Enhancing Positive Emotion Sharing in Toddlers at High Risk for Autism: Findings from
the Social ABCs Parent-Mediated Intervention
J Brian, I Smith, T McCormick, E Dowds, W Roberts, L Zwaigenbaum, S Bryson, et al.
Abstract
(presented at IMFAR 2010)
Background: With the increased activity of longitudinal studies examining earliest signs of ASD
in high-risk infants and toddlers, the age of detection and diagnosis continues to decrease. This
has generated the question of what role earliest intervention might play (and what form it should
take) in enhancing the development of these toddlers. We have been examining this question
through a parent-mediated intervention program using an adaptation of the evidence-based
principles of Pivotal Response Treatment (PRT; Koegel & Koegel, 2006), together with effective
parent training techniques used with infants at high risk for sub-optimal outcomes (e.g., Landry
et al., 2001). The targets of our intervention focus on two core domains of development: positive
emotion sharing and early social communication. Following the original claim of Kanner (1943),
who viewed autism as a disorder of “affective contact”, the literature is increasingly recognizing
the fundamental role of emotion in the psychopathology of autism. Positive facial affect is
thought to motivate the earliest developing communicative skills, notably eye-to-eye gaze and
reciprocal social smiling (Berger, 2006; Farroni et al., 2002; Messinger et al., 2001), both of
which are fundamental to connecting with others emotionally (Hobson, 2004; Gallese, 2003;
Mundy & Acra, 2006). The putative significance of shared positive emotion to subsequent social
development, also reflected in our preliminary infant sibling findings (Bryson et al., 2007),
argues for interventions that target these core domains as well as later developing
communicative skills.
Objectives: To present preliminary data on the expression of positive emotion in the child and
parent, as well as ‘shared’ positive emotion in our first 9 cases, comparing pre- versus postintervention, and follow-up, rates.
Methods: Parents received our 12-week Social ABC’s parent training program consisting of 14,
1.5-hour home visits with manualized instruction and in-vivo coaching and support. Using a preestablished coding scheme, incidents of child-, parent-, and shared positive affect (i.e., smiling
together) were coded and averaged across three 10-minute video segments at each of three
time points: baseline, post-training (week 12), and follow-up (week 24).
Results: This poster presents data on our first 8 cases since we have increased our focus on
positive emotion sharing. Video coding revealed increases in child (mean change 14%) and
parent smiling (mean change 5%) between pre- and post-intervention, decreases in the
proportion of child smiles to objects (vs. more smiling to parent; p = .039), as well as significant
correlations between gains in parent, child, and shared smiling (all p’s < .05). Some, but not all
change was maintained at the follow-up appointment.
Conclusions: Discussion will centre on the importance of enhancing positive emotion in both
partners in an effort to increase positive emotion sharing in high-risk-toddler-parent dyads.
Implications for designing intervention programs are discussed as is the issue of parent
stress/emotions which may vary through the process of receiving the diagnosis. Putative
explanations for the less promising findings at follow-up are offered.
SPONSOR: Autism Speaks