Comparing Intervention Outcome Measures Across Clinic and Home for Young Autistic Children: Brief Observation of Social Communication Change (BOSCC) and Measure of NDBI Strategy Implementation-Caregiver Change (MONSI-CC).

Abstract

Purpose: Growing use of multiple Naturalistic Developmental Behavioral Interventions (NDBIs) across service settings has highlighted the need for flexible outcome measures. However, prior research has been limited by a lack of standardized tools to sensitively capture changes in autistic children's behavior and caregiver strategy use across contexts. The present study examined the feasibility and reliability of the Brief Observation of Social Communication Change (BOSCC) and the Measure of NDBI Strategy Implementation-Caregiver Change (MONSI-CC) across clinic and home settings, as well as cross-context comparability and associations between child and caregiver behaviors.

Methods: Sixty caregiver-child dyads completed standardized 12-minute caregiver-led play tasks in both clinic and home contexts. During home administration, research staff provided real-time remote support and prompts consistent with clinic procedures. Feasibility and acceptability of home administration were evaluated using descriptive statistics. Reliability was examined in terms of internal consistency, inter-rater reliability, and test-retest reliability. Cross-context comparability and associations between the two measures were examined using paired-sample t-tests and Pearson correlations.

Results: Home administration showed high caregiver acceptability and strong fidelity. The BOSCC and MONSI-CC showed generally similar reliability patterns across contexts. Most BOSCC and MONSI-CC scores did not differ significantly between contexts, and several showed significant cross-context associations. Associations between autistic children's social communication and caregiver strategy use were strongest within the same context but also evident across settings.

Conclusion: Brief, standardized observational assessments may provide scalable tools for assessing caregiver and child behavior across clinic- and home-based early intervention settings.