the number of participants in the regression analyses, though a maximum of four
variables were considered within each given model in line with statistical guidelines for
these types of analyses. In addition, the PLS-4 is not without drawbacks in measuring child
language outcomes. The PLS-4 assesses a more developmentally advanced range of
language skills in children. One could argue that parent follow-in comments, along with the
other types of parent responsiveness examined in this study (i.e., linguistic mapping) mainly
consist of object and action labels, which can be expected to specifically and directly build
vocabulary but not grammar. Lexical learning might not be well indexed by the PLS-4.
Therefore, it may be that a more comprehensive measure of vocabulary (e.g., the CDI) is
more useful when studying children with beginning language skills; however, such a
measure was not administered at Time 2. Indeed, some may argue that use of a parent report
instrument is not appropriate for a study of parent responsiveness as more responsive parents
may systematically differ from less responsive parents when reporting their children’s word
knowledge. In addition, such a measure may over-estimate functional communication
abilities in children with ASD. The PLS-4 might have been most appropriate for the verbally
fluent subgroup which, according to the ADOS module administered, was already
combining words into phrases or sentences and used an average of over 126 words
according to parent report at Time 1.
Finally, coding of the initial parent-child observation was limited to just 10 minutes of a 15-
minute interaction, which may not be adequate to represent the nature of parent-child
interactions. It could be argued that it would have been ideal to capture and analyze a longer
sample for each dyad to provide a more representative picture of the parent-child interaction
or to capture the language sample in a more familiar or naturalistic environment . However,
previous studies assessing parent verbal responsiveness have coded play samples of similar
or shorter durations than those used in the current study (e.g., McDuffie & Yoder, 2010
coded 15 minutes, and Siller & Sigman, 2002 coded 2 minutes) and use of a laboratory
based sample allowed standardization of the language sampling procedures. We do
recognize, though, that other groups of researchers have collected longer samples or have
used brief samples collected across different contexts (e.g., Warren, Brady, Sterling,
Fleming, & Marquis, 2010). How much time is needed to collect a representative sample is
an empirical question that needs to be addressed through further research.
Clinical Implications
Responsive techniques that may be beneficial for use in clinical practice and as targets in
parent mediated intervention programs were identified. The most compelling finding
indicated that children may benefit more from particular kinds of parent input during
different stages of language development. Specifically, the findings suggest that follow-in
comments may be especially beneficial to young children with ASD at the earliest stages of
language learning. This is particularly important given that many often assume that children
with more severe disabilities are less likely to benefit from intervention or stimulating input
and, therefore, more vigorous services are sometimes directed toward children with less
significant disabilities because they may seem more “ready to learn.” Our findings, along
with the findings of other research (e.g., Carter et al., 2011; Yoder & Stone, 2006) refute this
misconception and stress the value of meaningful input for children who have more severe
impairments. In addition, follow-in directives, in the form of questions which the child has
the lexical knowledge to answer, may help to support the child’s use of their own linguistic
knowledge within an interactive context. As discussed by Scherer and Olswang (1984),
follow-in directives may be necessary to prompt child verbal communication acts, which
subsequently allow opportunities for parents to expand the child’s communicative message.
When parents ask their child a question, it is important for them to recognize that that the
child’s response sets the occasion for parents to provide additional language input by
expanding the child’s response.
Future Directions
This study used child language outcomes that were measured one year following the initial
visit. It would be beneficial to assess language outcomes at subsequent points of time
through longer term longitudinal studies. Alternatively, treatment studies can teach parents
of children with ASD to increase parent responsiveness and assess child language outcomes
to demonstrate a causal relationship between the two. Previous studies have shown that
parents of children with ASD can learn to use language facilitation strategies (Carter et al.,
2011; Venker, McDuffie, Ellis Weismer, & Abbeduto, 2011). Future studies should focus on
demonstrating that a causal relationship between a parent-mediated intervention program
and child language outcomes is indeed mediated through gains in parent responsivity.
Acknowledgments
Funding for this project was provided by NIH R01 DC007223 and NIH T32 DC05359-06 (Susan Ellis Weismer,
PI), as well as a core grant support to the Waisman Center P30 HD03352 (Marsha Seltzer, PI). We sincerely
appreciate the contribution of the families who participated in this study. Also, we would like to thank Amy Stern
for her valuable help.
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Figure 1.
Interaction between group and follow-in comments when assessing language comprehension
and production. This figure illustrates that children with ASD with minimal expressive
language benefit from parent follow-in comments both in receptive and expressive domains.
NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript
Table 1
Participant Characteristics at Time 1 and Language Outcomes at Time 2
Total Sample (N= 40) MEL Subgroup (n = 22) VF Subgroup (n = 18)

Haebig et al.
Time 1 Measure M SD Range M SD Range M SD Range

CA 31.15 4.37 24–39 29.50 4.18 24–37 33.17 3.79 25–39
ADOS Severity 7.50 1.81 4–10 8.09 1.90 5–10 6.78 1.44 4–10
NVMA1 24.24 4.64 17–34 21.36 3.40 17–31 27.47 3.64 22–34
CDI WU 151.75 112.92 1–396 103.41 89.08 1–396 210.83 112.82 50–396
CDI WP 60.75 95.54 0–384 7.09 9.04 0–37 126.33 112.06 9–384
PLS–4 AC RS 20.70 6.13 10–42 17.68 2.38 10–22 24.39 7.28 18–42
PLS-4 AC SS 60.20 14.07 50–116 56.27 5.82 50–75 65.00 19.18 50–116
PLS-4 EC RS 25.18 6.15 16–40 20.82 2.54 16–25 30.50 4.91 24–40
PLS-4 EC SS 72.50 11.38 56–106 66.27 6.38 56–79 80.11 11.64 62–106
Parent YOE 14.00 2.04 12–19 13.82 1.92 12–19 14.22 2.21 12–18
Time 2
PLS-4 AC RS 28.42 11.05 17–55 21.59 4.44 17–32 36.78 11.02 20–55
PLS-4 AC SS 64.45 21.53 50–126 51.68 3.70 50–61 80.06 24.04 50–126
PLS-4 EC RS 32.53 9.20 19–56 26.36 5.46 19–39 40.06 6.94 31–56
PLS-4 EC SS 70.85 17.66 50–122 61.14 9.01 50–83 82.72 18.55 54–122
1
Only 34 participants had valid data for NVMA.
Note: MEL = minimal expressive language; VF = verbally fluent; CA = chronological age; ADOS = Autism Diagnostic Observation Schedule; NVMA = nonverbal mental age; CDI = MacArthur–Bates
Communicative Development Inventory; WU = words understood; WP = words produced; PLS–4 = Preschool Language Scales, Fourth Edition; AC = Auditory Comprehension; RS = raw score; SS =
standard score; EC = Expressive Communication; YOE = years of education.
Page 20
Table 2
Parent Responsiveness to Child’s Focus of Attention
Code Definition Example

Follow-in comments Parent describes child’s action or focus of attention “You have the piggy!”
without directing the child to change his or her “Run horsey!” (as child moves horse)
behavior “Moo moo” (as child plays with the cow)
Parent descriptions of his or her Parent describes his or her own action with a toy “I’ll put the lips on.” (as parent places lips on
own behavior (provided that the child is attending to the parent’s toy) Mr. Potato Head)
Follow-in directives for behavior Parent directs the child to change his/her behavior “Put the eyes here.”
“Push the tractor.”
Follow-in directives for Parent directs the child to produce a communication act “What is this?”
language (verbal or nonverbal) “What does the pig say?”
Redirects Parent redirects an engaged child “Look at the cow.” or “Here’s the cow.” (while
child is playing with the pig)
Introductions Parent introduces a toy to an unengaged child “I have a hat.”
“See this pig?”
Other talking Other talking “oh” “ok”
Table 3
Parent Verbal Responsiveness to Child Intentional Communication Acts
Code Description Example

Linguistic Mapping Parent puts into words the presumed message of the child’s nonverbal Child: reach for toy cow + eye gaze to adult
communication act Parent: “Cow” or “Want cow”
Expansion Parent repeats what the child said, but adds additional linguistic Child: “Horse”
information Parent: “Yellow horse”
Table 4
Mean Frequencies of Child Engagement, Child Communication Acts, and Parent Responsiveness
MEL Subgroup (n = 22) VF Subgroup (n = 18)

Haebig et al.
Code Mean SD Range Mean SD Range

Child Engagement in Seconds
Engaged 529.00 80.87 297–600 533.89 100.51 315–600
Not engaged 66.50 79.27 0–298 52.11 79.51 0–224
Parent Responses to Child Focus of Attention
FI comments1 55.36 24.48 26–111 46.17 28.43 11–128
Describes action 8.82 5.88 1–24 5.06 4.84 0–17

No talking 313.73 95.30 137–473 299.94 100.56 151–493
Other talking 17.36 9.02 3–42 14.28 7.53 3–29
FI directives (Lang)1 6.09 5.00 0–18 18.28 11.73 2–42
FI directives (Beh)1 12.64 11.00 0–41 16.22 11.11 3–47
Parent gestures 10.32 8.53 1–36 13.89 9.32 2–37

Redirect 31.27 17.11 11–78 32.50 16.39 10–88
Introduction 8.77 12.56 0–57 7.89 11.15 0–37
Child Communication Acts
Verbal 1.23 2.11 0–8 33.39 18.39 1–62
Nonverbal 3.18 3.43 0–12 6.22 6.29 0–20
Parent Responses to Child Communication Acts
Linguistic mapping 1.36 1.84 0–6 2.94 3.11 0–11
Repetition .91 1.69 0–6 9.61 9.06 0–33
Expansion .09 0.29 0–1 4.67 3.27 0–12
1
Follow-in
Page 23
Table 5
Bivariate Intercorrelations (N = 40)
Measure 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Haebig et al.
1. C-Engagement - .35* .16 .30* .03 .17 .33* −.03 .18 −.84** .39** .01 .01 .31* .05
2. C- Nonverbal com acts - .48** .32* .16 −.004 .41** .03 −.20 −.37** .74** .39** .40** .42** .20
3. C- Verbal com acts - −.15 −.18 −.20 .67** .20 −.18 −.13 .36* .82** .12 .67** .26
4. P- Follow-in comments - .55** .31* .09 .03 .05 −.24 .52** −.01 .40** −.13 .09
5. P- Descr. talk of own beh. - .23 −.05 .09 −.05 −.04 .28* .02 .23 −.30* -.16
6. P- Other talking - −.13 .17 .38** −.02 .14 −.14 .21 −.23 −.26
7. P- Directives for lang. - .36* −.09 −.21 .42** .51** −.05 .66** .40**
8. P- Directives for beh. - −.08 −.002 .12 .01 −.085 .14 .15
9. P- Redirects - −.14 −.06 −.14 .04 −.23 −.08
10. P- Introductions - −.38** .01 −.004 −.14 −.02
11. Linguistic mapping - .34* .24 .15 −.01
12. Expansion - .11 .51** .18
13. P- Years of education - .06 .43**

14. PLS AC difference - .50**
15. PLS EC difference -
*
p < .05.
**
p < .01.
Page 24
Table 6
Results of Multiple Regression Analyses Predicting Language Gain Scores
View publication stats

Language Outcomes
Haebig et al.
Language Comprehension 1 Language Production 2
Step ΔR2 B SE B β ΔR2 B SE B β

Step 1 .00 .18**
Parent Years of Education .22 .58 .06 1.22 .42 .43**
Step 2 .34** .09* .34**
Group 8.48 1.93 .59** 3.55 1.62 .31*
Step 3 .02 .002
Group 7.91 2.00 .55** 3.41 1.70 .30*
Follow-in Comments −25.72 24.34 −.16 −6.46 20.74 −.05
Step 4 .10** .11**
Parent Years of Education −.06 .51 −.02 .93 .43 .33*
Group 8.09 1.87 .56** 3.56 1.59 .31*
Follow-in Comments 35.33 33.40 .22 46.34 28.38 .39
Group X Follow-in Comments −105.66 42.32 −.47** −91.38 35.97 −.51**
Note. Parent years of education and follow-in comments were grand mean centered. Ratio values for follow-in comments were used to account for child engagement.
1
PLS-4 Auditory Comprehension difference score.
2
PLS-4 Expressive Communication difference score.
*
p < .05.
**
p < .01.
Page 25

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The Contribution of Two Categories of Parent Verbal Responsiveness to Later

Article in American Journal of Speech-Language Pathology · February 2013

Eileen Haebig Susan Ellis Weismer

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Am J Speech Lang Pathol. 2013 February ; 22(1): 57–70. doi:10.1044/1058-0360(2012/11-0004).

The Contribution of Two Categories of Parent Verbal

Purpose—Longitudinal associations between two categories of parent verbal responsiveness and

According to a social interactionist approach to language development, children acquire

Joint Attention in Children with Autism

The Role of Parent Responsiveness

Responsiveness to the child’s focus of attention

directives, and parent descriptions of their own actions.

Responsiveness to child communication acts

In summary, certain categories of parent language provided in the context of parent-child

inclusive coding scheme and by examining longitudinal associations between parent

Assessments and Measures

disorder includes individuals who function along a continuum of abilities. To adequately

Language and Cognition—The MacArthur-Bates Communicative Development

Coding and Reliability

Responsiveness to the Child’s Focus of Attention—Parent responsiveness to the

cow, moo moo.”

Responsiveness to Child Communication Acts—Coding this category of parent

be verbal (i.e., a word or sign) or nonverbal (i.e., communicative gesture or a vocalization

Reliability—Reliability was computed by having a separate coder independently recode 20

Interobserver reliability was computed using intraclass correlation coefficients (ICC).

Parent Responses to Child Communication Acts—Bivariate correlations were

Hierarchical Multiple Regressions—Parent behaviors that emerged as significant

Parent variables that responded to the child’s focus of attention—After

Parent variables that responded to child communication acts—After controlling

regression analysis to determine if there is an interaction between responsiveness (i.e.,

−2.54, p = .008, one-tailed, B = -91.38, β = 35.97, R2 change = .11). As Figure 1 depicts,

Responsiveness to the Child’s Focus of Attention

Follow-in Commenting—Although parent follow-in comments (i.e., comments that

engagement unless the child is actively manipulating an object.

Follow-in directives for language—One difficulty in interpreting the contribution of

parent verbal input to be meaningful.

Responsiveness to Child Communication Acts

contribution to later language.

Expansions—Positive bivariate associations with later language comprehension and

Limitations of the Current Study

1320. [PubMed: 19415479]

non-verbal communication measures. Journal of Psychology and Psychiatry. 1986; 27:657–669.

manual: First normed edition. Baltimore, MD: Brookes; 2002.

Total Sample (N= 40) MEL Subgroup (n = 22) VF Subgroup (n = 18)

Time 1 Measure M SD Range M SD Range M SD Range

Code Definition Example

Code Description Example

MEL Subgroup (n = 22) VF Subgroup (n = 18)

Code Mean SD Range Mean SD Range

FI comments1 55.36 24.48 26–111 46.17 28.43 11–128

Describes action 8.82 5.88 1–24 5.06 4.84 0–17

FI directives (Lang)1 6.09 5.00 0–18 18.28 11.73 2–42

FI directives (Beh)1 12.64 11.00 0–41 16.22 11.11 3–47

Parent gestures 10.32 8.53 1–36 13.89 9.32 2–37