| Video-recorded parent-child or teacher-child play interaction |
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| Parental responsiveness to the child |
Parent-child play interaction with a standardized set of toys – The percentage of parental acts that were responsive to the child’s focus was coded. |
Paul114114. Paul R, Campbell D, Gilbert K, Tsiouri I. Comparing spoken language treatments for minimally verbal preschoolers with autism spectrum disorders. J Autism Dev Disord. 2013;43:418-31. |
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10-min PCI with a standard set of toys – The number of total parent communication acts (comments, statements, acknowledgements or social interaction maintaining the child’s responses) which were synchronous to the child’s play behaviors were coded. |
Aldred5656. Aldred C, Green J, Emsley R, McConachie H. Brief report: mediation of treatment effect in a communication intervention for pre-school children with autism. J Autism Dev Disord. 2012;42:447-54. |
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5-min parent-child play interaction in a child-led play situation according to the Dyadic Parent-Child Interaction Coding System – Two categories of parents’ communication skills were coded: positive following (the sum of verbal “do skills” [i.e., behavior descriptions, reflections, and praises]), and negative leading (the sum of verbal “don’t skills” [i.e., commands, questions, and critical statements]) |
Furukawa,7878. Furukawa K, Okuno H, Mohri I, Nakanishi M, Eyberg SM, Sakai S. Effectiveness of child-directed interaction training for young Japanese children with autism spectrum disorders. Child Fam Behav Ther. 2018;40:166-86. Zlomke141141. Zlomke KR, Jeter K, Murphy J. Open-trial pilot of parent-child interaction therapy for children with autism spectrum disorder. Child Fam Behav Ther. 2017;39:1-18. |
| Child’s social communication skills |
Structured Laboratory Observation – 10-min PCI with a standardized set of toys in which the parent was asked to elicit as much language from the child as possible to assess the total frequency of the child’s functional utterances. These utterances were classified as unintelligible, imitative, verbally prompted, non-verbally prompted, or spontaneous. |
Gengoux7979. Gengoux GW, Berquist KL, Salzman E, Schapp S, Phillips JM, Frazier TW, et al. Pivotal response treatment parent training for autism: findings from a 3-month follow-up evaluation. J Autism Dev Disord. 2015;45:2889-98. |
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Natural Language Sample – 20-min caregiver-child interaction with a standardized set of toys to assess the child’s spontaneous expressive language ability, coded in terms of comments, requests, and verbal protests made by the child |
Kasari,9696. Kasari C, Kaiser A, Goods K, Nietfeld J, Mathy P, Landa R, et al. Communication interventions for minimally verbal children with autism: a sequential multiple assignment randomized trial. J Am Acad Child Adolesc Psychiatry. 2014;53:635-46. Almirall5757. Almirall D, DiStefano C, Chang YC, Shire S, Kaiser A, Lu X, et al. Longitudinal effects of adaptive interventions with a speech-generating device in minimally verbal children with ASD. J Clin Child Adolesc Psychol. 2016;45:442-56. |
| Child’s Attachment-related behaviors |
Structured interaction between parent and child consisting of three parts. Part 1: 10-min parent-child play interaction; Part 2: a stranger entered the assessment room and mothers were asked to step outside. The stranger remained with the child, engaging him or her in play; Part 3: after about 2 min of separation, mothers re-entered the room, following three instructions: a) calling the child’s name loudly from outside the door; b) pausing momentarily after opening the door; and c) greeting the child naturally thereafter. Children’s behaviors during the reunion part were videotaped and coded for attachment-related behaviors using two scales: the Proximity and Contact Seeking Behaviors Scale (evaluates the intensity of a child’s effort to regain contact with, or proximity to, their mother) and Avoidant Behaviors Scale (evaluates the intensity and duration of the child’s avoidance toward their mother) |
Siller121121. Siller M, Swanson M, Gerber A, Hutman T, Sigman M. A parent-mediated intervention that targets responsive parental behaviors increases attachment behaviors in children with ASD: results from a randomized clinical trial. J Autism Dev Disord. 2014;44:1720-32. |
| Child’s play behavior and/or joint attention |
Structured Play Assessment – The child is presented with four different set of toys at a table to assess functional play types, SP types and play level.15-min parent-child play interaction with a standardized set of toys to assess the child’s JA (frequency of JA initiations and responses) and play behaviors (the highest level of mastered play and SP types). |
Kasari,9191. Kasari C, Freeman S, Paparella T. Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. J Child Psychol Psychiatry. 2006;47:611-20.,9292. Kasari C, Gulsrud A, Freeman S, Paparella T, Hellemann G. Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play. J Am Acad Child Adolesc Psychiatry. 2012;51:487-95. |
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10-min parent-child play interaction using the Precursors of Joint Attention Measure observational protocol to assess the child’s focus on faces (defined as the child looking once or more at any part of the parent’s face), turn-taking (child performed one of at least two related actions in concert with a parent action within no more than two consecutive intervals), responding to JA (after the parent attempted to draw the child’s attention to an object the child alternated looks between the parent’s face and the object for the apparent purpose of sharing social interest), and initiating JA (child alternated looks between the parent’s face and an object for the apparent purpose of drawing the parent’s attention to the object) |
Schertz4343. Schertz HH, Odom SL, Baggett KM, Sideris JH. Mediating parent learning to promote social communication for toddlers with autism: effects from a randomized controlled trial. J Autism Dev Disord. 2018;48:853-67. |
| Parent and child’s social communication skills |
10-min parent-child play interaction – The number of occurrences of parent social communication behaviors (follow-in commenting, linguistic mapping, expansions, prompts, and redirects) and child social communication behaviors (prompted communication acts, spontaneous verbal communication acts, and spontaneous nonverbal communication acts) were coded. |
Venker128128. Venker CE, McDuffie A, Ellis Weismer S, Abbeduto L. Increasing verbal responsiveness in parents of children with autism:a pilot study. Autism. 2012;16:568-85. |
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7.5 min PCFP interaction – The child’s attention and initiation were coded using the Child Behavior Rating Scale. The parent’s behavior was coded for domains of responsiveness/child-oriented, affect/animation, achievement orientation, and directiveness using the Maternal Behavior Rating Scale. |
Solomon124124. Solomon R, Van Egeren LA, Mahoney G, Quon Huber MS, Zimmerman P. PLAY project home consultation intervention program for young children with autism spectrum disorders: a randomized controlled trial. J Dev Behav Pediatr. 2014;35:475-85. |
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5 min PCI playing with a puzzle – Child’s social competence (autonomy, responsiveness, empathy, motor regulation, and emotional regulation) and the caregiver’s child rearing competence (respect for autonomy development, respect for responsiveness development, respect for empathy development, respect for cognitive development, and respect for social-emotional development) were coded using the Interaction Rating Scale. |
Ichikawa8888. Ichikawa K, Takahashi Y, Ando M, Anme T, Ishizaki T, Yamaguchi H, et al. TEACCH-based group social skills training for children with high-functioning autism: a pilot randomized controlled trial. Biopsychosoc Med. 2013;7:14. |
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Parent-child play interaction with a standardized set of toys – The Dyadic Communication Measure for Autism was used to code child and parent communication acts (verbal and non-verbal behaviors that have communicative intent), child and parent shared attention (episodes in which the parent and child shared attentional focus), synchronous parental communication (comments, statements, acknowledgments, or social interaction which maintained the child’s responses), and asynchronous parental communication (responses aimed at redirecting, controlling or making demands on the child to respond). |
Aldred,5555. Aldred C, Green J, Adams C. A new social communication intervention for children with autism: pilot randomised controlled treatment study suggesting effectiveness. J Child Psychol Psychiatry. 2004;45:1420-30. Green,8383. Green J, Charman T, McConachie H, Aldred C, Slonims V, Howlin P, et al. Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial. Lancet. 2010;375:2152-60. Rahman115115. Rahman A, Divan G, Hamdani SU, Vajaratkar V, Taylor C, Leadbitter K, et al. Effectiveness of the parent-mediated intervention for children with autism spectrum disorder in south Asia in India and Pakistan (PASS): a randomised controlled trial. Lancet Psychiatry. 2016;3:128-36. |
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10-min mother-child play interaction with a standardized set of toys to assess parent verbal behavior (if synchronized or unsynchronized with the child’s attention and actions) and child toy-directed attention (the proportion of observation time children were attending to the target toys). |
Siller120120. Siller M, Hutman T, Sigman M. A parent-mediated intervention to increase responsive parental behaviors and child communication in children with ASD: a randomized clinical trial. J Autism Dev Disord. 2013;43:540-55. |
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PCFP interaction to assess nonverbal parent responsivity (when a parent aided the child in their play, performed the same action as the child with a similar object, expanded on the child’s play, or responded to a child’s request), verbal parent responsivity (when a parent described or talked about the child’s current focus of attention, or verbally expanded upon a child’s communication act, without directing the child’s behavior), and frequency of child intentional communication (gestures or nonword vocalizations during which the child coordinated attention between the message recipient and an object or salient event; conventional gestures, as distal points, head nods, pantomime, with attention to an adult; spoken words or signs used in a non-imitative manner) |
Carter6868. Carter AS, Messinger DS, Stone WL, Celimli S, Nahmias AS, Yoder P. A randomized controlled trial of Hanen's 'More Than Words' in toddlers with early autism symptoms. J Child Psychol Psychiatry. 2011;52:741-52. |
| Parent-child/teacher-child joint engagement |
10-min parent-child play interaction with a standardized set of toys to assess child play diversity (different types of play) and joint engagement between caregiver and child (the child and caregiver engaged with the same activity and with both aware of the roles of the other). |
Kasari9696. Kasari C, Kaiser A, Goods K, Nietfeld J, Mathy P, Landa R, et al. Communication interventions for minimally verbal children with autism: a sequential multiple assignment randomized trial. J Am Acad Child Adolesc Psychiatry. 2014;53:635-46. |
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10-min parent-child and teacher-child play interaction with a standardized set of toys to assess joint engagement (when they were engaged for at least 3 s and both the adult and the child were visible on the screen) and child initiation of JA (frequency of alternating gaze, showing, pointing, and giving to share) |
Kaale,9090. Kaale A, Fagerland MW, Martinsen EW, Smith L. Preschool-based social communication treatment for children with autism: 12-month follow-up of a randomized trial. J Am Acad Child Adolesc Psychiatry. 2014;53:188-98. Lawton101101. Lawton K, Kasari C. Teacher-implemented joint attention intervention: pilot randomized controlled study for preschoolers with autism. J Consult Clin Psychol. 2012;80:687-93. |
| Child’s RRBs |
10-min PCI with a standardized set of toys to assess the frequency and duration of child RRBs (narrow repetitive interests, stereotyped behavior/non-functional interests, specific sensory interests, unusual or repetitive motor movement, repetitive words/sounds) and the parents’ response to these RRBs (non-intervening, preventing, engaging, and distracting/developing). |
Grahame8282. Grahame V, Brett D, Dixon L, McConachie H, Lowry J, Rodgers J, et al. Managing repetitive behaviours in young children with autism spectrum disorder (ASD): pilot randomised controlled trial of a new parent group intervention. J Autism Dev Disord. 2015;45:3168-82. |
| Video-recorded family-child interaction during dinnertime |
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| Child’s affect during family interaction situation |
5-min family-child interaction during dinnertime to assess the child’s level of happiness, interest, stress, and communication style |
Koegel9999. Koegel RL, Bimbela A, Schreibman L. Collateral effects of parent training on family interactions. J Autism Dev Disord. 1996;26:347-59. |
| Video-recorded observation of the children during their classroom routines |
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| Engagement states and play behavior |
Observation of the child in their classroom setting to assess the frequency and type of spontaneous child-to-teacher communications with subsequent adult responses, and frequency and type of teacher-to-child communications with subsequent child responses. |
Carr6767. Carr D, Felce J. “Brief report: increase in production of spoken words in some children with autism after PECS teaching to Phase III”. J Autism Dev Disord. 2007;37:780-7. |
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15-20 min of observation of the child during normal classroom routines to assess engagement states (unengaged, on looking, object engagement, person engagement, supported joint engagement, and coordinated joint engagement) by the Structured Play Assessment: the child is presented with four different set of toys at a table to assess functioning play types, SP types and play level. |
Boyd,6565. Boyd BA, Watson LR, Reszka SS, Sideris J, Alessandri M, Baranek GT, et al. Efficacy of the ASAP intervention for preschoolers with ASD: a cluster randomized controlled trial. J Autism Dev Disord. 2018;48:3144-62. Goods8080. Goods KS, Ishijima E, Chang YC, Kasari C. Preschool based JASPER intervention in minimally verbal children with autism: pilot RCT. J Autism Dev Disord. 2013;43:1050-6. |
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At least two 10-to-15-min classroom observations to assess how the child: handles the unexpected, compromise, reciprocity, follows rules, transitions, gets stuck, negativity/overwhelm, and participates |
Kenworthy9898. Kenworthy L, Anthony LG, Naiman DQ, Cannon L, Wills MC, Luong-Tran C, et al. Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum. J Child Psychol Psychiatry. 2014;55:374-83. |
| Video-recorded examiner-child play interaction |
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| Child’s focus of interest |
15-min examiner-child unstructured free play interaction, with the examiner imitating the child’s play to assess the child’s focus of interest (the number of toys with which children used non-imitative, differentiated play actions) |
Mcduffie109109. McDuffie AS, Lieberman RG, Yoder PJ. Object interest in autism spectrum disorder: a treatment comparison. Autism. 2012;16:398-405. |
| Verbal expressive language |
15-min examiner-child semistructured play interaction, in which the examiner imitated the child’s play to assess the child’s spoken communication (frequency of non-imitative spoken communication acts and the number of different non-imitative words spoken) |
Yoder137137. Yoder P, Stone WL. A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD. J Speech Lang Hear Res. 2006;49:698-711. |
| Child’s social communication skills |
15-min examiner-child unstructured free play interaction to assess JA, verbal and nonverbal requests, initiation, cooperative play, and eye contact. |
Lerna,103103. Lerna A, Esposito D, Conson M, Russo L, Massagli A. Social-communicative effects of the Picture Exchange Communication System (PECS) in autism spectrum disorders. Int J Lang Commun Disord. 2012;47:609-17.,104104. Lerna A, Esposito D, Conson M, Massagli A. Long-term effects of PECS on social-communicative skills of children with autism spectrum disorders: a follow-up study. Int J Lang Commun Disord. 2014;49:478-85. |
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15-min interaction between the child and a speech-language pathologist to assess the Functional Communicative Profile (number of communicative acts produced per minute, percentage of interactive acts, and percentage of communicative space used) and the Social Cognitive Performance (gestural and vocal communication intention, use of the mediating object, gestural and vocal imitation, combinatorial play, and SP). |
Martins,106106. Martins LZ, Fernandes FD. Short-term speech-language intervention for children with disorders of the autism spectrum. Codas. 2013;25:542-7. Sun4444. Sun IY, Varanda CA, Fernandes FD. Stimulation of executive functions as part of the language intervention process in children with autism spectrum disorder. Folia Phoniatr Logop. 2017;69:78-83. |
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10-min examiner-child interaction to assess the child’s social initiations, classified as unprompted (i.e., spontaneous) question, and unprompted attempt at a question. |
Verschuur131131. Verschuur R, Huskens B, Verhoeven L, Didden R. Increasing opportunities for question-asking in school-aged children with autism spectrum disorder: effectiveness of staff training in pivotal response treatment. J Autism Dev Disord. 2017;47:490-505. |
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15-min videotaped observation of children during their class snack session with other children and class staff to asses frequency of child-initiated communication |
Gordon8181. Gordon K, Pasco G, McElduff F, Wade A, Howlin P, Charman T. A communication-based intervention for nonverbal children with autism: what changes? Who benefits? J Consult Clin Psychol. 2011;79:447-57. |
| Video-recorded observation of the autistic children with typically developing peers |
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| Child’s social communication skills |
5-to-15-min play interaction with peers during recess to assess social skills on three levels: positive social interaction (activities that exhibit verbal and nonverbal social behaviors that lead to an effective social process with peers), low-level social interaction (behaviors that indicate social intention but with minimal social enactment, such as close proximity to other children without initiating a positive social interaction), and negative social interaction (unpleasant social behaviors that operate to stop or decrease the likelihood of a positive social interaction). |
Hopkins,8686. Hopkins IM, Gower MW, Perez TA, Smith DS, Amthor FR, Wimsatt FC, et al. Avatar assistant: improving social skills in students with an ASD through a computer-based intervention. J Autism Dev Disord. 2011;41:1543-55. Bauminger6060. Bauminger N. The facilitation of social-emotional understanding and social interaction in high-functioning children with autism: intervention outcomes. J Autism Dev Disord. 2002;32:283-98. |
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15-min play interaction with peers during recess to assess social behavior. Behaviors were categorized into four types based on the child’s actions: solitary, initiation, response, and interaction. Peer responses were also assessed and classified as positive (when the action of the target child resulted in a clear positive response by the peer, such as an enthusiastic comment, a smile, a high-five, inclusion in an activity, or other behavior that had a distinctly positive quality), neutral (when the peer’s behavior lacked a specific positive or negative quality), or negative (ignoring, criticizing, aggression, or active exclusion). |
Wood136136. Wood JJ, Ehrenreich-May J, Alessandri M, Fujii C, Renno P, Laugeson E, et al. Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial. Behav Ther. 2015;46:7-19. |
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30-min play interaction with peers during class break to assess social behavior, classified as positive responses (when the child answers a question, obeys an order, responds with a positive emotion, or imitates the actions of another child) and negative responses (when the child refuses to respond to a question or instruction from another child) |
Arabi5959. Arabi M, Saberi Kakhki A, Sohrabi M, Soltani Kouhbanani S, Jabbari Nooghabi M. Is visuomotor training an effective intervention for children with autism spectrum disorders? Neuropsychiatr Dis Treat. 2019;15:3089-102. |
| Child’s social initiations and duration of social interactions |
10-min play interaction with peers (familiar, typically developing children that attended the same school as the target child) during class break in the school playground to assess the frequency of self-initiated social contact with peers and the duration of social interactions with peers. |
Owens112112. Owens G, Granader Y, Humphrey A, Baron-Cohen S. LEGO therapy and the social use of language programme: an evaluation of two social skills interventions for children with high functioning autism and Asperger Syndrome. J Autism Dev Disord. 2008;38:1944-57. |
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15-min play interaction with peers during class snack session to assess the frequency of child communicative initiations, frequency of use of Picture Exchange Communication System symbols, and frequency of speech (including non-word vocalizations). |
Howlin8787. Howlin P, Gordon RK, Pasco G, Wade A, Charman T. The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: a pragmatic, group randomised controlled trial. J Child Psychol Psychiatry. 2007;48:473-81. |
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Direct observation of the children during unstructured periods at school when they had free access to familiar peers to assess the frequency of self-initiated social contact and the duration of social interactions |
LeGoff102102. LeGoff DB. Use of LEGO as a therapeutic medium for improving social competence. J Autism Dev Disord. 2004;34:557-71. |
| Child’s engagement |
Playground Observation of Peer Engagement – 15-min observation of the child during play interaction with peers in the playground during class recess or lunch play period to assess percentage of intervals the target child spent in solitary play or jointly engaged with others (i.e., turn-taking in games with rules and engagement in conversations or joint activities). |
Kasari,9797. Kasari C, Dean M, Kretzmann M, Shih W, Orlich F, Whitney R, et al. Children with autism spectrum disorder and social skills groups at school: a randomized trial comparing intervention approach and peer composition. J Child Psychol Psychiatry. 2016;57:171-9. Shih119119. Shih W, Patterson SY, Kasari C. Developing an adaptive treatment strategy for peer-related social skills for children with autism spectrum disorders. J Clin Child Adolesc Psychol. 2016;45:469-79. |
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PIP – 20-min playground interaction with two novel peers to assess cooperative play (participant engaged in reciprocal play with at least one child) and cortisol levels in saliva. One peer was instructed to elicit play during prompted time intervals. The other child was a typically developing child with no specific directions. |
Corbett7272. Corbett BA, Swain DM, Coke C, Simon D, Newsom C, Houchins-Juarez N, et al. Improvement in social deficits in autism spectrum disorders using a theatre-based, peer-mediated intervention. Autism Res. 2014;7:4-16. |
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PIP – 20-min playground interaction with two novel peers to assess group play (the duration of activity when the participant is engaging with the group together in an activity by using the same types of equipment or toys as other members of the group) and equipment play (the duration of activity when the child is using equipment or toys on his/her own and not as part of a group). One peer was instructed to elicit play during prompted time intervals. The other child was a typically developing child and received no specific directions |
Corbett7373. Corbett BA, Key AP, Qualls L, Fecteau S, Newsom C, Coke C, et al. Improvement in social competence using a randomized trial of a theatre intervention for children with autism spectrum disorder. J Autism Dev Disord. 2016;46:658-72. |
| Video-recorded observation of the autistic children with autistic peers |
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| Social communication skills and quality of friendship |
Friendship Observation Scale – Autistic dyad interaction while playing with 18 puzzle images projected onto a 32-inch-wide touch sensitive horizontal surface through a video projector. Social communication behaviors coded were: positive social interaction (goal-directed behaviors – e.g., offering a goal-oriented action; sharing behaviors – e.g., showing and directing attention; prosocial behavior – encouraging; conversation – e.g., negotiation; and nonverbal interaction – e.g., eye contact), negative social interaction (such as teasing and aggression), affect, play (parallel play, simple social play, collaborative play, and unoccupied play), and autistic behaviors (such as repetitive stereotypical motor and verbal behaviors). |
Ben-Sasson6363. Ben-Sasson A, Lamash L, Gal E. To enforce or not to enforce? The use of collaborative interfaces to promote social skills in children with high functioning autism spectrum disorder. Autism. 2013;17:608-22. |
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