Initiation of joint attention and related visual attention processes in infants with autism spectrum disorder: Literature review

ABSTRACT

Autism spectrum disorder (ASD) represents a group of neurodevelopmental disabilities that can be difficult to identify before the age of 2 or 3 years, the age when the full range of behavioral symptoms has emerged in most cases. Initiation of joint attention is an important developmental function in which impairments are already observable before the second birthday and can predict children’s ASD symptomatology. In the first part of this review, we summarize results pertaining to retrospective studies of initiation of joint attention in children with ASD and prospective studies of infants at high risk for ASD during the first 2 years, when this behavior is becoming more complex in terms of frequency, quality, and variety. We will also discuss the implications of impairments in dyadic engagement, a precursor of joint attention behavior, for the early development of joint attention. Finally, the early development of initiation of joint attention has been related to specific visual attention mechanisms such as social orienting and visual disengagement. In the second part of this review, we provide an overview of the relationship between those visual attention mechanisms and subsequent social-communication impairments. Clinical and research implications of these findings for both early detection and early intervention will be discussed.

KEYWORDS:

• Autism spectrum disorder
• initiation of joint attention
• dyadic engagement
• social orienting
• visual disengagement

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research [grant number MOP102655], and Autism Speaks Canada [grant number ASCanada-2010-01]. Author MF was supported by an individual grant from the Swiss National Science Foundation [grant number P2GEP1_171686]. Author IMS was supported by the Joan & Jack Craig Chair in Autism Research.