The Effects of Directive and Responsive Communication Intervention Strategies on Autistic Children’s Disruptive Behavior

Abstract

Naturalistic developmental behavior interventions (NDBIs) are commonly taught to caregivers to target social communication in autistic children. In addition to social communication challenges, 50% of autistic children engage in disruptive behaviors. This study aims to evaluate the impact of responsive and directive NDBI social communication strategies on autistic children’s disruptive behavior. At baseline, mother–child dyads were randomized to receive 8 weeks of a caregiver-mediated intervention focused on either responsive or directive NDBI communication strategies (n = 73, M_age = 33.49, standard deviation [SD] = 6.37, directive n = 36, responsive n = 37). Before and after intervention, 10-min mother–child interactions were video-recorded and coded using an event-based disruptive behavior code. A linear model revealed that children in the directive condition were more likely to display disruptive behavior as compared to the responsive condition. This study’s findings can be used by providers and caregivers when engaging in shared decision-making to identify NDBI strategies that best fit the family’s priorities. Additional research is needed to examine (a) disruptive behavior over time and across contexts and (b) the effects of directive and responsive strategies implemented in tandem on disruptive behavior. The original clinical trial was prospectively registered in a publicly accessible database (NCT02632773, clinicaltrials.gov).