Influence of Caregiver Input and Dyadic Arrangement on Naturalistic Communication Sampling for Children With Neurogenetic Syndromes

PURPOSE: Natural communication samples are a useful tool for measuring social communication and language remotely via telehealth, particularly for children with low-incidence neurogenetic syndromes (NGS). The purpose of this study is to examine how dyadic factors (caregiver language input, dyadic positioning, and dyadic proximity) impact measures of social communication derived from remotely collected caregiver-child communication samples in children with and without NGS. METHOD: Participants included 72 young children and their caregivers (16 Angelman syndrome, 24 Down syndrome, 13 fragile X syndrome, and 19 low-likelihood controls). Participants completed a 10-min video-recorded play interaction with their caregiver in their home, and all video recordings were coded for social communication using the Communication Complexity Scale (CCS), dyadic positioning, and dyadic proximity. Caregiver language input was derived from Language Environment Analysis recordings of the 10-min play interaction. Moderated multiple regression analyses were used to determine whether dyadic interaction variables (positioning, proximity, and caregiver input) predicted CCS scores and whether these effects varied by NGS status. RESULTS: More caregiver language input was associated with higher CCS scores in non-NGS dyads but not in NGS dyads, though there was no relationship between language input and CCS scores when controlling for developmental age. Dyadic positioning and proximity were not associated with CCS scores across the sample, though higher CCS scores were associated with more time spent at right angles or facing the caregiver in children who demonstrated primarily pre-intentional social communication skills. CONCLUSIONS: Results show that measurement of social communication using the CCS via remotely collected natural communication samples is robust to variability in dyadic factors. Developmental age should be considered when interpreting measures from remote communication samples, and procedures for optimal positioning should be considered for children with primarily pre-intentional social communication skills. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.33209097.