Joint attention training for children with autism using behavior modification procedures

J Child Psychol Psychiatry. 2003 Mar;44(3):456-68. doi: 10.1111/1469-7610.00135.


Background: Deficits in joint attention are considered by many researchers to be an early predictor of childhood autism (e.g., Osterling & Dawson, 1994) and are considered to be pivotal to deficits in language, play, and social development in this population (Mundy, 1995). Although many researchers have noted the importance of joint attention deficits in the development of children with autism (e.g., Mundy, Sigman, & Kasari, 1994) and have called for intervention strategies (e.g., Mundy & Crowson, 1997), few studies have attempted to target joint attention. In this study, joint attention behaviors were taught to children with autism using a behavior modification procedure.

Methods: A multiple-baseline design was implemented to evaluate intervention effects. The following target behaviors were included in the intervention: 1) Responding to showing, pointing, and gaze shifting of adult; 2) Coordinated gaze shifting (i.e., coordinated joint attention); and 3) Pointing (with the purpose of sharing, not requesting). Generalization to setting and parent, follow-up sessions, and social validation measures were also analyzed.

Results: Joint attention behaviors were effectively trained and targeted behaviors generalized to other settings. In addition, positive changes were noted by naive observers using social validation measures.

Conclusions: Integrating joint attention training into existing interventions may be important for children with autism. In addition, training parents in these techniques may help to maintain joint attention skills outside of the treatment setting.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Attention*
  • Autistic Disorder / therapy*
  • Behavior Therapy / methods*
  • California
  • Child Development
  • Child, Preschool
  • Humans
  • Play and Playthings
  • Reproducibility of Results
  • Social Behavior*