Do joint attention problems persist in verbal children with autism?

Background:

The extent and nature of the joint attention impairment in autism varies across development. Joint attention encompasses a range of social-communicative functions, forms and motivations which may develop independently. Explaining the successful development of some facets of joint attention alongside enduring areas of impairment is fundamental to theoretical accounts of autism. Two accounts which offer such explanations invoke reduced self-initiation (Klin, 2003; Mundy, 2003) and reduced interpersonal engagement (Hobson, 2002).

Objectives:

1) To show that verbal children with autism demonstrate joint attentional abilities: in terms of response to the bids of others and production of the surface forms of pointing and showing when prompted.

2) To test whether these joint attention skills are characterised by:

a) reduced spontaneous initiation of joint attention or

b) diminished interpersonal engagement (shared affect and directedness of body, gestures, eye gaze and language). 

Methods:

20 children with autism and 20 children with learning difficulties (6-13 years; language above 3.5 years; matched on age, gender and language; diagnoses confirmed) took part in semi-structured interactive tasks with the researcher involving proximal and distal objects of interest. The frequency of joint attentional responses and initations and the presence and quality of communicative forms were coded from video-tape. 

Results:

All children in both groups responded to joint attention within two bids. Data will be presented on group comparisons in the frequencies of spontaneous and prompted joint attentional acts and in behavioural and subjective ratings of shared affect and directedness within those acts.

Conclusions:

The results show that joint attention is not globally impaired in autism as previously reported (e.g. Baron-Cohen, 1995). They also allow us to evaluate whether theoretical accounts centred on initiation (Klin, 2003; Mundy, 2003) or interpersonal engagement (Hobson, 2002) adequately explain the development of some facets of joint attention alongside enduring impairment.