Joint Attention Intervention in the Preschool – a Randomized Study

Background: Young children with autism experience severe difficulties in joint attention (JA), and their ability to initiate and respond to JA is associated with social engagement and later language skills. Recent JA-intervention studies have shown promising results. However, there is a need to investigate the effectiveness of JA-intervention when it is moved from the University clinic in to the mainstream preschool.

Objectives: The present study investigates the possible improvement in joint engagement in children with autism following a JA-intervention implemented in mainstream preschools.

Methods: Sixty one children diagnosed with autism (age 24 to 60 months (mean CA=48 months, range 29-60) were randomly assigned to a JA intervention group (n=34) or a control group (n=27). The intervention was based on an adaptation of the JA-intervention method developed by Connie Kasari at UCLA. Children in both groups continued their regular programs while the children in the intervention group also participated in two daily JA-intervention sessions for a period of 8 weeks (total of 26 hours of intervention). The sessions were done in the preschool by preschool teachers or aids receiving weekly supervision by trained counselors. For this part of the study participants were videotaped during 10 minutes of free play with their mother with a standard set of toys at pre- and post-treatment. The videotapes were then coded for six different engagement states (Bakeman and Adamson; 1984, 2004).

Results: Videotapes are now in the process of being coded. Preliminary findings from 33 children indicate that children randomized to the JA-intervention group evinced a higher proportion of time in joint engagement compared to children in the control group at post-test (intervention group 62% and control group 50% of the time spent in joint engagement). Data for the entire sample with control for pre-test measures will be presented at the conference.

Conclusions: It is important to investigate whether intervention targeting JA implemented within mainstream preschools yields beneficial outcome for young children with autism. This study provides information about this question.