Dissecting joint attention

Reduced initiation of joint attention using gestures at 12 months of age. What’s that a sign of? Autism? (yep) Developmental language disorder*? (yes!)


How we know: 

This study classified infants into four groups*: 

  1. ASD

  2. Language Disorder

  3. High Risk, no disorder

  4. Low Risk, no disorder

Initiation of joint attention, or IJA, was measured by frequency (how often the children initiated joint attention), variety (how many different ways the children initiated joint attention, such as eye gaze or pointing), and quality (whether the children were able to coordinate different varieties of communication to establish joint attention). Initiations of behavioral requests (IBR) were also coded. IBR and IJA differ in the purpose of the gestures: with IBR, children are communicating for the purpose of getting something they want or need. IJA is more social and more related to sharing a moment with a caregiver. If you’ve ever given the ADOS or the M-CHAT-R/F, this distinction shouldn’t be new.  

IJA and IBR were also broken down into high- and low- level categories (see Table 2 in the study for more detailed descriptions):


Unsurprisingly, the ASD group showed less frequent, less varied, and lower quality IJA than the other three groups at 18 months. What was surprising was that both children with ASD and Language Disorder had fewer instances of high-level IJA and IBR at 12 months than the non-disordered groups, indicating that reduced gesture use could be a red flag for both ASD and language disorder in 1-year-olds.

Data from the Autism Observation Scale for Infants (AOSI), Mullen Scales of Early Learning (MSEL), the Autism Diagnostic Observation Schedule (ADOS), and video-recorded sessions.

*Developmental language disorder is the same as language impairment, and a broader term than specific language impairment (SLI). Not familiar with this new term? Read more here or here.

Franchini, M., Hamodat, T., Armstrong, V. L., Sacrey, L.-A R., Brian, J., Bryson, S. E., …, & Smith, I. M. (2018). Infants at risk for autism spectrum disorder: Frequency, quality, and variety of joint attention behaviors. Journal of Abnormal Child Psychology. Advance online publication. doi: 10.1007/s10802-018-0471-1.