Joint Attention, Play Behavior, and Language Abilities in Toddlers with ASD, Developmental Delay, and Typical Development

Background: Joint attention abilities and play behavior are associated with language development in both typically developing children and children with ASD. Children with ASD are impaired in attending to faces and voices and responding to and initiating joint attention. These early social orienting deficits may represent one of the earliest indicators for ASD and contribute to later social, communicative, and language impairments. However, most of the research in this area has been conducted in the preschool age range. This study is one of the first studies to examine joint attention, play behavior, and language in toddlers with ASD. Objectives: To investigate the relationship between play, joint attention, language, and cognitive abilities in toddlers with ASD, developmental delay, and typical development. Methods: Participants included children 18-30 months of age with ASD (n = 58), developmental delay (n = 21), and typical development (n = 27). Toddler's play behavior, joint attention, cognitive, and language abilities were measured in all three groups using the Communication and Symbolic Behavior Scales (CSBS), Play Assessment Scale (PAS), Joint Orient, Preschool Language Scale-4, and Mullen Scales of Early Learning. Results: Preliminary results indicate significant group differences on measures of language (F(2,100) = 152.95, p < .01), joint attention (F(2, 95) = 70.56, p < .01), and play behavior (F(2, 98) = 71.70, p < .01). This pattern of results remained significant even when IQ was covaried. In the overall sample, joint attention (b = .27, t(3.35), p <.01) and play behavior (b = .48, t(5.80), p < .01) were significant predictors of concurrent language ability. However, when examining the ASD group alone, the relationship between joint attention and language ability was not significant. Conclusions: These preliminary data replicate findings of joint attention, play, and language deficits seen in young children with autism. One possibility in examining the lack of relationship between joint attention and language ability in the ASD group is due to low variability in the joint attention measure. Additional analyses will examine multiple measures of joint attention and play behaviors to clarify the relationship between joint attention, play, and language abilities in toddlers with ASD. It is important to examine the relationship between early communication, joint attention, and play skills since these may be useful targets for intervention. Future analysis of this sample will examine the development of these abilities longitudinally.