strategies for developing joint attention in children with asd stephanie d. becker, phd ksha annual...

Strategies for Developing Joint Attention in Children

with ASD

Stephanie D. Becker, PhD

KSHA Annual Conference

September 26, 2015

Learning Outcomes

1. Describe the role that joint attention plays in early communication.

2. Describe at least 4 different joint attentional skills.

3. Identify at least 2 strategies that can be used to teach joint attentional skills.

Pre-Verbal Communication

Before children are talking,

they are communicating.

Pre-Verbal Communication

Three primary functions of early communication (Bruner, 1981):

1. Joint attention

2. Behavior regulation

3. Social interaction

What is Joint Attention?

Importance of Joint Attention

• Crucial role in developing social-communicative competence

• Correlated with current language abilities

• Predicts later language development

Development of Joint AttentionDyadic

Interaction Child Communication Partner

Development of Joint AttentionDyadic

Interaction Child Communication Partner

Triadic Interaction Object

Communication PartnerChild

Development of Joint Attention

Development of Joint Attention

Video

Joint Attention and ASD

Children with ASD

Joint attention deficits: core feature in diagnosis

Early ID: deficits seen at 12 months for declarative but not imperative points

Deficits in Children with ASD

• Responding to eye contact from others• Following points from others• Gaze shifting from toy to adult• Using declarative points• Showing items

Kasari, Freeman, & Paparella (2006)

ABA• Use drill and repetition• Prompt, reinforce

Play-based• Sit close, make eye contact• Follow the child’s interests, engage• Give corrective feedback

Respond to Eye Contact

Respond to Eye Contact

• Get in close proximity• Obtain eye contact prior to activity of

high interest• Lean in toward child and wait• Use hands as blinders if needed• Have an animated social response• Immediately do something fun!

Follow a point

Follow a Point• Teach proximal (< 6 in) and distal (> 6 in)

points• Set up the environment with interesting /

novel items• Get the child’s attention first• Point to item and comment “Look, a

monkey!” • Re-establish eye contact again and make a

comment “That is a funny monkey!”

Follow a Point: Materials• Miniature toys set around the room• Silly posters on the wall or hanging from the

ceiling• Items you can throw and stick to the wall• Door left open• Item in wrong location• Start a remote controlled toy• Turn music on• Find a missing item

Gaze Shift

Gaze Shift

• Obtain eye contact with the child• Shift child’s attention to toy/picture• Shift child’s attention back to

communication partner: Lean in, give an expectant pause

• Make an excited/animated comment

Show

Show

• Establish eye contact• Hold item toward child to model a show • Prompt child to “show” you or other

adult the item• Make a comment about the item• Re-establish eye contact

Show: Materials

• Unusual or silly toys• Ball with an object inside• Fidget toys• Items pulled out of a bag• Ducks with pictures hidden underneath• Child’s artwork• Photos• Items that are found

Initiate a Point

Initiate a Point

• Proximal (< 6 in) or Distal Point (> 6 in)• Establish eye contact• Set up environment • Prompt child to point• Re-establish eye contact

Initiate a Point: Materials• Pictures hanging from ceiling • Party materials• Toy flashlight that shines pictures on wall• Wind-up toy• Broken toy (car missing wheel)• Pop-up puppet• Potato head pieces in wrong locations• Animated book• Hidden items in a container filled with rice