An operant approach to teaching joint attention skills to children with autism

A lack of joint attention skills may constitute a core impairment in autism. In the present study, a training protocol was developed, based on the literature on joint attention and on behavioral interventions. The training was organized into a sequence of three main parts respectively aimed at establishing each of the following skills: (1) responding to joint attention bids, (2) engaging in turn‐taking activities based on joint attention skills, and (3) initiating joint attention. Two novel components were incorporated in the training: (a) a discrimination training procedure aimed at establishing the adult's nods as conditioned reinforcers and (b) tasks based on turn‐taking, where joint attention skills were targeted and reinforced. The study was conducted according to a single‐subject experimental design, in which joint attention skills were measured before and after intervention, using the “behavioral assessment of joint attention.” Four 3.5–5.5 year‐old children diagnosed with autism participated in the study. All four children completed the training successfully and made significant progress in engaging in joint attention and in initiating joint attention skills. Following the completion of training and at 1 month follow‐up, parents reported that their children used their skills in different settings. Moreover, at follow‐up, all four children were reported to engage in joint attention behaviors and to enjoy doing so. Copyright © 2009 John Wiley & Sons, Ltd.