Coaching Caregivers to Implement Joint Attention Interventions in the Natural Environment Heather Brownfield Kent State University Early Childhood Special Education Program Discussion Future Directions Research MethodsIntroduction “Individuals with autism spectrum disorders (ASD) exhibit deficits in language and communication, affecting social interaction in a pervasive and often debilitating manner” (Murdock & Hobbs, 2010) ASD’s can cause significant social, communication, and behavioral challenges 1 in 68 children are diagnosed with Autism (CDC, 2014) Interventions have been developed to promote joint attention Joint attention is the “ability to share attention with another towards the same object or event” ("Relate to autism," 2014) Joint attention is a prerequisite to social interactions Joint attention is proven to work in the field of Early Intervention (EI; children birth-3 years old) and in natural environments (such as home settings or community settings) Joint attention is an intervention easy to embed in daily routines and can be easily implemented by caregivers In this case, joint attention interventions used to help promote language in a child with ASD with a language delay Participants: 30 month old with Autism Spectrum Disorder (moderate-to-severe) Qualified due to personal-social, receptive communication, expressive communication, fine motor, & cognitive development Mother, 26 years old Low-Middle SES Setting: Home (Akron) Intervention Strategies: Contingent imitation- imitating all of the child’s actions with toys, gestures, and vocalizations Ex. Child rolls car on the floor and says, “Vroom, vroom.” Adult rolls a similar car on the floor and says, “Vroom, vroom.” Ex. Child claps and blows “raspberries'.” Adult claps and blows “raspberries'.” Modeling- modeling an action and corresponding verbal marker Ex. Adult rolls a ball on the floor and says, “Roll, roll.” Linguistic mapping: providing a running commentary of the actions the adult and child are simultaneously performing Ex. As the child pushes a car across the floor the adult says, “You’re pushing your red car.” Then if the adult pushes their car they say, “Now I’m pushing my blue car. Oops my car crashed.” etc. The results should show an increase in use of language, imitations, eye contact, vocalizations, and turn-taking Research studies had similar results Children were able to generalize skills in studies Interventions successful in a home setting Practical Implications Research studies and my research will show positive effects of these interventions Interventions are easy for professionals and parents to implement Children, specifically with ASD, are able to share joint attention with others with support from these interventions CitationPurpose of ResearchMain Findings Ingersoll et al., 2010To increase the use of appropriate language in children with Autism Spectrum Disorder. Children showed increase in vocabulary, object, and gesture imitation skills. Ingersoll et al., 2006To increase use of imitation, imitative language, spontaneous language, pretend play, appropriate play, and coordinated joint attention in children with Autism. Children showed increase in rate of imitation, imitative language, pretend play, and coordinated joint attention. Rogers et al., 2006To increase use of functional speech in children with Autism Spectrum Disorder. Children showed an increase in their functional, spontaneous use of words, and use of words in general. Schertz et al., 2007To promote joint attention in toddlers with Autism in a parent- mediated developmental model. Children showed improved performance in joint attention. Heimann et al., 2006To increase “social interest” (touching, looking at person, and requesting) in children with Autism. Children showed significant increase in social interest. Continued research to expand use of interventions across children, ages, and settings Practitioners should implement interventions to promote language in children Practitioners should coach caregivers to implement interventions Caregivers implement interventions throughout daily routines to promote language Eye contact: The child looks or glances at the adults eyes during an interaction. Vocalization: The child makes a sound, or says a word/words, that is not an imitation, to communicate. The vocalization must be in context and have a purpose (to get the adults attention, to give sound to an object, to show emotion, etc.) Imitation: The child imitates an action, vocalization/sound, or word(s) the adult models within 10 seconds of the model. An imitation of part of a word or vocalization counts. Turn-taking: The child performs an action, the adult performs an action, and the child performs another action. This counts as one turn/interaction. The actions should be related and in response to one another, it should be a shared interaction. Eye ContactVocalizationImitationTurn-Taking 5 minute Observation Results Coaching Strategies: (Rush & Shelden, 2011) Started by discussing joint attention, why it is important, and what areas of development it will support. Discussed what I was looking for the child to do during the interactions. Modeled the intervention for the mother with the child, explaining what I was doing throughout. Asked mom if she had any questions and then asked her to give it a try while I observed. Gave mom feedback throughout and told her exactly what she was doing well. We then discussed how the interventions could be embedded in daily routines. Reflected on the intervention together Data Collection: 5 minute video sequences, 2 times a day during play time for 10 days Coding of eye contact, vocalizations, imitations, and turn-taking The Effectiveness of Joint Attention Interventions on Interactions