High and Lower Order Supported Joint Attention in Autism and Typical Development
Joint attention (JA) (i.e. the child and caregiver alternate between each other and an object) has been found to play a role in the language development of typically developing (TD) children, as well as children with ASD (e.g. 6). JA behaviors are generally impaired in children with ASD (e.g. 3, 4, 5, 7). However, more recent analyses of caregiver-child interactions have revealed that children with ASD participate in Supported Joint Engagement (SJE), in which the caregiver influences the child's object play, but the child engages with the caregiver without visually referencing him/her (1). Bottema-Beutel et al., (2014) also reported that by dividing SJE into Higher order (HSJE; the child responds by reciprocating and collaborating with the caregiver) and Lower order (LSJE; the child responds without reciprocal or collaborative exchange with the caregiver) types, HSJE predicted later social communication and expressive language in children with ASD. However, less is known about the relative proportions of time in which children with ASD participate in different types of social interactions and the nature of SJE activities in TD children.
We extend the paradigm of Bottema-Beutel et al. (2014) to a new sample of children with ASD, compare them to TD children, and investigate the amount of time TD children and children with ASD engage in episodes of SJE and JA.
The sample includes 15 children with ASD (ASDMA ge = 34.93 months, 12 males), and 15 TD children ( TDMAage = 19.82 months, 13 males), who were recorded at 3 visits, 4 months apart, and matched on language level (raw scores) (M ASDMullenEL = 16.44(6.22), M TDMullenEL = 20.35(5.70)) at visit 1. Children and their parents engaged in 30-minute play sessions, which were coded for amount of time spent in HSJE, LSJE and JA episodes.
Figure 1 presents the mean episode durations of all TD children and children with ASD across the 3 visits. The TD children were engaged with their caregivers for approximately 77% of the play session whereas the children with ASD were engaged for 67% (p = .15). TD children spent more time in JA episodes than children with ASD (p = .006), whereas children with ASD spent more time in LSJE episodes than the TD children (p = .005). Interestingly, children with ASD spent approximately one-third of the play session engaged within JA episodes.
Contrary to earlier findings, children with ASD participated in several different types of social interactions with their caregivers for about two-thirds of the play session, with considerable amounts of time spent in JA, LSJE, and HSJE. All three types of interactions were also observed in the TD group, although as expected the duration of JA episodes was longer, and LSJE episodes, shorter. These findings warrant further investigation into the predictive value of each interaction type for later development, as well as the more detailed examinations of the nature of the children’s and caregivers' activities.