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Joint Attention

Joint Attention. A definition of Joint Attention (JA). “Two people actively sharing attention with respect to an object or event and monitoring each other’s attention to that object or event” (Jones & Carr, 2004, p.13)

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Joint Attention

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  1. Joint Attention

  2. A definition of Joint Attention (JA) • “Two people actively sharing attention with respect to an object or event and monitoring each other’s attention to that object or event” (Jones & Carr, 2004, p.13) • Example: Kitten runs into the room and 3-year-old girl smiles and then looks at her mother and points at the cat • Other terms for JA: • Joint visual attention • Commenting • Indicating • Social referencing • Gaze following • Monitoring • Protodeclaratives • Protoimperatives • Coordinated joint engagement • NOT the same thing as joint control

  3. Holth (2005) • Research on Joint Attention (JA) has been conducted primarly by cognitive/developmental psychologist • Has focused on typically-developing children • Emergence of JA skills • How JA skills are related to development of other skills • Many have thought that JA can’t be taught • Not much attention from behavior analysts (or others working in the field of autism tx) • Strange b/c JA deficit is defining characteristic of autism • Recent calls for BAs to develop interventions! • Outcome studies should report measures of JA skills • JA may be linked to the development of other skills (pivotal? cusp?)

  4. Development of JA(Jones & Carr, 2004) • Develops about the end of 1st year – 2 forms: • Responding to another person’s directive attention – develops at end of 1st year • At 12-14 months, infants begin to “check back” and look at the person after first looking at the object • Initiating attention of another person to the object or event • Gaze shifts between object and familiar person • Adults usually respond by labeling object or event • Later combined with gestures, verbalizations, pointing, reaching, showing • By the middle of the 2nd year, joint attention is well-developed

  5. JA and Autism (Jones & Carr, 2004) • Some researchers say that deficits in JA are the earliest indicators of autism • Can be detected before 1 year old • Infant screening measures for autism (e.g., CHAT) include assessments of JA • Compared with children with MR and language delays matched for developmental level, only children with autism show deficits in JA • One of the DSM-IV criteria for autism: “a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)” • By comparison, using gestures and eye gaze to request objects is “relatively unimpaired”

  6. JA and Autism (Jones & Carr, 2004) • Joint attention may be important to the development of language because… • Language is learned in the context of joint attention interactions • Early in the 2nd year, when children hear a novel word, they look at the adult and then at the object the adult is looking at • If a child with autism doesn’t do this, he may not learn from this interaction at all or may look at the wrong object

  7. Operant Analysis of JAHolth (2005) • Gaze Following • Lower-level responding - Orienting head and eyes toward someone else • Higher-level responding – Following someone’s line of regard to the object or event • Adult’s gaze in a direction is an SD for looking in same direction • Interesting/novel/irregular activity or object reinforces following adult’s gaze SD: Adult points or touches something Reinforcer? Child orients head and eye toward adult’s face or pointing finger SΔ: Adult not pointing or touching No reinforcer

  8. Operant Analysis of JAHolth (2005) • Protodeclarative – Tact? Interesting object Child looks at mom Child points Child says “cat!” SR+: Mom looks and gives attention

  9. Holth (2005) • Visual orienting of one person is under discriminative control of pointing/visual orientation of other person • This control may be conditional upon other stimuli • Gaze following may be more likely when someone says, “look” or you have just asked for directions • The direction of the person’s gaze and the interesting object may jointly control looking at the object • Small changes in another person’s gaze may function to reinforce the pointer’s responding; sight of novel stimulus may reinforce continuing to look at object • Pointing to something and looking when someone else points may be conditioned reinforcers because other behavior (e.g., verbal behavior) is likely to be reinforced in that situation • A limited number of exemplars may be sufficient for learning this skill

  10. A Model for Assessing JA(MacDonald et al., 2006) • Participants ages 2-4 • 26 children with autism/PDD-NOS • 21 TD children • JA Responding Tests – Measured orientation in direction of examiner’s point • Following a point to pictures in a book • Following a point to items around the room • JA Initiating Tests - Measured gaze shift, gestures, vocalizations • Toy Activation Task: Bear • Book Presentation Task • Toy Activation Task: Elephant

  11. Joint Attention Responding Results

  12. Joint Attention Initiation Results About ½ of children didn’t initiate at all

  13. Interventions for JA(Jones & Carr, 2004) • JA seems important goal for EI, but there’s relatively little research to guide a program for teaching it to children with autism • Some procedures used in the literature • Introducing silly, out of place events/objects into normal routines to evoke a response • Teacher puts high preference item and face in line of vision to evoke gaze responses • Teaching child to point to/show something to someone else and say, “look” • Limitation: these procedures teach a response, but do not necessarily teach the child that social interactions are interesting (reinforcing)

  14. Establishing Nodding and Smiling as Reinforcers(Holth, 2005)

  15. Establishing Monitoring(Holth, 2005)

  16. Establishing Gaze or Point Following(Holth, 2005) • Recall Weiss and Harris (2001) • Teach by having person hold it and look at it • Then touching it & looking • Then reaching toward & looking • Fade reaching prompt

  17. Establishing Mands with JA(Holth, 2005)

  18. Establishing Tacts with JA(Holth, 2005)

  19. Jones and Carr (2004): PRT Model for Teaching JACould remediating the deficit in JA result in improvements in language and social skills (without specific training in those areas)? • Establishing the presence of adults as generalized reinforcers • Adult presents a variety of highly preferred items repeatedly over time • Once the child seeks proximity to the adult… • Using child choice • When teaching JA, let child choose items to be used in teaching • Use items that are salient (e.g., move, light up) • Use a variety of items and incorporate novel items • Natural consequences • Natural consequence for JA initiation is a social interaction about the object • Deliver idiosyncratic attention (e.g., loud “wow”, funny face, high-amplitude tickles) • Activity interspersal • Interspersing easy tasks with difficult tasks has been shown to increase acquisition of difficult tasks • They recommend using playing with the preferred item as the easy task

  20. Jones, Carr, and Feely (2006)Study 1 • Participants • 5 children ages 2-3 with PDD/NOS, autism, or “likely autism-spectrum disorder” • Purpose – evaluate effectiveness of discrete trial + PRT in teaching JA initiations and responding • Method • Rotated use of a large number of high-preference, activation toys • Design: MB Probe Design across behaviors (initiating & responding) • Conditions…

  21. JA Responding Procedures

  22. JA Initiating Procedures

  23. Social Validity Assessment

  24. References • Dube, W.V., MacDonald, R.P.F., Mansfield, R.C., Holcomb, W.L., & Ahearn, W.H. (2004). Toward a behavioral analysis of joint attention. The Behavior Analyst, 27, 197-207. • Holth, P. (2005). An operant analysis of joint attention skills. Journal of Early and Intensive Behavior Intervention, 2, 160-175. • Jones, E.A., & Carr, E.G. (2004). Joint attention in children with autism: Theory and intervention. Focus on Autism and Other Developmental Disabilities, 19, 13-26. • Jones, E.A., Carr, E.G., & Feeley, K.A. (2006). Multiple effects of joint attention intervention for children with autism. Behavior Modification, 30, 782-834. • MacDonald, R., Anderson, J., Dube, W.V., Geckeler, A., Green, G., Holcomb, W., Mansfield, R., Sanchez, J. (2004). Behavioral assessment of joint attention: A methodological report. Research in Developmental Disabilities, 27, 138-150.

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