Joint Engagement and Social Communication in Minimally Verbal Children with ASD

Background: Both joint engagement and language have been studied in the context of parent-child dyads. It is well established that episodes of joint engagement facilitate children’s early language development, but to our knowledge the relationship between joint engagement and social language between child and therapist is yet to be examined.

Objectives: This study examined the association between joint engagement and child language abilities within therapist-child interactions with minimally verbal children diagnosed with autism spectrum disorders.

Methods: Participants were selected from the large multi-site study, Characterizing Cognition in Nonverbal Individuals with ASD. All children used fewer than twenty spontaneous, functional words during a language sample, and had received at least two years of prior intervention. Videotaped baseline intervention sessions were coded for 61 children between the ages of 5 and 8 years. Episodes of joint engagement were defined as time a child and therapist coordinated their involvement around an object or activity. The mean length of joint engagement was used from the first intervention session. Child language abilities were: (1) total social communicative utterances (TSCU), which excluded all scripted utterances; (2) number of different word roots (NDWR), which represented the variety of novel words; (3) total number of comments (TCOM), defined as utterances used for the function of sharing information, or describing an action or object in their attentional focus. The language variables were averaged over the first two sessions to gain a more accurate representation of abilities from this minimally verbal population.

Results: The Spearman’s rho revealed a statistically significant relationship between the mean length of joint engagement and TSCU (r_s = 0.261, p < 0.05) and TCOM (r_s = 0.309, p< 0.05). However, mean length of joint engagement was not significantly correlated with the NDWR.

Conclusions: Language abilities are a key target for minimally verbal children with autism spectrum disorders. Results demonstrate that joint engagement is associated with social communication and commenting language. Joint engagement between a child and a therapist may be a critical factor to facilitate social language development of minimally verbal children.