1. A Research Project Beth Reed
Joint Attention:
A Research Project
Beth Reed

2. What is Joint Attention?

3. Rational
According to the CDC (2015), autism is a communication and social disorder that affects 1 in 68 children.
Children with autism frequently have difficulty with the ability to establish appropriate social relationships. Smith (2013), considers that, “Social-emotional development is believed to be foundational to the development of cognition, language, and adaptive life skills (Smith, 2013, p. 395)”.
Learning joint attention skills early on can assist in the formation of social relationships and theory of mind later in development (Warreyn & Roeyers, 2013).

4. Synthesis of Literature
In three studies, the chosen participants all had a diagnosis of ASD (Autism Spectrum Disorder) and were between three and seven years of age (Warreyn & Roeyers, 2013; Wong, 2012; Wong & Kasari, 2013).
Each group had an average total of 45 participants, which makes the testing population comparable across articles.
Although the amount of participants and the autism identification link the studies, the impact of the results could possibly vary based upon the fact that the children were recruited from dissimilar settings.  

5. Synthesis of Literature Cont.
The behavioral techniques included : modeling appropriate actions, allowing a child to lead, and integrating the exercises into routine activities (Warreyn & Roeyers, 2013).  
Wong (2013) imbedded joint attention strategies into classroom activities with the guidance of a treatment manual.
Warreyn and Roeyers (2013) and Wong (2013) show that teacher-directed joint attention interventions have a positive impact on joint attention skills in preschoolers with autism.
Children with autism tend to initiate fewer joint attention skills, and teachers have a tendency to respond to acts of joint attention more so in structured activities (Wong and Kasari, 2012).

6. Limitations in the literature
Possibility of teacher and therapists not completing all of the forms, checklists, and surveys due to the amount of time it may demand (Warreyn and Roeyers, 2013).
Creating an effective and time-manageable method of collecting data will help to ensure the teachers will participate fully.
Taking into account that teacher and child variables (i.e. years of teaching experience, IQ of the child, etc.) may possibly influence the effectiveness of the intervention (Wong, 2013).
Future longitudinal studies- the long-term effects of the attained joint attention skills and the ability to generalize the skill across settings and people. 

7. Implications for future research
As we ascertain more about how children with autism learn we are opening new doors to interventions.
Finding a solid, data-driven intervention to aide in the growth of joint attention skills will guide a child’s team toward successful implementation of that skill. Parents, speech pathologists, occupational therapists, and early childhood educators can benefit from research-based interventions to implement with young children with autism. Working together, utilizing each other’s strengths, will allow professionals and team members to support the child comprehensively.
When a child is able to establish joint attention with another person his/her world opens up into a new realm of communication and socialization. As this new world opens, the child will have the skills to be included in typical preschool settings with more success.
General and special education teachers can work together to establish an inclusive environment where all children’s needs are being reached.
Research indicates teacher-guided interventions used to promote joint attention produce positive outcomes, therefore an increase in the awareness of these interventions ought to be spread throughout the early childhood intervention community. Responsiveness on the part of the community allows for an increase in implementation and an overall growth in joint attention skills for preschoolers with autism.  

8. Research Question
To what extent will teacher-guided intervention impact a preschooler with autism’s ability to independently establish joint attention during a one-to-one play- based activity?

9. Participants
Preschooler with a medical or educational diagnosis of autism or developmental delay.
The child needs will be three or four years old.
Must have deficits in social skills as demonstrated in his/her limited ability or complete absence in the skills needed to establish joint attention interactions with others. (Observations, parent report, developmental assessments)
A teacher and/or paraprofessional with at least two years of experience in working with young children with severe social impairments will guide the intervention.

10. Procedures
A combination of the interventions to improve joint attention skills in children with autism will be used in a self-contained special education environment (Lawton & Kasari, 2012; Wong, 2013; Warreyn & Roeyers, 2013.)
Adult-led activity in a well-established setting for play-time activities. (Prior to the guided play sessions the adult will gather information about the child and what types of toys/activities motivate that child).
Using a preferred item/activity, the adult (teacher or paraprofessional) will lead the child to the play area and begin interacting with the toys.
The adult will give wait time (five seconds) to see if the child directs his eye-gaze toward the toy.
If the child is not engaged-The prompt hierarchy will begin with gestures, then verbal prompts, and lastly hand-over-hand assistance.
Four 20 minute sessions per week.

11. Data Analysis
Baseline, intervention, and post intervention data will be collected using a frequency data form.
A tally mark will be placed next to the behavior when it occurs. Transferring the tally marks to a graph during the baseline and intervention phase will allow the researcher to see if the intervention is successful (Hojnoski, Gischlar, & Missall, 2009).
If the intervention is showing no increase in joint attention skills the intervention will be adjusted.
Use of a second adult sitting behind the child and prompting him if he is unengaged.
Redo the preference assessment to determine what objects/toys motivate the child.
Initially, there may be a decrease in the joint attention behaviors, but the hope is to see an increase in behaviors from the baseline data. The objective after the intervention is to determine if the child will independently establish joint attention more frequently.

12. Data Collection Forms Another adult will observe and record
the tally marks.
Video will be used if another adult is unavailable.

13. Recommendations
Throughout the data collection the researcher will involve the paraprofessionals in the classroom with team meetings and also model the appropriate strategies.
The parents of the child should be involved via frequent conversations about joint attention, the techniques to improve joint attention, and suggestions for use in the home.
Similarly, the speech and occupational therapist will also be abreast of the intervention in order to maintain consistency and exposure to joint attention strategies throughout the school environment.
Peer models and siblings will be utilized to help enhance the joint attention skills across settings and people.

14. Collaboration
Parents-Share results with parents to demonstrate the importance of teaching shared engagement skills. The family encouraged to view the videos and/or data on sessions conducted with their child. Open dialogue will be welcomed with support provided if requested.
Team of Professionals-The child’s entire team of professionals will also be given the findings and asked for input to enhance the skills for the future.
Colleagues- shared with early childhood educators to determine if they would like to add the intervention and data collection form to their repertoire of social skills instruction.

15. References
Case-Smith, J. (2013). Systematic review of interventions to promote social–emotional
development in young children with or at risk for disability. American Journal of
Occupational Therapy, 67, 395–404.
Centers for Disease Control and Prevention. (2015). Data & Statistics. Retrieved December from
Hojnoski, R. L., Gischlar, K. L., & Missall, K. N. (2009). Improving child outcomes with data-
based decision making: Collecting data. Young Exceptional Children, 12(3),
Lawton, K., & Kasari, C. (2012). Brief report: Longitudinal improvements in the quality of join
attention in preschool children with autism. Journal of Autism and Developmental
disorders, 42(2),
Warreyn, P., & Roeyers, H. (2014). See what I see, do as I do: Promoting joint attention and
imitation in preschoolers with autism spectrum disorder. Autism, 18(6),
Wong, C. (2013). A play and joint attention intervention for teachers of young children with
autism: A randomized controlled pilot study. Autism, 17(3), 
Wong, C., and Kasari C. (2012) Play and joint attention of children with autism in the
preschool special education classroom. Journal of Autism and Developmental Disorders,
42(10),