Quantifying the Child–Therapist Interaction in ASD Intervention: An Observational Coding System

Abstract

Background: Observational research plays an important part in developmental research due to its noninvasiveness. However, it has been hardly applied to investigate efficacy of the child–therapist interaction in the context of naturalistic developmental behavioral interventions (NDBI). In particular, the characteristics of child–therapist interplay are thought to have a significant impact in NDBIs in children with autism spectrum disorder (ASD). Quantitative approaches may help to identify the key features of interaction during therapy and could be translated as instruments to monitor early interventions. Methods: n = 24 children with autism spectrum disorder (ASD) were monitored from the time of the diagnosis (T0) and after about one year of early intervention (T1). A novel observational coding system was applied to video recorded sessions of intervention to extract quantitative behavioral descriptors. We explored the coding scheme reliability together with its convergent and predictive validity. Further, we applied computational techniques to investigate changes and associations between interaction profiles and developmental outcomes. Results: Significant changes in interaction variables emerged with time, suggesting that a favorable outcome is associated with interactions characterized by increased synchrony, better therapist’s strategies to successfully engage the child and scaffold longer, more complex and engaging interchanges. Interestingly, data models linked interaction profiles, outcome measures and response trajectories. Conclusion: Current research stresses the need for process measures to understand the hows and the whys of ASD early intervention. Combining observational techniques with computational approaches may help in explaining interindividual variability. Further, it could disclose successful features of interaction associated with better response trajectories or to different ASD behavioral phenotypes that could require specific dyadic modalities.

Interpersonal synchrony: Interaction variables and gender differences in preschoolers with ASD

“…We employed an observational coding system to quantitatively study the bidirectional interaction patterns displayed by the child and the clinician during the exchange ( 30 ). The coding schema consists of 15 codes that individuate both adult and child behaviors.…”

“…The Observational coding schema has previously shown a satisfactory construct validity. Further, two coders, experts in the field of autism spectrum disorder, were trained by a researcher to a reliability criterion of α > 0.80 and have previously shown satisfactory inter-rater reliability, measured with the Intraclass Correlation Coefficient (ICC) on the 20% of the videos independently coded ( n = 10) ( 30 ) (For further information, see Table 1 ).…”

Interpersonal Synchrony in the Context of Caregiver-Child Interactions: A Document Co-citation Analysis

“…Not only do newborns largely depend on significant others in order to satisfy their fundamental needs, but the quality of early relational exchanges influence the infants' subsequent emotional, cognitive and social development (Belsky and Fearon, 2002 ; Malekpour, 2007 ; Groh et al, 2017 ; Bell, 2020 ; Cataldo et al, 2021 ). For this reason, studying the quality of early interactions has become the key to understanding typical and atypical trajectories that can emerge in the individual's development (Harrist and Waugh, 2002 ; Bertamini et al, 2021 ). Among others, synchrony proved useful in assessing relational quality (Leclère et al, 2014 ).…”

Still a Long Way to Go. Editorial for the Special Issue “Understanding Autism Spectrum Disorder”

“…This technique may help harmonize the results of clinical trials and pool them in meta-analyses to better understand the actual efficacy of treatments for ASD. Finally, Bertamini et al [38] developed a novel observational coding system to quantify the child-therapist interaction in ASD intervention. The authors suggested that increased synchrony, successful strategies in engaging the children and longer and more complex interchanges, may be associated with favorable outcomes [38].…”

“…Finally, Bertamini et al [38] developed a novel observational coding system to quantify the child-therapist interaction in ASD intervention. The authors suggested that increased synchrony, successful strategies in engaging the children and longer and more complex interchanges, may be associated with favorable outcomes [38].…”