Qualitative Differences of Joint Focus of Attention Between Korean-Speaking Toddlers with Autistic Spectrum Disorder and Toddlers with Developmental Disabilities

Background:  It has been reported in the literature that children with autistic spectrum disorder (ASD) share a number of features with other children with developmental disabilities (DD), involving difficulty with joint focus of attention (JFA). As well known, impaired JFA may affect more advanced communication skills.

Objectives:  The present study aims at investigating the complexity of child JFA behaviors in toddlers with ASD as compared with those with DD in terms of dyadic and triadic joint interactions. Participants were forty-five in total, composed of twenty-eight Korean-speaking children with ASD (27 males and 1 female, M=30.6 months, CA range=21-37 months, SD=4.5 months) and seventeen Korean-speaking children with DD (14 males and 3 females, M=31.4 months, CA range=13-39 months, SD=6.4 months). For the purpose of this research, dyadic JFA is defined as acts of exchanging facial expressions and of pointing and showing behaviors, triadic JFA being marked by the individual coordinating their attention back and forth between himself and the other individual after looking at the same object in one activity.

Methods:  Each of 45 mother-child dyads was observed during a 10-minute videotaped free-play session in a sound-proof lab designed for child study provided with a standardized set of toys such as a doll, cars, trucks, a spinner, books, and stuffed animals. The parent was instructed to respond naturally when the child was seeking an interaction. The video segments of mother-child interactions were transcribed and coded verbatim in CHAT modes by trained students and coders for three main categories of utterances (verbal, non-verbal, and vocative) and two types of interactions (dyadic and triadic), and CLAN was performed for final results to be obtained.

Results:  Data analyses showed that there were no statistically significant quantitative differences between the children with ASD and those with DD regarding the JFAs expressed in all three main categories, verbal, nonverbal, and vocative utterances, while the number of JFAs was greater than that of Non-JFAs in both groups. Qualitative differences between them, however, emerged with respect to the JFAs across the three main categories. No statistically significant difference was found between the two groups as far as dyadic interactions were concerned. Importantly, on the other hand, the two groups differed statistically significantly regarding the triadic JFAs across the three main categories (verbal 4.93(SD=10.0) vs. 3.24(SD=6.43), t(43) = 2.179, p = .036; non-verbal 14.79(SD=15.47) vs. 26.0(SD=20.29), t(43) = -2.094, p = .042; vocatives 1.36(SD=3.06) vs. 3.47(3.09), t(43) = -2.241, p = .030).

Conclusions:  Overall, our results are noteworthy in that children with ASD were significantly different from and more impaired than those with DD in triadic JFAs, but not in dyadic JFAs. This finding is extremely important in two respects. It supports previous research on prominent impairment of JFAs in children with ASD and with DD. It further provides an insight into the ongoing research on the development of JFA in ASD and DD toddlers, suggesting that they should be differentiated on rather specific terms involving qualitative differences of JFAs, in particular.