Promoting Joint Attention in Toddlers with Autism: A Parent-Mediated Developmental Model

Abstract

Joint attention, a foundational nonverbal social-communicative milestone that fails to develop naturally in autism, was promoted for three toddlers with early-identified autism through a parent-mediated, developmentally grounded, researcher-guided intervention model. A multiple baseline design compared child performance across four phases of intervention: focusing on faces, turn-taking, responding to joint attention, and initiating joint attention. All toddlers improved performance and two showed repeated engagement in joint attention, supporting the effectiveness of developmentally appropriate methods that build on the parent-child relationship. A complementary qualitative analysis explored family challenges, parent resilience, and variables that may have influenced outcomes. Intervention models appropriate for toddlers with autism are needed as improved early identification efforts bring younger children into early intervention services.

Joint Engagement and the Emergence of Language in Children with Autism and Down Syndrome

“…Although there are yet few studies that focus on the caregiver's contribution to children's engagement states, there is evidence that parents interacting with children with autism or with other developmental disorders may synchronize their actions with the child's actions at the same rate as parents interacting with a typically developing child (Siller & Sigman, 2002), and that they may modify their actions in ways that increase the salience of objects by, for example, supplementing words and pointing gestures with more literal acts such as banging and waving (Baranek, 1999;McArthur & Adamson, 1996). Moreover, evidence is mounting that parents may implement interventions that promote joint attention in toddlers with autism (e.g., Schertz & Odom, 2007).…”

Early Intervention for Children With Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research

“…Because few studies focused exclusively on this age group, studies in which participants included some children aged .3 years were assessed as long as there was sufficient information to draw inferences about younger children. The group reviewed additional reports, which have not been listed in Table 1, including single-subject studies, [39][40][41][42][43][44] other relevant studies, 16,[45][46][47][48][49][50] metaanalyses, 51,52 and reviews. [53][54][55][56] Compared with early intervention models evaluated for preschool-aged children (aged 3-5 years), programs for children aged ,3 years were more likely to use developmental approaches, more intensively involve parents, and target social communication.…”

Parent and Family Outcomes of PEERS: A Social Skills Intervention for Adolescents with Autism Spectrum Disorder

“…The great majority of outcome studies to date have focused directly on the child, ignoring the broader family environmental context and leading to an incomplete picture of the benefits and costs of any particular treatment (Karst and Van Hecke 2012). The limited research on family and parent outcomes, which to date has primarily stemmed from evaluation of parent training programs, suggests a number of family and caregiver-level benefits of intervention; including improved family relationships (Rogers 2000;Schertz and Odom 2007), reduced levels of parenting stress and depression (McConachie and Diggle 2007;Roberts and Pickering 2010) and greater parenting self-efficacy (e.g., Sofronoff and Farbotko 2002). It is likely that these positive environmental changes serve to enhance, or at least maintain, gains made by a child or adolescent in treatment.…”