Breakdowns and repairs: Communication initiation and effectiveness in infants with and without an older sibling with autism.

Researchers studied how 18-month-old babies at higher risk for autism communicate compared to typical babies. They found that at-risk babies try to communicate and fix misunderstandings just as much as other babies, but they do it differently. Babies later diagnosed with autism showed some strengths in their communication attempts, though they used simpler repair strategies. This research helps identify early communication patterns that could guide better support strategies.

This study examined communication patterns in 18-month-old infants at elevated likelihood (EL) for autism compared to typical likelihood (TL) infants. Researchers analyzed naturalistic videos to assess how infants initiate communication, experience communication breakdowns, and attempt repairs when misunderstood. EL infants, including those later diagnosed with autism (EL-AUT), initiated communication and experienced breakdowns at similar rates to TL infants. However, differences emerged in communication strategies: EL infants showed relative strength in behavior regulation bids, while EL-AUT infants used more developmentally appropriate repair behaviors despite having smaller repair repertoires.

EL-AUT infants also used more simplification repairs, which are less advanced. The findings suggest potential strengths in early communication that could inform intervention approaches.

Early communication patterns in at-risk infants reveal both strengths and areas for support. Interventions could capitalize on preserved initiation abilities and behavior regulation strengths while supporting development of more sophisticated repair strategies. Findings support individualized approaches based on communication profile assessment.

Small sample size of typical likelihood infants (N=15) limits generalizability. Study design unclear from abstract. Naturalistic video analysis may introduce observer bias. Long-term outcomes beyond 18 months not reported.

Infants initiate interactions to get their wants and needs met; but sometimes they are not effective in their communication and are misunderstood by caregivers. When this happens, they must recognize this breakdown in communication and attempt repairs. Experimental literature suggests that in neurotypically developing infants these skills develop during the first two years. However, little work has investigated communication breakdowns and repairs in populations of infants with known social communication difficulties (e.g., infants with an elevated likelihood for autism).

Here we explored early social communication initiations, breakdowns, and repair strategies in naturalistic videos of 18-month-old infants (N = 64) with elevated likelihood (EL) for autism and other developmental delays (N = 49) and infants with population-level likelihood for autism (e.g., typical likelihood, TL, N = 15). EL infants, including those who later met criteria for autism (EL-AUT), initiated with caregivers, experienced breakdowns, and made repairs at similar rates to TL infants. However, the types of behaviors used differed, such that EL infants appeared to have a relative strength in making behavior regulation bids. EL-AUT infants used a large proportion of developmentally appropriate repair behaviors (i.e., addition and substitution), even though their repertoires of repair strategies were smaller.

Additionally, EL-AUT infants produced a larger proportion of simplification repairs, which are less developmentally advanced and less helpful to interlocutors. Identifying patterns in how EL infants communicate with caregivers and capitalizing on their strengths could improve interventions focused on social communication.