Symbol Use in the Home Environment in Toddlers Suspected of Having Autism Spectrum Disorder

A deficit in communication is not only one of the earliest and most frequently reported concerns by parents of young children later diagnosed with autism spectrum disorder (ASD), but is also among the most frequent reasons for the initial referral to a specialist for young children with ASD. Although extensive research has explored diagnostic features of communication in preschool aged children with ASD, few studies have examined these deficits in toddlers. In addition, the majority of research examining communication is conducted through parent report or within a clinic setting and provides limited information about communication profiles of toddlers with ASD within the home environment. The purpose of the present study was to explore early social communication profiles of toddlers suspected of having ASD (N = 74) during systematic observations within the home environment. Communicative acts were measured for rate, mode and function from video-recorded home observations of toddlers interacting with parents during everyday activities. The results of this study suggest that toddlers suspected of having ASD exhibit lower rates of communication in their home environment when compared to previous research within clinical settings. Toddlers in this study primarily directed their communication to others through the combination of gestures and vocalizations rather than with either a gestures or vocalizations. As expected, they communicated most frequently to regulate the behavior of their parents and communicated less frequently to join or share attention with another person or to interact socially. Results also suggest that the strongest predictors of outcomes at age three were rate of communication, communicative acts with a combination of gestures and vocalizations, and acts for behavior regulation. This study provides further understanding of social communication in toddlers suspected of having ASD, but also provides new information regarding communication within the home environment which may help build consensus with families of young children suspected of having ASD on early diagnostic features and provide the important first step families need in order to seek an evaluation and consider a diagnosis of ASD for their child.