Promoting Social Communication Competency
in Toddlers with Autism

Background: We have witnessed a monumental increase in the prevalence of Autism Spectrum Disorders (ASD) (Wing & Potter, 2002). Effective and cost sensitive early intervention methodologies are now critically needed to address this concern. The autism intervention literature has not yet produced evidence-based models for toddler-aged children (Volkmar, Chawarska, & Klin., 2005); however, implications are suggested from research on early developmental patterns in autism (Odom, Rogers, McDougle, & Hume, in press). As infants transition into toddlerhood at 12 months, nonverbal social communication in the form of joint attention typically emerges. However, this is not the case for children who will later be diagnosed with autism (Dahlgren & Gillberg, 1989). Joint attention, a critical social-communication milestone (Bakeman & Adamson, 1984). is defined as visually coordinating attention with another person in relation to an object or event, sharing social interest, and perceiving the partner’s mutual interest. Joint attention supports development across communication, cognitive, and social-emotional domains (Schertz & Odom, 2004). Strong relationships have shown between joint attention and language (e.g., Carpenter, Nagell, & Tomasello, 1998; Paparella & Kasari, 2004) with joint attention deficits producing a cascading effect on language development (Wetherby, 2006).

Study Rationale: The current study builds on research demonstrating intervention effects for toddlers with early indicators of autism (Schertz & Odom, 2006), namely, promotion of joint attention through a parent-mediated intervention approach. The purpose of this study is to demonstrate preliminary efficacy and feasibility of a Joint Attention Mediated Learning (JAML) model, a model that builds on empirical knowledge of early development in autism while incorporating developmentally appropriate and family-centered practices. The goal is to capitalize on the neurologically sensitive early period to open social, communication, and cognitive learning paths that are restricted for toddlers with or at-risk for autism, maximizing potential for future learning.

Study Aims: The aims of this study are to:

• Field test, refine, and evaluate an early intervention model designed to promote early development of foundational social-communication skills (joint attention) in toddlers identified with or at high-risk for autism;
• Improve child performance in targeted precursors of joint attention (focusing on faces and turn-taking);
• Demonstrate that joint attention is achieved and generalized by study participants as a result of JAML.

Study Design: Parents who are at least 18 years of age and who have toddlers between 12 and 25 months of age who have been screened and diagnosed with autism or who show behavioral patterns that place them at-risk for autism, will be eligible for inclusion in Kansas, Colorado, and North Carolina. Following development activities in Year 1, a set of mixed method, single subject and qualitative design studies will address procedural questions about implementation, followed by a cross-site group comparison design study in Year 3 to gather initial evidence about efficacy of the JAML model. During the first two years, we will use a series of three-tiered multiple baseline probe designs across a total of 24 participants (Kennedy, 2005) to closely analyze individual comparative data to refine final treatment procedures. By the end of Year 2, we will have conducted a series of systematic replication studies. In Year 3, a small experimental study will be conducted in which twenty-four children and their parents are randomly assigned to treatment or control conditions.

Project Directors:

Hannah Schertz, Ph.D., University of Northern Colorado
Kathleen Baggett, Ph.D, University of Kansas
Samuel Odom, Ph.D., University of North Carolina