“It just depends”: Parent, teacher, and expert conceptualization of social communication in young autistic children

Abstract

Improving social communication is a frequent goal of early autism services. However, it is unclear whether existing models of social communication align with the perspectives and priorities of key stakeholders, including parents, teachers, and expert clinicians. Stakeholder perspectives on social communication characteristics and priorities for young autistic children were gathered during seven focus groups. Participants included parents (three groups; n = 21), teachers (two groups; n = 8), and experts in early social communication and autism (two groups; n = 14). Content analysis procedures were used to develop and refine a codebook for themes and sub-themes that emerged from the focus group data and to code this data. Qualitative data analysis revealed several themes consistent with existing models of social communication in autism (expressive and receptive communication; social interaction), as well as novel themes related to unconventional communication, the impact of context on social communication, and the role of emotion regulation in social communication. Overall, participants expressed that adequately capturing autistic children’s social communication skills was challenging because autistic social communication is influenced greatly by a number of contextual, relational, motivational, and regulatory factors. These findings provide valuable insight for aligning social communication measurement and support with stakeholder priorities. Lay abstract Improving social communication is often one goal during early autism services. However, researchers do not yet know whether their ideas about which social communication skills should be targeted during services for young autistic children are the same as the goals of autism community members, such as parents, teachers, and expert clinicians. This study used focus groups (meetings of small groups of community members) to ask people from these groups about what aspects of social communication are most important to support in young autistic children. A total of 43 people participated in these focus groups. These groups included parents (three groups; 21 people), teachers (two groups; 8 people), and experts in early social communication and autism (two groups; 14 people). Focus group participants talked about several aspects of social communication that were already familiar to the research team, such as problems with expressive communication, language understanding, and social interaction. However, participants also talked about several parts of social communication that were less familiar to the research team and had usually not been mentioned in previous research. These included (1) considering the value of unusual forms of communication, (2) taking context and setting into account when considering social communication, and (3) how communication and emotion regulation impact one another. The information from these focus groups will be helpful to making sure that researchers and clinicians focus their social communication supports on areas that are most important to parents and teachers.