Attentional processes in interactions between people with profound intellectual and multiple disabilities and direct support staff.
Adults with PIMD rarely start joint attention, but staff can spark it with quick tactile cues.
01Research in Context
What this study did
The team watched the adults with profound intellectual and multiple disabilities during everyday care.
Each client-staff pair was filmed for 15 minutes.
Observers counted who looked where, who touched, and when both looked at the same thing.
What they found
Clients almost never pointed or shifted their eyes to share interest.
Staff rarely used hand-over-hand or tactile cues when the client was still.
On the rare moments when both looked at the same object, the client stayed engaged longer.
How this fits with other research
Eisenhower et al. (2006) taught preschoolers with autism to follow gaze and point using toys and praise.
Their kids gained language and play skills, showing joint attention can be trained in verbal children.
The new study did not test training; it only mapped what already happens with non-verbal adults.
Together the papers say: joint attention is scarce in severe disability, but earlier work proves it can be taught to younger, higher-functioning learners.
Why it matters
If you serve adults with PIMD, expect almost zero initiation.
Add brief tactile prompts—hand taps or object placement—when clients look away.
Start with items that already grab fleeting eye contact, then gently guide their hands.
One extra shared look per session is a win.
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02At a glance
03Original abstract
Few studies have examined joint attention in interactions with persons with profound intellectual and multiple disabilities (PIMD), despite its important role in high-quality interaction. The purpose of this study is to describe the attention-directing behaviours of persons with PIMD and their direct support staff and the attention episodes resulting from their interactions, and to understand how these variables relate to each other. Video observations of 17 staff-client dyads were coded using partial interval recording. The results showed considerable variation across individuals and dyads. In general, persons with PIMD directed the attention of staff members infrequently. The staff members frequently directed their clients' attention towards a topic of interest but did not often use the tactile modality. Within the staff-client dyad, there was not much joint attention; however, shared attention episodes occurred frequently. Shared attention and joint attention are strongly correlated. A negative correlation was found between clients not using attention-directing behaviours and staff members using tactile methods to direct the attention, and joint attention episodes. This study presents both directions for future research and practical implications.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2010.12.034