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Measuring Intentional Communication in Infants at Elevated Likelihood of Autism: Validity, Reliability, and Responsiveness of a Novel Coding Scale

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Title: Measuring Intentional Communication in Infants at Elevated Likelihood of Autism: Validity, Reliability, and Responsiveness of a Novel Coding Scale
Language: English
Authors: Elizabeth Choi-Tucci (ORCID 0009-0007-5535-8711), John Sideris, Cristin Holland, Grace T. Baranek (ORCID 0000-0002-5321-6353), Linda R. Watson (ORCID 0000-0001-7722-406X)
Source: Journal of Speech, Language, and Hearing Research. 2025 68(3):1151-1160.
Availability: American Speech-Language-Hearing Association. 2200 Research Blvd #250, Rockville, MD 20850. Tel: 301-296-5700; Fax: 301-296-8580; e-mail: slhr@asha.org; Web site: http://jslhr.pubs.asha.org
Peer Reviewed: Y
Page Count: 10
Publication Date: 2025
Sponsoring Agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (DHHS/NIH)
Contract Number: R21HD09154702
Document Type: Journal Articles
Reports - Research
Descriptors: Infants, Autism Spectrum Disorders, Caregiver Child Relationship, Nonverbal Communication, Verbal Communication, Intentional Learning, Test Construction, Test Reliability, Test Validity, Disability Identification, Early Intervention, Interrater Reliability, Resistance to Change
Geographic Terms: North Carolina
DOI: 10.1044/2024_JSLHR-23-00787
ISSN: 1092-4388
1558-9102
Abstract: Purpose: Intentional communication acts, or purposefully directed vocalizations and gestures, are particularly difficult for infants at elevated likelihood for eventual diagnosis of autism. The ability to measure and track intentional communication in infancy thus has the potential to aid early identification and intervention efforts. This study assesses the validity of a novel measure of intentional communication intended for use within semistructured caregiver--infant interactions. Method: The Intentional Communication Coding Scale (IC Coding Scale) captures infants' Vocalizations, Gestures, and Combined (vocalizations paired with gestures) acts. Using data from 36 infants at elevated likelihood for autism, we tested the convergent and discriminant validity of the IC Coding Scale with established language measures using Spearman's rho. We tested interrater reliability using intraclass correlation coefficient (ICC) calculations. Finally, we tested responsiveness (i.e., sensitivity to change) using Wilcoxon signed-ranks tests and Spearman's rho. Results: Our initial psychometric tests suggested adequate levels of convergent and discriminant validity. ICCs ranged from 0.77 to 0.92, while confidence intervals were wide, suggesting that Gestures and Combined acts were coded more variably than Vocalizations were among raters. Tests of the scale's responsiveness suggested adequate sensitivity to change across a 12-week period. Conclusions: This study is an important first step toward validating the IC Coding Scale for use in measuring and tracking intentional communication behaviors in infants at elevated likelihood for autism within more naturalistic, semistructured activities. Additional studies are needed to disentangle the effects of intervention from maturation and to examine types of intentional communication acts in more detail.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1467193
Database: ERIC
FullText Links:
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PubType: Academic Journal
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IllustrationInfo
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  Data: Measuring Intentional Communication in Infants at Elevated Likelihood of Autism: Validity, Reliability, and Responsiveness of a Novel Coding Scale
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  Data: English
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  Data: <searchLink fieldCode="AR" term="%22Elizabeth+Choi-Tucci%22">Elizabeth Choi-Tucci</searchLink> (ORCID <externalLink term="https://orcid.org/0009-0007-5535-8711">0009-0007-5535-8711</externalLink>)<br /><searchLink fieldCode="AR" term="%22John+Sideris%22">John Sideris</searchLink><br /><searchLink fieldCode="AR" term="%22Cristin+Holland%22">Cristin Holland</searchLink><br /><searchLink fieldCode="AR" term="%22Grace+T%2E+Baranek%22">Grace T. Baranek</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5321-6353">0000-0002-5321-6353</externalLink>)<br /><searchLink fieldCode="AR" term="%22Linda+R%2E+Watson%22">Linda R. Watson</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-7722-406X">0000-0001-7722-406X</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Speech%2C+Language%2C+and+Hearing+Research%22"><i>Journal of Speech, Language, and Hearing Research</i></searchLink>. 2025 68(3):1151-1160.
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  Label: Availability
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  Data: American Speech-Language-Hearing Association. 2200 Research Blvd #250, Rockville, MD 20850. Tel: 301-296-5700; Fax: 301-296-8580; e-mail: slhr@asha.org; Web site: http://jslhr.pubs.asha.org
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  Data: Y
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  Data: 10
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  Data: 2025
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  Data: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (DHHS/NIH)
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  Data: R21HD09154702
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="DE" term="%22Infants%22">Infants</searchLink><br /><searchLink fieldCode="DE" term="%22Autism+Spectrum+Disorders%22">Autism Spectrum Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Caregiver+Child+Relationship%22">Caregiver Child Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Nonverbal+Communication%22">Nonverbal Communication</searchLink><br /><searchLink fieldCode="DE" term="%22Verbal+Communication%22">Verbal Communication</searchLink><br /><searchLink fieldCode="DE" term="%22Intentional+Learning%22">Intentional Learning</searchLink><br /><searchLink fieldCode="DE" term="%22Test+Construction%22">Test Construction</searchLink><br /><searchLink fieldCode="DE" term="%22Test+Reliability%22">Test Reliability</searchLink><br /><searchLink fieldCode="DE" term="%22Test+Validity%22">Test Validity</searchLink><br /><searchLink fieldCode="DE" term="%22Disability+Identification%22">Disability Identification</searchLink><br /><searchLink fieldCode="DE" term="%22Early+Intervention%22">Early Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Interrater+Reliability%22">Interrater Reliability</searchLink><br /><searchLink fieldCode="DE" term="%22Resistance+to+Change%22">Resistance to Change</searchLink>
– Name: Subject
  Label: Geographic Terms
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  Data: <searchLink fieldCode="DE" term="%22North+Carolina%22">North Carolina</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1044/2024_JSLHR-23-00787
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1092-4388<br />1558-9102
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: Intentional communication acts, or purposefully directed vocalizations and gestures, are particularly difficult for infants at elevated likelihood for eventual diagnosis of autism. The ability to measure and track intentional communication in infancy thus has the potential to aid early identification and intervention efforts. This study assesses the validity of a novel measure of intentional communication intended for use within semistructured caregiver--infant interactions. Method: The Intentional Communication Coding Scale (IC Coding Scale) captures infants' Vocalizations, Gestures, and Combined (vocalizations paired with gestures) acts. Using data from 36 infants at elevated likelihood for autism, we tested the convergent and discriminant validity of the IC Coding Scale with established language measures using Spearman's rho. We tested interrater reliability using intraclass correlation coefficient (ICC) calculations. Finally, we tested responsiveness (i.e., sensitivity to change) using Wilcoxon signed-ranks tests and Spearman's rho. Results: Our initial psychometric tests suggested adequate levels of convergent and discriminant validity. ICCs ranged from 0.77 to 0.92, while confidence intervals were wide, suggesting that Gestures and Combined acts were coded more variably than Vocalizations were among raters. Tests of the scale's responsiveness suggested adequate sensitivity to change across a 12-week period. Conclusions: This study is an important first step toward validating the IC Coding Scale for use in measuring and tracking intentional communication behaviors in infants at elevated likelihood for autism within more naturalistic, semistructured activities. Additional studies are needed to disentangle the effects of intervention from maturation and to examine types of intentional communication acts in more detail.
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  Data: 2025
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  Data: EJ1467193
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1467193
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      – Type: doi
        Value: 10.1044/2024_JSLHR-23-00787
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 10
        StartPage: 1151
    Subjects:
      – SubjectFull: Infants
        Type: general
      – SubjectFull: Autism Spectrum Disorders
        Type: general
      – SubjectFull: Caregiver Child Relationship
        Type: general
      – SubjectFull: Nonverbal Communication
        Type: general
      – SubjectFull: Verbal Communication
        Type: general
      – SubjectFull: Intentional Learning
        Type: general
      – SubjectFull: Test Construction
        Type: general
      – SubjectFull: Test Reliability
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      – SubjectFull: Test Validity
        Type: general
      – SubjectFull: Disability Identification
        Type: general
      – SubjectFull: Early Intervention
        Type: general
      – SubjectFull: Interrater Reliability
        Type: general
      – SubjectFull: Resistance to Change
        Type: general
      – SubjectFull: North Carolina
        Type: general
    Titles:
      – TitleFull: Measuring Intentional Communication in Infants at Elevated Likelihood of Autism: Validity, Reliability, and Responsiveness of a Novel Coding Scale
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            NameFull: Elizabeth Choi-Tucci
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            NameFull: Linda R. Watson
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              Type: published
              Y: 2025
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              Value: 68
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