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Imitation in Children with Developmental Delay and their Caregivers: Effects of a Parenting Intervention Targeting Behavior Problems

Children with developmental delay (DD) are at risk for poor developmental outcomes. Behavioral parenting interventions, such as Parent-Child Interaction Therapy (PCIT), have been found to be efficacious for children with DD. Few studies have focused on the relevant skill of imitation as a potential mechanism for change in developmental and behavioral outcomes. Furthermore, the examination of linguistic and cultural factors within parenting interventions is critical for the understanding of individual differences and optimization of child outcomes. This dissertation is comprised of five chapters with three manuscripts that are focused on improvement of behavior and executive functioning through interventions for children with and at risk for DD, as well as the impact of cultural factors on child outcomes. In the first manuscript (Chapter II), I highlight the bilingual advantage for executive functioning in children born preterm. In Chapter III, I examine the use of an observational coding system for parent and infant imitation following an adaptation of PCIT for infants (n = 60) and find more imitation displayed in English-speaking parents and Spanish speaking infants. In Chapter IV, I build upon my findings from Chapter III and examine the effect of internet-delivered PCIT (iPCIT) on caregiver and child imitation in a sample of children with DD (n = 150). Findings support associations between imitation and child behavioral outcomes, as well as the moderating role of acculturation and enculturation on the associations between iPCIT and imitation. These findings highlight a need to further explore the impact of behavioral parenting interventions on imitation and adaptations to these interventions to better meet the needs of families with varying levels of acculturation and enculturation, particularly with children with DD. The current dissertation emphasizes mechanisms by which interventions lead to positive developmental outcomes for children with and at risk for DD, highlighting the importance of linguistic and cultural factors in interventions for children and families from predominantly minoritized backgrounds. Future research should examine the use of imitation and individual and cultural factors to inform the development of more effective and culturally responsive interventions for optimal behavioral and developmental outcomes for children with and at risk for DD.

Major Professor: Dr. Daniel M. Bagner

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