Introduction Deficits in joint attention are commonly seen in children with autism spectrum disorder. Research examining joint attention in autism spectrum disorder commonly uses two broad strategies to cue and measure joint attention: behavioral observation and eye tracking. These strategies trade off prioritizing ecological validity vs. gaze measurement accuracy, with a focus on one sacrificing the other. The purpose of this case study was to develop a method to accurately measure gaze position while maintaining an ecologically valid dyadic interaction. Methods A child with autism spectrum disorder completed two developmentally appropriate tabletop activities. Each activity was guided by a different occupational therapist who purposefully used a different interaction style with the child. Mobile eye trackers worn by both the child and the therapist recorded the dyadic interactions. Data collection included audio and video recording of interactive behaviors, eye movements and visual fixations in regions of shared interest. Results Differences were detected in gaze use and interactive joint attention behaviors between the therapists working with the child and within the child’s respective dyadic interactions. Conclusions The proof of concept method maintained both ecological validity and measurement accuracy of therapist–child joint attention. This method has promise to be scaled for larger studies.

Introduction Individuals with autism spectrum disorder demonstrate difficulty with joint attention, affecting social and occupational performance. Studies of joint attention in children with autism spectrum disorder employ a variety of instrumentation, environments and occupations. From the occupational therapy perspective, current literature lacks a rigorous analysis of the transactions of person, environment and occupation embedded within the procedures of these studies. The goal of this scoping review was to investigate how these components transact to affect occupational performance. Method Using the Person–Environment–Occupation model as an evaluative lens, a scoping review was completed to summarize person, environment and occupation transactions in studies examining joint attention in children aged 6–12 years with autism spectrum disorder. Results Six studies were included. Findings indicated that simplified social environments and demonstrations of joint attention promoted higher joint attention performance in children with autism spectrum disorder, at the cost of ecological validity. Maintaining ecological validity in complex social environments resulted in lower joint attention performance. Conclusion The Person–Environment–Occupation model can be used to develop an occupational therapy perspective on literature from outside the discipline. There is a relationship between the person, environment, occupation transactions and joint attention in children with autism spectrum disorder.