Methods to improve joint attention in young children with autism: a review

Abstract

We provide an overview of studies in the past 10 years (2004–2014) that have aimed to improve joint attention (JA) in young children at risk for, or with, autism spectrum disorder. Thirteen randomized controlled trial (RCT) interventions were found, which received particular focus. Three studies used intervention methods with a developmental orientation and focused on caregiver-mediated methods. Others used combined developmental and behavioral approaches and delivered intervention via trained interventionists, caregivers, and teachers. Interventions ranged widely in density, both with respect to the amount of intervention delivered weekly and the total duration of intervention. Fourteen single-subject research design (SSRD) studies and one quasi-experimental pre–post design study were also included. Notably absent in the RCTs were studies using only behavioral methods, while behavioral methods dominated in the SSRDs. The outcomes of the RCTs using combined behavioral and developmental methods generally demonstrate short-term social communication gains. While some studies demonstrated long-term maintenance and positive outcomes in related areas such as language, many did not. The mixed results for language outcomes indicate a need for further investigation. In addition, future studies should further examine participants' developmental readiness and intervention dose in relation to outcome, as well as aim to isolate active ingredients of interventions.