Make room for daddy, say University of Florida autism experts

Make room for daddy, say University of Florida autism experts. Teaching fathers how to communicate and play with their autistic children pays dividends, for parents and kids alike.

Autism is a developmental disability that typically appears during the first three years of life and is characterized by problems interacting and communicating with others. Caring for an autistic child can be a relentless and labor-intensive task — one that is overwhelmingly performed by mothers, says UF nursing researcher Jennifer Elder.

Now UF researchers have found that teaching fathers how to talk to and play with their autistic children in a home setting improved communication, increased the number of intelligible words the youngsters spoke by more than 50 percent and helped dads get more involved in their care. The findings were published in a recent issue of the journal Nursing Research.

“We found that fathers were getting frustrated because they felt they couldn’t connect with their autistic child,” said Elder, the study’s principal investigator and an associate professor and chairwoman of the department of health care environments and systems at UF’s College of Nursing. “During one of our sessions, a child made eye contact with his father and said ‘Daddy’ for the first time in the child’s life.

“Traditionally, mothers are the primary caretakers of autistic children,” Elder added. “Through our training, we caused a shift in the paradigm of many of these families, with fathers taking on a more active role with their autistic children, sometimes even taking the lead in caretaking.”

At least 1.5 million Americans have some form of autism, and it now affects one in every 166 births, according to the Centers for Disease Control and Prevention.

UF researchers examined 18 father-child relationships before and after specialized training sessions. The families were recruited through UF’s Center for Autism and Related Disabilities and a community health practice in Central Florida and included 14 boys and four girls ranging in age from 3 years to 7 years old.

Building on a similar study of mothers of autistic children, Elder videotaped the father-child pairs in their homes during playtime sessions before training and at three key stages in the training process. The training emphasized language development and taught fathers to use everyday activities like playing with building blocks, puppets, cars and trucks, and bubbles to interact with their children.

UF researchers assessed each child’s behavior and evaluated how fathers interacted with them at the beginning of the study and during each of the three training stages. They also recorded each child’s autistic-like behaviors during and after play. During the first stage, fathers learned to initiate play with their children through animated repetition of their children’s vocalizations and actions. Fathers were told to resist the temptation to direct their child’s play and instead to follow the child’s lead. In the second phase, they were told to wait for their child’s response before continuing play. Eventually, the two techniques were used together.

The fathers were able to view the videotaped sessions to see their progress and areas needing improvement were discussed.

“We are really interested in promoting social balance, or turn-taking, in autistic children and their parents,” Elder said. “Normally, the parent might cue the child with one question, ask another question without waiting, and the child gets very frustrated and starts not to even attempt to respond. To combat that, we teach the parents to give a cue and wait for the response, with the expectation that the child will respond to establish that social balance.”

Fathers were more likely to initiate play in an animated way and responded more to their children during playtime. Children also became more vocal and were more than twice as likely to initiate play with their fathers. Surveys completed after the study was over also revealed that fathers viewed the training as valuable.

“One father related how after training, he felt empowered in his paternal role and became an active school liaison,” Elder said. “This proved beneficial for the child, who now had both parents consistently involved in his education.”

Researchers also were surprised to find that many fathers in the study actually took the lead in training the mothers and even siblings in the rest of the family, a key distinction from the mothers in her previous study, Elder said. In that study, researchers found similar benefits to training mothers, but moms weren’t as likely to attempt to teach fathers the techniques they learned.

Recent research has shown that early intervention with children can have a major influence on how the child develops and functions later in life.

“With the proper training at an early age, we feel that these techniques can help autistic children be more socially interactive and pick up language more easily,” Elder said.

Because of the study’s small sample size, Elder and her research team plan to continue their research with a larger group of fathers and fine-tune the interventions used based on their experiences in this study. They also plan to show fathers how to train their spouses in the techniques, and then evaluate the effectiveness of that approach. In addition, they are developing a Web site so training “booster” sessions can be broadcast via the Internet to participating fathers. Fathers will be able to view these training sessions and hear comments on how to improve upon their play sessions with their children.

“It is important for both the child’s mother and father to be involved in parent training whenever possible,” said Jaime Winter, a research scientist at the University of Washington Autism Center who previously conducted autism research at the University of California-San Diego. “Potential benefits that may follow from father participation include increased frequency of interaction and quality of interaction between fathers and their child with autism, increased treatment time for the child and support for the child’s mother.”