The development of joint attention in preschool aged children with autism : the effects of early intensive behavioural intervention

Abstract

Children with autism are often reported to be significantly delayed or deviant in their development of precursors to social communication including eye contact, sharing attention, and pointing out items of interest.  The present study monitored the longitudinal development of early social communication skills in a group of preschool aged children with autism who received Early Intensive Behaviour Intervention (EIBI) (n=21) and a Comparison group (n=16) who received a range of local educational authority (LEA) provision in the South of England across two years.

The aim was to identify whether Applied Behaviour Analysis (ABA) was able to indirectly target and improve joint attention behaviours in the group of children who received EIBI.  All of the children were assessed using the Early Social Communication Scales (ESCS) (Mundy, Hogan & Doehring, 1996) at three time points (baseline, 12 month follow-up, and 24 month follow up).  The ESCS is a videotaped structured observation measure that provides an index of individual differences in nonverbal communication skills.

Longitudinal data, describing the early social communication skills of preschool aged children with autism prior to and post intervention were obtained for the SCAmP Intervention and Comparison groups. Prior to intervention, no differences between the groups were observed either on the ESCS measures or on correlational analyses of the relations between these measures and structured measures of IQ, mental age (MA), and adaptive behaviour.  Relative to the Comparison group, after two years of ABA, children in the Intervention group made significant gains in their ability to respond to joint attention (RJA).  While initiating joint attention increased in frequency for both groups over time, significant group differences were not found.  Reliable Change Index calculations indicated that a greater proportion of individual children were approaching or meeting levels of reliable change with regards to their RJA abilities.  However, no mediation of intervention effect was found on change in IQ by RJA over time. This non-significant result is inconsistent with the hypothesis that joint attention is a pivotal skill in persons with autism that might be sensitive to a structured intervention like ABA.

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