The Effects of Joint Attention Intervention on the Social

Communication of a Child with Autism

Yolanda Mahoney
Kent State University

Introduction

Methods

Joint attention is a critical skill learned early in childhood, this skill supports
the development of social communication for all children (Rocha,
Schreibman & Stahmer 2007).

Participants: 30 month old male with a diagnosis of autism and his mother.
Setting: Natural environment (home)
Design : AB (baseline and intervention) single subject research

Joint attention is the ability to divide attention between the partner in a social
context and an object or event of interest. When this occurs the partner
supports the child by providing meaning language and supporting social
communication.

Independent Variables (IV) Parent behaviors:

1. Labeling-simple phrases and environmental sounds to give meaning to items of want, need or interest to child.
2. Following childs lead- Do what the child is doing
3. Turn taking- verbal or physical initiation or followed after partner initiates in social context.
4. Gestures-The use of the body in an attempt to communicate with the child to support an initiation from the child
or an initiation made by the parent to facilitate social interaction at a moment in time.

Joint attention refers to the ability to shift attention between objects or events
and other people in order to share interest and plays an important role in
language development (Wong, 2013).
Children with autism are more likely to use pointing and attention skills to
regulate others behavior rather than to share interest.
Joint attention is important because the ability to engage others in social
interactions such as smiling is related to the ability to talk (Kasari et al., 2010)
Coaching the parents on intervention of joint attention supports the child to
generalize the skills ( Kasari et al., 2010).
Deficits in joint attention appear to be very pronounced in children with
autism so it is critical to understand early disturbances in the social
development of these children (Roaha, Schreibman & Stahmer 2007)
Research Question:
Does coaching parents to implement intervention strategies support the
development of joint attention skills in a young child across environments?

Synthesis of Research
Author

Purpose

Rocha, Schreibman &

Stahmers (2007)

Can parents be taught to implement a joint

attention intervention with young children
with autism.

Shertz & Odom (2007)

Kasari et al. (2010)

Results
Parents were able to learn the joint
attention interventions and in turn,
their children not only responded, but
initiated joint attention more
themselves.

To determine the effectiveness of

intervention before age three on promoting
joint attention by building on it
developmental precursors and parent-child
relationship to mediate child learning.

All 3 toddlers improved

performance; focusing on faces, turntaking, responding to joint attention,
and initiating joint attention.

If a joint attention intervention would result

in greater joint engagement between
caregivers and toddlers with autism.

Children engaged in significantly less

object focused play, significantly
more joint engagement and showed
greater responsiveness to joint
attention.

MacDonald et al. (2014)

To examine the use of a direct assessment to

measure change over time for children with
autism receiving early intensive behavioral
intervention treatment.

An increase of joint attention, eye

contact, imitation and language skill
for all children with autism.

Schertz et al. (2012)

To determine effects of the Joint Attention

Mediated Learning intervention on
acquisition of joint attention and other early
social communication competencies for
toddlers with autism spectrum disorders.

Positive effects to promote

foundational preverbal social
communication, more frequent
attention to parents faces and
responses to parents joint attention
overtures.

Ferraioli & Harris (2011)

To systematically replicate an established,

adult-mediated intervention with typically
developing siblings teachers, and evaluate
the programs efficacy in teaching joint
attention skill to children with autism.

All four participants demonstrated

improvement on their early social
communication skills

Discussion

Dependent Variables (DV) Child behaviors:

5. Vocalization- Any attempt at using the voice to communicate a need, want or interest, is not intelligible.
Vocalizations in this context do not include random vocal sounds outside of social context.
6. Approximations-Any attempt at using intelligible words or word approximations understood by partner to
communicate a need, want or interest. Verbalizations in this context are not considered when used without a
specific meaning or interaction in social context.
7. Turn taking-Any attempt to participate in an activity with a partner, turn can be initiated by child or in response
to turn taken by partner. Turn does not have to be completed/successful.
8. Gestures-The use of the body in an attempt to communicate with a partner a need, want or interest at any
moment of interaction.

Alignment to Research:
Joint attention in children with autism is critical in the ability to learn and
use social communication skills.
The research supports that coaching parents to implement these strategies
has longer lasting effects.
Practical Implications:
Early Intervention providers need to understand joint attention strategies
and how to coach parents implementing evidence based strategies during
daily routines and activities.
The coaching interaction style supports adult learning and effect for parents
to learn and implement.

Coaching Strategies:
. Environmental arrangement
. Give child opportunity to make choices.
. Encourage turn taking.
. Label items of interest.
. Parent use of gestures to support communication .
. Opportunity for action practice, reflection and feedback

Critical importance of joint attention in children with autism:

The joint attention strategies implemented by caregivers support the
positive interactions and social emotional development of children with
ASD.
Joint attention strategies can be embedded in the natural environment by
familiar people, thus generalization of the joint attention skills will be more
likely
The interventions used helps give meaning to familiar environments
supporting the acquisition of social communication skills.

Data collection Procedure:

. 4 minute sessions were coded from video recordings
. Intervention will be ongoing.

Results
Baseline
During baseline the child had moments of social engagement with the partner, joint attention was initiated by both
partner and child. Initiations made by child were in context of interactions of the partner.
Intervention
During intervention parent will use joint attention strategies and the initiation of joint attentions interaction made by
child will increase.

Future Directions

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More scaled up research needed in intervention strategies that foster Joint

Attention in children with ASD (larger sample sizes & randomized designs)
Data collected long term (longitudinal research).
Follow up with parent maintenance of intervention skills and examining if
the parents were able to continue to use strategies after supports were
removed.
Family satisfaction and social validity in the long term implementation and
sustainability.
Bridging evidence and early intervention practice invaluable and should be
investigated further!