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Cited by 954Autism Spectrum Disorder ResearchChild and Animal Learning DevelopmentBehavioral and Psychological Studies

Joint attention and symbolic play in young children with autism: a randomized controlled intervention study

Kasari, Connie, Freeman, Stephanny, Paparella, Tanya·2006·Journal of Child Psychology and Psychiatry
DOI 10.1111/j.1469-7610.2005.01567.x
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Abstract

Background: Delays and deficits in joint attention and symbolic play constitute two important developmental problems in young children with autism. These areas of deficit have been well studied in autism but have rarely been the focus of treatment efforts (see ). In this study, we examine the efficacy of targeted interventions of joint attention and symbolic play. Methods: Participants were 58 children with autism aged 3 and 4 years (46 boys). Children were randomized to a joint attention intervention, a symbolic play intervention, or control group. Interventions were conducted 30 minutes daily for 5–6 weeks. Both structured assessments of joint attention and play skills and mother–child interactions were collected pre and post intervention by independent assessors. Results: Results indicate that both intervention groups improved significantly over the control group on certain behaviors. Children in the joint attention intervention initiated significantly more showing and responsiveness to joint attention on the structured joint attention assessment and more child‐initiated joint attention in the mother–child interaction. The children in the play group showed more diverse types of symbolic play in interaction with their mothers and higher play levels on both the play assessment and in interaction with their mothers. Conclusions: This randomized controlled trial provides promising data on the specificity and generalizability of joint attention and play interventions for young children with autism. Future studies need to examine the long‐term effects of these early interventions on children's development.

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  • PACT was administered for more hours than similar interventions in other studies.

    “PACT was administered for more hours than were similar interventions in other studies.13,15”

    From Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial (2010) · cites this paper as [13]

  • In a randomized controlled study, focused joint attention content delivered by skilled interventionists for 30 minutes daily over an average of 6 weeks and layered into an intensive early intervention program of 30 hours per week produced significant effects on joint attention skills.

    “For example, significant effects on joint attention skills were found in a study in which focused content on joint attention was delivered by skilled interventionists for 30 minutes daily over an average of 6 weeks and layered into an intensive early intervention program of 30 hours per week.25”

    From Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play (2012) · cites this paper as [25]

  • Both of the comprehensive intervention programs (Early Start Denver Model and UCLA/Lovaas model) and the 4 targeted interventions (focusing on social communication or imitation skills) exhibited significantly improved outcomes relative to comparison groups after therapeutic durations of 8 weeks to 2 to 3 years.

    “both of the comprehensive intervention programs (Early Start Denver Model [ESDM] and the UCLA/Lovaas model) and the 4 targeted interventions (focusing on social communication or imitation skills) exhibited significantly improved outcomes relative to comparison groups after therapeutic durations of 8 weeks to 2 to 3 years.”

    From Early Intervention for Children With Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research (2015) · cites this paper as [32]

  • Several of the 6 studies reported effect sizes: large effect sizes after 6 and 8 weeks of therapy for increases in joint attention skills, a moderate effect size after 12 months for expressive language growth, and small effect sizes after 13 months for parent-child interaction measures.

    “Several of the 6 studies reported effect sizes: large effect sizes after 6 and 8 weeks of therapy for increases in joint attention skills, 20 , 32 a moderate effect size after 12 months for expressive language growth, 33 and small effect sizes after 13 months for parent–child interaction measures. 18”

    From Early Intervention for Children With Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research (2015) · cites this paper as [32]

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Authors
Kasari, C., Freeman, S., & Paparella, T.
Affiliations
University of California, Los Angeles (US)
Corresponding author
Kasari, Connie
ORCID
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2006-04-26
Volume
47
Issue
6
Pages
611-620
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
DOI
10.1111/j.1469-7610.2005.01567.x
OpenAlex
W2143287186
Cited by
951
References
39
Citations by year
2026: 37 · 2025: 38 · 2024: 42 · 2023: 42 · 2022: 50 · 2021: 71 · 2020: 64 · 2019: 68 · 2018: 53 · 2017: 43 · 2016: 58 · 2015: 51 · 2014: 55 · 2013: 57 · 2012: 51
FWCI
7.78
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD035470)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Keywords
autism spectrum disorder, joint attention, pretend play, early intervention, young children, mother-child interaction, play skills, intervention efficacy
MeSH terms
Adult, Attention, Autistic Disorder, Child, Child, Preschool, Communication, Female, Humans, Interpersonal Relations, Male, Play and Playthings, Social Behavior, Symbolism, Caregivers

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