Autism & Developmental

Joint attention and set-shifting in young children with autism.

Stahl et al. (2002) · Autism : the international journal of research and practice 2002
★ The Verdict

Joint attention and set-shifting travel together in typical toddlers but not in autistic ones—assess each domain on its own.

✓ Read this if BCBAs completing developmental assessments with toddlers on the spectrum.
✗ Skip if Clinicians who only serve verbal school-age clients.

01Research in Context

01

What this study did

Stahl et al. (2002) watched toddlers with autism and same-age typical kids.

They scored two things: how well each child shared gaze and pointed, and how fast the child could switch from one task to another.

Then they asked, do these two skills move together?

02

What they found

In typical toddlers, strong joint attention went hand-in-hand with quick set-shifting.

In autistic toddlers, the link was gone.

A child could point well yet still struggle to switch rules, or vice-versa.

03

How this fits with other research

Neef et al. (1986) and Rapport et al. (1996) already showed that autistic kids lag in joint attention itself.

Laura’s team adds that the lag is not tied to general shifting trouble, because Wilkinson et al. (1998) and Austin et al. (2015) found autistic children can shift when they must; their brains just work harder.

Petry et al. (2007) later linked joint attention more to language than to stereotypy, echoing the idea that each skill domain needs its own probe.

So the picture is: joint attention is weak in autism, set-shifting is effortful but possible, and the two do not predict each other.

04

Why it matters

When you test a toddler with autism, score joint attention and executive flexibility separately.

A child who points may still need extra cues to change activities, while a child who switches fast may not share attention.

Plan lessons for each skill path instead of assuming one will lift the other.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Run a brief joint-attention probe and a separate shifting game; note scores in different columns.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
36
Population
autism spectrum disorder, neurotypical
Finding
mixed

03Original abstract

Executive function deficits in autism have been consistently found in many studies, using a wide range of measures, but usually involving older children and adults and those of higher IQ. The interpretation of executive function deficits is difficult because the concept itself is poorly defined (inhibition of prepotent responses, set-shifting, action planning etc.). Analyses have focused mainly on the attention participants pay to physical entities (object handling and problem solving) rather than social ones. The present study investigated whether these two types of attention are linked in autistic development. Fifteen children with autism (mean mental age = 24 months) were compared to 21 normally developing children (mean mental age = 25 months). A strong correlation was found between joint attention and set-shifting in the typically developing children but not those with autism. The results are discussed from a psychopathological perspective on development.

Autism : the international journal of research and practice, 2002 · doi:10.1177/1362361302006004005