ArticlePsychology research and behavior management2025
"Let's Try to Stay on Track": Exploring Therapists' Responses to Digressive Utterances of Children with ASD.
Article in Psychology research and behavior management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Autistic children's digressive utterances can disrupt therapeutic progress, yet remain understudied in China. This study investigates how Chinese therapists respond to such digressions during Naturalistic Intervention (NI) sessions, specifically exploring how they navigate the tension between structured therapeutic goals and spontaneous interactions while adapting evidence-based practices (EBPs) to individual child profiles and sociocultural contexts. Participants and Methods: Applying discourse analysis (DA), we analyzed 19 NI sessions involving five Board Certified Behavior Analysts (BCBAs; ≥2 years of experience; trained in NI) and ten Chinese autistic boys (aged 29-78 months; Level 1 ASD). Therapists delivered tailored NI sessions (4-30 hours/week), embedding communication goals within play-based routines. Sessions were video-recorded in therapeutic settings. Results: Therapists employed seven distinct response practices spanning a directive-to-elicitory continuum. Immediate refocusing practices (restatement with nonverbal cues, digression-termination before refocusing, and integration) prioritized task adherence but risked further disengagement. Delayed refocusing practices (minimal acknowledgment before refocusing, accommodation before refocusing, and following the child's lead before refocusing) validated children's agency and elicited higher rates of goal-aligned responses. Digression-following practices fostered spontaneity but risked further divergence. Notably, accommodation and following the child's lead before refocusing elicited the most contingent responses, while abrupt termination often provoked resistance. Senior therapists employed more diverse practices while favoring delayed refocusing practices, whereas juniors favored immediate refocusing practices. Practice selection was influenced by digression sub-focus, therapist experience, child characteristics, and sociocultural contexts. Conclusion: Findings reframe digressions as agentic bids necessitating mutual adaptation, aligning with "the double empathy problem". As the first DA study of therapist responses to digressions in China, this study underscores the clinical importance of culturally attuned flexibility for validating autistic agency while maintaining therapeutic progress. Based on the research findings, therapist training should emphasize reflective, context-responsive practices to enhance engagement across cultures.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.