Early Receptive and Expressive Language Skills: A Joint Attention Intervention for Young Children with ASD

Background:  Joint attention skills include the ability of young children to share focus on an object with another individual using eye-gaze, verbal utterances, pointing or other nonverbal gestures (Moore & Dunham, 2014). Previous studies have shown that mediated joint attention opportunities between parents and young children are critical for early language development and social communication skills (Delinicolas & Young, 2007; Kasari et al., 2010). Young children diagnosed with autism demonstrate pivotal deficits in joint attention skills that are directly and significantly correlated with deficits in both receptive and expressive language development (Adamson et al., 2009). However, in targeted interventions that focus on structured opportunities and parent-mediated engagement activities, both joint attention and language skills can have significant positive outcomes for these young children. These interventions provide learning opportunities for the development of pivotal skills in effective intercommunication such as turn-taking, social reciprocity, and theory of mind (Vaughan Van Hecke et al., 2012).

Objectives:   To document the impact of a joint attention parent-mediated intervention on subsequent targeted language skills in young children with autism.

Methods:   A sample of (N=11) children, 9 males and 2 females recently diagnosed with autism participated in the current study. Children ranged from the ages of 24 to 44 months (M= 33.2, SD= 5.98) with mental ages ranging from 14 to 51 months (M= 22.5, SD=10.69). The 16-week parent-mediated intervention included weekly parent-reports that documented the relative frequency of joint attention skills, eye contact, gestures, pointing, turn taking, sharing, and showing (α = .75). The item scores ranged from “very often to “none.” Children’s receptive and expressive vocabulary, phrases understood, and total gestures scores were measured pre-and post-intervention from the MacArthur-Bates Communicative Development Inventories (CDI; Fenson et al., 1993).

Results:  Data were analyzed using longitudinal regression panel models in order to assess inter-individual differences in joint attention and language abilities prior-to and post-intervention. The analyses indicated a significant relation between joint attention pre-and post-intervention (β = .56, p < .05), even after controlling for language abilities prior to the implementation of the intervention (β = .53, p < .05). Additionally, children with ASD who scored higher on language abilities prior to the intervention also scored higher on language skills post-intervention (β = .93, p < .01). Future analyses will expand these results by including mixed-multilevel models for repeated measures that includes the 16-weeks parent-reported changes in joint attention and language development in order to explore the between-and within-person differences found during this parent-mediated intervention.

Conclusions:   Findings from the current study suggest significant between-person differences in joint attention and language abilities following participation in a 16-week parent-mediated intervention. These targeted interventions, have recently gained much support (e.g., Kasari et al., 2010). The current study was designed to determine if parents, taught to provide targeted joint attention opportunities could mediate the language outcomes of their young children with autism. These results suggest promising outcomes for parent-mediated interventions with strong adherence to the intervention, as well as emergence of generalization to other language routines in everyday contexts.