Child gestures during a home observation (Delehanty & Wetherby, 2021)

Purpose: Most toddlers with autism spectrum disorder and other developmental delays receive early intervention at home and may not participate in a clinic-based communication evaluation. However, there is limited research that has prospectively examined communication in very young children with and without autism in a home-based setting. This study used granular observational coding to document the communicative acts performed by toddlers with autism, developmental delay, and typical development in the home environment.

Method: Children were selected from the archival database of the FIRST WORDS Project (N = 211). At approximately 20 months of age, each child participated in everyday activities with a caregiver during an hour-long, video-recorded, naturalistic home observation. Inventories of unique gestures, rates per minute, and proportions of types of communicative acts and communicative functions were coded and compared using a one-way analysis of variance. Concurrent and prospective relationships between rate of communication and measures of social communication, language development, and autism symptoms were examined.

Results: A total of 40,738 communicative acts were coded. Children with autism, developmental delay, and typical development used eight, nine, and 12 unique gestures on average, respectively. Children with autism used deictic gestures, vocalizations, and communicative acts for behavior regulation at significantly lower rates than the other groups. Statistically significant correlations were observed between rate of communication and several outcome measures.

Conclusion: Observation of social communication in the natural environment may improve early identification of children with autism and communication delays, complement clinic-based assessments, and provide useful information about a child’s social communication profile and the family’s preferred activities and intervention priorities.

Supplemental Material S1. Proportion of the sample observed to use gestures on at least one occasion during a home observation at 20 months.

Delehanty, A. D., & Wetherby, A. M. (2021). Rate of communicative gestures and developmental outcomes in toddlers with and without autism spectrum disorder during a home observation. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2020_AJSLP-19-00206