Joint Attention Interventions for Young Children with Autism Spectrum Disorders: Caregiver and Child Actions and Transactions

Background: The development of joint attention behaviors is one of the central accomplishments of infancy and the early childhood period (Mundy & Newell, 2007).  Joint attention has been linked theoretically and empirically to a number of other essential skill sets and developmental processes including language acquisition, affective sharing, social cognition, cultural learning, and the development of theory of mind (Adamson & McArthur, 1995; Baron-Cohen, Tager-Flusberg, Cohen, 1993; Carpenter, Nagell, & Tomasello, 1998; Kasari, Sigman, Mundy, & Yirmiya, 1990; Tomasello, 1995).  Deficits in joint attention, characteristic of children with autism spectrum disorders (ASD), can have serious consequences for these children’s functioning in multiple areas of development (Carpenter & Tomasello, 2000).  As a result, it is essential that effective early interventions are used to target and ameliorate joint attention deficits in young children with ASD.  Recent research on various interventions designed to promote joint attention in young children with ASD (e.g., Kasari, Freeman, Paparella, & Jahromi, 2008; Schertz & Odom, 2007; Whalen, Schreibman, & Ingersoll, 2006) shows promise, but is limited in two primary ways.  First, most interventions fail to situate joint attention within the natural context of early caregiver-child relationships by involving caregivers in central roles.  Second, the assessment of intervention outcomes is hampered by the absence of measurement systems capable of representing the changes that occur as a result of intervention in both child and caregiver actions and transactions.  Objectives: Aim 1: To examine changes in the occurrence of child and caregiver joint attention actions across the course of a caregiver-mediated joint attention intervention for young children with autism spectrum disorders.  Aim 2: To examine the sequential association between child and caregiver joint attention actions across the course of a caregiver-mediated joint attention intervention for young children with autism spectrum disorders.  Methods: Participants were six parent-child (two-years-of-age or below) dyads who had completed participation in a parent-implemented joint attention mediated learning intervention study conducted by Schertz, Odom, and Baggett (2007-2010).  Extant digital video data from weekly parent-child interaction sessions was examined using a researcher-developed observational coding system (Caregiver-Child Joint Attention Coding System) supported by observational coding software.  Aim 1 was addressed by using descriptive statistics and single-case design graphs to examine observational data resulting from the coding of digital video interaction sessions recorded throughout the course of the Schertz et al. (2007-2010) study.  Aim 2 was addressed by using sequential analysis procedures to examine the relationship between temporally associated caregiver and child joint attention actions occurring in the coded observational data.  Results: Data analyses to address both aims are currently being conducted. Preliminary findings indicate that caregiver actions and subsequent child joint attention actions are positively related to each other and reciprocal in nature. Conclusions: Data will be presented and discussed in terms of implications for intervention and the assessment of outcomes in future joint attention research.