Joint attention in autism: Teaching smiling coordinated with gaze to respond to joint attention bids

Children with autism demonstrate early deficits in joint attention and expressions of affect. Interventions to teach joint attention have addressed gaze behavior, gestures, and vocalizations, but have not specifically taught an expression of positive affect such as smiling that tends to occur during joint attention interactions. Intervention was applied to teach smile and gaze shift with eye contact to respond to others’ joint attention instructions. All targeted responses increased during intervention, with generalized performance as well as maintenance of performance during follow-up. Related measures of joint attention and characteristics of autism showed overall improvements from pre- to post-intervention.

► We examined intervention to teach smiling during responding joint attention (RJA).
► Children acquired smiling coordinated with gaze shifting to RJA.
► Children also showed improvements on related measures of joint attention and smiling.
► Children showed collateral improvements in autism symptomatology.