The emergence of nonverbal joint attention and requesting skills in young children with autism.

UNLABELLED: Joint attention (JA) skills are deficient in children with autism; however, children with autism seem to vary in the degree to which they display joint attention. Joint attention skills refer to verbal and nonverbal skills used to share experiences with others. They include gestures such as pointing, coordinated looks between objects and people, and showing. Some nonverbal gestures are used to request rather than merely to share. These requesting gestures include reaching, pointing to request, and giving to gain assistance. Although these skills also relate to expressive language development, we know little about when they emerge and how they change as language develops in children with autism. Several studies report the emergence of nonverbal requests in children with autism to be similar to that of typically developing children, but other studies report impairments in such skills. This study investigates the emergence of nonverbal JA and requesting skills in typically developing children and in children with autism with expressive language ages between 12 and 60 months, using both a both cross-sectional and a longitudinal design. Results suggest that the sequence of JA skill emergence in autism differs from a normative model, while the sequence of requesting skills emerges in accord with typical development. Furthermore, several joint attention skills appeared to emerge later than in typical children. With regards to intervention it appears that a curriculum based on a normative developmental model for the emergence of requesting skills is mostly appropriate for use with children with autism. However, since children with autism acquired nonverbal joint attention skills in a sequence that differed from a normative model, it might be that a non-normative autism-specific joint attention curriculum would be more likely to benefit children with autism. LEARNING OUTCOMES: The reader will (1) identify 3 specific initiating gestures used to communicate for the purpose of joint attention, (2) identify 2 specific nonverbal responsive joint attention skills, (3) be able to state that children with autism appear to develop specific nonverbal requesting gestures in a similar sequence to typically developing children, (4) be able to state that children with autism appear to develop specific nonverbal joint attention gestures in a different sequence than that of typically developing children, and (5) be able to identify 2 specific nonverbal joint attention skills that appear significantly impaired in children with autism relative to typically developing children.