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Joint attention skills in infants and toddlers: What is it and why does it matter for development?

Joint attention skills in infants and toddlers: What is it and why does it matter for development?. A. Rebecca Neal, Ph.D. University of Texas at Austin. Brown Center for the Study of Infants at Risk Barry Lester Steven Sheinkopf Lyn LaGasse Jiu Ling Brenda Salley Dennis Daniel

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Joint attention skills in infants and toddlers: What is it and why does it matter for development?

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  1. Joint attention skills in infants and toddlers: What is it and why does it matter for development? A. Rebecca Neal, Ph.D. University of Texas at Austin

  2. Brown Center for the Study of Infants at Risk Barry Lester Steven Sheinkopf Lyn LaGasse Jiu Ling Brenda Salley Dennis Daniel Ashley Johnson UC Davis MIND Institute Peter Mundy NYU Child Study Center C. Francoise Acra Marquette University Amy Vaughan VanHecke University of Texas at Austin Bridget Gamber Larissa D’Abreu Jessie Raye Bodenhamer An army of undergraduate RAs Acknowledgements

  3. Program of Research Identifying early markers of developmental delay Developmental Processes (Joint Attention, Regulation) Methodology Applications Diverse Populations (At-risk, autism, DD, ND)

  4. Nonverbal Communication • Infants develop the ability to coordinate their attention with others regarding an object or event between 6 and 18 months. • These behaviors serve two distinct functions: • Protodeclaratives → Joint Attention • Protoimperatives → Requesting

  5. Joint Attention • Joint attention emerges at 6 months and is well-developed by 18 months. • Initiating joint attention (IJA) → involves child-initiated episodes of joint attention. • Responding to joint attention (RJA) → reflects this child’s capacity to follow the attention of a social partner.

  6. Initiating Joint Attention (IJA) IJA is demonstrated by the coordination of attention around an object or event through eye contact, pointing, or showing.

  7. Responding to Joint Attention (RJA) Indicated by the child shifting gaze or turning their head in the same direction as the examiner (Mundy et al, 1996).

  8. Theoretical Links • Social Learning Opportunities • Social Cognition: • Representational CapacityIntentionality Intersubjectivity • Executive Function Language & Cognitive Capacity Joint Attention

  9. Theoretical Links • Social Learning Opportunities • Social Cognition: • Representational CapacityIntentionality Intersubjectivity • Executive Function Language & Cognitive Capacity Joint Attention

  10. Research Findings • Previous research has found significant associations between individual differences in development of IJA and RJA and cognitive and language outcome in typically-developing infants (Morales, Mundy, & Rojas, 1998; Morales, Mundy, Fullmer, Yale, Neal & Schwartz, submitted; Mundy & Gomes, 1998; Tomasello & Farrar, 1986; however, see Rollins, Marchman, & Mehta, 1998), high-risk infants (Smith, Fagan & Ulvund, 1997; Ulvund & Smith, 1996) and atypica children (Harris, Kasari, & Sigman, 1996; Mundy, Sigman, & Kasari, 1994). • However, • Small number of data sets • Small sample size • Concurrent or short-term prediction

  11. Joint Attention & Prenatal Cocaine Exposure • .3%-30% prevalence of exposure to cocaine. • Concern for “Crack Babies” yielded funding initiatives for several large longitudinal studies. • Results of these studies suggest a complicated developmental prognosis. • Confounded by exposure to other substances & maladaptive environmental factors. • Subtle effects • Sleeper effects?

  12. Participants • 81, prenatally cocaine-exposed infants who were enrolled at the Linda Ray Intervention Center from birth to age 3 • Gender: 45% male, 55% female • Ethnicity: 72% African-American, 9% Bi-racial, 8% Anglo, 8% Hispanic, 3% Haitian • Birthweight range = 710g-4360g (mean = 2774g, sd = 706g) • Public Aid: 78% Full, 10% Partial, 12% None 1-R01-HD28052 & 1 KD1 SP08984; Neal, Mundy, Claussen, Malik, Scott, & Acra (under review).

  13. Measures • Joint Attention (12 and 18 months) • Early Social-Communication Scales (ESCS) • Language Outcome (24 months) • Reynell Developmental Language Scales, expressive and receptive language • Cognitive Outcome (36 months) • Bayley Scales of Infant Development - II • Covariates • Initial cognitive status, birthweight(g), public aid, intervention group

  14. Descriptive Data: Predictor & Outcome Variables

  15. Hypothesis 1 • Initiating and responding to joint attention at 12 and 18 months will be positively associated with language outcome at 24 months and cognitive outcome at 36 months. • Semi-partial correlational coefficients were calculated for IJA/RJA and outcome. MDI_36; r = .207, p = .03 MDI_36; r = .207, p = .03

  16. Results: Hypothesis 1 • Correlations: • RJA_18 was positively associated with cognitive (r = .29, p < .01), expressive language (r = .29, p < .01), and receptive language outcome (r = .32, p < .01). • IJA_12 was negatively associated with cognitive outcome (r = -.31, p < .01).

  17. Hypothesis 2 • Initiating and responding to joint attention at 12 and 18 months will provide incremental validity in the prediction of language and cognitive outcome. • Hierarchical regression analyses were conducted: • Step 1: BW, Public Aid, Intervention, initial cognitive status • Step 2: IJA at 12 mos and RJA at 18 mos

  18. Prediction to Outcome

  19. Discussion: JA Predicted Findings • Responding to joint attention at 18 months was positively associated with cognitive, receptive language, and expressive language outcome. • RJA at 18 months added incremental validity in the prediction of cognitive outcome in at-risk infants.

  20. Discussion: JA Unexpected Findings • Initiating joint attention (IJA) at 12 months added incremental validity in the prediction of cognitive outcome in at-risk infants (in the negative direction). • Explanations? • Social monitoring vs. social sharing • The contribution of fear, social approace and regulatory control

  21. Joint Attention in the Maternal Lifestyles Study (MLS) • MLS is a 4 site study (Brown University, University of Miami, University of Tennessee-Memphis, Wayne State University) • n = 1,388 (658 cocaine-exposed, 730 comparison) • Groups were matched on gender, gestation, and race. • The exposed group included cocaine and/or opiate use. Exposure status was determined by self-report and/or meconium toxicology. • Background substances associated with cocaine and opiate use (alcohol, marijuana, and tobacco) included in both groups.

  22. Participants • n = 1065 (opiates & missing mastery motivation excluded) • 441 cocaine-exposed, 624 non-exposed • Gender: 48% male, 52% female • Race/Ethnicity: 79% African-American, 21% Caucasian, 6% Hispanic* • Birthweight mean = 2639g, sd = 821g (range 519g-4880g) • Hollingshead SES mean = 3.62, sd = 1.04 (1-R03-DA017985; Neal, Lester, Sheinkopf, et al., in preparation)

  23. Measures • Joint Attention • Adapted ESCS coding scheme to coded extant videotape data at 12 & 18 mos. • 1801 videotapes were coded. • Coding yielded frequency data for high level and low level IJA at 12 and 18 months • Strong Reliability: • Inter-rater reliability (rICC=.90-94) • Intra-rater reliability range ( rICC=.89-.97)

  24. Measures: Language Outcome • Sequenced Inventory of Communicative Development (SICD) at 30 months • Receptive Language age mean = 25.45, sd = 4.04 • Expressive Language age mean = 27.42, sd = 4.58 • Developmental Inventories for the Assessment of Learning, Revised (DIAL-R) at 48 months. • Language Score mean = 96.01, sd = 13.83

  25. Measures: Cognitive Outcome • Bayley Scales of Infant Development, Second Edition (Bayley-II) at 36 months • Bayley-II DQ (mean = 82.71 , sd = 12.67) • Wechsler Preschool Primary Scales of Intelligence, Revised (WPPSI-R) at 54 months • WPPSI-R FSIQ (mean = 81.17, sd = 13.75) • WPPSI-R VIQ (mean = 82.43, sd = 13.18) • WPPSI-R PIQ (mean = 83.42, sd = 14.23)

  26. Measures: Covariates • Site • Birthweight (g) • Hollingshead SES • Exposure other substances: • tobacco (48%), alcohol (59%), marijuana (25%) • Maternal IQ via the PPVT • mean = 73.44, sd = 17.16

  27. Specific Aim 1 • To test for cocaine effects on joint attention skill development at 12 and 18 months with adjustment for covariates. • Mixed-plot analyses to examine a possible main effect of cocaine, as well as a possible interaction between cocaine & time.

  28. Low Level IJA

  29. High Level IJA

  30. Specific Aim 2 • To examine the predictive validity of 12 and 18 months joint attention skill development in the prediction of language outcome (2½ and 4 years) and cognitive outcome (3 and 4½ years) in the cocaine-exposed and comparison infants with adjustment for covariates. • Hierarchical Regression: Step 1: Site, BW, SES, Maternal IQ, substance exposure Step 2: Low and High IJA at each age.

  31. IJA 12 to Language Outcome

  32. IJA 12 to Cognitive Outcome

  33. IJA 18 to Language Outcome

  34. IJA 18 to Cognitive Outcome

  35. Summary • High Level joint attention behaviors at 12 and 18 months added unique information in the prediction of: • language scores at 2½ and 4 years. • cognitive scores at age 3 and 4½. above and beyond birthweight, SES, maternal IQ, and exposure to drugs. • Cocaine effects on growth in high level joint attention behaviors from 12 to 18 months

  36. Child & Maternal Characeristics Developmental Processes (Joint Attention, Regulation) Methodology Applications Diverse Populations (At-risk, autism, DD, ND)

  37. Visual attention, positive engagement & IJA • n= 1065 infants enrolled in the MLS study • NICU Network Neurobehavioral Scale (NNNS, Lester & Tronick, 1993) at 1 month • Face-to-face still face task with mother (Tronick, Als, Adamson, Wise, & Brazleton, 1978) at 4 months • IJA coded from mastery motivation paradigm at 12 and 18 months Salley, Sheinkopf, Neal et al. (2012; in preparation)

  38. Results • Hierarchical regression analyses revealed • Higher levels of visual attention at 1 month significantly predicted more frequent IJA at 12 months. • Higher levels of attention to animate objects at 1 month predicted a higher proportion of 4-month positive social engagement • Greater 4-month positive social engagement predicted more frequent IJA at 18 months Salley, Sheinkopf, Neal et al. (2012; in preparation)

  39. Implications • This provides evidence to support theories of joint attention as a social cognitive process. • Joint attention skill development, in this high risk sample, may be influenced by individual differences in visual attention (cognitive/regulatory capacity) and tendency toward social approach. Salley, Sheinkopf, Neal et al. (2012; in preparation)

  40. Synchrony & Sensitivity • Maternal synchrony is the degree to which a mother follows or redirects her child’s focus of attention and action during play (Siller & Sigman, 2002). • Maternal sensitivity reflects the emotional qualities of the child-caregiver interaction including maternal sensitivity, maternal non intrusiveness, and maternal involvement while taken in the context of child responsiveness (Biringen & Robison, 1991)

  41. Synchrony & Sensitivity • Participantsincluded 20 mother-toddler dyads • 12 boys, 8 girls • Mage= 32.71 mos (sd 1.81) • Method • Early Social Communication Scale (IJA, RJA) • 15-minute unstructured play session • Emotional Availability Scales, 3rd Ed. (Sensitivity) • Dyadic synchrony (Siller & Sigman, 2002)

  42. Gamber, Neal,& Stefanatos, 2012

  43. Implications • Synchrony & sensitivity may be relatively distinct constructs • Each may contribute separately to the development of joint attention in infants • However, these data reflect joint attention skills development at mastery. • Do synchrony and sensitivity predict individual differences in JA during development?

  44. Current studies • 100 infants • 2 Sites (UT Austin, University of Miami) • Unstructured play and ESCS at 9, 12, 15, 18, and 24 months of age • Preliminary data (n=18) suggest positive associations between maternal synchrony and growth in IJA between 9 & 12 months

  45. Implications • Growth in JA between 9 and 12 months is affected by the extent to which mothers follow their infant’s focus during play. • Maternal verbalizations contingent upon the child’s interest may promote IJA development; however, it may undermine RJA development. • This may have implications for promoting adaptive communication-learning environments.

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