Autism & Developmental

Joint attention initiation with and without positive affect: risk group differences and associations with ASD symptoms.

Gangi et al. (2014) · Journal of autism and developmental disorders 2014
★ The Verdict

Flat joint-attention bids forecast autism symptoms better than smiling ones.

✓ Read this if BCBAs who screen baby siblings in clinic or home visits.
✗ Skip if Practitioners working only with verbal school-age clients.

01Research in Context

01

What this study did

The team watched baby siblings of children with autism. They coded two kinds of joint-attention bids: pointing or showing while smiling, and pointing or showing with no smile. They tracked the babies for two years and then measured autism symptoms.

02

What they found

Babies who pointed without smiling had more autism signs at age two. Smiling bids were less useful for predicting later symptoms.

03

How this fits with other research

Bottema-Beutel (2016) found that responding to joint attention links strongly to language in ASD. That review did not split bids by affect, so the new finding adds a warning flag: watch the flat bids, not just the cute ones.

Rutherford et al. (2007) first showed that ASD-sibs smile less overall. Lifshitz et al. (2014) zooms in and says the absence of smile during an IJA moment is the real red flag.

Lin et al. (2026) later echoed the same idea with a different measure. They saw that low affective synchrony, not poor gaze, predicted ASD. Both papers tell clinicians to look past eye contact and check whether the baby’s face lights up.

04

Why it matters

When you screen an infant sibling, count how many bids come with a smile and how many do not. A flat point at nine months deserves a follow-up more than a grinning point. Add this quick tally to your parent questionnaire or play sample.

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During your next infant play sample, tally IJA bids with and without smiles; flag flat bids for re-screen.

02At a glance

Intervention
not applicable
Design
other
Population
autism spectrum disorder
Finding
mixed
Magnitude
small

03Original abstract

Infants at risk for autism spectrum disorders (ASD) may have difficulty integrating smiles into initiating joint attention (IJA) bids. A specific IJA pattern, anticipatory smiling, may communicate preexisting positive affect when an infant smiles at an object and then turns the smile toward the social partner. We compared the development of anticipatory smiling at 8, 10, and 12 months in infant siblings of children with ASD (high-risk siblings) and without ASD (low-risk siblings). High-risk siblings produced less anticipatory smiling than low-risk siblings, suggesting early differences in communicating preexisting positive affect. While early anticipatory smiling distinguished the risk groups, IJA not accompanied by smiling best predicted later severity of ASD-related behavioral characteristics among high-risk siblings. High-risk infants appear to show lower levels of motivation to share positive affect with others. However, facility with initiating joint attention in the absence of a clear index of positive affective motivation appears to be central to the prediction of ASD symptoms.

Journal of autism and developmental disorders, 2014 · doi:10.1007/s10803-013-2002-9