The Collateral Effects of Joint Attention Training on Social Initiations, Positive Affect, Imitation, and Spontaneous Speech for Young Children with Autism

  • Christina WhalenEmail author
  • Laura Schreibman
  • Brooke Ingersoll


Joint attention may be a core deficit in autism which underlies the abnormal development of later emerging social-communication behaviors. Given this theory, researchers have suggested that teaching young children with autism to engage in joint attention may lead to collateral increases in other non-targeted social-communication behaviors. In this study, children with autism participated in a 10-week joint attention training program and collateral changes in non-targeted behaviors were assessed. Following participation in the intervention, positive collateral changes were observed in social initiations, positive affect, imitation, play, and spontaneous speech. Results support the hypothesis that teaching joint attention skills leads to improvement in a variety of related skills and have implications for the treatment of young children with autism.


Joint attention Language Social skills Play Imitation 



This research was funded in part from support by U.S. Public Health Grant No. MH39434 from the National Institute of Mental Health. This paper was also supported by a center grant from the National Institute of Mental Health No. U54MH066399, which is part of the NIH STAART Centers Program. We are grateful to all of the families who participated in this research. We also are appreciative of the undergraduate research assistants who helped in the implementation of this study.


  1. Adamson, L., & McArthur, D. (1995). Joint attention, affect, and culture. In C. Moore, & P. Dunham (Eds.), Joint attention: Its origins and role in development (pp. 205–221). Hillsdale, NJ: Erlbaum.Google Scholar
  2. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  3. Baron-Cohen, S. (1987). Autism and symbolic play. British Journal of Developmental Psychology, 5, 139–148.Google Scholar
  4. Baron-Cohen, S. (1995). Mindblindness: An essay on autism and theory of mind. Cambridge, MA: MIT Press.Google Scholar
  5. Bates, E., Benigni, L., Bretherton, I., Camaioni, L., & Volterra, V. (1979). The emergence of symbols: Cognition and communication in infancy. New York: Academic Press.Google Scholar
  6. Bayley, N. (1993). Bayley infant scales of development (2nd ed.). San Antonio, TX: Harcourt Brace & Co.Google Scholar
  7. Bieberich, A. A., & Morgan, S. B. (1998). Affective expression in children with autism or Down syndrome. Journal of Autism and Developmental Disorders, 4, 333–338.CrossRefGoogle Scholar
  8. Bruner, J. (1974). The ontogenesis of speech acts. Journal of Child Language, 2, 1–19.Google Scholar
  9. Charman, T., Swettenham, J., Baron-Cohen, S., Cox, A., Baird, G., & Drew, A. (1997). Infants with autism: An investigation of empathy, pretend play, joint attention, and imitation. Developmental Psychology, 33, 781–789.PubMedCrossRefGoogle Scholar
  10. Fenson, L., Dale, P. S., Reznick, J. S., Thal, D., Bates, E., Hartung, J. P., Pethick, S., & Reilly, J. S. (1993). MacArthur communicative development inventories. San Diego, CA: Singular Publishing Group, Inc.Google Scholar
  11. Gilliam, J. E. (1995). Gilliam autism rating scale. Austin, TX: Pro-Ed.Google Scholar
  12. Joseph, R. M., & Tager-Flusberg, H. (1997). An investigation of attention and affect in children with autism and Down syndrome. Journal of Autism and Developmental Disorders, 4, 385–396.CrossRefGoogle Scholar
  13. Kamps, D. M., Leonard, B. R., Versnon, S., Dugan, E. P., Delquadri, J. C., Gershon, B., Wade, L., & Folk, L. (1992). Teaching social skills to students with autism to increase peer interactions in an integrated first-grade classroom. Journal of Applied Behavior Analysis, 25(2), 281–288.CrossRefGoogle Scholar
  14. Kanner, L. (1943). Autistic disturbances of affective content. The Nervous Child, 2, 217–250.Google Scholar
  15. Kasari, C., Freeman, S., & Paparella, T. (2001). Early intervention in autism: Joint attention and symbolic play. In L. M. Glidden (Ed.), International review of research on mental retardation. New York: Academic Press.Google Scholar
  16. Kasari, C., Sigman, M., Mundy, P., & Yirmiya, N. (1990). Affective sharing in the context of joint attention interactions of normal, autistic, and mentally retarded children. Journal of Autism and Developmental Disorders, 20, 87–99.PubMedCrossRefGoogle Scholar
  17. Kazdin, A. E. (1973). Methodological and assessment considerations in evaluating reinforcement programs in applied settings. Journal of Applied Behavior Analysis, 6, 517–531.PubMedCrossRefGoogle Scholar
  18. Koegel, R. L., Koegel, K. L., & Schreibman, L. (1991). Assessing and training parents in teaching pivotal behaviors. In R. J. Prinz (Ed.), Advances in behavioral assessment of children and families (pp. 65–82). Greenwich, CT: JAI Press.Google Scholar
  19. Koegel, R. L., O’Dell, M. C., & Koegel, L. K. (1987). A natural language teaching paradigm for nonverbal autistic children. Journal of Autism and Developmental Disorders, 17, 187–200.PubMedCrossRefGoogle Scholar
  20. Koegel, R. L., Schreibman, L., Good, A., Cerniglia, L., Murphy, C., & Koegel, L. (1989). Howto teach pivotal behaviors to children with autism: A training manual. Santa Barbara: University of California.Google Scholar
  21. Lewy, A., & Dawson, G. (1992). Social stimulation and joint attention in young autisticchildren. Journal of Abnormal Child Psychology, 20, 555–566.PubMedCrossRefGoogle Scholar
  22. Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.PubMedCrossRefGoogle Scholar
  23. Loveland, K., & Landry, S. (1986). Joint attention and language in autism and developmental language delay. Journal of Autism and Developmental Disorders, 16, 335–349.PubMedCrossRefGoogle Scholar
  24. Maurice, C., Green, G., & Luce, S. C. (Eds.). (1996). Behavioral intervention for young children with autism: A manual for parents and professionals. Austin, TX, US: PRO-ED, Inc.Google Scholar
  25. Meltzoff, A. N., & Moore, M. (1994). Imitation, memory, and the representation of persons. Infant Behavior and Development, 17, 83–99.CrossRefGoogle Scholar
  26. Mundy, P. (1995). Joint attention and social-emotional approach behavior in children with autism. Development and Psychopathology, 7, 63–82.CrossRefGoogle Scholar
  27. Mundy, P., & Crowson, M. (1997). Joint attention and early social communication: Implications for research on intervention with autism. Journal of Autism and Developmental Disorders, 27, 653–676.PubMedCrossRefGoogle Scholar
  28. Mundy, P., & Gomes, A. (1998). Individual differences in joint attention skill development in the second year. Infant Behavior and Development, 21, 469–482.CrossRefGoogle Scholar
  29. Mundy, P., & Hogan, A. (1994). Intersubjectivity, joint attention, and autistic developmental pathology. In D. Cicchetti, & S. L. Toth (Eds.), Disorders and dysfunctions of the self. Rochester symposium on developmental psychopathology (Vol. 5, pp. 1–30). Rochester, NY: University of Rochester Press.Google Scholar
  30. Mundy, P., & Sigman, M. (1989). The theoretical implications of joint attention deficits in autism. Development and Psychopathology, 7, 63–82.CrossRefGoogle Scholar
  31. Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. Journal of Autism and Developmental Disorders, 20, 115–128.PubMedCrossRefGoogle Scholar
  32. Mundy, P., Sigman, M., Ungerer, J., & Sherman, T. (1996). Defining the social deficits of autism: The contribution of nonverbal communication measures. Journal of Child Psychology and Psychiatry, 27, 657–669.CrossRefGoogle Scholar
  33. Pierce, K., & Schreibman, L. (1995). Increasing complex social behaviors in children with autism: Effects of peer-implemented pivotal response training. Journal of Applied Behavior Analysis, 28(3), 285–295.CrossRefGoogle Scholar
  34. Rocha, M., Sherer, M., Paredes, S., & Schreibman, L. (1999). The progression of joint attention behaviors in children with autism. Poster Presentation: Chicago, IL: Association for Behavior Analysis.Google Scholar
  35. Ruskin, E., Kasari, C., Mundy, P., & Sigman, M. (1994). Attention to people and toys during social and object mastery in children with Down syndrome. American Journal on Mental Retardation, 99(1), 103–111.PubMedGoogle Scholar
  36. Schopler, E., Reichler, R. J., DeVellis, R. F., & Daly, K. (1980). Toward object classification of childhood autism: Childhood Autism Rating Scale (CARS). Journal of Autism and Developmental Disorders, 10, 91–103.PubMedCrossRefGoogle Scholar
  37. Seibert, J. M., & Hogan, A. E. (1982). Procedures manual for Early Social Communication Scales (ECSC). University of Miami, FL: Mailman Center for Child Development.Google Scholar
  38. Sigman, M. (1998). Change and continuity in the development of children with autism. Journal of Child Psychology and Psychiatry & Allied Disciplines, 39, 817–827.CrossRefGoogle Scholar
  39. Sigman, M., & Capps, L. (1997). Children with autism: A developmental perspective. Cambridge, MA; London: Harvard University Press.Google Scholar
  40. Stahmer, A. C. (1999). Using pivotal response training to facilitate appropriate play in children with autism spectrum disorders. Child Language Teaching and Therapy, 15, 29–40.CrossRefGoogle Scholar
  41. Striano, T., & Rochat, P. (1999). Developmental link between dyadic and triadic social competence in infancy. British Journal of Developmental Psychology, 17(4), 551–562.CrossRefGoogle Scholar
  42. Whalen, C., & Schreibman, L. (2003). Joint attention training for children with autism using behavior modification procedures. Journal of Child Psychology and Psychiatry and Allied Disciplines, 44(3), 456–468.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Christina Whalen
    • 1
    • 4
    Email author
  • Laura Schreibman
    • 2
  • Brooke Ingersoll
    • 3
    • 5
  1. 1.University of Washington Autism CenterSeattleUSA
  2. 2.Department of PsychologyUniversity of CaliforniaSan DiegoUSA
  3. 3.Oregon Health & Science UniversityPortlandUSA
  4. 4.SeattleUSA
  5. 5.Lewis and Clark CollegePortlandUSA

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