Type of Document Dissertation Author Richmond, Alisha S. Author's Email Address firstname.lastname@example.org URN etd-05032010-173623 Title The Joint Engagement Skills of Children at Risk for Autism Spectrum Disorder Degree Doctor of Philosophy Department Communication, School of; Communication Science and Disorders, School of; and the Library and Inform Advisory Committee
Advisor Name Title Amy M. Wetherby Committee Chair Shurita Thomas-Tate Committee Chair Juliann Woods Committee Member Ann Mullis University Representative Keywords
- Mother-child Interactions
- Early Identification
Date of Defense 2010-04-20 Availability unrestricted AbstractJoint engagement is the child’s ability to share an experience involving an object with
social partners. This skill is critical to the social and communication development of young
children. Previous semi-structured investigations in clinical settings revealed that children with
Autism Spectrum Disorder (ASD) present with deficits in joint engagement. Additionally,
findings from retrospective studies of home videotapes of children later diagnosed with ASD
indicate that ASD symptoms can be observed within naturally occurring activities prior to a
diagnosis. Therefore a systematic method of examining the joint engagement skills of children at
risk for ASD within everyday activities is warranted.
Children between 17 and 34 months (N = 42) were recruited from the FIRST WORDS®
Project prospective study based on risk for ASD. Participants were videotaped during everyday
activities and interactions with maternal caregivers. Consistent with the results of retrospective
home video studies of children diagnosed with ASD and previous joint engagement
investigations, the participants in the current study spent more time playing with toys than in
other everyday activities, such as book reading and playing with people. Results indicated that
the participants spent the majority of their time in object engagement without symbols and rarely
participated in supported or coordinated joint engagement. Children who spent more time in
coordinated joint engagement received lower autism severity ratings in the social affect domain
of the Autism Diagnostic Observation Schedule (ADOS; Lord, Rutter, DiLvore, & Risi, 2002).
Additionally, object engagement with and without symbols was associated with autism severity.
The understanding and use of symbols during various engagement states was associated with
fewer autism symptoms and higher verbal ability.
Overall, these findings indicated that systematic home observations of children’s joint
engagement skills could contribute to the early identification of ASD symptoms in infants and
toddlers. These observations also provide detailed information on children’s use and
understanding of symbols within everyday activities. Examining the joint engagement skills of
children at risk for ASD in natural environments could validate caregivers’ concerns of ASD
symptoms and help build consensus with a diagnostic evaluation in a clinical setting. The current
findings also have important implications for promoting the education of caregivers and
professionals on the importance of this pivotal skill.
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