Caregiver-child observation
In a caregiver-child observation, the evaluator is observing how the child communicates with a familiar caregiver, and how the caregiver responds to the child. Although the caregiver interview will identify the types of communicative functions used by the child, caregivers may interpret their child’s reaching behavior as a request, whereas the evaluator may observe that the child does not show clear awareness of the adult as a communicative partner rather than just a means to an end (Wetherby & Prizant, 1989). Adults also may use a variety of strategies such as gesturing, demonstrating their meaning through actions on objects or the child, using specific intonation patterns or signals to get the child’s attention repetition, and talking about objects and actions on which the child’s attention is already focused. Faced with communicative breakdowns, the adult may question, rephrase and add or change communication cues. Caregivers will vary in the extent to which they talk about the child’s current interests (Watson, 1998), and the findings of Siller and Sigman (2002) suggest that parents who do little of such “following-in” to the child’s interests might have a more positive impact on their children’s language development if they adopt more responsive interaction strategies. Parents who are already highly responsive to their children’s interest, however, do not need an intervention approach that includes coaching on these types of interaction strategies. Thus, it is critical to evaluate the strategies used spontaneously by caregivers, as well as their effectiveness in engaging or maintaining the child’s engagement in a communicative interaction, before creating an intervention plan (Peck, 1989).
Communication Sampling
The communication sample is used as an attempt to collect a representation of the child’s communicative behavior. We recommend that the sample be ongoing, not episodic, and that it should dynamically explore situational contexts to facilitate or entice the child to participate in communicative interactions (e.g., does the child initiate communication if you blow bubbles and then screw the lid tightly on the bubbles and hand it to the child?) (Wetherby & Prizant, 1989). Qualitative and quantitative analyses of the child’s means and functions is necessary for intervention planning as the functions used least often and/or those functions that are absent should be those targeted in the intervention plan (Quill, 1995). Toddlers with ASD usually need to increase both the number and diversity of effective and intentional communicative means and functions, but the specific needs of the individual child can be determined only through careful assessment.
Norm-referenced measures
Formal measures are available to assess the skills discussed above. Available normative data will not be applicable to children in cultures outside of the United States, but due to the focus of these measures on nonverbal and early verbal behaviors, they have utility for structuring the assessment of toddlers with ASD across different cultures. Once a child has begun to use some intentional communication, but before they begin to talk, The Communication and Symbolic Behavior Scales (CSBS; Wetherby & Prizant, 2002), a tool specifically designed to measure the social-communicative abilities of young children with ASD, or The Early Social-Communicative Scales (ESCS, Siebert, Hogan, & Mundy, 1982) can be used to analyze the child’s communicative means, functions, and repairs. The MacArthur Communicative Development Inventory (Fenson et al., 1993) is a parent report measure that can be used to assess communicative gestures, some symbolic play skills, and lexical knowledge.
