Measuring Joint Attention in Children with Autism Spectrum Disorder Through Structured and Unstructured Play

Joint attention, or the shared experience of an object or activity, is one of the earliest indicators of social interaction, and an important precursor to language. Skills used to coordinate joint attention often emerge within the first and second years of life. Research shows that children with an autism spectrum disorder (ASD) exhibit atypical development of joint attention skills compared to typically developing children. Considering the important role joint attention plays in language development, the accurate assessment of joint attention skills in children with ASD is critical for identifying deficits and designing early interventions. The commonly accepted gold standard for joint attention assessment is the Early Social Communication Scales (ESCS). However, researchers and clinicians may benefit from expanding their methods of joint attention assessment. Multiple observations across different constructs may improve the accuracy of assessing a child’s development of joint attention, and improve ecological validity. The current study aims to explore the validity of measuring joint attention within structured and unstructured play interactions by comparing rates of joint attention in these contexts with rates of joint attention in the ESCS. Using the same guidelines established by the ESCS, joint attention skills were coded from structured play assessments and unstructured caregiver child interactions administered to 28 young children with ASD, ages 2 to 5 years. Correlation analysis shows strong positive correlations between rates of child initiated joint attention in the structured (r = .67) and unstructured (r = .61) play when compared to the ESCS. Comparison of correlation coefficient rates of child initiated joint attention against rates of child initiated behavior regulation coded in the three measures provides evidence of convergent and discriminant validity. These findings suggest that structured and unstructured play assessments can be utilized as tools to measure child initiated joint attention, providing researchers with more opportunities to observe these skills in young children with ASD