1. Strategies for Developing Joint Attention in Children with ASD Stephanie D. Becker, PhD KSHA Annual Conference September 26, 2015

2. Learning Outcomes 1. Describe the role that joint attention plays in early communication. 2. Describe at least 4 different joint attentional skills. 3. Identify at least 2 strategies that can be used to teach joint attentional skills.

3. Pre-Verbal Communication Before children are talking, they are communicating.

4. Pre-Verbal Communication Three primary functions of early communication (Bruner, 1981): 1.Joint attention 2.Behavior regulation 3.Social interaction

5. What is Joint Attention?

6. Importance of Joint Attention Crucial role in developing social- communicative competence Correlated with current language abilities Predicts later language development

7. Development of Joint Attention Dyadic Interaction ChildCommunication Partner

8. Development of Joint Attention Dyadic Interaction ChildCommunication Partner Triadic Interaction Object Communication Partner Child

9. Development of Joint Attention

10. Video

11. Joint Attention and ASD

12. Children with ASD Joint attention deficits: core feature in diagnosis Early ID: deficits seen at 12 months for declarative but not imperative points

13. Deficits in Children with ASD Responding to eye contact from others Following points from others Gaze shifting from toy to adult Using declarative points Showing items

14. Kasari, Freeman, & Paparella (2006) ABA Use drill and repetition Prompt, reinforce Play-based Sit close, make eye contact Follow the child’s interests, engage Give corrective feedback

15. Respond to Eye Contact

16. Get in close proximity Obtain eye contact prior to activity of high interest Lean in toward child and wait Use hands as blinders if needed Have an animated social response Immediately do something fun!

17. Follow a point

18. Follow a Point Teach proximal ( 6 in) points Set up the environment with interesting / novel items Get the child’s attention first Point to item and comment “Look, a monkey!” Re-establish eye contact again and make a comment “That is a funny monkey!”

19. Follow a Point: Materials Miniature toys set around the room Silly posters on the wall or hanging from the ceiling Items you can throw and stick to the wall Door left open Item in wrong location Start a remote controlled toy Turn music on Find a missing item

20. Gaze Shift

21. Obtain eye contact with the child Shift child’s attention to toy/picture Shift child’s attention back to communication partner: Lean in, give an expectant pause Make an excited/animated comment

22. Show

23. Show Establish eye contact Hold item toward child to model a show Prompt child to “show” you or other adult the item Make a comment about the item Re-establish eye contact

24. Show: Materials Unusual or silly toys Ball with an object inside Fidget toys Items pulled out of a bag Ducks with pictures hidden underneath Child’s artwork Photos Items that are found

25. Initiate a Point

26. Proximal ( 6 in) Establish eye contact Set up environment Prompt child to point Re-establish eye contact

27. Initiate a Point: Materials Pictures hanging from ceiling Party materials Toy flashlight that shines pictures on wall Wind-up toy Broken toy (car missing wheel) Pop-up puppet Potato head pieces in wrong locations Animated book Hidden items in a container filled with rice