Joint Attention and the First Person

Joint attention consists in following another’s gaze onto an environmental object, which leads to the alignment of both subjects’ attention onto this object. It is a fundamental mechanism of non-verbal communication, and it is essential for dynamic, online, interindividual synchronization during interactions. Here we aimed at investigating the oscillatory brain correlates of joint attention in a face-to-face paradigm where dyads of participants dynamically oriented their attention toward the same or different objects during joint and no-joint attention periods respectively. We also manipulated task instruction: in socially driven instructions, the participants had to follow explicitly their partner’s gaze, while in color-driven instructions, the objects to be looked at were designated at by their color so that no explicit gaze following was required. We focused on oscillatory activities in the 10 Hz frequency range, where parieto-occipital alpha and the centro-parietal mu rhythms have been described, as these rhythms have been associated with attention and social coordination processes respectively. We tested the hypothesis of a modulation of these oscillatory activities by joint attention. We used dual-EEG to record simultaneously the brain activities of the participant dyads during our live, face-to-face joint attention paradigm. We showed that joint attention periods – as compared to the no-joint attention periods – were associated with a decrease of signal power between 11 and 13 Hz over a large set of left centro-parieto-occipital electrodes, encompassing the scalp regions where alpha and mu rhythms have been described. This 11–13 Hz signal power decrease was observed independently of the task instruction: it was similar when joint versus no-joint attention situations were socially driven and when they were color-driven. These results are interpreted in terms of the processes of attention mirroring, social coordination, and mutual attentiveness associated with joint attention state.

Introduction The absence of joint attention is one of the earliest symptoms of autism, reflecting the hallmark social disturbance that characterizes the disorder (Mundy & Crowson, 1997). Joint attention, first seen in infants between 9 and 12 months of age, involves two people sharing attentional focus on interesting objects and events (Bakeman & Adamson, 1984). Early joint attention behaviors involve children's use of eye gaze and conventional gestures. For example, a child might initiate joint attention, directing his mother's attention to a toy on the floor, by looking from the toy to his mother and back to the toy (i.e., gaze alternating) while simultaneously pointing at the toy. Alternatively, a mother might direct her child's attention by pointing and looking at an object while commenting on the object (e.g., What a fun toy!) to which the child responds by looking from the object to his mother and back to the object (i.e., gaze alternating). These joint attention interactions are considered uniquely social in that they result in an interaction between adult and child about the object/event. Joint attention is also related to social and language skill development, playing a significant role in typical development (Mundy & Gomes, 1998; Mundy, Sigman, & Kasari, 1990; Travis, Sigman, & Ruskin, 2001). Deficits in joint attention are evident in children with autism from very early in development (Baron-Cohen, Allen, & Gillberg, 1992; Charman et al., 1998; Osterling & Dawson, 1994). Infant screening and diagnostic instruments for autism, such as the Checklist for Autism in Toddlers (CHAT) (Baron-Cohen et al., 1992) and the Autism Diagnostic Observation Schedule (ADOS) (Lord, Rutter, DiLavore, & Risi, 1999), include assessment of deficits in joint attention as a marker for autism. In comparison to children with mental retardation or specific language delay (matched for developmental level), preschool children with autism show significant deficits in both responding to others' joint attention directives and initiating joint attention (Charman et al., 1998; Mundy, Sigman, Ungerer, & Sherman, 1986; Sigman, Mundy, Sherman, & Ungerer, 1986; Stone, Ousley, Yoder, Hogan, & Hepburn, 1997). This impairment in joint attention discriminates 80% to 90% of children with autism from those with other developmental disabilities (Lewy & Dawson, 1992; Mundy et al., 1986). Because of the social nature of joint attention, its absence reflects the core social disturbance that characterizes autism (Mundy & Crowson, 1997). Joint attention is also related to two of the areas, social and communication development (Mundy & Gomes, 1998; Mundy et al., 1990; Travis et al., 2001), that are significantly impaired in individuals with autism (American Psychiatric Association, 2000). Thus, the development of effective intervention procedures to address joint attention deficits in young children with autism is of utmost importance. A handful of studies have examined intervention procedures to address joint attention deficits in children with autism with at least some improvement in targeted joint attention skills (e.g., Hwang & Hughes, 2000; Kasari, Freeman, & Paparella, 2001, 2006). Using a behaviorally based intervention, Whalen and Schreibman (2003) examined pivotal response training strategies (Koegel, Koegel, Harrower, & Carter, 1999; Pierce & Schreibman, 1995) with an emphasis on the use of child preferred materials, interspersing difficult tasks among easier ones, and using natural reinforcers as consequences for appropriate behavior to teach joint attention skills to 5 participants with autism (all 4 years of age). All participants acquired responding to others' joint attention directives and 4 of the participants acquired skills to initiate joint attention. More recently, we (Jones, Carr, & Feeley, 2006) also examined the use of a behavioral intervention consisting of discrete trial instruction and pivotal response training strategies to teach five 2-3 year old children with autism to both respond to others' joint attention directives and initiate joint attention. …

Functional near-infrared spectroscopy (fNIRS) was used to measure the prefrontal activity in joint attention experience. 16 healthy adults participated in the experiment in which 42 optical channels were fixed over the anterior prefrontal cortex (aPFC), dorsolateral prefrontal cortex (DLPFC), inferior frontal gyrus (IFG) and a small anterior portion of the superior temporal gyrus (STG). Video stimuli were used to engender joint or non-joint attention experience in observers. Cortical hemodynamic response and functional connectivity were measured and averaged across all subjects for each stimulus condition. Our data showed the activation in joint attention located in the aPFC and DLPFC bilaterally, but dominantly in the left hemisphere. This observation, together with the previous findings on infants and children, provides a clear developmental scenario on the prefrontal activation associated with joint attention process. In the case of non-joint attention condition, only a small region of the right DLPFC was activated. Functional connectivity was observed to be enhanced, but differently in joint and non-joint attention condition.

Collective gatherings foster group cohesion through providing occasion for emotional sharing among participants. However, prior studies have failed to disentangle two processes that are involved in emotional sharing: 1) focusing shared attention on the same emotion-eliciting event and 2) actively sharing one’s experiences and disclosing one’s feelings to others. To date, it has remained untested if shared attention influences group cohesion independent of active emotional sharing. Our experiment investigated the effect of shared versus individual attention on cohesion in groups of strangers. We predicted that differences in group cohesion as called forth by shared vs. individual attention are most pronounced when experiencing highly arousing negative affect, in that the act of experiencing intensely negative affect with others buffers negative affect’s otherwise detrimental effect on group cohesion. Two-hundred sixteen participants were assembled in groups of 3 to 4 people to either watch an emotion-eliciting film simultaneously on a common screen or to watch the same emotion-eliciting film clip on a laptop in front of each group member using earphones. The film clips were chosen to elicit either highly arousing negative affect or one of three other affective states representing the other poles in Russel’s Circumplex model of affect. We examined self-reported affective and cognitive group cohesion and a behavioral measure of group cohesion. Results support our buffer-hypothesis, in that experiencing intense negative affect in unison leads to higher levels of group cohesion than experiencing this affect individually despite the group setting. The present study demonstrates that shared attention to intense negative emotional stimuli affects group cohesion independently of active emotional sharing.

Diffuse optical imaging of brain activation to joint attention experience

자폐스펙트럼장애(Autism Spectrum Disorder)의 가장 큰 특징 중 하나는 사회적 상호작용을 위한 핵심기술인 공동주의 능력의 심각한 결함이다. 본 연구에서는 행동주의적 기법을 사용하여 자폐스펙트럼장애 아동의 공동주의 행동에 직접적으로 개입하였던 문헌 27개를 분석하여, 1) 행동주의 교수전략이 공동주의 능력의 향상에 효과적인지를 알아보고, 2) 공동주의 능력을 공동주의에 대한 반응과 공동주의 개시로 나누어서 각 영역에 효과적인 교수법이 무엇인지 살펴보았다. 본 문헌고찰 연구의 결과는 자폐스펙트럼장애에 특징적인 교수법의 사용이 공동주의 능력의 증진에 효과적임을 보여준다. 공동주의에 대한 반응의 경우, 고찰에 포함된 94%의 논문이 행동주의 교수전략이 개입에 효과적임을 보고하였으며, 특히 자폐스펙트럼장애에 특정적인 교수법의 사용 여부에 무관하게 개입의 효과를 확인할 수 있어 행동주의적 기법만으로도 공동주의에 대한 반응이 증진하는 것으로 나타났다. 반면, 공동주의 개시의 경우, 68%의 문헌만이 개입이 효과적임을 보고해 공동주의에 대한 반응에 비해 상대적으로 개입이 어려운 것으로 나타났는데, DTT와 자연주의적 개입을 함께 사용한 Kasari, Freeman, 그리고 Paparella(2006)의 전략이 그 중 가장 효과적인 것으로 나타났다. 이 결과는 공동주의의 개시가 공동주의에 대한 반응에 비해서 보다 집중적이고 체계적인 훈련이 필요하며, 각 영역에 맞는 접근법을 취했을 때 더욱 효과적인 개입이 이루어질 수 있음을 시사한다.

In children with autism spectrum disorder (ASD), joint attention is regarded as a predictor of language function, social skills, communication, adaptive function, and intelligence. However, existing information about the association between joint attention and intelligence is limited. Most such studies have examined children with low intelligence. For this study, we investigated whether joint attention is related to intelligence in young children with autism spectrum disorder (ASD) without severe intellectual disability. We analyzed 113 children with ASD aged 40–98 months. Their Kaufman Assessment Battery (K‐ABC) Mental Processing Index (MPI) scores are 60 and more (mean 93.4). We evaluated their intelligence using K‐ABC and evaluated their joint attention using ADOS‐2. After we performed simple regression analyses using K‐ABC MPI and its nine subscales as dependent variables, using joint attention as the independent variable, we identified joint attention as a positive predictor of the MPI and its two subscales. From this result, we conclude that joint attention is related to intelligence in young children with ASD without severe intellectual disability. This result suggests a beneficial effect of early intervention targeting joint attention for children with ASD.Lay SummaryJoint attention is the ability to coordinate visual attention with another person and then shift one's gaze toward an object or event. Impairment of joint attention is regarded as an early marker of autism spectrum disorder (ASD). This study revealed impairment of joint attention as associated with lower intelligence in ASD children. These results are expected to constitute a rationale for future studies, particularly addressing beneficial effects of early intervention targeting joint attention for children with ASD.

Using a structured literature search and meta-regression procedures, this study sought to determine whether associations between joint attention and language are moderated by group (autism spectrum disorder [ASD] vs. typical development [TD]), joint attention type (responding to joint attention [RJA] vs. other), and other study design features and participant characteristics. Studies were located using database searches, hand searches, and electronic requests for data from experts in the field. This resulted in 71 reports or datasets and 605 effect sizes, representing 1,859 participants with ASD and 1,835 TD participants. Meta-regression was used to answer research questions regarding potential moderators of the effect sizes of interest, which were Pearson's r values quantifying the association between joint attention and language variables. In the final models, conducted separately for each language variable, effect sizes were significantly higher for the ASD group as compared to the TD group, and for RJA as compared to non-RJA joint attention types. Approximate mental age trended toward significance for the expressive language model. Joint attention may be more tightly tied to language in children with ASD as compared to TD children because TD children exhibit joint attention at sufficient thresholds so that language development becomes untethered to variations in joint attention. Conversely, children with ASD who exhibit deficits in joint attention develop language contingent upon their joint attention abilities. Because RJA was more strongly related to language than other types of joint attention, future research should involve careful consideration of the operationalization and measurement of joint attention constructs. Autism Res 2016, 9: 1021-1035. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Back-and-forth interaction, or turn taking, may support later joint attention, a more complex form of interaction, when promoted in interventions for young children with autism, especially depending on the child's intent when interacting. In the present study, we observed videos of 20 toddlers with autism engaging in turn taking with their caregivers during an intervention designed to support children's joint attention. We sought to identify when the children displayed turn taking socially and when they were using it for nonsocial purposes in the intervention videos. We also observed videos after the intervention was complete to identify when children used joint attention when interacting with their caregivers. After these observations, we used these video data to explore the relationship of social turn taking to joint attention, and the relationship of nonsocial turn taking to joint attention. We found a significant relationship between social turn taking and joint attention, but not between nonsocial turn taking and joint attention. These findings support the importance of considering social turn taking in interactions between young children with autism and their caregivers.

Schools are the portal through which many children with autism spectrum disorder access early intervention. Collaborating with teachers can be an effective way to implement evidence-based practices. In this study, teachers learned to embed strategies from the Joint Attention, Symbolic Play, Engagement, and Regulation intervention into the standard preschool curriculum. Twelve schools with special education preschool classrooms for students with moderate to severe disabilities from under-resourced neighborhoods were randomized to augment their curriculum with Joint Attention, Symbolic Play, Engagement, and Regulation strategies or continue the standard curriculum. Teachers’ strategy implementation, children’s time on task, and social communication were examined before and after completing the intervention phase. Teachers in the Joint Attention, Symbolic Play, Engagement, and Regulation group implemented more Joint Attention, Symbolic Play, Engagement, and Regulation strategies than the control group after the intervention phase. Children in both groups increased time on task during teacher-led small group instruction. Children in the Joint Attention, Symbolic Play, Engagement, and Regulation group were more likely to be engaged with peers during small group instruction at the end of the intervention phase. Children from both groups improved in standardized measures of joint attention, requesting, expressive language, and receptive language. Training teachers to embed Joint Attention, Symbolic Play, Engagement, and Regulation strategies into small group instruction can help facilitate peer engagement, providing children more opportunities for peer socialization.Lay abstractChildren with autism spectrum disorder attending special education preschool classrooms may not receive support that addresses their core challenges, such as engagement and social communication. There are interventions designed to target these core challenges, like the play-based intervention known as Joint Attention, Symbolic Play, Engagement, and Regulation. Embedding strategies from an intervention like Joint Attention, Symbolic Play, Engagement, and Regulation into more traditional academic activities can help teachers target engagement and social communication throughout the school day. In the current study, we collaborated with special education preschool teachers to embed Joint Attention, Symbolic Play, Engagement, and Regulation strategies during small group time for moderate to severe disability students with autism spectrum disorder, 3–5 years of age. Compared to teachers implementing the standard preschool curriculum, teachers trained in Joint Attention, Symbolic Play, Engagement, and Regulation strategies effectively embedded these strategies in their small group activities, and their students were more likely to engage with peers during these activities. Supporting teachers to embed targeted strategies in academic activities can help them provide students more opportunities to engage with peers during the school day. Teachers can support their autistic students to interact appropriately with their peers. Unlike interventions that train peers to act as a teacher, embedding Joint Attention, Symbolic Play, Engagement, and Regulation strategies during small group academic activities facilitates naturalistic social interactions for autistic students.

This chapter reviews prelinguistic communication and joint attention in infants with typical development and in individuals with autism spectrum disorder who have minimal verbal skills. Joint attention is described as triadic coordination or sharing between self, communication partner, and an object or event. From early on, infants show developmental progression in joint attention abilities. Joint attention in infancy can be classified into two types, depending on if infants are responding to others’ joint attention bids (by following another person’s eye gaze and/or points) or spontaneously initiating joint attention overtures with others (by producing triadic gaze shift, pointing and/or showing gestures). By 13 months of age, young children with typical development enter into sustained episodes of coordinated joint engagement. Individuals with autism spectrum disorder have differences in both joint attention and sustained joint engagement. Joint attention abilities relate to concurrent and later language development in individuals with autism spectrum disorder. Teaching joint attention, symbolic play, and imitation may affect other areas of development. Clinical implications for promoting joint attention in individuals with or at risk for autism spectrum disorder are discussed.

Individuals with autism spectrum disorder (ASD) have been found to have impaired joint attention (JA), which is considered key for learning social communication. This study reviewed the JA literature from the past decade to explore the generality of the deficit and looked at the JA assessment methods to see whether children's interests and preferences that may impact the results had been taken into account. While this review found evidence of impaired JA, it also found evidence of intact JA skills at the individual and group levels, indicating a non-uniform impairment of JA. A largely homogeneous assessment methodology within the published research was discovered, and no study reported using children's interests to create the assessment situation. The finding of JA skill variation between and within groups and individuals suggests that JA is within the scope of the learning capabilities of individuals with ASD. Due to the JA skill variation, we suggest that reporting individual data among group data to be an important aspect. We also propose that the uniform testing methods for JA might not be bringing to the surface all the capabilities held by individuals with ASD, and hence, individualized assessments based on preferences are suggested.

Relevance. The article discusses the relationship between the development of joint (shared) attention of a child with an adult, and the social and cognitive development of the child. Based on previous studies of typically developing children that demonstrate their participation and responsiveness to fundamental social characteristics, it is significant to identify manifestations of atypical joint attention when a child does not register which object (event) or which aspects of this object (event) are the focus of an interlocutor’s attention. The question of which aspects of joint attention are related to the normative development of the child makes this relevant for comparing groups with different forms of atypical development. For the study, the main indicator of understanding the intentions of the other in the direction of view was used, as one of the aspects of joint attention. Objective. To compare the development of social cognition and joint attention among typically developing children and children with various forms of atypical development in order to identify the correlation between the theory of mind and cognitive lesion. Methods. In a sample of preschool children with typical development and of those with mental retardation, hearing impairment, speech impairment, or visual impairment (N = 90), the following methods were used to evaluate the children’s understanding of the intentions, desires, and interests of others by their behavioral manifestations: “Test for Erroneous Opinion”, “Sally-Ann”; the “What does Charlie want?” task, and others. The task was also used to assess the child’s ability to use the direction of a character’s gaze in a picture to determine the person’s intentions. Results. We identified the “primary psychological” characteristics of the atypical development of the child, which prioritize violations of social communication. Several variations of the violation of joint attention were singled out by determining a person’s intentions by the direction of their gaze. It was shown that determining intentions by the direction of gaze is associated with the normative age formation of the child. Symptoms of deficiency in this skill vary depending on the specifics of the child’s atypical development. Conclusions. Secondary deviations in the development of social cognition are specific to a particular primary defect. The limited inflow of information in the event of a violation of the analyzer creates unusual conditions in the children’s accumulation of the experience of social interaction that is necessary to form a mental model.

Étude clinique des processus sous-jacents de l’attention conjointe de très jeunes enfants avec trouble du spectre autistique

We report a series of 10 studies on the social-cognitive abilities of three young chimpanzees. The studies were all ones previously conducted with human infants. The chimpanzees were 1-5 years of age, had been raised mostly by humans, and were tested mostly directly by a familiar human experimenter. First, in a longitudinal investigation with repeated measurements from a social-cognitive test battery, the three young chimpanzees were similar in many ways to human infants; the major difference was a total lack of attempts to share attention with others either in joint attentional interactions or through declarative gestures. Second, in imitation-based tests of the understanding of intentional action, the chimpanzees, like human infants, showed an understanding of failed attempts and accidents; but they did not pay attention to the behavioral style of the actor or the actor's reasons for choosing a particular behavioral means. Third, in tests of their understanding of visual perception, the chimpanzees followed the gaze direction of a human to an out-of-sight location behind a barrier and gestured more to a human who could see them than to one who could not; but they showed no understanding that perceivers can focus their attention on one thing, or one aspect of a thing, within their perceptual fields for a reason. Finally, in tests of joint intentions and joint attention, the chimpanzees showed no ability to either reverse roles with a partner in a collaborative interaction or to set up a joint attentional framework for understanding the communicative intentions behind a pointing gesture. Taken together, these findings support the idea that the early ontogeny of human social cognition comprises two distinct trajectories, each with its own evolutionary history: one for understanding the basics of goal-directed action and perception, common to all apes, and another for sharing psychological states with others in collaborative acts involving joint intentions and attention, unique to the human species.