78 Chapter 4 Video-outcome measures JERI. Joint engagement and parental intervention skills are measured with the Joint Engagement Rating Inventory (JERI; Adamson, Bakeman & Suma, 2020) through semistructured 12 minute videotaped interactions between parent and child. The JERI was administered for each dyad at T1 and T2 during pilot testing. Parent and child were presented with a standardized set of toys in two boxes (A and B) and were asked to engage in free play with box A for four minutes, followed by blowing bubbles for two minutes. Next, parents were asked to repeat the aforementioned, but now with box B. Recordings were subsequently coded for four engagement states: total joint engagement, supported joint engagement, coordinated joint engagement and symbol-infused joint engagement. Total joint engagement describes the overall quantity of joint engagement during the video. Supported joint engagement involves the child and parent being actively engaged with the same object or event, but the child does not actively acknowledge the parent’s participation. In coordinated joint engagement, the child and parent are actively involved with the same object or event and the child is actively and repeatedly acknowledging the caregiver’s participation. Symbol-infused joint engagement involves the child and caregiver engaging with the same object and event, with the child paying attention to symbols (Adamson, Bakeman & Suma, 2020). Each engagement state was rated on a 7-point scale (1 = no joint engagement, 7 = almost constant joint engagement), with a midpoint of 4 indicating joint engagement for approximately one half (total joint engagement) or one third of the interaction (supported, coordinated and symbol-infused joint engagement). The child’s expressive language level and use was also observed through the JERI and was rated from 1 (no expressive language) to 7 (fluent and frequent use of sentences). Parental intervention skills, defined as the accurate and consistent execution of parentimplemented techniques, were assessed using the parent scales of the JERI. The scales included four items: caregivers’ scaffolding, symbol highlighting, following in on child’s focus and caregivers’ affect. Scaffolding assesses how well the parent supports the child’s activities and provides learning opportunities. Symbol highlighting focuses on how often the caregiver directs the child’s attention to symbols (language and/or symbolic gestures and acts). Following in on child’s focus captures if the parent is following the child’s interests and maintain focus with the child. Finally, caregivers’ affect measures the parent’s affect and how it influences the parent-child interaction (Adamson & Suma, 2020). Parental items were rated on a scale from 1 (minimal support) to 7 (continual support) and midpoint of 4 (moderate support). Parental skills were rated based on the same videotaped dyadic interaction as the joint engagement measure.
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