Deficits In Joint Attention Research Articles

The Impact of Cues on Joint Attention in Children with Autism Spectrum Disorder: An Eye-Tracking Study in Virtual Games.

Joint attention (JA), a core deficit in children with autism spectrum disorder (ASD), is crucial for social interaction, emotional understanding, and cognitive development. This study aims to compare and analyze the eye-tracking data of ASD and typically developing children (TDC) during virtual games, exploring how different cue types affect JA performance in ASD children. A total of 31 TDC and 40 ASD children participated in the study. Using eye-tracking devices, we recorded the children's eye movements as they played virtual games, selecting the correct target based on cues provided by virtual characters. Our findings revealed that different cue types significantly impacted the game scores of ASD children but had no significant effect on TDC, highlighting a notable disparity between the two groups. ASD children showed a lower fixation frequency, irregular fixation paths, and increased attention to non-target objects compared to TDC. Interestingly, among the three cue types, ASD children exhibited a preference for the third type, leading to longer fixation on the region of interest and higher game scores. These results underscore the importance of cue selection in enhancing JA in ASD children. This study provides novel insights into the JA deficits in ASD children and offers a scientific basis for the development of targeted and individualized intervention programs.

Review of joint attention deficit intervention based on virtual reality for children with autism

Joint attention deficit is one of the core disorders in children with autism, which seriously affects the development of multiple basic skills such as language and communication. Virtual reality scene intervention has great potential in improving joint attention skills in children with autism due to its good interactivity and immersion. This article reviewed the application of virtual reality based social and nonsocial scenarios in training joint attention skills for children with autism in recent years, summarized the problems and challenges of this intervention method, and proposed a new joint paradigm for social scenario assessment and nonsocial scenario training. Finally, it looked forward to the future development and application prospects of virtual reality technology in joint attention skill training for children with autism.

Multimodal pathways to joint attention in infants with a familial history of autism

Joint attention (JA) is an early-developing behavior that allows caregivers and infants to share focus on an object. Deficits in JA, as measured through face-following pathways, are a defining feature of autism spectrum disorder (ASD) and are observable as early as 12 months of age in infants later diagnosed with ASD. However, recent evidence suggests that JA may be achieved through hand-following pathways by children with and without ASD. Development of JA through multimodal pathways has yet to be studied in infants with an increased likelihood of developing ASD. The current study investigated how 6-, 9- and 12-month-old infants with (FH+) and without (FH-) a family history of ASD engaged in JA. Parent-infant dyads played at home while we recorded the interaction over Zoom and later offline coded for hand movements and gaze. FH+ and FH- infants spent similar amounts of time in JA with their parents, but the cues available before JA were different. Parents of FH+ infants did more work to establish JA and used more face-following than hand-following pathways compared to parents of FH- infants, likely reflecting differences in infant motor or social behavior. These results suggest that early motor differences between FH+ and FH- infants may cascade into differences in social coordination.

Айтрекинг-исследование визуального внимания детей с нарушением слуха в ситуации обучения

<p>Potential mechanisms underlying atypical joint attention that impede effective learning are analyzed using the example of the consequences of hearing impairment. A sample of preschool children with hearing impairment after cochlear implantation (sensorineural hearing loss, ICD-10 class H90) was studied. For the study, an experimental situation was created that would allow tracing the learning difficulties in children with hearing impairments associated with the skills of joint attention. In the course of completing a training task jointly with an adult in children with hearing impairment, eye movements were recorded with a portable tracker in the form of Pupil Headset glasses. In the course of the study, it was possible to identify and visualize markers of oculomotor activity that impede their effective learning: distribution of visual attention over a wide area of the visual field, not in a focused mode; in the trajectory of eye movements and the position of fixations, there is a preference for non-social signals, non-target objects, difficulties in switching attention from one object to another. The main manifestation of joint attention deficit in preschoolers with hearing impairment is a decrease in the volume and time of stable maintenance of synchronicity of perception in the learning process. The parameters of oculomotor activity can serve as an indicator of the ability of a child with a hearing impairment to maintain attention to the sample form and a diagnostic indicator of the possible number of errors in the learning process. Such indicators are the duration and number of fixations. The role of multimodal means of maintaining visual attention to the sample in the process of teaching children with hearing impairment is shown. It was revealed that the attention of a child with hearing impairment to the face of an adult is part of the joint attention to the object, which improves the effectiveness of learning and is associated with a longer visual attention to the object (teaching pattern).</p>

Co-Occurring Autism Spectrum and Borderline Personality Disorder: An Emerging Clinical Challenge Seeking Informed Interventions.

Co-Occurring Autism Spectrum and Borderline Personality Disorder: An Emerging Clinical Challenge Seeking Informed Interventions.

Sharing Worlds: Design of a Real-Time Attention Classifier for Robotic Therapy of ASD Children.

Joint attention is the capacity of sharing attention between two agents and an aspect of the environment, through the use of different cues, namely gaze. This capacity is of paramount importance for social skills. People with Autism Spectrum Disorder (ASD) present certain deficits in joint attention. Therefore, there is an increasing interest in finding therapies to improve this skill. Some of these therapies include robots since they are known to be attractive to people with autism due to their motivation ability and predictability when compared with humans. In this line, we have designed a real-time attention classifier for a triadic robotic therapy, using Gaze360 and geometrical considerations of the scene. We were able to classify the gaze of the therapist and the one of the child during the whole session, even in a highly unconstrained scenario with a single camera, achieving a mean accuracy of 59%. This classifier can be used for the measurement of joint attention, an important metric for the development of adaptive robotic therapies, where increasing levels of difficulty and engagement are provided dependent on the ASD children, who are characterised by high heterogeneity. Future work will pass by the calculation of this metric and integration on a robotic platform for ASD therapy to understand the impact of these robotic therapies in improving ASD symptoms, specifically on how ASD children share their attention with other people present in the rehabilitation scenarios.

Social orienting and initiated joint attention behaviors in 9 to 12 month old children with autism spectrum disorder: A family home movies study.

According to the Social Motivation model children with autism show deficits in social orienting (looking at faces and responding to name) at the end of their first year of life. In this model, those deficits are both the earliest behavioral consequences of an alteration in the dopamine reward system balance and the foundation of the social impairments that characterize this neurodevelopmental disorder. The current study tests two of the main predictions of this model: that social orienting deficits are the first behavioral manifestation of autism, and that they are developmentally related to joint attention deficits. We retrospectively analyzed family home movies of 9- to 12-month-old infants, 29 of whom were later diagnosed with autism and 16 of whom were typically developing. After confirming that the videotapes of both groups were similar in content of the scenes recorded (contexts, type of social activity, etc.), we compared their social orienting (social gaze and responding to name) and joint attention behaviors (gaze alternation and gestures). No significant differences between groups were found in looking at faces, but the group with autism showed deficits in responding to name and initiations of joint attention (IJA). Looking at people was not significantly correlated with IJA behaviors, but response to name was. The lack of group differences in looking at faces between 9 and 12 months, and the existence of IJA difficulties in the ASD group without concurrent impairment in looking at faces, do not support predictions of the Social Motivation model. LAY SUMMARY: Various theories have been proposed to explain the emergence of autism symptoms early in life. This study tested two key predictions of the Social Motivation model. Comparing family movies of children 9- to 12-months-old later diagnosed with autism or with typical development, we did not observe difficulties in looking at other people's faces but children with autism responded to name and used gaze and gestures to direct the adult's attention to events of interest less frequently. This absence of difficulties in looking at faces does not fit with what the Social Motivation model of autism predicts and therefore we must develop alternative explanations.

Eye-tracking study of joint attention deficits in pre-school age

The article investigates joint attention deficits in various forms of atypical development using eye movement recording. Preschoolers aged 5-7 years from different clinical groups participated in the study: typically developing (n = 20), with mental retardation (ICD-10 class F83) (n = 20), preschoolers with delayed speech development (ICD-10 class R47) (n = 20), with hearing impairment (sensorineural hearing loss, ICD-10 class H90) (n = 10) and with visual impairment (amblyopia and strabismus, IBC-10 class H53) (n = 20). Contrasting group analyses allowed us to identify both specific and universal manifestations of joint attention deficit symptoms in the different forms of atypical development. Gaze tracking was used to analyze fixation duration and frequency, fixation distribution, areas of interest, and to identify markers of joint attention deficits that interfere with the child's productive interaction with an adult. Potential mechanisms of atypical joint attention are described, including atypical direction of gaze, changes in the dynamics of the operative visual field, duration of visual concentration, and accuracy in fixing the object’s elements. It is shown that fixation time in joint attention episodes can be regarded as a prognostic marker of joint attention disorders: joint attention is associated not only with spatial characteristics of areas of interest, but also with fixation duration on the object (decrease/increase in fixation duration).

Shared intentionality in children with Autism Spectrum Disorder (ASD)

It is well documented that the ability and motivation to engage with others in collaborative activities with joint goals and shared intentions is the foundation of human uniqueness. However, children with Autism Spectrum Disorder (ASD) show difficulties in sharing their motives, intentions, and emotions with others about topics in the environment and manifest low levels of engagement. The purpose of the present study was to compare the level of intentionality and social engagement in 10 children with ASD and 10 typically developing (TD) children, matched for mental age, during free play interactions with their mothers. Children were video recorded while playing with their mothers in a naturalistic condition with toys provided by the researcher. For the microanalysis of the video recordings the EUDICO Linguistic Annotator was used, which permits the analysis of joint behaviors and captures subtle qualitative differences in social engagement. Results indicated that children with ASD showed deficits in joint attention, exhibited no functional play and employed less communicative gestures than their peers in the comparison group. These differences between the two groups in their mode of communication led to the emergence of two distinct patterns of engagement which depict the different level of intentionality that these groups have in sharing their experiences during mother-child interactions. These representative patterns of interaction can be used as a potential tool for early identification of children at risk of ASD well before other behaviors become fully manifested.

Robot dramas may improve joint attention of Chinese-speaking low-functioning children with autism: stepped wedge trials

Introduction Children with autism spectrum disorder (ASD), especially those with low cognitive functioning, have deficits in joint attention. Previous research has found that these children are interested in engaging with social robots. Purpose In the present study, we designed a robot drama intervention for promoting responses to joint attention abilities (RJA) of children with low-functioning autism (IQs < 70). Materials and methods Using a stepped wedge design, Chinese-speaking children aged six to eight were randomly assigned to three tiers (N = 18). Children of all three tiers had comparable autism severity, language and cognitive function, and joint attention abilities. Tier 1 first received intervention, followed by Tiers 2 and 3. They watched six dramas in which social robots demonstrated RJA behaviours. Results The RJA of children of all tiers improved after intervention and such improvement was maintained over time. Despite initiation of joint attention (IJA) not being explicitly taught, IJA of all children was found to improve after intervention. Conclusions It was, therefore, concluded that a robot drama could enhance the joint attention of children with low-functioning ASD. Implications for rehabilitation In comparison to typically developing children, children with autism spectrum disorder (ASD), especially those with low cognitive functioning, have deficits in joint attention. Robot-based drama intervention program was developed to promote responses to joint attention (RJA) abilities of children with low-functioning autism (IQs < 70). Modelling RJA in robot dramas can promote RJA abilities in these children. An improvement in RJA also yielded an increase in the initiation of joint attention (IJA) abilities. Children with low-functioning autism might be able to extract the initiation of joint attention skills from the drama, even though these behaviours were not explicitly taught.

Investigating joint attention in a guided interaction between a child with ASD and therapists: A pilot eye-tracking study

Introduction Deficits in joint attention are commonly seen in children with autism spectrum disorder. Research examining joint attention in autism spectrum disorder commonly uses two broad strategies to cue and measure joint attention: behavioral observation and eye tracking. These strategies trade off prioritizing ecological validity vs. gaze measurement accuracy, with a focus on one sacrificing the other. The purpose of this case study was to develop a method to accurately measure gaze position while maintaining an ecologically valid dyadic interaction. Methods A child with autism spectrum disorder completed two developmentally appropriate tabletop activities. Each activity was guided by a different occupational therapist who purposefully used a different interaction style with the child. Mobile eye trackers worn by both the child and the therapist recorded the dyadic interactions. Data collection included audio and video recording of interactive behaviors, eye movements and visual fixations in regions of shared interest. Results Differences were detected in gaze use and interactive joint attention behaviors between the therapists working with the child and within the child’s respective dyadic interactions. Conclusions The proof of concept method maintained both ecological validity and measurement accuracy of therapist–child joint attention. This method has promise to be scaled for larger studies.

Autism spectrum symptoms in children with congenital blindness

Autism spectrum symptoms in children with congenital blindness Abstract. Objective: Previous studies reported increased rates of autistic symptoms in children with impaired visual abilities (IV). However, the application of existing screening questionnaires for autism spectrum disorders (ASD) proved problematic, as intact visual abilities are typically required. The current study examines the general applicability of three autism-screening questionnaires in children with congenital blindness. Methods: Autistic symptoms were assessed in 15 children with congenital blindness, 15 children with ASD (without IV), and 20 typically developing controls (aged from 8 to 14 years), using the Social Communication Questionnaire, the Marburg Rating Scale for Asperger's Syndrome, and the Social Responsiveness Scale. Results: Items assessing motor, mimic/gesture-related, or joint attention deficits were identified as highly prevalent in children with congenital blindness. These children scored, in general, higher on ASD-screening questionnaires than typically developing controls but lower than sighted children with ASD. Depending on the screening questionnaire used, between 23 % and 67 % of the sample with congenital blindness reached clinical cutoff scores for ASD. SRS total score was negatively correlated to cognitive empathy and verbal IQ in those children. Conclusions: Mothers of children with congenital blindness reported increased autistic symptoms in ASD-screening questionnaires. ASD and IV might share a broad range of symptoms. Future development and validation of screening instruments specifically adapted to the needs of persons with impaired visual abilities seem necessary.

Atypical visual direction of in the episodes of joint attention with pre-school children

Introduction.The article is devoted to the problem of manifestations of joint attention deficit in preschool age. Joint attention is considered as a key skill in dyadic orientation and providing joint access to the reference to the reference object in the communication process. The study focuses on how skills in a joint search in episodes of joint attention and understanding of the intentional actions of another person are interconnected in typical and atypical ontogenesis.Materials and methods.In the present study, an experiment examines the visual orientation of directional social signals (orientation toward the direction of eye movements of the communication partner) in typically developing children (n = 21) and children with mental retardation (n = 20). The sample of the study consisted of children of preschool age (5-7 years). To fix the data, we used the recognition criteria and using the correct (congruent) or incorrect (incongruent) direction of eye movements of another person to determine the location of the target (object) that the communication partner chooses during the experiment.Results.A comparison was made of the use of unmarked instructions by preschool children, which help them to carry out a joint search for potential visually accessible referents and contributes to the selection of a relevant object that the adult had in mind. It is shown that preschoolers with mental retardation have difficulty in the functional use of joint attention for social exchange. Markers of joint attention deficit associated with atypical development at an early stage of ontogenesis were found.Discussion and Conclusions.In the episodes of joint attention with preschoolers with mental retardation, there are changes in the profile of suggestive attitudes, sensitivity to the direction of the partner’s gaze, differences in the mechanistic and mentalistic gaze. We can single out the following specific difficulties in children with mental retardation: deficiencies in the reference search, deficiencies in the declarative indication and display, deficiencies in the search, where others indicate.

A Robot-Based Play-Drama Intervention May Improve the Joint Attention and Functional Play Behaviors of Chinese-Speaking Preschoolers with Autism Spectrum Disorder: A Pilot Study.

Children with autism spectrum disorder (ASD) have deficits in joint attention and play behaviors. We examined whether a robot-based play-drama intervention would promote these skills. Chinese-speaking preschool children were randomly assigned to an intervention group (N = 12) and a waitlist control group (N = 11). Children in the intervention group watched three robot dramas and engaged in role-plays with both robots and human experimenters over the course of 9weeks. There were significant improvements in joint attention initiations and functional play behaviors in the intervention group. Parents of this group of children also reported less severe social impairments. It was therefore concluded that a robot-based play-drama intervention can enhance the joint attention and play behaviors of children with ASD.

Beta oscillations precede joint attention and correlate with mentalization in typical development and autism

A precursor of adult social functioning is joint attention (JA), which is the capacity to share attention on an object with another person. JA precedes the development of the capacity to attribute mental states to others (i.e., mentalization or theory of mind). The neural mechanisms involved in the development of mentalization are not fully understood. Electroencephalographic recordings were made of children while they watched stimuli on a screen and their interaction with the experimenter was assessed. We tested whether neuronal activity preceding JA correlates with mentalization in typically developing (TD) children and whether this activity is impaired in children with autistic spectrum disorder (ASD) who evidence deficits in JA and mentalization skills. Both groups exhibited JA behavior with comparable frequency. TD children displayed a higher amplitude of negative central (Nc) event-related potential preceding JA behavior (∼500 msec after stimuli presentation), than did the ASD group. Previous to JA behavior, TD children demonstrated beta oscillatory activity in the temporoparietal region, while ASD children did not show an increase in beta activity. In both groups, the beta power correlated with mentalization, suggesting that this specific neuronal mechanism is involved in mentalization, which used during social interaction.

Asistranto: An Assistive Educational Platform for Promotion of Interest in Autistic Children

Asistranto is an assistive educational platform that involves information and communication technology in the education, engineering and models of affective computing, and its name is a translation of the word “assistance” into the Esperanto language. This platform was developed based on Vygotsky’s socio-historical theory in order to promote the affective state of interest and joint attention scenes in children with autistic spectrum disorder (ASD). ASD leads the child to developmental deficit condition, with manifestation scale in the behavioral, communicative and in some cases cognitive domains. The interest and joint-attention deficits in children with ASD are also manifestations widely mentioned in the literature. The qualitative methodology is used with case study of multiple cases. An educational storytelling activity was developed using a product called Electronic Puppet, created on the Asistranto Platform. Four storytelling with Electronic Puppet was presented to four autistic students from 7th and 8th grade, limited to 16 cases. The results showed that Asistranto’s Electronic Puppet promoted over 80% of joint attention scenes, and an increase of three positive cases without technology to nearly 10 with Electronic Puppet, representing a gain of over 200%. In addition, 83% of the cases presented positive indicative of affective state of interest. This confirms the importance of Asistranto as a contextualized technological support for communicative and joint attention activities.

Relações funcionais entre estímulos condicionais sociais, atenção conjunta, tato e mando em crianças com autismo

Déficits na atenção conjunta (AC), caracterizada como resposta de atenção conjunta (RAC) e iniciação de atenção conjunta (IAC), têm sido relacionados com os problemas de linguagem observados em pessoas com autismo. O estabelecimento do comportamento de outras pessoas como estímulos discriminativos/reforçadores condicionais pode ser importante para AC. Este estudo investigou, em três crianças com autismo, as relações funcionais que podem ocorrer entre o estabelecimento do comportamento de outras pessoas como estímulos discriminativos/reforçadores condicionais e os repertórios de RAC, IAC, tato e mando. Foram realizados treinos de repertórios de sessão e pré-testes da efetividade reforçadora/discriminativa de estímulos condicionais sociais, de RAC, IAC, mando e tato. Com base nos prétestes, foram definidas diferentes linhas de base entre os participantes para iniciar os treinos dos repertórios inexistentes e poder avaliar os efeitos de um ou mais repertórios sobre os demais. Os resultados sugerem uma independência funcional entre a aquisição de RAC, mando e tato e o estabelecimento de respostas a estímulos sociais.

Design, Development, and Evaluation of a Noninvasive Autonomous Robot-mediated Joint Attention Intervention System for Young Children with ASD.

Research indicates that human-robot interaction can help children with Autism Spectrum Disorder (ASD). While most early robot-mediated interaction studies were based on free interactions, recent studies have shown that robot-mediated interventions that focus on the core impairments of ASD such as joint attention deficit tend to produce better outcomes. Joint attention impairment is one of the core deficits in ASD that has an important impact in the neuropsychological development of these children. In this work, we propose a novel joint attention intervention system for children with ASD that overcomes several existing limitations in this domain such as the need to use body-worn sensors, non-autonomous robot operation requiring human involvement and lack of a formal model for robot-mediated joint attention interaction. We present a fully autonomous robotic system, called NORRIS, that can infer attention through a distributed non-contact gaze inference mechanism with an embedded Least-to-Most (LTM) robot-mediated interaction model to address the current limitations. The system was tested in a multi-session user study with 14 young children with ASD. The results showed that participants' joint attention skills improved significantly, their interest in the robot remained consistent throughout the sessions, and the LTM interaction model was effective in promoting the children's performance.

Social Cognition in Children Born Preterm: A Perspective on Future Research Directions

Preterm birth is a major risk factor for children’s development. It affects children’s cognitive and intellectual development and is related to impairments in IQ, executive functions, and well-being, with these problems persisting into adulthood. While preterm children’s intellectual and cognitive development has been studied in detail, their social development and social-cognitive competencies have received less attention. Namely, preterm children show problems in interactions with others. These interaction problems are present in relationships with parents, teachers, and peers. Parents’ behavior has been identified as a possible mediator of children’s social behavior. Maternal sensitivity and responsiveness as well as absence of mental disorders foster children’s social development. In this article, we will report on the social side of impairments that preterm children face. The review of the literature revealed that preterm infants’ joint attention abilities are impaired: They are less likely to initiate joint attention with others and to respond to others’ efforts to engage in joint attention. These deficits in joint attention might contribute to later impairments in social cognition, which in turn might affect social interaction skills. Based on these three domains (i.e., problems in social interaction, parental behavior, and impairments in joint attention), we suggest that preterm children’s social cognitive abilities should be investigated more intensively.

Associations between joint attention and language in autism spectrum disorder and typical development: A systematic review and meta-regression analysis.

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.