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There’s Hope for Social-skills Stumbling Block

One of the core challenges of autism spectrum disorder (ASD) is social skills, and Kennedy Krieger Institute researchers found that early intervention improves social development in toddlers. The National Institute of Mental Health (NIHM) published findings on December 8, 2010, in the Journal of Child Psychology and Psychiatry that showed sustained improvements in social and communication skills in a group of toddlers between 21-33 months old who were diagnosed with ASD.

The comprehensive behavior intervention model included school-based developmental activities emphasizing frequent, organized communication opportunities with peers and adults imitating others’ actions (socially-engaged imitation), as well as sharing responses (joint attention) and emotions with others by pairing eye contact and facial expressions (affect sharing). The in-home component focused on and included toddlers carrying the learned skills into other settings and parents receiving specialized training in the interventions.

Joint attention (which encompasses affect sharing), is easily incorporated into a home or school ABA program. It involves planning for and setting up natural and enticing opportunities with the child throughout the day to teach the child joint attention skills.

Simply defined, joint attention is looking/referencing where someone else is looking (following their gaze). It is a shared experience—a reciprocal interaction or back-and-forth turn-taking with another person.

Here’s an example of a seamless joint attention interaction: a parent and child approach a playground. The child sees a swing (a favored activity), points to the swing, and looks at his mother. The parent reciprocates by looking at the child, then the swing, eyes widened, and saying, “Look! A swing!”  and the two approach the swing. In this simple transaction, the child points to the favored activity to get permission to approach the activity and then looks at the parent to make sure she is looking at him as well as what he is referencing. It sounds simple enough, but there are many pieces to be taught.

If a child with ASD is struggling with this critical skill, it should be part of every ABA program that will teach and reinforce the child contingent on, for example, gaze following, simple gestures, securing attention before making a request, sharing and monitoring emotion, and sharing experience (i.e., for comfort, permission, or commenting on objects or events).  The parent should take part in the skill training so that the parent can take the myriad teachable moments throughout the day to teach their child these reciprocal skills.

For more information about the research study, visit the NIH website and search the title listed below.

Reference:

Landa RJ, Holman KC, O’Neill AH, Stuart EA. Intervention Targeting Development of Socially Synchronous Engagement in Toddlers with Autism Spectrum Disorder: A Randomized Controlled Trial. J Ch Psychol Psychiatry. 2010 Dec 8.

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