Combining a Being Imitated Strategy With IBT Improves Basic Joint Attention Behaviors in Young Children With ASD.

Birgitta Spjut Janson,Felix-Sebastian Koch,Mikael Heimann

doi:10.3389/fpsyt.2021.784991

Birgitta Spjut Janson, Felix-Sebastian Koch + Show 1 more

Open Access

https://doi.org/10.3389/fpsyt.2021.784991

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Abstract

In the present study, we examined how an initial being imitated (BIm) strategy affected the development of initiating joint attention (IJA) among a group of children newly diagnosed with autism spectrum disorder (ASD). One group received 3 months of BIm followed by 12 months of intensive behavior treatment (IBT) which equaled treatment as usual whereas a second group received IBT for the entire 15-month study period. We utilized two measures of IJA: an eye gaze and a gesture score (point and show). IJA did not change during the first 3 months of treatment, nor were any significant between-group differences noted. However, at the end of the 15-month-long intervention period, the BIm group used eye gaze significantly more often to initiate joint attention. No significant change was noted for the gesture score. These results suggest that an early implementation of a being imitated strategy might be useful as less resource intensive but beneficial “start-up” intervention when combined with IBT treatment as a follow-up.

Highlights

Autism is a neurodevelopmental disorder characterized by impairments in communication and social interaction, along with a restricted repertoire of activities and interests [1]
One example of an early developing communication and social interaction skill found to be problematic for autistic children is joint attention, an ability that signifies that a child has developed a capacity to coordinate attention between a social partner and a proximal object or is able to use eye gaze or gestures to establish a moment of triadic attention between him/herself, another person, and an object or event [2]
The results showed that children who received a Novel package that included a focused being imitated (BIm) intervention (2.2 h weekly during training phase 1) followed by Intensive Behavior Treatment (IBT) equaling treatment as usual (TAU) (20–25 h weekly during training phase 2) showed increased ability to use eye gaze to initiate joint attention compared to the children who received TAU only (15–25 h weekly) over the complete 15-month study period

Summary

Introduction

Autism is a neurodevelopmental disorder characterized by impairments in communication and social interaction, along with a restricted repertoire of activities and interests [1]. A child’s ability to follow gaze and to respond to bids for joint attention from others are important both for language and early social-cognitive development [e.g., [3, 4]]. It is of much relevance that several studies have shown that a delayed or altered developmental trajectory of joint attention is one of the earliest problems reported for children with autism [e.g., [8, 9]]. To measure initiating of joint attention (IJA) at T1, T2, and T3, we used the Early Social Communication Scale (ESCS, 37), a structured assessment in which the experimenter presents toys. We used only the ESCS tasks that measure IJA [45]: eye contact and alternating eye gaze constitutes our eye gaze measure while point and show constitutes our measure of gestures relevant for initiating joint attention bids. Eye contact was noted if the child held an inactive toy and looked at the tester while alternating gaze was coded whenever the child looked back and forth between the tester and an active object

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