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Data from a 12-week randomized control trial of the Pathways Early Autism Intervention were analyzed. Pathways provides coaching to parents to facilitate early development of pragmatic skills for shared emotions with their toddlers. Thirty-four culturally and socioeconomically diverse toddlers with suspected or confirmed ASD were randomized into one of three groups: Pathways with an innovative protocol (IP) to facilitate social eye gaze, a similar intervention without the IP, and a business-as-usual group. Pre- and post-analyses of caregiver–child interactions and the Vineland Social subscale were used. A two-way mixed ANOVA tested response to treatment for the dependent variables. There was a significant group-by-time interaction for the sharing emotions measures of social eye gaze, F(2, 31)=7.34, p=.002, partial η2=.321, vocal-verbal reciprocity, F(2, 31)=3.753, p=.035, partial η2=.195; Vineland social, F(2, 31)=3.48, p=.043, partial η2=.183. Social eye gaze and Vineland scores favored the Pathways group, and vocal-verbal reciprocity favored Pathways and the intervention without the IP. There was a significant main effect of post-intervention Vineland social on pragmatic diversity, F(1, 30)=5.84, p=.022, partial η2=.163, and on rate of communication, F(1, 30)=5.63, p=.024, partial η2=.158. The Pathways group, with its protocol for social eye gaze, was more effective at facilitating the shared emotion skills than the other two groups, suggesting that eye gaze may be a pivotal skill for the development of early pragmatic skills in children with ASD.
