Abstract

Children with Autism display significant difficulties in interactional reciprocity, particularly in Joint Attention behaviors. Joint attention refers to the integrated use of eye contact or gestures to indicate interest in objects and/or to share an affective experience of an event with others (Mundy, 1995). Several studies of both typically developing children, and children with developmental delay such as Autism or Down syndrome, have shown that joint attention is a prerequisite of language development (Charman, 2003; Charman et al., 2003a; Farrant, Maybery, & Fletcher, 2011; Poon, 2005; Whalen, Schreibman, & Ingersoll, 2006). Children with Autism who responded more frequently to bids for joint attention made larger gains in language skills over time compared to children who responded less frequently to such bids (Bono, Daley, & Sigman, 2003; Charman et al., 2003a; Dawson et al., 2004; Morales et al., 2000; Siller & Sigman, 2002). The impairments in language and joint attention shown by children with Autism limit the effectiveness of their communication and capacity to share experiences with others. It is therefore important to investigate the possible contributions of family interactions to children’s joint attention and language. Studies suggest that mother's responsiveness, sensitivity, and optimal structuring when interacting with their children, promote their development, including joint attention and language skills (Siller & Sigman, 2002). Only a few studies have been conducted on the possible contributions of parents to their children’s joint attention and language, and all focused on the dyadic, parent-child context. The present study expanded this line of research to include the triadic, mother- father child context. Specifically, the aim of this short-term longitudinal study was to examine whether parental coordinated support during triadic play interactions with their preschoolers with Autism will predict gains in joint attention and language skills over a one-year period.

The following hypotheses were tested: 1. Parental coordinated support will predict gains in children's joint attention. 2. Parental coordinated support will predict gains in children's language abilities. 3. Gains in children's joint attention will mediate the association between parental coordinated support and gains in children's language.

Seventy-seven boys with Autism and their parents participated in the study when they were between 2.5 – 5.8 years old and again one year later. Children’s diagnoses were confirmed using the Autism Diagnostic Observation Schedule (ADOS) and the Social Communication Questionnaire (SCQ). Additionally, children’s cognitive functioning, Adaptive Behavior, Joint Attention and Language were assessed in the study’s two time points. Parental coordinated support was assessed using the Lausanne Trilogue Play procedure (LTP; Fivaz Depeursinge & Corboz-Warnery, 1999) during the study’s first time point, in which mothers, fathers, and children were videotaped playing together.

Supporting the first study hypothesis parental coordinated support predicted gains in two out of four joint attention measures: IJA LOW (lower level behaviors of initiation of joint attention - alternating gaze between an object and the tester's eyes) and RJA HIGH (higher level behaviors of responding to joint attention - Following Line of Regard). No prediction was found for IJA HIGH (higher level behaviors of initiation of joint attention - showing and/or pointing) and RJA LOW (lower level behaviors of responding to joint attention - Following a proximal pointing gesture). Supporting the second study’s hypothesis, parental coordinated support predicted improvement in children's language skills. The third hypothesis was partially supported. Gains in IJA LOW mediated the association between parental coordinated support and gains in children's language abilities, but a mediated effect was not found for gains in RJA HIGH.

While joint attention and particularly children’s language skills showed considerable stability over a one-year period, the findings showed a significant (albeit modest) contribution of parental coordinated support during triadic play interactions to gains in children’s joint attention and language during the preschool years.

These findings highlight the significance of the joint attention, as a prerequisite of language development (Tomasello, 1992; Markus et al., 2000), and can facilitate the development of parent-mediated interventions which can effect positive communicational outcomes for young children with Autism.