Social referencing training in children with autism spectrum disorder: A randomized controlled study

Sivaraman et al. (2022) split children with autism into two groups. One group got social-referencing lessons. The other group kept their usual program.

Trainers used pictures, videos, and live actors. They taught kids to look at an adult’s face when unsure. Then they faded the prompts.

Kids who got the lessons learned to check adult faces more often. When the team compared the two groups, the trained group did not score higher on joint-attention tests.

In short: referencing went up, but joint attention stayed flat.

McParland et al. (2021) also boosted social looking in class. They used quick operant gaze training and saw fast gains. Both studies show brief teaching can change where kids look.

Cooper et al. (1990) taught one child to start social bids. Disruptive behavior dropped only when the child, not the peer, made the first move. Sivaraman’s group training echoes that idea: teach the child to act first, then watch for results.

Jonsson et al. (2016) warn that many autism RCTs skip details we need to copy them. Sivaraman’s paper gives clear steps, but we still need to know staff time, toy sets, and kid traits before we can run the same program in our clinic.

You can add a five-minute social-referencing drill to any session. Use photos, then real faces, then fade prompts. Expect kids to look at you more, but do not bank on big joint-attention jumps. Track both skills so you and parents see real progress.