RUNNING HEAD: JOINT ATTENTION
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Joint attention in preschoolers
Beth Reed
Virginia Commonwealth University
JOINT ATTENTION
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Introduction
There are a variety of challenges that arise for people diagnosed with an autism spectrum
disorder. Children with autism frequently have difficulty with the ability to establish appropriate
social relationships. Smith (2013), considers that, “Social-emotional development is believed to
be foundational to the development of cognition, language, and adaptive life skills (Smith, 2013,
p. 395)”. One of the most evident weaknesses in social-emotional competence occurs with the
struggle to establish joint attention with other people. According to Wong and Kasari, 2012, joint
attention is “the ability to shift attention between another person and an object or event” (p.
2152). Pointing at a common item, engaging in eye contact with the speaker, and looking back
to the item are some the specific skills needed to be successful with joint attention (Wong, 2013).
Teaching preschoolers to engage in joint attention will help them to relate and communicate
more closely with people in their lives. Furthermore, learning joint attention skills early on can
assist in the formation of social relationships and theory of mind later in development (Warreyn
& Roeyers, 2014).
Guiding the review of this literature is the following question: To what extent will
teacher-guided intervention impact a child’s ability to establish joint attention during a one-toone activity?
A research was conducted to find articles relating to joint attention and preschoolers.
Many articles were discovered in several databases. The VCU libraries search engine was the
first place I discovered an abundance of articles. I initially searched everything with the key
words: joint attention and preschool. Once I noticed a vast amount of information in need of
narrowing down, I checked the limiters of peer-reviewed and restricted the articles to being
published with the past five years. Limiting the articles to peer-reviewed is essential in order to
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have quality, accurate material. Interventions for children with autism are constantly evolving,
therefore, using the most recent information, within the last five years, would supply me with the
most up-to-date research. I began opening articles to read the abstract and was able to eliminate
several publications because the studies focused on toddlers and/or school-age children and my
target age group is preschoolers. Several of the articles were not an actual study, yet an overview
of joint attention; those works were excluded as well.
The Google Scholar database is another place I chose to use to access articles on joint
attention and preschoolers. When I struggled to open an article I input the name of the article into
the VCU Libraries database and read the article within the EBSCOhost. I selected articles that
specifically focused on interventions that were shown to increase joint attention. The Case-Smith
(2013) article helped me to review several approaches contained in one article, which saved me
time and also described a variety of interventions. Within the reference list of the Case-Smith
(2013) article, I was able to find an author’s name I had noticed several searches prior, which led
me to investigate articles with the name C. Kasari as an author.
Article Review
In all three studies, the chosen participants all had a diagnosis of ASD (Autism Spectrum
Disorder) and were between three and seven years of age. Each group had an average total of 45
participants, which makes the testing population comparable across articles. Wong (2013), chose
to gathered children from a large via fliers from the school district and local autism workshops
and conferences. Rehabilitation centers were used as a source to find participants in the Warreyn
and Roeyers (2013), study and Wong and Kasari (2012), found their preschoolers in a suburban,
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public early childhood program. Although the amount of participants and the autism
identification link the studies, the impact of the results could possibly vary based upon the fact
that the children were recruited from dissimilar settings.
Observations, rating scales, play assessments, and teacher surveys were used as methods
to collect data for 1 month to acquire data about joint attention (Wong & Kasari, 2012).
Researchers collected data on specified teacher and child behaviors within a 45 minute block of
observation time in structured and unstructured settings (Wong, 2013). Both researchers and the
adults responsible for implementing the intervention contributed to the gathering of the research
obtained from the methods provided.
Teacher-guided interventions had different meanings across the articles for this review.
Developmental and behavioral techniques were used along with positive social reinforcement in
small group or one-to-one type settings. In another study a familiar adult to the child was given a
training package which contained the guidelines for the intervention where they were encouraged
to participate in two 30 minutes sessions per week with their given child (Warreyn & Roeyers,
2013). By way of a person the child already knows, such as a teacher or therapist, the
intervention creates a naturalistic approach in its implementation. Imbedding joint attention
strategies into classroom activities with the guidance of a treatment manual was used in one
study. The teachers had the choice to implement the intervention one to one, in small groups, or
as a whole class (Wong, 2013). Two of the articles talked about similar teacher-guided
interventions, whereas the third article simply observed a setting to witness how joint attention
skills were address naturally by the teacher.
The findings from two of the studies show that teacher-directed joint attention
interventions do have a positive impact on joint attention skills in preschoolers with autism.
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Increase in joint attention quality was noted on four study points across 12 months according to
Lawton and Kasri (2012). The Warreyn and Roeyers (2013) research showed that the
experimental group, exposed to the intervention, made more progress than the control group for
joint attention. Because the teachers were not given a specific intervention in the Wong and
Kasri (2012) article, joint attention skills were rarely reinforced within the classroom
environment. The results signify that with specific training and/or intervention joint attention
skills can increase. Children with autism tend to initiate fewer joint attention skills, and teachers
tend to respond to acts of joint attention more so in structured activities (Wong and Kasri, 2012).
Consequently, structured interventions, provided by trained teachers, would likely increase a
preschooler with autism’s joint attention skills.
The limitations of the included articles include the possibility of teacher and therapists
not completing all of the forms, checklists, and surveys due to the amount of time it may take
(Warreyn and Roeyers, 2013). Taking into consideration that teacher and child variables may
possibly influence the effectiveness of the intervention could be another limitation (Wong,
2013). The long-term effects of the attained joint attention skills and the ability to generalize the
skill across settings and people should be demonstrated in future longitudinal studies. Once
researchers are able to determine the effects the interventions have on a child’s future social
skills then we can truly say the methods are successful.
Future research in joint attention and preschoolers with autism is needed because as we
ascertain more about how children with autism learn we are opening new doors to interventions.
Finding a solid, data-driven intervention to aide in the growth of joint attention skills will guide a
child’s team toward successful implementation of that skill. Parents, speech pathologists,
occupational therapists, and early childhood educators can benefit from research-based
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interventions to implement with young children with autism. When a child is able to establish
joint attention with another person his/her world opens up into a new realm of communication
and socialization. Teacher-guided interventions to promote joint attention have been proven to
work, therefore an increase in the awareness of these interventions should be spread throughout
the early childhood intervention community. Responsiveness on the part of the community
allows for an increase in implementation and an overall growth in joint attention skills for
preschoolers with autism.
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References
Case-Smith, J. (2013). Systematic review of interventions to promote social–emotional
development in young children with or at risk for disability. American Journal of
Occupational Therapy, 67, 395–404.
Lawton, K., & Kasari, C. (2012). Brief report: Longitudinal improvements in the quality of join
attention in preschool children with autism. Journal of autism and developmental
disorders, 42(2), 307-312.
Warreyn, P., & Roeyers, H. (2014). See what I see, do as I do: Promoting joint attention and
imitation in preschoolers with autism spectrum disorder. Autism, 18(6), 658-671.
Wong, C., and Kasari C. "Play and joint attention of children with autism in the
preschool special education classroom." Journal of Autism and Developmental
Disorders 42.10 (2012): 2152-2161.