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Connie Kasari - One of the best experts on this subject based on the ideXlab platform.
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developmental screening and early intervention in a childcare setting for young children at risk for autism and other developmental delays a feasibility trial
Autism Research, 2019Co-Authors: Amanda C. Gulsrud, Wendy Shih, Themba Carr, Justin Williams, Jonathan Panganiban, Felica Jones, Jackie Kimbrough, Connie KasariAbstract:: Efforts to decrease disparity in diagnosis and treatment for under-resourced children with developmental delays, such as autism spectrum disorder, have led to increased interest in developing programs in community settings. One potential setting that has already demonstrated feasibility in conducting universal screening is the childcare setting. The current study conducted developmental screening in a total of 116 children ages 16-80 months of age in an urban low-income community childcare center. Parents of 20 children who screened positive were enrolled in the intervention phase of the study, where children received a staff-delivered targeted early intervention or a waitlist control condition. Given the small and imbalanced sample sizes, confidence intervals from mixed effect models were used to measure changes across time for each group. Of the children who received treatment, there was an average increase in child initiated Joint Engagement, symbolic play, and language use. This study provides initial feasibility data for the implementation of a screening and early intervention program to service a predominantly low-resource and ethnically diverse population within the childcare system in a large metropolitan city. Autism Res 2019, 12: 1423-1433. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Identifying and delivering treatment services for young children with developmental delays, such as autism spectrum disorder, may be most successful in community settings, especially for those children from under-resourced areas. This study found preliminary evidence that the childcare setting is a good place to conduct screening and deliver early interventions for children at risk for autism and other developmental delays.
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early interaction in autism spectrum disorder mothers and children s behaviours during Joint Engagement
Child Care Health and Development, 2018Co-Authors: Lars Smith, Anett Kaale, Anders Nordahlhansen, Morten W Fagerland, Connie KasariAbstract:Background More knowledge about the interaction between young children with autism spectrum disorder and their parents is one way to improve intervention. This study aims to investigate the behaviours of mothers and children with autism spectrum disorder during Joint Engagement, with a focus on pacing or rate (i.e., incidences per minute) of their behaviours when being in this state. Method Video recordings of 10 min of free-play between 58 children (2–4 years) diagnosed with childhood autism and their mothers were used to examine rate of mothers' and children's behaviours (i.e., toy introduction, toy expansion, positive affect, and language) during Joint Engagement, the association between rate of mothers and children's behaviours, the relation between rate of mothers' behaviours and time in Joint Engagement, and how child factors might be associated with the latter. Results Mothers(m) and children(c) showed similar rate of positive affect (Mm = 0.6/Mc = 0.5) and toy expansion (Mm = 0.7/Mc = 0.7) per minute, whereas mothers talked almost three times more than their children (Mm = 10.2/Mc = 3.8). In contrast, mothers introduced fewer toys compared to the children (Mm = 0.7/Mc = 1.2). Rate of mothers' toy introduction, toy expansion, and positive affect was inversely related to time in Joint Engagement (Regression coefficient = −70.7 to −48.5, p = .006 to .024). Rates of mothers' and children's behaviours were associated (Spearman rank order coefficient = .53 to .29, p < .001 to .03), but neither rate of children's behaviours nor mental age was associated with the observed relation between rate of these maternal behaviours and time in Joint Engagement. Conclusion Time in Joint Engagement was related to rate of mothers' behaviours and children's mental age but not to rate of children's behaviours in this study. Thus, intervention teaching parents of young children with autism strategies designed to increase time in Joint Engagement may be vital. The complex nature of the interaction between mother and child behaviours in promoting Joint Engagement warrants further elucidation. Key messages Increased understanding of parent and child behaviours during Joint Engagement is important for identification of targets for parent-mediated early interventions in autism spectrum disorder. Time in Joint Engagement was related to rate of mothers' behaviours and children's mental age but not to rate of children's behaviours in this study. Higher rate of some maternal behaviours was inversely related to time in Joint Engagement, but it is not clear yet if higher rate may facilitate or disrupt Joint Engagement. The complex nature of the interaction between mother and child behaviours in promoting Joint Engagement warrants further elucidation.
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the relationship between treatment attendance adherence and outcome in a caregiver mediated intervention for low resourced families of young children with autism spectrum disorder
Autism, 2016Co-Authors: Themba Carr, Wendy Shih, Kathy Lawton, Catherine Lord, Bryan H King, Connie KasariAbstract:Rates of participation in intervention research have not been extensively studied within autism spectrum disorder. Such research is important given the benefit of early intervention on long-term prognosis for children with autism spectrum disorder. The goals of this study were to examine how family demographic factors predicted treatment attendance and adherence in a caregiver-mediated randomized controlled trial targeting core deficits of autism spectrum disorder, and whether treatment attendance and adherence predicted outcome. In all, 147 caregiver-child dyads from a low-resourced population were randomized to in-home caregiver-mediated module or group-based caregiver education module treatment. Treatment attendance, adherence, and outcome (time spent in Joint Engagement) were the primary outcome variables. The majority of families who entered treatment (N = 87) maintained good attendance. Attendance was significantly predicted by socioeconomic status, site, and treatment condition. Families in caregiver-mediated module reported lower levels of treatment adherence, which was significantly predicted by site, condition, caregiver stress, and child nonverbal intelligence quotient. Dyads in caregiver-mediated module had significantly longer interactions of Joint Engagement, which was significantly predicted by an interaction between treatment attendance and condition. Overall, the results from this study stress the importance of considering demographic variables in research design when considering barriers to treatment attendance and adherence.
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isolating active ingredients in a parent mediated social communication intervention for toddlers with autism spectrum disorder
Journal of Child Psychology and Psychiatry, 2016Co-Authors: Amanda C. Gulsrud, Connie Kasari, Stephanie Y Shire, Gerhard HellemannAbstract:Background Behavioral interventions are commonplace in the treatment of autism spectrum disorders, yet relatively little is known about how and why these interventions work. This study tests the relationship between isolated core components of a packaged social communication intervention and the primary outcome, Joint Engagement, to better understand how the intervention is affecting change in individuals. Methods A total of 86 toddlers and their parents were enrolled in the study and randomized to one of two treatments, the Joint attention, symbolic play, Engagement, and regulation (JASPER) parent-mediated intervention or a psychoeducational intervention. Measures regarding the parent's use of intervention strategies were collected before and after the 10-week intervention. Additional measures of child and parent Joint Engagement were also collected. Results A significant effect of treatment was found for all four of the core strategies of the intervention, favoring a larger increase in the JASPER condition. A hierarchical linear regression revealed several individual predictors of Joint Engagement, including parent-rated buy-in, interventionist-rated parent involvement, and parental use of strategies. To complement the hierarchical analysis, we also tested the potential mediating effect the strategies may have on the relationship between treatment and Joint Engagement. Results showed that the strategy of mirrored pacing mediated the relationship between treatment and Joint Engagement in the positive direction. Conclusions These results strongly suggest that the mirrored pacing strategy is an active ingredient of the JASPER treatment.
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increasing responsive parent child interactions and Joint Engagement comparing the influence of parent mediated intervention and parent psychoeducation
Journal of Autism and Developmental Disorders, 2016Co-Authors: Stephanie Y Shire, Amanda C. Gulsrud, Connie KasariAbstract:Enhancing immediate and contingent responding by caregivers to children's signals is an important strategy to support social interactions between caregivers and their children with autism. Yet, there has been limited examination of parents' responsive behaviour in association with children's social behaviour post caregiver-mediated intervention. Eighty-five dyads were randomized to one of two 10-week caregiver-training interventions. Parent-child play interactions were coded for parental responsivity and children's Joint Engagement. Significant gains in responsivity and time Jointly engaged were found post JASPER parent-mediated intervention over a psychoeducation intervention. Further, combining higher levels of responsive behaviour with greater adoption of intervention strategies was associated with greater time Jointly engaged. Findings encourage a focus on enhancing responsive behaviour in parent-mediated intervention models.
Anett Kaale - One of the best experts on this subject based on the ideXlab platform.
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early interaction in autism spectrum disorder mothers and children s behaviours during Joint Engagement
Child Care Health and Development, 2018Co-Authors: Lars Smith, Anett Kaale, Anders Nordahlhansen, Morten W Fagerland, Connie KasariAbstract:Background More knowledge about the interaction between young children with autism spectrum disorder and their parents is one way to improve intervention. This study aims to investigate the behaviours of mothers and children with autism spectrum disorder during Joint Engagement, with a focus on pacing or rate (i.e., incidences per minute) of their behaviours when being in this state. Method Video recordings of 10 min of free-play between 58 children (2–4 years) diagnosed with childhood autism and their mothers were used to examine rate of mothers' and children's behaviours (i.e., toy introduction, toy expansion, positive affect, and language) during Joint Engagement, the association between rate of mothers and children's behaviours, the relation between rate of mothers' behaviours and time in Joint Engagement, and how child factors might be associated with the latter. Results Mothers(m) and children(c) showed similar rate of positive affect (Mm = 0.6/Mc = 0.5) and toy expansion (Mm = 0.7/Mc = 0.7) per minute, whereas mothers talked almost three times more than their children (Mm = 10.2/Mc = 3.8). In contrast, mothers introduced fewer toys compared to the children (Mm = 0.7/Mc = 1.2). Rate of mothers' toy introduction, toy expansion, and positive affect was inversely related to time in Joint Engagement (Regression coefficient = −70.7 to −48.5, p = .006 to .024). Rates of mothers' and children's behaviours were associated (Spearman rank order coefficient = .53 to .29, p < .001 to .03), but neither rate of children's behaviours nor mental age was associated with the observed relation between rate of these maternal behaviours and time in Joint Engagement. Conclusion Time in Joint Engagement was related to rate of mothers' behaviours and children's mental age but not to rate of children's behaviours in this study. Thus, intervention teaching parents of young children with autism strategies designed to increase time in Joint Engagement may be vital. The complex nature of the interaction between mother and child behaviours in promoting Joint Engagement warrants further elucidation. Key messages Increased understanding of parent and child behaviours during Joint Engagement is important for identification of targets for parent-mediated early interventions in autism spectrum disorder. Time in Joint Engagement was related to rate of mothers' behaviours and children's mental age but not to rate of children's behaviours in this study. Higher rate of some maternal behaviours was inversely related to time in Joint Engagement, but it is not clear yet if higher rate may facilitate or disrupt Joint Engagement. The complex nature of the interaction between mother and child behaviours in promoting Joint Engagement warrants further elucidation.
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relations between specific and global outcome measures in a social communication intervention for children with autism spectrum disorder
Research in Autism Spectrum Disorders, 2016Co-Authors: Anders Nordahlhansen, Sue Fletcherwatson, Helen Mcconachie, Anett KaaleAbstract:Abstract Assessment of relevant outcomes is a key challenge in evaluating effects of social-communication interventions. However, few studies have investigated in what ways specific and more global measures may influence reported results of social-communication interventions for children with autism spectrum disorder (ASD). In this study both a specific and a global, more global autism symptom measure were used to assess effects of a brief social-communication intervention. Fifty-nine children (2–4 years) diagnosed with autistic disorder were assessed with the Joint Engagement (JE) states coding procedure and a preliminary version of the Brief Observation of Social Communication Change (BOSCC). A statistically significant difference was found between intervention and control groups from baseline to intervention endpoint on JE but not on BOSCC. Degree of change on the measures was moderately related, and both were independent of language level and non-verbal mental age. This study adds to the knowledge of what may be expected of different outcome measures and provides suggestions to how measures may be deployed to investigate underlying mechanisms and developmental pathways.
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a randomized controlled trial of preschool based Joint attention intervention for children with autism
Journal of Child Psychology and Psychiatry, 2012Co-Authors: Anett Kaale, Lars Smith, Eili SponheimAbstract:Background: Deficits in Joint attention (JA) and Joint Engagement (JE) represent a core problem in young children with autism as these affect language and social development. Studies of parent-mediated and specialist-mediated JA-intervention suggest that such intervention may be effective. However, there is little knowledge about the success of the intervention when done in preschools. Aim: Assess the effects of a preschool-based JA-intervention. Methods: 61 children (48 males) with autistic disorder (29‐60 months) were randomized to either 8 weeks of JA-intervention, in addition to their preschool programs (n = 34), or to preschool programs only (n = 27). The intervention was done by preschool teachers with weekly supervision by trained counselors from Child and Adolescent Mental Health Clinics (CAMHC). Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale (ESCS) and video taped preschool teacher‐child and mother‐ child play at baseline and post-intervention. Clinical trials registration: Clinicaltrials.gov: NCT00378157. Results: Intention-to-treat analysis showed significant difference between the intervention and the control group, with the intervention group yielding more JA initiation during interaction with the preschool teachers. The effect generalized to significantly longer duration of JE with the mothers. Conclusions: This is the first randomized study to show positive and generalized effects of preschool-based JA-intervention. Keywords: Autism, Joint attention, Joint Engagement, intervention, preschool, randomized controlled trial.
Amanda C. Gulsrud - One of the best experts on this subject based on the ideXlab platform.
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developmental screening and early intervention in a childcare setting for young children at risk for autism and other developmental delays a feasibility trial
Autism Research, 2019Co-Authors: Amanda C. Gulsrud, Wendy Shih, Themba Carr, Justin Williams, Jonathan Panganiban, Felica Jones, Jackie Kimbrough, Connie KasariAbstract:: Efforts to decrease disparity in diagnosis and treatment for under-resourced children with developmental delays, such as autism spectrum disorder, have led to increased interest in developing programs in community settings. One potential setting that has already demonstrated feasibility in conducting universal screening is the childcare setting. The current study conducted developmental screening in a total of 116 children ages 16-80 months of age in an urban low-income community childcare center. Parents of 20 children who screened positive were enrolled in the intervention phase of the study, where children received a staff-delivered targeted early intervention or a waitlist control condition. Given the small and imbalanced sample sizes, confidence intervals from mixed effect models were used to measure changes across time for each group. Of the children who received treatment, there was an average increase in child initiated Joint Engagement, symbolic play, and language use. This study provides initial feasibility data for the implementation of a screening and early intervention program to service a predominantly low-resource and ethnically diverse population within the childcare system in a large metropolitan city. Autism Res 2019, 12: 1423-1433. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Identifying and delivering treatment services for young children with developmental delays, such as autism spectrum disorder, may be most successful in community settings, especially for those children from under-resourced areas. This study found preliminary evidence that the childcare setting is a good place to conduct screening and deliver early interventions for children at risk for autism and other developmental delays.
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isolating active ingredients in a parent mediated social communication intervention for toddlers with autism spectrum disorder
Journal of Child Psychology and Psychiatry, 2016Co-Authors: Amanda C. Gulsrud, Connie Kasari, Stephanie Y Shire, Gerhard HellemannAbstract:Background Behavioral interventions are commonplace in the treatment of autism spectrum disorders, yet relatively little is known about how and why these interventions work. This study tests the relationship between isolated core components of a packaged social communication intervention and the primary outcome, Joint Engagement, to better understand how the intervention is affecting change in individuals. Methods A total of 86 toddlers and their parents were enrolled in the study and randomized to one of two treatments, the Joint attention, symbolic play, Engagement, and regulation (JASPER) parent-mediated intervention or a psychoeducational intervention. Measures regarding the parent's use of intervention strategies were collected before and after the 10-week intervention. Additional measures of child and parent Joint Engagement were also collected. Results A significant effect of treatment was found for all four of the core strategies of the intervention, favoring a larger increase in the JASPER condition. A hierarchical linear regression revealed several individual predictors of Joint Engagement, including parent-rated buy-in, interventionist-rated parent involvement, and parental use of strategies. To complement the hierarchical analysis, we also tested the potential mediating effect the strategies may have on the relationship between treatment and Joint Engagement. Results showed that the strategy of mirrored pacing mediated the relationship between treatment and Joint Engagement in the positive direction. Conclusions These results strongly suggest that the mirrored pacing strategy is an active ingredient of the JASPER treatment.
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increasing responsive parent child interactions and Joint Engagement comparing the influence of parent mediated intervention and parent psychoeducation
Journal of Autism and Developmental Disorders, 2016Co-Authors: Stephanie Y Shire, Amanda C. Gulsrud, Connie KasariAbstract:Enhancing immediate and contingent responding by caregivers to children's signals is an important strategy to support social interactions between caregivers and their children with autism. Yet, there has been limited examination of parents' responsive behaviour in association with children's social behaviour post caregiver-mediated intervention. Eighty-five dyads were randomized to one of two 10-week caregiver-training interventions. Parent-child play interactions were coded for parental responsivity and children's Joint Engagement. Significant gains in responsivity and time Jointly engaged were found post JASPER parent-mediated intervention over a psychoeducation intervention. Further, combining higher levels of responsive behaviour with greater adoption of intervention strategies was associated with greater time Jointly engaged. Findings encourage a focus on enhancing responsive behaviour in parent-mediated intervention models.
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the association between parental interaction style and children s Joint Engagement in families with toddlers with autism
Autism, 2014Co-Authors: Stephanie Y Patterson, Amanda C. Gulsrud, Lauren Elder, Connie KasariAbstract:Purpose:This study examines the relationship between parental interaction style (responsive vs directive) and child-initiated Joint Engagement within caregiver–child interactions with toddlers diagnosed with autism spectrum disorders.Method:Videotaped interactions of 85 toddler–caregiver dyads were coded for child Engagement and both parental responsiveness and directiveness.Results:Altogether, children spent less than one-third of the interaction Jointly engaged. After controlling for child characteristics, parental style was associated with the initiator (child or parent) of Joint Engagement. Specifically, responsiveness predicted total time in child-initiated Joint Engagement, while directiveness predicted total time in parent-initiated Joint Engagement. Children’s social behaviours were associated with child-initiated Joint Engagement.Discussion:Social initiations are a key target for children with autism spectrum disorders. Results demonstrate that child initiations and global social behaviour rating...
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Randomized Controlled Caregiver Mediated Joint Engagement Intervention for Toddlers with Autism
Journal of Autism and Developmental Disorders, 2010Co-Authors: Connie Kasari, Amanda C. Gulsrud, Connie Wong, Susan Kwon, Jill LockeAbstract:This study aimed to determine if a Joint attention intervention would result in greater Joint Engagement between caregivers and toddlers with autism. The intervention consisted of 24 caregiver-mediated sessions with follow-up 1 year later. Compared to caregivers and toddlers randomized to the waitlist control group the immediate treatment (IT) group made significant improvements in targeted areas of Joint Engagement. The IT group demonstrated significant improvements with medium to large effect sizes in their responsiveness to Joint attention and their diversity of functional play acts after the intervention with maintenance of these skills 1 year post-intervention. These are among the first randomized controlled data to suggest that short-term parent-mediated interventions can have important effects on core impairments in toddlers with autism. Clinical Trials #: NCT00065910.
Wendy Shih - One of the best experts on this subject based on the ideXlab platform.
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developmental screening and early intervention in a childcare setting for young children at risk for autism and other developmental delays a feasibility trial
Autism Research, 2019Co-Authors: Amanda C. Gulsrud, Wendy Shih, Themba Carr, Justin Williams, Jonathan Panganiban, Felica Jones, Jackie Kimbrough, Connie KasariAbstract:: Efforts to decrease disparity in diagnosis and treatment for under-resourced children with developmental delays, such as autism spectrum disorder, have led to increased interest in developing programs in community settings. One potential setting that has already demonstrated feasibility in conducting universal screening is the childcare setting. The current study conducted developmental screening in a total of 116 children ages 16-80 months of age in an urban low-income community childcare center. Parents of 20 children who screened positive were enrolled in the intervention phase of the study, where children received a staff-delivered targeted early intervention or a waitlist control condition. Given the small and imbalanced sample sizes, confidence intervals from mixed effect models were used to measure changes across time for each group. Of the children who received treatment, there was an average increase in child initiated Joint Engagement, symbolic play, and language use. This study provides initial feasibility data for the implementation of a screening and early intervention program to service a predominantly low-resource and ethnically diverse population within the childcare system in a large metropolitan city. Autism Res 2019, 12: 1423-1433. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Identifying and delivering treatment services for young children with developmental delays, such as autism spectrum disorder, may be most successful in community settings, especially for those children from under-resourced areas. This study found preliminary evidence that the childcare setting is a good place to conduct screening and deliver early interventions for children at risk for autism and other developmental delays.
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the relationship between treatment attendance adherence and outcome in a caregiver mediated intervention for low resourced families of young children with autism spectrum disorder
Autism, 2016Co-Authors: Themba Carr, Wendy Shih, Kathy Lawton, Catherine Lord, Bryan H King, Connie KasariAbstract:Rates of participation in intervention research have not been extensively studied within autism spectrum disorder. Such research is important given the benefit of early intervention on long-term prognosis for children with autism spectrum disorder. The goals of this study were to examine how family demographic factors predicted treatment attendance and adherence in a caregiver-mediated randomized controlled trial targeting core deficits of autism spectrum disorder, and whether treatment attendance and adherence predicted outcome. In all, 147 caregiver-child dyads from a low-resourced population were randomized to in-home caregiver-mediated module or group-based caregiver education module treatment. Treatment attendance, adherence, and outcome (time spent in Joint Engagement) were the primary outcome variables. The majority of families who entered treatment (N = 87) maintained good attendance. Attendance was significantly predicted by socioeconomic status, site, and treatment condition. Families in caregiver-mediated module reported lower levels of treatment adherence, which was significantly predicted by site, condition, caregiver stress, and child nonverbal intelligence quotient. Dyads in caregiver-mediated module had significantly longer interactions of Joint Engagement, which was significantly predicted by an interaction between treatment attendance and condition. Overall, the results from this study stress the importance of considering demographic variables in research design when considering barriers to treatment attendance and adherence.
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parents adoption of social communication intervention strategies families including children with autism spectrum disorder who are minimally verbal
Journal of Autism and Developmental Disorders, 2015Co-Authors: Stephanie Y Shire, Kelly Stickles Goods, Wendy Shih, Charlotte Distefano, Ann P Kaiser, Courtney Wright, Pamela Mathy, Rebecca Landa, Connie KasariAbstract:Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in Autism Res 6:468-478, 2013). Sixty-one children with autism age 5-8 with minimal spontaneous communication received a 6-month social communication intervention including parent training. Parent-child play interactions were coded for parents' strategy implementation and children's time Jointly engaged (Adamson et al. in J Autism Dev Disord 39:84-96, 2009). Parents mastered an average of 70% of the strategies. Further analyses indicated some gains in implementation occurred from mere observation of sessions, while the greatest gains occurred in the first month of active coaching and workshops. Children's Joint Engagement was associated with parents' implementation success across time demonstrating parents' implementation was relevant to children's social Engagement.
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caregiver mediated intervention for low resourced preschoolers with autism an rct
Pediatrics, 2014Co-Authors: Connie Kasari, Wendy Shih, Rebecca Landa, Kathy Lawton, Tyson V Barker, Catherine Lord, Felice Orlich, Bryan H King, Amy M Wetherby, Damla SenturkAbstract:OBJECTIVES: To compare 2 short-term, community caregiver training interventions for preschool-aged children with Autism Spectrum Disorder who had low resources. Low resource was defined by the US Department of Housing and Urban Development low-income index or 1 “indicator,” (eg, Medicaid eligibility). Child outcomes focused on Joint Engagement, Joint attention, and play. METHODS: Participants included 112 families of a child who had Autism Spectrum Disorder who met criteria for being low-resourced and who were randomly assigned to 1 of 2 3-month interventions, group caregiver education or individualized caregiver-mediated intervention (CMM). Children were assessed for social communication skills pre- and post-treatment, and followed up at 3 months. RESULTS: All children improved in Joint Engagement and initiating Joint attention, with significantly greater improvement by the CMM group. Outcomes on play skills were mixed, with improvement of symbolic play for the CMM group and no change in functional play skills. Joint Engagement maintained over time for the CMM group, and initiating Joint attention maintained for both groups over time. CONCLUSIONS: This study is among the first randomized trials comparing 2 active interventions with a large sample of low-resourced families. Results suggest improvements in core autism deficits of Joint Engagement, Joint attention, and symbolic play with relatively brief, caregiver-mediated interventions, but additional support is necessary to maintain and generalize these gains over time.
Lauren B Adamson - One of the best experts on this subject based on the ideXlab platform.
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an expanded view of Joint attention skill Engagement and language in typical development and autism
Child Development, 2019Co-Authors: Lauren B Adamson, Roger Bakeman, Katharine Suma, Diana L RobinsAbstract:This study provides an expanded view of Joint attention and its relation to expressive language development. A total of 144 toddlers (40 typically developing, 58 with autism spectrum disorder [ASD], 46 with developmental delay [DD]) participated at 24 and 31 months. Toddlers who screened positive for ASD risk, especially those subsequently diagnosed with ASD, had poorer Joint attention skills, Joint Engagement during parent-toddler interaction, and expressive language. Findings highlight the dynamic relation between Joint attention and language development. In the ASD and DD groups, Joint Engagement predicted later expressive vocabulary, significantly more than predictions based on Joint attention skills. Joint Engagement was most severely impacted when toddlers did not talk initially and improved markedly if they subsequently began to speak. [ABSTRACT FROM AUTHOR]
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from interactions to conversations the development of Joint Engagement during early childhood
Child Development, 2014Co-Authors: Lauren B Adamson, Roger Bakeman, Deborah F Deckner, Brooke P NelsonAbstract:This research traces the development of symbol-infused Joint Engagement during mother–child interactions into the preschool years. Forty-nine children, who had been previously observed as toddlers (L. B. Adamson, R. Bakeman, & D. F. Deckner, [Adamson, L. B., 2004]), were systematically observed during interactions with their mothers at ages 3½, 4½, and 5½ during activities related to the past and future, internal states, and graphic systems. Although the amount of symbol-infused Joint Engagement reached a ceiling by 3½, its focus continued to become more complex and its form more balanced. Individual differences in children's symbol-infused Joint Engagement were stable across 4 years. These findings highlight both how Joint Engagement is transformed as conversational skills develop and how it remains rooted in earlier interactions and supported by caregiver's actions.
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rating parent child interactions Joint Engagement communication dynamics and shared topics in autism down syndrome and typical development
Journal of Autism and Developmental Disorders, 2012Co-Authors: Lauren B Adamson, Roger Bakeman, Deborah F Deckner, Brooke P NelsonAbstract:A battery of 17 rating items were applied to video records of typically-developing toddlers and young children with autism and Down syndrome interacting with their parents during the Communication Play Protocol. This battery provided a reliable and broad view of the Joint Engagement triad of child, partner, and shared topic. Ratings of the child’s Joint Engagement correlated very strongly with state coding of Joint Engagement and replicated the finding that coordinated Joint Engagement was less likely in children with autism. Ratings of other child actions, of parent contributions, and of shared topics and communicative dynamics also documented pervasive variations related to diagnosis, language facility, and communicative context.
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Joint Engagement and the emergence of language in children with autism and down syndrome
Journal of Autism and Developmental Disorders, 2009Co-Authors: Lauren B Adamson, Roger Bakeman, Deborah F Deckner, Mary Ann RomskiAbstract:Systematic longitudinal observations were made as typically developing toddlers and young children with autism and with Down syndrome interacted with their caregivers in order to document how Joint Engagement developed over a year-long period and how variations in Joint Engagement experiences predicted language outcome. Children with autism displayed a persistent deficit in coordinated Joint attention; children with Down syndrome were significantly less able to infuse symbols into Joint Engagement. For all groups, variations in amount of symbol-infused supported Joint Engagement, a state in which the child attended to a shared object and to language but not actively to the partner, contributed to differences in expressive and receptive language outcome, over and above initial language capacity.
