Background and aims

Response to joint attention (RJA) and initiation of joint attention (IJA) are impaired in pre-schoolers with autism spectrum disorder (ASD). Children’s response to joint attention may depend on the presence of the target in the child's field of vision or on the type of deictic index (head and eye orientation, pointing and verbalisations) used by the adult to initiate joint attention.

Methods

This study deals with 50 ASD children aged from 2 years 8 months to 11 years 7 months, with a communicative level comparable to children under 31 months of age, according to the French version of the Early Social Communication Scales (ECSP, by its French acronym). We compared the aforementioned ASD children with 50 typically developing (TD) children, aged 9 to 30 months who had no communication disorders according to the ECSP. During the ECSP test, we analysed joint attention behaviours on three posters present or absent from the children's visual field.

Results

We did not observe any difference in the number of IJAs between groups, but ASD children were less responsive than TD children were. Our results showed a developmental progression in the responses of children with ASD if several deictic cues were used by an adult simultaneously (looking and pointing, or looking and verbalising to indicate a target), whether the referent was present or absent from the child’s visual field. In addition, we observed developmental progression when the referent was behind the child and the adult only used their gaze to refer to it.

Conclusion

Thus, we argue that the type of cues used affects ASD children’s response behaviours during joint attention towards a referent that may be present or absent from their visual field.

Implications: Regarding the social and the sensory difficulties of children with ASD, many therapeutic approaches focus their intervention methods on non-verbal communication skills and joint attention. This fundamental research makes it possible to identify the most appropriate type of deictic index for children with ASD with developmental delay, depending on the presence or absence of the referent in the child's visual field.

中文翻译：

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自闭症谱系障碍儿童联合注意投标的启动和响应取决于目标的可见性

背景和目标

患有自闭症谱系障碍 (ASD) 的学龄前儿童对共同注意 (RJA) 和启动共同注意 (IJA) 的反应受损。儿童对共同注意的反应可能取决于目标在儿童视野中的存在或成人用来启动共同注意的指示指数类型（头部和眼睛的方向、指向和语言）。

方法

本研究涉及 50 名年龄从 2 岁 8 个月到 11 岁 7 个月的 ASD 儿童，其交际水平与 31 个月以下的儿童相当，根据早期社会沟通量表法文版（ECSP，其法文首字母缩写） ). 根据 ECSP，我们将上述 ASD 儿童与 50 名年龄在 9 至 30 个月之间且没有沟通障碍的正常发育 (TD) 儿童进行了比较。在 ECSP 测试期间，我们分析了儿童视野中存在或不存在的三张海报的联合注意行为。

结果

我们没有观察到 IJA 数量在各组之间有任何差异，但 ASD 儿童的反应不如 TD 儿童。我们的结果表明，如果成人同时使用多个指示性提示（看和指点，或看和用语言来指示目标），无论所指对象是否出现在儿童的视野中，自闭症儿童的反应都会出现发展进展. 此外，我们观察到当参照物在孩子身后并且成人仅用他们的目光来指代它时的发展进程。

结论

因此，我们认为，所使用的提示类型会影响 ASD 儿童在共同注意可能存在或不存在于他们的视野中的指涉物时的反应行为。

启示：关于自闭症儿童的社交和感官困难，许多治疗方法将其干预方法集中在非语言沟通技巧和共同注意上。这项基础研究可以根据儿童视野中是否存在参照物，为患有发育迟缓的 ASD 儿童确定最合适的指示指数类型。