The use of joint attention in the naturalistic setting in children with Autism Spectrum Disorder

Abstract

This study investigates the deficits in the quantity and quality of joint attention in children with Autism Spectrum Disorder (ASD). To obtain a holistic measure of joint attention, the following four aspects were considered: a) the quantity of Initiation Joint Attention (IJA) and Response Joint Attention (RJA), b) non-verbal behaviours which were atypically used during joint attention, c) the quality of joint attention and d) the association between quality and quantity of joint attention in children with ASD. These aspects were measured in three children with ASD and three typically-developing children (TDC). Measures were derived from 30-minute video recordings of a play session between each child and his/her caregiver and compared. This study established that there was a statistically significant difference in the quantity of joint attention in both IJA and RJA. The difference in the quality of joint attention was not statistically significant. However, when analysing children with ASD individually, a deficit in the quality of joint attention was identified in two of the three subjects. Compared to TDC, children with ASD engaged significantly less in IJA through manipulation of objects and eye-gaze and significantly more in IJA and RJA through challenging behaviour. In addition, there was no association between the deficits in quality and quantity of joint attention within individuals with ASD, as the three subjects portrayed diverse profiles. Children with ASD exhibited atypical joint attention skills when compared to the control group. Moreover, the frequency of initiations of joint attention bids was the most negatively affected aspect in children with ASD. Quality of joint attention is rarely researched and to the researchers’ knowledge, no other study has measured both quality and quantity of joint attention in children with ASD