OARacle Newsletter

In November, OAR’s Board of Directors authorized funding for seven applied autism research studies in 2023. These new grants, totaling $276,212, bring OAR’s total research funding to more than $4.7 million since 2002. This article is the sixth of seven previews to be featured in The OARacle this year.  

Autistic children have marked deficits in communication that can persist across the lifespan. Developing interventions that can be widely and effectively implemented by caregivers to improve communication skills for autistic children is critical.

To date, parent intervention research has focused primarily on mothers. By not involving fathers, clinicians, and researchers are missing important opportunities to involve a primary communication and play partner in achieving maximal communication gains for autistic children. Fathers play an important role in early language input. In general, fathers use parent-child language models that differ from mothers, including more directive language and higher-level syntax and vocabulary, which may influence child communication outcomes in critical ways.

An OAR-funded two-year study led by Michelle Flippin, Ph.D., CCC-SLP, and Adam Moore, Ph.D., will pilot the feasibility and efficacy of Father Communication Coaching, a telehealth coaching program optimized to effectively involve fathers in intervention and improve social communication skills for autistic children. The study, Optimized Father Coaching to Advance Communication Skills for Children with Autism Spectrum Disorder, will contribute to a better understanding of factors that lead to increased use of intervention strategies by fathers and improved child outcomes.

The goals of the study are to:

• Determine the positive outcomes of a responsive parent coaching intervention, tailored to fathers, to improve child social communication skills.
• Identify parent and child characteristics associated with fathers’ use of targeted strategies and child joint engagement and communication gains.
• Understand how fathers’ perceived implementation successes and challenges impact use of the strategies and intervention outcomes.

Dr. Flippin is an assistant professor in the Department of Communicative Disorders at the University of Rhode Island. She is a speech-language pathologist specializing in autism spectrum disorder and developmental disabilities. Her research focuses on social communication development and intervention for children with ASD, specifically in understanding and enhancing the role of fathers in interventions to improve social communication outcomes for autistic children. As a clinical speech-language pathologist, she provided assessment and treatment for autistic children in early intervention, preschool, and public-school settings.

Dr. Moore is an assistant professor of special education and director of special education graduate programs at the University of Rhode Island. He is a board-certified exceptional needs specialist and former special education teacher. He has published 21 peer-refereed manuscripts concerning the experiences of families of children with disabilities (specifically autistic children), college students with disabilities, and inclusive practices and interventions for children and families.

Dr. Flippin and Dr. Moore wrote this month’s How To, focusing on how to more effectively involve fathers in intervention.

Methodology

Dr. Flippin and Dr. Moore will recruit 12 pairs of autistic children and fathers to participate in the study in groups of three pairs each. For each group, the researchers will establish baseline data for how fathers use responsive strategies, child joint engagement, and child spontaneous expressive communication. Dr. Flippin will be the clinician for the intervention, teaching fathers two verbal strategies (follow-in comments, follow-in directives) and two play strategies (physical play, object play). Each strategy will include seven steps:

1. Clinician creates buy-in with the father.
2. Clinician describes the strategy and the rationale for using it.
3. Clinician provides a model of the strategy.
4. Father completes an implementation plan.
5. Father implements the strategy during the father-child session.
6. Father completes a reflection log.
7. Clinician and father review how the father did with booster lessons as needed.

Once the father has mastered the strategy, instruction will begin on the next strategy, continuing until the fourth and final strategy is mastered.

Evaluation

Dr. Flippin and Dr. Moore will examine data from the intervention to document overall performance across participants and to identify associations between parent and child characteristics and how the fathers learned and used the targeted strategies. Parental characteristics include socioeconomic status, parental stress, and broad autism phenotype (mild impairments in social and communication skills that are similar to those shown by autistic individuals but exhibited to a lesser degree). Child characteristics include autism severity, adaptive skills, language skills, and sensory profile.

They will also collect data to examine changes from pre-intervention to post-intervention in adult word count, child vocalizations, and father-child conversational turns. Examining the influences of both parent and child characteristics on parent strategy use and child communication skills across intervention phases will enable the researchers to test the intervention in a larger study.

At the completion of each intervention, the researchers will interview the fathers to assess their belief systems, expectations, achieved goals and outcomes, and problem-solving strategies. Dr. Flippin and Dr. Moore believe that getting their input on which strategies work for them and are best for their children may increase their adherence to using the strategies, ultimately helping to improve the child’s social communication.

Practical Relevance

The study will potentially result in three important outcomes for the autism community. First, it will provide an effective intervention for fathers that can be delivered via telehealth. Understanding how to overcome the barriers to effectively involving fathers in interventions will have immediate clinical implications and allow speech-language pathologists to expand service offerings for autistic children.

Second, study findings will provide the research team with data to determine how to improve the coaching program to further enhance outcomes for autistic children. Specifically, the findings will include information about characteristics associated with more frequent use of the strategies by fathers and improved child social communication outcomes.

Finally, the findings will provide clinicians and researchers with a better understanding of how the fathers’ beliefs and perspectives influence implementation practice and autistic children’s communication skills.

Because there are so few effective communication interventions for autistic children that involve fathers, the knowledge gained from this study has the potential to bridge that gap in clinical services offered to the families of autistic children.

Sherri Alms is the freelance editor of The OARacle, a role she took on in 2007. She has been a freelance writer and editor for more than 20 years.