Caregiver responsiveness as a mechanism to improve social communication in toddlers: Secondary analysis of a randomized controlled trial.
Paige Huguely Davis, Heba Elsayed, Elizabeth R Crais and 2 others
PMID 34799999WHAT IT FOUND
Caregiver coaching did not directly improve toddler social communication scores.
However, when caregivers increased their verbal responses to their child's cues, the children's social communication skills improved. The coaching worked by changing how caregivers interacted, not through the coaching itself.
Key findings
01The coaching intervention did not have a significant direct effect on the toddlers' social communication change scores.
02Increases in caregiver verbal responsiveness mediated the link between the coaching group and improved toddler social communication.
03Nonverbal caregiver responses alone were not significantly related to changes in the toddlers' social communication skills.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample was predominantly White and highly educated, limiting generalizability. The study only had two time points, so it cannot rule out regression to the mean. The primary outcome of the original trial was null; this is a secondary mechanism analysis. Caregiver responsiveness was only measured for the primary caregiver, mostly mothers, despite other family members often participating in coaching.
Declared interests
Dr. Grzadzinski has received compensation for trainings on the ADOS and BOSCC but not for this manuscript. Drs. Watson and Crais have received compensation for invited talks and workshops on the ART intervention.
The easy way to misread this
Do not conclude that caregiver coaching is ineffective for social communication. The direct effect was null, but the coaching successfully changed caregiver behavior, which in turn improved child outcomes. The mechanism is the change in how caregivers talk and respond to their child.