AUTHOR=Seese Sydney , Matar Angelina , Mendes Lily , Gulsrud Amanda , Kasari Connie 
  
TITLE=Optimizing joint engagement in autism: considering toddler developmental abilities and caregiver stress
  
JOURNAL=Frontiers in Child and Adolescent Psychiatry
  
VOLUME=Volume 5 - 2026
  
YEAR=2026
  
URL=https://www.frontiersin.org/journals/child-and-adolescent-psychiatry/articles/10.3389/frcha.2026.1858019
  
DOI=10.3389/frcha.2026.1858019
  
ISSN=2813-4540
  
ABSTRACT=IntroductionPlay interactions between caregivers and their toddlers provide a critical context for the emergence of joint engagement, a state that supports early learning andsocial communication. Differences in toddler's developmental characteristics and caregiver experiences may influence how joint engagement is established during these interactions. This study examined whether toddler characteristics, including age, cognitive abilities, language abilities (expressive and receptive), and caregiver stress attenuated or amplified the association between caregiver strategy use and joint engagement in toddlers with autism.MethodsParticipants include 80 toddlers with autism (M age = 26.26 months) and their caregivers. Toddler cognitive and language abilities were assessed at baseline (prior to any intervention) using the Mullen Scales of Early Learning, and caregiver stress was measured using the Parenting Stress Index. Caregiver strategies and child engagement were observationally coded during a 10-min caregiver-child free-play interaction.ResultsResults indicated that age, cognitive abilities, expressive and receptive language significantly moderated the association between caregiver strategy use and joint engagement. The positive association between higher quality caregiver strategies and joint engagement was stronger for toddlers who were older and had more advanced cognitive and language abilities. In contrast, caregiver stress attenuated this relationship, such that higher quality caregiver strategies were less predictive of joint engagement at higher levels of stress.DiscussionThese findings suggest that the impact of caregiver strategies on engagement is shaped by both toddler developmental capacities and caregiver well-being, highlighting the importance of tailoring caregiver-mediated interventions to account for individual differences in the toddler - caregiver dyad to optimize joint engagement outcomes.