Caregiver-infant interactions in infants at elevated familial likelihood for autism in India

Prospective studies of infants at elevated likelihood for autism (EL-A) have identified differences in caregiver-infant interactions (CII) when compared to infants at typical likelihood (TL). These differences begin to emerge prior to the infant's first birthday and may impact social opportunities essential for facilitating social-communicative development. To our knowledge, all studies to date have focused on Western samples (Australian, European, and US). However, parenting science has long recognised cultural variability in CII. This study investigated whether global features of CII differed between EL-A and TL infants in India. Caregiver-infant free-play videos involving 33 EL-A and 15 TL infants aged 9-15 months were rated using the Manchester Assessment of Caregiver-Child Interaction-Infant (MACI). EL-A infants received lower sensitive responsiveness and psychological stimulation compared to TL infants in age-controlled analyses. No significant group differences were found in caregiver directiveness or in infant or dyadic MACI scales. Furthermore, caregiver sensitive responsiveness and psychological stimulation (incorporating social and cognitive stimulation) were positively associated with concurrent parent-reported infant play and leisure, lending support for ecological validity. This first study in a South Asian context demonstrates a partial replication of previous CII studies. Early pre-emptive interventions targeting caregiver-infant interaction are recommended for Indian families to enhance infant exposure to responsive and stimulating social interactions. The strength of findings is understood in the context of utilising caregiver self-recorded CII, the sample size and broad age range.