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Joint attention in autism: Assessment in multiple settings

Posted Oct 03 2008 11:31am
A review of: Roos, E.M., McDuffie, A.S., Weismer, S.E., Gernsbacher, M.A. (2008). A comparison of contexts for assessing joint attention in toddlers on the autism spectrum. Autism, 12 (3), 275-291. DOI: 10.1177/1362361307089521

Earlier this year I reported on a study that showed significant improvement in joint attention after systematic training. Limited joint attention behaviors is seen as an early indicator of autism. In this new study, a team from the University of Wisconsin – Madison compared naturalistic (play interactions) and structured (Early Social Communication Scale protocol - ESCS) joint attention behaviors in toddlers, in order to examine the utility and viability of using naturalistic observations as an alternative to, or in support of, structured protocols such as the ESCS.

The ESCS assesses for two aspects of joint attention, namely: initiation of joint attention (IJA) and response to joint attention (RJA).

RJA refers to the child’s use of attention-following behaviors, such as head turns and eye gaze to follow the visual focus of a communicative partner. IJA refers to the child’s use of attention-directing behaviors, such as pointing or showing to coordinate attention with a social partner with reference to an object or event.

The authors wanted to explore IJA and RJA in multiple contexts in order to determine how stable these behaviors are across settings. To this end, the authors examined 20 toddlers with symptoms of autism (16 boys, four girls, mean age = 33.2 months). The experimenters conducted the ESCS during a first home visit and a play session during a second visit approximately one week apart. Both sessions were coded for IJA and RJA events. The authors found that the ESCS elicited significantly more IJA when compared to naturalistic play. However, the naturalistic play session elicited significantly more RJA. This indicates that the ESCS may underestimate a child’s use of RJA, and that conducting assessments in multiple contexts may provide a more valid measure of the child’s use of joint attention behaviors.
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