Abstract
Deficits in Joint Attention (JA) may be one of the earliest signs of Autism Spectrum Disorders (ASD). In this longitudinal study we investigated several types of JA behaviors at the age of 24 and 42 months, and their development over time. Eleven children with ASD, 10 children with other developmental disorders, and eight children without a developmental disorder participated. It was found that children with ASD showed significantly less JA at the age of 24 months. At this age, the various types of JA (Basic Joint Attention, Associated Joint Attention, Joint Visual Attention) were correlated with developmental level and number of autistic characteristics. However, at the age of 42 months, these associations were absent. Although children with ASD may show less JA at the age of 24 months compared to other groups of children, by the age of 42 months they reach about the same level of JA, except for joint visual attention. In fact, at both ages, children with ASD differed consistently only on JVA from the other groups. JVA may be a core component of an early screening device for ASD.
Similar content being viewed by others
References
Baird G, Charman T, Baron-Cohen S, Cox A, Swettenham J, Wheelwright S, Drew A (2000) A screening instrument for autism at 18 months of age: a 6-year follow-up study. J Am Acad Child Adolesc Psychiat 39(6):694–702
Baird G, Charman T, Cox A, Baron-Cohen S, Swettenham J, Wheelwright S, Drew A (2001) Screening and surveillance for autism and pervasive developmental disorders. Arch Dis Childhood 84(6):468–475
Bakeman R, Adamson LB (1984) Coordinating attention to people and objects in mother–infant and peer–infant interaction. Child Dev 55:1278–1289
Baron-Cohen S, Allen J, Gillberg C (1992) Can autism be detected at 18 months – the needle, the haystack, and the chat. Brit J Psychiat 161:839–843
Baron-Cohen S, Cox A, Baird G, Swettenham J, Nightingale N, Morgan K, Drew A, Charman T (1996) Psychological markers in the detection of autism in infancy in a large population. Brit J Psychiat 168(2):158–163
Bates JAV (1979) Progress in clinical neurophysiology. 1. Attention, voluntary contraction and event-related cerebral potentials – Desmedt, Je. Quart J Exp Psychol 31:366–367
Bono MA, Daley T, Sigman M (2004) Relations among joint attention, amount of intervention and language gain in autism. J Autism Dev Disord 34(5):495–505
Bruinsma Y, Koegel RL, Koegel L (2004) Joint attention and children with autism: a review of the literature. Mental Retard Dev Disabil Res Rev 10:169–175
Carpenter M, Nagell K, Tomasello M (1998) Social cognition, joint attention, and communicative competence from 9 to 15 months of age. Monogr Soc Res Child Dev 63(4):1–142
Charman T (2003) Why is joint attention a pivotal skill in autism? Philos Trans Roy Soc Lond Ser B Biol Sci 358:315–324
Claussen AH, Mundy PC, Mallik SA, Willoughby JC (2002) Joint attention and disorganized attachment status in infants at risk. Dev Psychopathol 14:279–291
Cox A, Klein K, Charman T, Baird G, Baron-Cohen S, Swettenham J, Drew A, Wheelwright S (1999) Autism spectrum disorders at 20 and 42 months of age: stability of clinical and ADI-R diagnosis. J Child Psychol Psychiat Allied Discipl 40(5):719–732
Curcio F (1978) Sensomotori functioning and communication in mute autistic children. J Autism Childhood Schizophr 8:281–292
van Daalen E, Swinkels SHN, Dietz C, Buitelaar JK, van Engeland H, Early detection of autism spectrum disorders: reliability and stability of diagnosis. Manuscript in preparation
Dawson G, Toth K, Abbott R, Osterling J, Munson J, Estes A, Liaw J (2004) Early social attention impairments in autism: social orienting, joint attention, and attention to distress. Dev Psychol 40:271–283
Dietz C, Swinkels SHN, van Daalen E, van Engeland H, Buitelaar JK (2006) Screening for autistic spectrum disorders in children aged 14 to 15 months. II: population screening with the Early Screening of Autistic Traits (ESAT) Design and general findings. J Autism Dev Disord 36:713–722
Fisher K, Rose S (1994) Dynamic development of coordination of components in brain and behavior: a framework for theory and research. In: Dawson G, Fisher K (eds) Human behavior and the developing brain. Guilford Press, New York, pp 3–66
Hobson RP (1993) Autism and the development of mind. Erlbaum, London
Leekam SR, Moore C (2001) The development of attention and joint attention in children with autism. In: Charman T, Burack JA (eds) The development of autism: perspectives from theory and research. Lawrence Erlbaum Associates, Mahwah, NJ, US, pp 105–129
Leekam SR, Lopez B, Moore C (2000) Attention and joint attention in preschool children with autism. Dev Psychol 36:261–273
Lord C, Risi S (1998) Frameworks and methods in diagnosing autism spectrum disorders. Mental Retard Dev Disabil Res Rev 4(2):90–96
Lord C, Rutter M, Le Couteur A (1994) Autism Diagnostic Interview-Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 24:659–685
Lord C, Rutter M, DiLavore P, Risi S (1999) Autism Diagnostic Observation Schedule (ADOS) manual. Western Psychological Services, Los Angeles, CA
Lord C, Leventhal BL, Cook EH (2001) Quantifying the phenotype in autism spectrum disorders. Am J Med Genet 105:36–38
Loveland KA, Landry SH (1986) Joint attention and language in autism and developmental language delay. J Autism Dev Disord 16:335–349
Meltzoff AN (1988) Infant imitation and memory – 9-month-olds in immediate and deferred tests. Child Dev 59:217–225
Mullen EM (1995) Mullen scales of early learning. AGS, Circle Pines, MN
Mundy P (1995) Joint attention and social-emotional approach behavior in children with autism. Dev Psychopathol 7(1):63–82
Mundy P (2003) Annotation: the neural basis of social impairments in autism: the role of the dorsal medial-frontal cortex and anterior cingulate system. J Child Psychol Psychiat Allied Discipl 44(6):793–809
Mundy P, Gomes A (1997) A skills approach to early language development: lessons learned from research and research on developmental disabilities. In: Adamson LB, Romsky MA (eds) Communication and language acquisition: discoveries from atypical development. Brookes, Baltimore, pp 107–139
Mundy P, Gomes A (1998) Individual differences in joint attention skill development in the second year. Infant Behav Dev 21(3):469–482
Mundy P, Willoughby J (1996) Non-verbal communication, joint attention and social emotional development. In: Lewis M, Sullivan M (eds) Emotional development in atypical children. Wiley, New York, pp 65–87
Mundy P, Willoughby J (1998) Non-verbal communication, affect, and social-emotional development. In: Wetherby A, Warren S, Reichle J (eds) Transitions in prelinguistic communication, vol 7. Brookes Publishing, Baltimore, MD, pp 111–134
Mundy P, Sigman M, Ungerer J, Sherman T (1986) Defining the social deficits of autism – the contribution of nonverbal-communication measures. J Child Psychol Psychiat 27:657–669
Mundy P, Sigman M, Kasari C (1990) A longitudinal-study of joint attention and language-development in autistic-children. J Autism Dev Disord 20:115–128
Mundy P, Sigman M, Kasari C (1994) Joint attention, developmental level, and symptom presentation in autism. Dev Psychopathol 6(3):389–401
Mundy P, Card J, Fox N (2000) EEG correlates of the development of infant joint attachment skills. Dev Psychobiol 36:325–338
Naber FBA, Swinkels SHN, Buitelaar JK, Dietz C, van Daalen E, Bakermans-Kranenburg MJ, Van IJzendoorn MH, van Engeland H (in press) Joint attention and attachment in toddlers with autism. J Abnorm Child Psychol
Noldus LPJJ (1991) The observer – a software system for collection and analysis of observational data. Behav Res Methods Instrum Comp 23:415–429
Paparella T, D’Angiola N, Kasari C (2000) Emergence of joint attention and requesting skills in young children with autism. J Intellect Disabil Res 44:422–423
Phillips W, Baron-Cohen S, Rutter M (1992) The role of eye contact in goal-direction: evidence from normal infants and children with autism or mental handicap. Dev Psychopathol 4:375–383
Prizant BM, Wetherby AM (1987) Communicative intent – a framework for understanding social-communicative behavior in autism. J Am Acad Child Adolesc Psychiat 26(4):472–479
Robins DL, Fein D, Barton ML, Green JA (2001) The modified checklist for autism in toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord 31(2):131–144
Scambler D, Rogers SJ, Wehner EA (2001) Can the checklist for autism in toddlers differentiate young children with autism from those with developmental delays? J Am Acad Child Adolesc Psychiat 40(12):1457–1463
Sheinkopf SI, Mundy P, Claussen AH, Willoughby J (2004) Infant joint attention skill and preschool behavioral outcomes in at-risk children. Dev Psychopathol 16(2):273–291
Sigman M, Ruskin E (1999) Continuity and change in the social competence of children with autism, Down syndrome, and developmental delays. Monogr Soc Res Child Dev 64(1):115–130
Swinkels SHN, Dietz C, van Daalen E, Kerkhof I, van Engeland H, Buitelaar JK (2006) Screening for autistic spectrum disorders in children aged 14 to 15 months. I. The development of the Early Screening of autistic traits questionnaire. J Autism Dev Disord 36:723–732
Tiegerman E, Primavera L (1984) Imitating the autistic child: facilitating communicative gaze behavior. J Autism Dev Disord 14(1):27–38
Tomasello M (1995) Joint attention as social cognition. In: Moore C, Dunham PJ (eds) Joint attention; its origins and role in development Hillsdale. Erlbaum, NJ, pp 103–130
Wetherby AM, Prutting CA (1984) Profiles of communicative and cognitive-social abilities in autistic children. J Speech Hear Res 27:364–377
Acknowledgements
This research was supported by research grants to van IJzendoorn and Bakermans-Kranenburg from the Netherlands Organization for Scientific Research (NWO SPINOZA PRize; NWO VIDI Grant 452-04-306), and by research grants to Buitelaar, Swinkels and van Engeland (Korczak Foundation, Ministry of Health, Welfare, and Culture, Cure Autism Now, NWO-MW and NWO-Chronic Diseased, and Preventie Fonds).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Naber, F.B.A., Bakermans-Kranenburg, M.J., van IJzendoorn, M.H. et al. Joint attention development in toddlers with autism. Eur Child Adolesc Psychiatry 17, 143–152 (2008). https://doi.org/10.1007/s00787-007-0648-6
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-007-0648-6