Initiating and responding to joint attention bids in children with autism: A review of the literature

Joint attention is a skill that involves coordinating the attention of at least two individuals towards an object or event. Although it is seen as a critical skill in early child development, it is frequently absent in children with autism and has been linked to poorer language outcomes for those children. As a result, multiple interventions have been developed to teach children with autism to respond to, and initiate, bids for joint attention. These interventions, however, differ widely both in terms of procedures used and in whether they focus on teaching children to respond to, or initiate, bids for joint attention. This literature review was conducted to document research gaps and intervention similarities between joint attention intervention studies for children with autism. The specific intent of this review was to determine whether researchers teach responding and initiating separately or sequentially, describe the extent to which procedures differ among studies, and identify whether social or non-social consequences are used during joint attention training. Implications for the treatment of joint attention deficits are discussed and recommendations to both researchers and practitioners are provided.

Research highlights
► Researchers primarily use nonsocial consequences to increase joint attention.
► Basic prompting–reinforcing interventions teach joint attention more effectively.
► Responding to and initiating bids are taught as separate and sequential skills.
► Increases in responding to bids do not lead to increases in initiating bids.
► Common-place interventions may increase joint attention as a byproduct.