Joint attention also termed as shared attention is important for the development of play, social and language. It involves gestures, eye contact and other forms for communication in order to share the experience of an object or any events with person. The ability to link words to features, events, and objects are learned through parent facilitation providing them with gestural feedback and attending behavior. This is established through joint attention which typically develops at age 6- 9 months. Autistic children have serious deficits in developing joint attention.

The significance of joint attention is imitation, which is lacking in autistic children. Imitation is a skill which is required to imitate or copy the parent’s language and thus they acquire different skills. Attending and imitating along with the parents occurs naturally and if it is absent there occurs delay in development of other communication abilities. Therefore joint attention therapy is needed and it focuses on the skills such as pointing, showing and coordinating looks between a person and object.

There are several therapeutic techniques available for the enhancement of joint attention and it includes occupational therapy, speech and language therapy, applied behavior analysis and physical therapy.

Applied Behavior Analysis (ABA) teaches the child in a structured way initially by providing them with more natural setting once a level of competence is achieved.

An occupational therapist’s  works on joint attention skills through completing each activity e.g. in fine motor skills writing, threading, in gross motor activities includes attending to a model of an action and imitating them.

Play and developmental therapies such as floor time and Relationship Development Intervention (RDI) have also been shown to be effective for these children.

To build joint attention skills the various techniques that can be used are:

• When child do something to an object like pressing, throwing appreciate the child and prompt in during early stages.
• Can use animated voice. Expressions or gestures for gaining the child’s attention.
• Make the child imitate us and other children during activities for improving imitation skills.
• If the child does not imitate us, copy the activity that child do, like if he is sitting on floor and playing, we also should play with him by getting down on the floor and imitate his sounds and expressions.
• Engage child with their interest as if he likes teddy a lot, make the teddy jump and thus can gain his attention.
• Can blow the bubbles and make the child pop them by using an isolated finger.
• Roll a ball between the child and another guy.
• Provide them with shared activities so that they need to put attention to complete it or provide them with puzzles.

STUDIES

1. A study on joint attention behaviors in autistic preschool children was conducted by Jinah Kim to look after the effects of improvisational music therapy .It was a randomized controlled study. Two different conditions that are improvisational music therapy and play sessions with toys are used to compare a single subject. The behavioral changes were observed using standardized tools and DVD analysis. . The overall results shows that effectiveone is improvisational music therapy than play sessions as it facilitates joint attention behaviors and non-verbal social communication skills in children. More and lengthier eye contact and turn taking occurs in improvisational music therapy.
   
2. Daniel O David conducted a study using a social robot. In ASD social difficulties act as a core symptom and one of the main psychological factor underlying this condition is lack of joint attention with interaction partners. The use of social robot as an intervention in ASD children gained more attention in last few years. The main aim of the study is to investigate joint attention in ASD children is dependent on the social cues provided by the robot during therapy sessions. For that three different cues were selected that is gaze orientation, pointing and vocal instruction. In this the robot enhanced treatment produce similar pattern when compared to human treatment. 5 children were used to conduct the study and provide 20 intervention sessions and the result shows a consistent pattern in all types of sessions as they needed more cues for prompting joint attention and thus their performance increases.
   
3. A behavior modification procedure study was done by Christina and Laura for joint attention training for autistic children. Deficits in joint attention can be an early predictor of childhood autism and due to this deficit in language, play and social development occurs. In this study joint attention behaviors were taught to autistic children using behavior modification procedure. The target behavior included in the intervention are showing response ,coordinated joint attention, pointing. Generalization to parents and different settings were also evaluated. The results shows that the behaviors were effectively trained and these targeted behaviors were generalized to other settings. For children with autism it is important to integrate joint attention training with other interventions. And training these techniques to parents help to maintain joint attention skills outside the treatment setting.

Related Blogs

1. Importance of Joint attention
2. Importance of joint attention skills in young children with ASD
3. Importance of Joint attention in language development

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