Joint Attention Behaviors Research Articles

Social and joint attention during shared book reading in young autistic children: a potential marker for social development.

Atypical patterns of social engagement and joint attention behaviors are diagnostic criteria for people with autism spectrum disorder. Experimental tasks using eye-tracking methodologies have, however, shown inconsistent results. The development of tasks with greater ecological validity and relevance for developmentally appropriate social milestones has been identified as important for the field. We developed a novel, dynamic eye-tracking task emulating a shared book reading (SBR) scenario. Four SBR videos of an adult reader engaging with the viewer while reading a children's picture book and including sequenced bids for joint attention were developed. Participants included 90 children (N = 56 autistic children, N = 34 neurotypical children; aged 3-12). Social attention was also measured in a live free play task between participants and an experimenter. Compared to neurotypical children, autistic children displayed reduced attention to socially salient stimuli including the reader's face and picture book across SBR videos and during joint attention bids specifically. In contrast, they showed increased attention to nonsalient background stimuli compared to their neurotypical peers. These attention patterns in autistic children were associated with reduced verbal and nonverbal cognitive skills and increased symptoms associated with autism. Interestingly, positive correlations in the frequency of eye gaze between SBR and free play suggested a potential predictive value for social attention in live social interactions. Findings highlight the utility of SBR eye-tracking tasks in understanding underlying divergences in social engagement and joint attention between autistic and neurotypical children. This commonly practiced early childhood activity may provide insights into the relationship between social engagement and learning to reveal how such attentional patterns might influence broader developmental and educational outcomes.

Fostering concentration and engagement of peer mediators in primary classrooms as joint concentration agents

The concept of joint concentration agents suggests that kids actively promote and sustain Fostering Concentration (FC) and engagement between their classmates. Fostering concentration and engagement in the current setting means establishing an atmosphere that motivates kids to pay FC and actively engage in educational activities. This might include a variety of tactics, approaches, and interventions that educators use to improve their students' capacity for sustained FC and engagement throughout class activities. Primary Classrooms (PC) strongly emphasize social and emotional development in addition to intellectual study. Students pick up social skills such as cooperating, sharing with peers, and developing empathy. Kids with developmental difficulties, such as Autism Spectrum Disorder (ASD), risk being excluded from other kids of the same age. Additionally, studies show that focused therapies and support benefit kids with ASD, even in inclusive environments. Joint Concentration (JC) has been recognized as a critical talent for improving period-suitable social skills and announcements. JC is a joint involvement between two persons on a third item or event. An increasing corpus of research describes successful interventions on JC skills for kids with ASD; despite this, few studies document the results of an intervention that uses a natural change agent. In the current research, Response to Joint Attention (RJA) behaviours shown by seven pre-schoolers with ASD was assessed using independent concurrent multiple baseline designs. The Peer Mediators (PM) can carry out a direct interference with accuracy, and the seven peers' overall RJA behaviours improved as a result of the intervention, as did the number of peer bids and replies to those bids.

Nonlinear features of gaze behavior during joint attention in children with autism spectrum disorder.

Since children with autism spectrum disorder (ASD) might exhibit a variety of aberrant response to joint attention (RJA) behaviors, there is growing interest in identifying robust, reliable and valid eye-tracking metrics for determining differences in RJA behaviors between typically developing (TD) children and those with ASD. Previous eye-tracking studies have not been deeply investigated nonlinear features of gaze time-series during RJA. As a main motivation, this study aimed to extract three nonlinear features (i.e., complexity, long-range correlation, and local instability) of gaze time-series during RJA in children with ASD, which can be measured by fractal dimension (FD), Hurst exponent (H), and largest Lyapunov exponent (LLE), respectively. To illustrate our idea, this study adopted a publicly accessible database, including eye-tracking data collected during RJA from 19 children with ASD (7.74 ± 2.73) and 30 TD children (8.02 ± 2.89), and conducted a battery of nonparametric analysis of covariance (ANCOVA), where gender was used as covariable. Findings showed that gaze time-series during RJA in autistic children may generally have greater FD but lower H than that in TD controls. This implies that children with ASD possess more complex and unpredictable gaze behaviors during RJA than TD children. Furthermore, nonlinear metrics outperformed traditional eye-tracking metrics in obtaining higher identification performance with an accuracy of 82% and an AUC value of 0.81, distinguishing the differences between successful and failed RJA trails, and predicting the severity of ASD symptoms. Findings might bring some new insights into the understanding of the impairments in RJA behaviors for children with ASD.

Development and Validation of a Joint Attention–Based Deep Learning System for Detection and Symptom Severity Assessment of Autism Spectrum Disorder

Joint attention, composed of complex behaviors, is an early-emerging social function that is deficient in children with autism spectrum disorder (ASD). Currently, no methods are available for objectively quantifying joint attention. To train deep learning (DL) models to distinguish ASD from typical development (TD) and to differentiate ASD symptom severities using video data of joint attention behaviors. In this diagnostic study, joint attention tasks were administered to children with and without ASD, and video data were collected from multiple institutions from August 5, 2021, to July 18, 2022. Of 110 children, 95 (86.4%) completed study measures. Enrollment criteria were 24 to 72 months of age and ability to sit with no history of visual or auditory deficits. Children were screened using the Childhood Autism Rating Scale. Forty-five children were diagnosed with ASD. Three types of joint attention were assessed using a specific protocol. Correctly distinguishing ASD from TD and different levels of ASD symptom severity using the DL model area under the receiver operating characteristic curve (AUROC), accuracy, precision, and recall. The analytical population consisted of 45 children with ASD (mean [SD] age, 48.0 [13.4] months; 24 [53.3%] boys) vs 50 with TD (mean [SD] age, 47.9 [12.5] months; 27 [54.0%] boys). The DL ASD vs TD models showed good predictive performance for initiation of joint attention (IJA) (AUROC, 99.6% [95% CI, 99.4%-99.7%]; accuracy, 97.6% [95% CI, 97.1%-98.1%]; precision, 95.5% [95% CI, 94.4%-96.5%]; and recall, 99.2% [95% CI, 98.7%-99.6%]), low-level response to joint attention (RJA) (AUROC, 99.8% [95% CI, 99.6%-99.9%]; accuracy, 98.8% [95% CI, 98.4%-99.2%]; precision, 98.9% [95% CI, 98.3%-99.4%]; and recall, 99.1% [95% CI, 98.6%-99.5%]), and high-level RJA (AUROC, 99.5% [95% CI, 99.2%-99.8%]; accuracy, 98.4% [95% CI, 97.9%-98.9%]; precision, 98.8% [95% CI, 98.2%-99.4%]; and recall, 98.6% [95% CI, 97.9%-99.2%]). The DL-based ASD symptom severity models showed reasonable predictive performance for IJA (AUROC, 90.3% [95% CI, 88.8%-91.8%]; accuracy, 84.8% [95% CI, 82.3%-87.2%]; precision, 76.2% [95% CI, 72.9%-79.6%]; and recall, 84.8% [95% CI, 82.3%-87.2%]), low-level RJA (AUROC, 84.4% [95% CI, 82.0%-86.7%]; accuracy, 78.4% [95% CI, 75.0%-81.7%]; precision, 74.7% [95% CI, 70.4%-78.8%]; and recall, 78.4% [95% CI, 75.0%-81.7%]), and high-level RJA (AUROC, 84.2% [95% CI, 81.8%-86.6%]; accuracy, 81.0% [95% CI, 77.3%-84.4%]; precision, 68.6% [95% CI, 63.8%-73.6%]; and recall, 81.0% [95% CI, 77.3%-84.4%]). In this diagnostic study, DL models for identifying ASD and differentiating levels of ASD symptom severity were developed and the premises for DL-based predictions were visualized. The findings suggest that this method may allow digital measurement of joint attention; however, follow-up studies are necessary for further validation.

Eye-tracking correlates of response to joint attention in preschool children with autism spectrum disorder

BackgroundA number of differences in joint attention behaviour between children with autism spectrum disorder (ASD) and typically developing (TD) individuals have previously been documented.MethodWe use eye-tracking technology to assess response to joint attention (RJA) behaviours in 77 children aged 31 to 73 months. We conducted a repeated-measures analysis of variance to identify differences between groups. In addition, we analysed correlations between eye-tracking and clinical measures using Spearman’s correlation.ResultsThe children diagnosed with ASD were less likely to follow gaze compared to TD children. Children with ASD were less accurate at gaze following when only eye gaze information was available, compared to when eye gaze with head movement was observed. Higher accuracy gaze-following profiles were associated with better early cognition and more adaptive behaviours in children with ASD. Less accurate gaze-following profiles were associated with more severe ASD symptomatology.ConclusionThere are differences in RJA behaviours between ASD and TD preschool children. Several eye-tracking measures of RJA behaviours in preschool children were found to be associated with clinical measures for ASD diagnosis. This study also highlights the construct validity of using eye-tracking measures as potential biomarkers in the assessment and diagnosis of ASD in preschool children.

Joint Attention Behaviors in Children with Autism Spectrum Disorder and Psychological Adaption of Them and Their Mothers

Joint Attention Behaviors in Children with Autism Spectrum Disorder and Psychological Adaption of Them and Their Mothers

RJAfinder: An automated tool for quantification of responding to joint attention behaviors in autism spectrum disorder using eye tracking data.

Deficits in responding to joint attention (RJA) are early symptoms of autism spectrum disorder (ASD). Currently, no automated tools exist for identifying and quantifying RJA behaviors. A few eye tracking studies have investigated RJA in ASD children but have produced conflicting results. In addition, little is known about the trajectory of RJA development through developmental age. Here, a new video was designed including 12 clips of an actor pointing to or looking at an object. Eye tracking technology was used to monitor RJA in three groups: 143 ASD children assessed with the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) (4-7 years old), 113 age- and gender-matched typically developing children (TDC), and 43 typically developing adults (TDA) (19-32 years old). RJAfinder was developed in R and MATLAB to quantify RJA events from the eye tracking data. RJA events were compared among the three groups. Spearman correlation coefficients between total number of RJA events in ASD and the Social Responsiveness Scale (SRS) scores were calculated. A logistic regression model was built using the average valid sampling rate and the total number of RJA events as two predictive variables to classify ASD and TDC groups. ASD children displayed statistically significantly less RJA events than the TDC and TDA groups with medium-to-large-sized effects. ASD and TDC children both displayed more RJA events in response to pointing stimuli than to looking stimuli. Our logistic regression model predicted ASD tendency with 0.76 accuracy in the testing set. RJA ability improved more slowly between the ages of 4-7 years old in the ASD group than in the TDC group. In ASD children, RJA ability showed negative correlation with SRS total T-score as well as the scores of five subdomains. Our study provides an automated tool for quantifying RJA and insights for the study of RJA in ASD children, which may help improve ASD screening, subtyping, and behavior interventions.

Maternal mobile phone use during mother-child interactions interferes with the process of establishing joint attention.

Parental mobile device use while parenting has been associated with reduced parental responsiveness and increased negative affect among children. However, it remains unclear whether it can interfere with the process of acquiring social communication skills. Thus, this study sought to experimentally examine whether maternal mobile phone use while interacting with the child has an immediate effect on the frequency of mothers' and infants' joint attention (JA) behaviors, the likelihood that these behaviors will lead to JA episodes, and the duration of established JA episodes. Participants were a community sample of 114 (Mage = 11.36 months; 50% male) Israeli typically developing infants, in which most mothers were highly educated and living in two-parent families. Mother-infant dyads completed a modified still-face paradigm and were randomly assigned to one of three experimental conditions during the still-face phase: (a) mobile phone disruptions, (b) social disruptions, and (c) undisrupted play. Mother-infant interactions were coded for frequency of JA behaviors and duration of JA episodes. In dyads assigned to the mobile phone disruptions condition, infants produced more JA initiations, mothers were less likely to contingently respond to infant initiations, JA behaviors were less likely to result in established JA, and JA episodes were shorter compared to dyads in the two control conditions and the baseline free play phase. Findings suggest that maternal mobile phone use during face-to-face interactions with the infant can disrupt the process of establishing JA in ongoing mother-child interactions. Possible implications from this line of work for family digital media use are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effects of Rhythmic Gymnastics on Joint Attention and Emotional Problems of Autistic Children: A Preliminary Investigation.

The adaptive rhythmic gymnastics (ARG) course has been specially designed for children with autism spectrum disorders (ASD). The purpose of this study is to discover the influence of the course on the joint attention and emotional problems of ASD children. This study adopted A-B-A cross-subject multibaseline design in a single case research design. The joint attention behaviour of two 6-year-old ASD children was examined. The experiment process was recorded and coded, and the results were analysed. The results illustrated the following: (1) ARG is effective in promoting the development of joint attention in ASD children, but it has a better effect on increasing responding joint attention, and (2) to a certain extent, ARG can boost the classroom participation of ASD children and improve their emotional problems.

Joint attention in infants at high familial risk for autism spectrum disorder and the association with thalamic and hippocampal macrostructure.

Autism spectrum disorder (ASD) is a heritable neurodevelopmental disorder. Infants diagnosed with ASD can show impairments in spontaneous gaze-following and will seldom engage in joint attention (JA). The ability to initiate JA (IJA) can be more significantly impaired than the ability to respond to JA (RJA). In a longitudinal study, 101 infants who had a familial risk for ASD were enrolled (62% males). Participants completed magnetic resonance imaging scans at 4 or 6 months of age. Subcortical volumes (thalamus, hippocampus, amygdala, basal ganglia, ventral diencephalon, and cerebellum) were automatically extracted. Early gaze and JA behaviors were assessed with standardized measures. The majority of infants were IJA nonresponders (n = 93, 92%), and over half were RJA nonresponders (n = 50, 52%). In the nonresponder groups, models testing the association of subcortical volumes with later ASD diagnosis accounted for age, sex, and cerebral volumes. In the nonresponder IJA group, using regression method, the left hippocampus (B = −0.009, aOR = 0.991, P = 0.025), the right thalamus (B = −0.016, aOR = 0.984, P = 0.026), as well as the left thalamus (B = 0.015, aOR = 1.015, P = 0.019), predicted later ASD diagnosis. Alterations in thalamic and hippocampal macrostructure in at-risk infants who do not engage in IJA may reflect an enhanced vulnerability and may be the key predictors of later ASD development.

Could NAO Robot Function as Model Demonstrating Joint Attention Skills for Children with Autism Spectrum Disorder? An Exploratory Study

Previous studies reported that children with autism spectrum disorder (ASD) show a certain interest in social robots. This makes social robots potential to be a model to teach social skills. This exploratory study aims to investigate whether three types of joint attention skills (i.e., eye-contact, pointing, gaze-following) could be improved for five preschoolers with ASD using an evidence-based robot-modeling intervention with a humanoid social robot NAO. Our observation shows that these children were motivated when interacting with NAO by following and responding correctly to NAO’s joint attention behaviors. Although some improvements were found, no pattern or systematic effect could be revealed. In the future, more evidence-based studies are needed to investigate the benefits of robot-assisted therapy more deeply.

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.

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

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.

Modeling the subjective perspective of consciousness and its role in the control of behaviours

Consciousness has been hypothesized to operate as a global workspace, which accesses and integrates multimodal information in a unified manner, supports expectation violation monitoring and reduction, and the motivation, programming and control of action. One important yet open issue concerns how the subjective perspective at the core of consciousness, and subjective properties of manifestation of the environment in such perspective as an embodied experience, play a role in such process. We operationalised the concept of subjective perspective using the principles of the Projective Consciousness Model (PCM), based on the projective geometrical concept of Field of Consciousness. We show how these principles can account for documented relationships between appraisal and distance as an inverse distance law, yield a generative model of affective and epistemic drives based on purely subjective parameters, such as the apparent size of objects, and can be generalised to implement Theory of Mind, in a manner that is consistent with simulation theory. We used simulations of artificial agents, based on psychological rationale, to demonstrate how different model parameters could generate a variety of emergent adaptive and maladaptive behaviours that are relevant to developmental and clinical psychology: the ability to be resilient in the face of obstacles through imaginary projections, the emergence of social approach and joint attention behaviours, the ability to take advantage of false beliefs attributed to others, the emergence of avoidance behaviours as observed in social anxiety disorders, the presence of restricted interests as observed in autism spectrum disorders. The simulation of agents was applied to a specific robotic context, and agents’ behaviours were demonstrated by controlling the corresponding robots. Our results contribute to advance the scientific understanding of the causal relationships between core aspects of the phenomenology of consciousness and its functions in human cybernetics.

A Pilot Study Evaluating the Effects of Early Intervention for Italian Siblings of Children with Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a high-cost/high-burden problem. Early intervention may prevent development of the disorder, improving child outcomes and reducing long-term consequences. However, few studies have investigated the role of early intervention in children younger than two years. This study aims to examine the effect of early intervention in 18-month-old high-risk siblings of children with ASD (HR-ASD) with clinical signs of autism. The intervention is based on the principles of Applied Behavior Analysis and focuses on the development of early precursors to social and communicative competence (joint attention and imitation behaviors). After controlling for baseline differences, two comparison HR-ASD groups were included: 15 HR-ASD toddlers receiving behavioral intervention for 3 h per week for 5 months (INT+) and 15 HR-ASD toddlers who were only clinically monitored from age 18 months (INT−). Changes in social communication, restricted/repetitive behaviors, and language were assessed using standardized measures at pre- (T0) and post-intervention (T1). From T0 to T1, the INT+ group showed significant improvements in communication, social interaction, and language compared to INT− group. There was no effect on restricted/repetitive behaviors. Our findings highlighted the importance of early detection/intervention in autism and supported a positive impact of targeted interventions to improve outcomes in at-risk children.

Comparison of Joint Attention Behavior between Late-Talkers and Typically Developing Toddlers

Comparison of Joint Attention Behavior between Late-Talkers and Typically Developing Toddlers

Joint attention behaviour in remote collaborative problem solving: exploring different attentional levels in dyadic interaction

The current article describes an exploratory study that focussed on joint attention behaviour—the basis of interaction predicting productive collaboration—to better understand collaborative problem solving, particularly its social aspects during remote dyadic interaction. The study considered joint attention behaviour as a socio-linguistic phenomenon and relied on detailed qualitative interaction analysis on event-related measures of multiple observational data (i.e. log files, eye-tracking data). The aim was to illustrate and exemplify how the diverse attentional levels of joint attention behaviour (i.e. monitoring, common, mutual and shared attention) delineated by Siposova and Carpenter (Cognition 89:260–274, 2019) were achieved in remote collaborative problem solving in dyads, including the underlying basis of joint attention behaviour (i.e. individual attention experience). The results made visible the complex functioning of the social aspects of remote collaborative problem solving and provided preliminary insights into how the hierarchical and nested levels of ‘jointness’ and common knowledge were achieved in this context. The analysis reproduced all the theorised attentional levels as both isolated and parallel individualistic attention experiences whilst acknowledging the restrictions of the remote interaction environment and the specific task structures.

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.

Joint attention abilities in Brazilian preterm and full-term infants

Joint attention abilities of preterm and full-term Brazilian infants were assessed at 12- and 18-months, age corrected for prematurity. Results showed that preterm infants displayed significantly lower levels of correct responses to others’ bids for joint attention at both time-points, compared to full-term infants. Both groups improved their responding to joint attention from 12 to 18 months of age. Contrastingly, prematurity did not impact infants’ initiating joint attention behaviors, which remained stable over time for both groups. Findings were discussed in terms of the specific mental processes involved in distinct behavioural dimensions of joint attention.

Robot-Assisted Intervention for children with special needs: A comparative assessment for autism screening

Despite the increment of researches related to Social Assistive Robotics (SAR), achieving a plausible Robot-Assisted Diagnosis (RAD) for Children with Autism Spectrum Disorders (CwASD) remains a considerable challenge to the clinical and robotics community. The work of specialists regarding ASD diagnosis is hard and labor-intensive due to the condition’s manifestations are inherently heterogeneous and makes the process more difficult. Besides, the aforementioned complexity may be the main reason for the slow progress in the development of SAR with diagnostic purposes. Thus, this work provides a comprehensive Robot-Assisted Intervention for CwASD showing the conditions in which a Robot-based approach can be useful to assess autism risk factors for an autism diagnosis purpose. The intervention scheme consists of an improved version of a multimodal environment for Robot-based intervention proposed in our previous work. More specifically, we compared the behavior of CwASD with that of children in a control group during a human/robot-mediated intervention while Joint Attention (JA) behaviors are elicited and analyzed. Through statistical data analysis, it was possible to identify that 17 out of 23 children of the CwASD group showed a different behavior pattern related to three characteristics of autism, which suggests that this pattern can be used to identify autism risk factors through Robot-based interventions.