Dads Must Connect With Autistic Kids Too

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.”

Brief Commentary: To be fair to some dads, it should be pointed
out that presuming there is a genetic component to autism, some fathers too,
may have some social developmental deficits that make it difficult for them
to play empathetically with anyone, even their own kids, autistic or
otherwise. You can lead a horse to water, but you can’t make it do the
backstroke. (For the hyperbolic metaphor-impaired reader, this means one
cannot make someone do something he is not fundamentally equipped to do,
even if he wants to do it.) Non-nerdy dads should resist using this as an
excuse to not get involved with their families, however. -LS.

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