Initiating and responding to joint attention bids in children with autism: a review of the literature.
Teach responding and initiating joint attention as separate skills and pick reinforlers with intent, not habit.
01Research in Context
What this study did
Ahrens et al. (2011) read every joint-attention paper they could find. They sorted the studies by two questions. Did the program teach the child to respond to someone else’s point or gaze? Or did it teach the child to start the point or gaze?
They also listed what kind of reward each study used. Some gave stickers or snacks. Others gave only smiles or praise.
What they found
Most papers focused on teaching kids to respond. Fewer taught kids to start joint attention. The choice of reward varied a lot, and no paper explained why it picked one type over another.
How this fits with other research
Bottema-Beutel (2016) later pooled data and showed that responding to joint attention links to language gains more than any other form. This backs up the review’s call to track responding separately from initiating.
Liu et al. (2022) and Kourassanis-Velasquez et al. (2019) took the next step. They blended DTT with PRT or trained peers to evoke bids. Both teams saw gains in real preschool rooms, showing the field has moved from asking “what works?” to testing “how do we package it for Monday morning?”
MacDonald et al. (2006) gave a ready-made 15-minute probe that splits responding and initiating scores. Use it to turn the review’s big map into quick baseline data.
Why it matters
If your program lumps all joint attention targets together, split the sheet. Write one goal for responding (follow a point) and one for initiating (show an item). Run the Rebecca probe first so you know which side needs the heavier dose. Then pick reinforcers on purpose: try social first, add tangible only if smiles alone don’t work. This small shift aligns your treatment with the best data we have.
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02At a glance
03Original abstract
Joint attention is a skill that involves coordinating the attention of at least two individuals towards an object or event. Although it is seen as a critical skill in early child development, it is frequently absent in children with autism and has been linked to poorer language outcomes for those children. As a result, multiple interventions have been developed to teach children with autism to respond to, and initiate, bids for joint attention. These interventions, however, differ widely both in terms of procedures used and in whether they focus on teaching children to respond to, or initiate, bids for joint attention. This literature review was conducted to document research gaps and intervention similarities between joint attention intervention studies for children with autism. The specific intent of this review was to determine whether researchers teach responding and initiating separately or sequentially, describe the extent to which procedures differ among studies, and identify whether social or non-social consequences are used during joint attention training. Implications for the treatment of joint attention deficits are discussed and recommendations to both researchers and practitioners are provided.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.02.013