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Caregiver stress and language in infant siblings (Markfeld et al., 2023)

Version 2 2023-03-31, 21:40
Version 1 2022-12-16, 21:08
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posted on 2023-03-31, 21:40 authored by Jennifer E. Markfeld, Jacob I. Feldman, Samantha L. Bordman, Claire Daly, Pooja Santapuram, Kathryn L. Humphreys, Bahar Keçeli-Kaysılı, Tiffany G. Woynaroski

Purpose: Caregivers of autistic children present with high stress levels, which have been associated with poorer child outcomes in several domains, including language development. However, prior to this study, it was unknown whether elevated caregiver stress was associated with language development in infant siblings of autistic children (Sibs-autism), who are at increased likelihood of receiving a future diagnosis of autism and/or language impairment compared to infant siblings of non-autistic children. This study explored the degree to which, as well as the mechanisms by which, caregiver stress was linked with later language outcomes of Sibs-autism and infant siblings of non-autistic children (Sibs-NA).

Method: Participants were 50 infants (28 Sibs-autism; 22 Sibs-NA) aged 12–18 months at the first time point in this study (Time 1). Infants were seen again 9 months later, at 21–27 months of age (Time 2). Caregiver stress was measured via a validated self-report measure at Time 1. Caregiver language input, the putative mechanism by which caregiver stress may influence later language outcomes, was collected via two daylong recordings from digital recording (Language ENvironment Analysis) devices worn by the child at this same time point. Child language outcomes were measured via standardized and caregiver report measures at Time 2.

Results: Several models testing hypothesized indirect effects of caregiver stress on later child language outcomes through caregiver language input were statistically significant. Specifically, significant indirect effects suggest that (a) caregivers with increased stress tend to speak less to their infants, and (b) this reduced language input tends to covary with reduced child language outcomes later in life for Sibs-autism and Sibs-NA.

Conclusions: This study provides new insights into links between caregiver stress, caregiver language input, and language outcomes in Sibs-autism and Sibs-NA. Further work is necessary to understand how to best support caregivers and optimize the language learning environments for infants.

Supplemental Material S1. Associations between caregiver language input and later language, as moderated by sibling group. These associations covaried for caregiver stress.

Supplemental Material S2. Additional mediation analyses that were run post hoc to examine LENA variables that were specific to each infant’s reported primary caregiver.

Markfeld, J. E., Feldman, J. I., Bordman, S. L., Daly, C., Santapuram, P., Humphreys, K. L., Keçeli-Kaysılı, B., & Woynaroski, T. G. (2023). Associations between caregiver stress and language outcomes in infants with autistic and non-autistic siblings: An exploratory study. Journal of Speech, Language, and Hearing Research, 66(1), 190–205.


This work was supported by National Institutes of Health Grant U54 HD083211 (Principal Investigator [PI]: Neul), National Center for Advancing Translational Sciences Grant KL2TR000446 (PI: Woynaroski) and TL1R002244 (PI: Hartmann), National Institute on Deafness and Other Communication Disorders Grant 1R21DC016144 and 1R01DC020186 (PI: Woynaroski), National Science Foundation Research Traineeship Grant DGE 19-22697 (PI: Wallace), and Vanderbilt Institute for Clinical and Translational Research awards VR14759 (PIs: Cascio and Woynaroski), VR21082 and VR51537 (PI: Santapuram), and VR53067 (PI: Daly).