Background: Clinical research indicates that the early impairment of Joint Attention (JA) seems to be central for the disturbance of social development in autism. In particular, young children with autism are characterized by a specific impairment in the capacity for Initiating JA (IJA) and Responding to JA (RJA). Considering that these deficits have been related to social symptom intensity, intervention responsiveness and long term social outcomes in autism (Mundy, 1995), an accurate assessment of early JA abilities in young children with autism might be crucial in order to define more specific and effective interventions. Objectives: The present study wanted to explore the JA behaviours in young children with autism in multiple contexts and with different tools (direct observation and an interview to the parents), in order to determine how stable these behaviours are across different measures. Methods: To achieve this aim we examined 20 participants with ASD (14 males; 6 females; aver.chron.age=34 mths; DS=9,56; aver. developmental age=23 mths; ds=8 mths) in the Early Social Communication Scales (Mundy et al., 2003) and in the ADOS. The parents completed the Vineland Adaptive Behavior Scales (VABS). Results: In general, the children in our sample showed low scores in all the JA behaviors assessed across the two context of observation (ESCS and ADOS) and in the VABS. IJA was significantly correlated with the ADOS communication scores (r=-0.48; p<0.05) and the ADOS social interaction scores (r=-0.48; p<0.05). The correlation is pointing in a coherent direction, since high scores in the ADOS indicates a lack of social abilities. IJA correlates also with VABS communication scores (r=0.55; p<0.05) and VABS socialization scores (r=0.57; p<0.05). RJA was significantly correlated with all the ADOS and VABS measures except that with the ADOS communication scores (r=-1.93; p>0.05). Conclusions: These results confirms that infant's joint attention behaviors reflects a robust aspects of social deficit in autism that is stable across different context of observation and accross different measures (direct vs indirect). They indicated also that different types of joint attention behaviors might be underestimated by classical diagnostic tools, such as the ADOS. For this reason, the assessments conducted in multiple context may provide a more valid measure of the child’s joint attention behaviors.
Assessing Joint Attention in Autism across Multiple Settings
FADDA, ROBERTA;
2009-01-01
Abstract
Background: Clinical research indicates that the early impairment of Joint Attention (JA) seems to be central for the disturbance of social development in autism. In particular, young children with autism are characterized by a specific impairment in the capacity for Initiating JA (IJA) and Responding to JA (RJA). Considering that these deficits have been related to social symptom intensity, intervention responsiveness and long term social outcomes in autism (Mundy, 1995), an accurate assessment of early JA abilities in young children with autism might be crucial in order to define more specific and effective interventions. Objectives: The present study wanted to explore the JA behaviours in young children with autism in multiple contexts and with different tools (direct observation and an interview to the parents), in order to determine how stable these behaviours are across different measures. Methods: To achieve this aim we examined 20 participants with ASD (14 males; 6 females; aver.chron.age=34 mths; DS=9,56; aver. developmental age=23 mths; ds=8 mths) in the Early Social Communication Scales (Mundy et al., 2003) and in the ADOS. The parents completed the Vineland Adaptive Behavior Scales (VABS). Results: In general, the children in our sample showed low scores in all the JA behaviors assessed across the two context of observation (ESCS and ADOS) and in the VABS. IJA was significantly correlated with the ADOS communication scores (r=-0.48; p<0.05) and the ADOS social interaction scores (r=-0.48; p<0.05). The correlation is pointing in a coherent direction, since high scores in the ADOS indicates a lack of social abilities. IJA correlates also with VABS communication scores (r=0.55; p<0.05) and VABS socialization scores (r=0.57; p<0.05). RJA was significantly correlated with all the ADOS and VABS measures except that with the ADOS communication scores (r=-1.93; p>0.05). Conclusions: These results confirms that infant's joint attention behaviors reflects a robust aspects of social deficit in autism that is stable across different context of observation and accross different measures (direct vs indirect). They indicated also that different types of joint attention behaviors might be underestimated by classical diagnostic tools, such as the ADOS. For this reason, the assessments conducted in multiple context may provide a more valid measure of the child’s joint attention behaviors.
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