When parents of autistic teens have conversations about sensitive topics like sexual health, how do we know if the parents getting better at communicating? How can researchers capture the nuanced improvements in communication skills that happen over time?
We’ve developed a unique approach that goes beyond self-report surveys to measure real communication change through evaluating recorded conversations using trained observers and an incredibly detailed coding rubric. Over the past 10 years, dfusion has developed, tested, and refined the SkillFlix Video platform to teach and reinforce effective skills through the use of short Microskills® modeling videos with diverse audiences and skills (parents of autistic youth, autistic young adults, health educators, dentists, substance use treatment providers, and pharmacists). This has led us to a rigorous evaluation method that offers a window into the actual moment-to-moment interactions between parents and their autistic teens—capturing growth that might otherwise go unnoticed.
The Challenge of Measuring Communication Skills
Traditional research often relies on self-reported surveys where parents rate their own communication abilities. While valuable, these approaches have limitations:
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- Subjective bias: Parents might overestimate or underestimate their skills
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- Memory limitations: It’s hard to recall specific conversation details weeks later
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- Social desirability: Participants may report what they think researchers want to hear
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- Missing nuance: Surveys can’t capture the subtle dynamics of real conversations
We needed a method that could observe actual communication behaviors as they happen, not just perceptions of those behaviors.
Our Innovative Approach: Real Conversations, Real Data
In dfusion’s most recent research design for SkillFlix for Parents of Youth on the Autism Spectrum, we collected three audio-recorded conversations between parents and their autistic teens at baseline, 3-months, and 6-months. Parents were given a prompt for each conversation related to preventing sexually transmitted infections.
Parents used our secure Parent Hub mobile app to record 5-10 minute conversations at home—in their natural environment where authentic communication happens. This approach captures genuine parent-teen dynamics rather than artificial laboratory interactions.
The Heart of Our Method: A Comprehensive Coding Rubric
What makes our approach truly unique is our detailed coding rubric that evaluates multiple dimensions of effective communication. We don’t just ask “Did they talk about the topic?” Instead, we systematically assess specific microskills that research shows are crucial for effective parent-teen communication about sensitive topics.
Essential Skills
Our coding rubric for these conversations focuses intensively on four core communication skill steps for teaching about STIs that are modeled in our SkillFlix for Parents video curriculum:
1. Check for Understanding
2. Build on Past Knowledge
3. Share Resources
4. Invite Questions and Future Conversations
We also evaluate six supplementary steps that enhance the effectiveness of parent-child communication about STI prevention:
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- Engaging with the teen’s thoughts during conversation
- Providing alternative communication options
- Reinforcing family values connected to the topic
- Suggesting conversations with other trusted adults
- Expressing gratitude for the teen’s participation
- Using direct, medically accurate language
Recognizing that autistic teens have unique communication needs, we also code for specialized strategies that parents used that were also modeled in the SkillFlix video curriculum, for example using an established conversation routine, checklists, visuals, or role plays.
The Power of Detailed Scoring
Each skill receives a score from 0-10, with specific behavioral criteria for each level. For example, “checking for understanding” might score:
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- 0-3: Uses shaming language or makes statements without questions
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- 4-6: Asks questions but with critical tone or vague phrasing
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- 7-9: Asks general or closed-ended questions with positive tone
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- 10: Asks specific, open-ended questions with accepting language
This granular scoring allows us to detect subtle improvements that might be missed by broader measures.
Rigorous Training for Reliable Results
Our coders undergo extensive training to ensure reliability:
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- Study the detailed rubric definitions and examples
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- Practice with sample recordings until achieving consistency
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- Calibrate scoring through team discussions
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- Use both audio and transcripts for comprehensive analysis
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- Document specific quotes that illustrate each skill demonstration
What Makes This Approach Special
1. Ecological Validity: We capture communication as it naturally occurs in families, not in artificial research settings.
2. Behavioral Specificity: Rather than asking “Are you a good communicator?”, we observe specific, teachable behaviors.
3. Change Over Time: Three measurement points allow us to track skill development trajectories.
4. Autism-Informed: Our rubric recognizes that effective communication with autistic teens may look different from neurotypical communication norms.
5. Actionable Insights: The detailed scoring provides specific feedback about which skills to target for improvement.
Beyond the Numbers: Understanding Real Families
While our rubric provides quantitative scores, we never lose sight of the human element. We recognize that families have different communication styles, energy levels, and comfort zones. A parent might have a flat affect or be very direct—these aren’t communication failures, just different approaches.
The beauty of our method is that it honors this diversity while still measuring meaningful skill development. We’re not looking for one “perfect” way to communicate, but rather evidence that parents are developing their toolkit of effective strategies.
Looking Forward: Implications for Research and Practice
This approach offers several advantages for both researchers and practitioners:
For Researchers:
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- More sensitive measurement of communication skill change
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- Rich qualitative data alongside quantitative scores
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- Better understanding of which specific skills drive outcomes
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- Evidence for intervention effectiveness
For Practitioners:
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- Specific, behaviorally-defined targets for skill building
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- Concrete examples of effective communication strategies
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- Individualized feedback based on actual performance
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- Tools for tracking client progress over time
The Bottom Line
Measuring communication skills through recorded conversations and detailed behavioral coding represents a significant advance in how we study parent-teen interactions. By observing real conversations with systematic rigor, we can better understand what works, what doesn’t, and how to help families build stronger communication patterns.
This approach is particularly crucial when studying families with autistic teens, where communication differences are the norm rather than the exception. Our method respects these differences while still providing the precise measurement needed to advance the science of family communication.
As we continue analyzing data from our SkillFlix study, we’re excited about what these detailed observations will reveal about how parents develop confidence and skill in discussing sensitive topics with their autistic teens. The conversations we’re recording today will inform the support tools of tomorrow—helping families build stronger, more open communication for years to come.
The SkillFlix for Parents of Youth on the Autism Spectrum project is funded by the National Institute of Child Health and Human Development. Our research represents a collaboration between dfusion and Philliber Research & Evaluation, with oversight from an experienced IRB to ensure ethical research practices.