Toward a behavioral analysis of joint attention

Deictic Relational Responding and Perspective-Taking in Autistic Individuals: A Scoping Review

Perspective-taking skills are crucial for successful social interactions and some autistic individuals seem to demonstrate great difficulty in this area. The concept continues to generate clinical and research interest across mainstream psychology and within behavior analysis. Within behavior analysis, relational frame theorists have argued that deictic relational responding is critically involved in perspective-taking. We conducted a systematic search of the behavior analytic studies on deictic relational responding and perspective-taking in autistic individuals to highlight methods used to test perspective-taking and deictic relations, methods to train these if deficits were observed, and evidence for a relationship between deictic relational responding and perspective-taking. Seven studies met inclusion criteria and we conducted a descriptive analysis of these studies. We found some variation in the methods used to test and train perspective-taking through deictic relations. Only three of the studies attempted to demonstrate a link between deictic relational responding and perspective-taking. Overall, our review highlighted a need for more research into deictic relational responding and perspective-taking in autistic individuals, and we discussed specific areas for future research.

Teaching Joint Attention: Assessing Generalization and Maintenance of Effects using Multiple Exemplar Training

The purpose of the present study was to evaluate the effects of multiple exemplar training and social reinforcement on the maintenance and generalization of joint attention initiations across toy classes. Three children with autism spectrum disorder (ASD) participated. After analyzing samples of joint attention initiations from neurotypical peers, a composite score was developed and used to evaluate joint attention initiations of the children with ASD. Gaze shifting and commenting were taught using social reinforcement in a multiple exemplar format. Training sessions were followed by probes of untrained stimuli both within and across toy classes. Results showed that the participants acquired both gaze shifting and commenting using social consequences as reinforcers. Following training, participants initiated joint attention with a frequency within the range of their typically developing peers. Multiple exemplar training was also effective in facilitating acquisition within classes and joint attention maintenance during follow-up probes. Additionally, all participants generalized the acquired skills to a class of untrained stimuli.

Social referencing training in children with autism spectrum disorder: A randomized controlled study

Children with autism spectrum disorder (ASD) have been shown to exhibit fewer instances of social referencing compared to their typically developing peers. The current study evaluated the effectiveness of multiple-exemplar training, prompting, and social reinforcement to teach social referencing. We used a single-blind randomized control trial with a multiple-baseline design nested within the experimental group to evaluate treatment effects. Twenty-five children with ASD participated. Participants in the treatment group showed significantly higher social referencing scores. However, there were no statistically significant differences between the groups in the posttraining initiating and responding to joint attention scores. The clinical implications of our findings are discussed.

Improving Eye Contact and Gaze Following in Children with Autism Spectrum Disorder: Systematic Withdrawal of Stimulus Prompts and Tangible Reinforcers

The purpose of this study was to investigate the effects of a procedure involving systematic withdrawal of stimulus prompts and tangible reinforcers on the acquisition, maintenance, and generalization of eye contact and gaze following for two children with ASD in China. Two boys with ASD (5-6 years of age) participated. A concurrent multiple probe design across behaviors and participants was used. Results indicate that the procedure effectively established eye contact and gaze following for both children. Generalization to new instructors occurred in the free play setting, and the acquired behaviors were maintained for 1 month following training. Eye contact was maintained with social consequences for one child; the other child required tokens along with social consequences to maintain eye contact. Social consequences were sufficient to maintain gaze following for both children.

Revisiting how we operationalize joint attention

Parent-child interactions support the development of a wide range of socio-cognitive abilities in young children. As infants become increasingly mobile, the nature of these interactions change from person-oriented to object-oriented, with the latter relying on children's emerging ability to engage in joint attention. Joint attention is acknowledged to be a foundational ability in early child development, broadly speaking, yet its operationalization has varied substantially over the course of several decades of developmental research devoted to its characterization. Here, we outline two broad research perspectives-social and associative accounts-on what constitutes joint attention. Differences center on the criteria for what qualifies as joint attention and regarding the hypothesized developmental mechanisms that underlie the ability. After providing a theoretical overview, we introduce a joint attention coding scheme that we have developed iteratively based on careful reading of the literature and our own data coding experiences. This coding scheme provides objective guidelines for characterizing mulitmodal parent-child interactions. The need for such guidelines is acute given the widespread use of this and other developmental measures to assess atypically developing populations. We conclude with a call for open discussion about the need for researchers to include a clear description of what qualifies as joint attention in publications pertaining to joint attention, as well as details about their coding. We provide instructions for using our coding scheme in the service of starting such a discussion.

Differences in Established Joint Attention in Hearing-Hearing and Hearing-Deaf Mother-Child Dyads: Associations With Social Competence, Settings, and Tasks

The authors examined relations among observed joint attention, maternal report of child's social competence, setting (home vs. laboratory), task (unstructured vs. semi-structured), and dyad type [hearing mother-hearing child (n = 55, M_age  = 25.8 months) vs. hearing mother-deaf child (n = 27, M_age  = 26.9 months)]. Hearing child dyads scored higher on joint attention during unstructured tasks, especially in their home environment. Hearing child dyads displayed similar joint attention to deaf toddler dyads when they engaged in a semi-structured task, but higher on these measures during unstructured free play. Unlike hearing children, joint attention was differentially related to social competence in deaf children, with relatively higher versus lower social competence depending on relatively high versus low observed joint attention, respectively.

Autism Spectrum Disorder: Characteristics, Associated Behaviors, and Early Intervention

Autism spectrum disorder (ASD) is characterized by deficits in social communication and interaction and the presence of restricted and repetitive patterns of behavior and interests. Currently, ASD affects 1 in 59 individuals and can be a costly disorder across one's lifetime. Because of the prevalence, costs, and range of behavioral needs, early intervention is vital to teach skills across a variety of domains and prevent the development or exacerbation of behavioral deficits and excesses. Interventions based on applied behavior analysis have the most empirical support; several strategies to teach social skills, communication, and adaptive skills are discussed.

Interpersonal and Group Contingencies

Responding by individuals in groups has been a prominent interest of the field of psychology. Experimental analyses of human behavior have provided some unique findings of the role that the environment, including both social and nonsocial stimuli, may have on individual responding. Cooperative and competitive contingencies, previously evaluated in animal and human operant research, provide unique insight into applied interventions, in particular group contingencies. The current manuscript attempts to bridge these two literatures to foster the development of more effective technologies and lines of experimental or translational research that may better inform interventions in the applied realm.

Response to name in children with autism: Treatment, generalization, and maintenance

Deficits in response to name (RTN) are an early indicator of autism spectrum disorder (ASD), and RTN is a treatment goal in many early intervention curricula for children with ASD. However, little research has empirically evaluated methods for increasing RTN in children with ASD. We evaluated a series of conditions designed to increase RTN for 4 children with ASD using a multielement experimental design. The schedules of tangible reinforcement were thinned after mastery and generalization was tested across people and contexts. Tangible reinforcers were necessary to increase RTN for all 4 participants, and the schedule of reinforcement was successfully thinned with all participants after intervention. Generalization was also observed across people and experimental contexts.

The Relation Between Early Parent Verb Input and Later Expressive Verb Vocabulary in Children With Autism Spectrum Disorder

Purpose The purpose of this study was to evaluate if higher quantity, diversity, and grammatical informativeness of verb phrases in parent follow-in utterances (i.e., utterances that mapped onto child attentional leads) were significantly related to later expressive verb vocabulary in children with autism spectrum disorder (ASD). Method We examined these associations in a sample of 31 toddlers with ASD and their parents in a longitudinal correlational study. Key aspects of parents' verb input were measured in 2 video-recorded 15-min parent-child free-play sessions. Child expressive verb vocabulary was measured using parent report. Results An aggregate variable composed of the quantity, diversity, and grammatical informativeness of parent verb input in follow-in utterances across the 2 parent-child sessions strongly and positively predicted later child expressive verb vocabulary, total R ² = .25, even when early child expressive verb vocabulary was controlled, R ² change = .17. Parent follow-in utterances without verbs were not significantly related to later child expressive verb vocabulary, R ² = .001. Conclusions These correlational findings are initial steps toward developing a knowledge base for how strong verb vocabulary skills might be facilitated in children with ASD.

Individualizing Intervention to Teach Joint Attention, Requesting, and Social Referencing to Children with Autism

Social communication skills such as joint attention (JA), requesting, and social referencing (SR) are deficits in children with autism spectrum disorder (ASD). Shifting gaze is a common response across these skills. In many studies, children respond variably to intervention, resulting in modifications to planned intervention procedures. In this study, we attempted to replicate the procedures of Krstovska-Guerrero and Jones (Journal of Developmental and Physical Disabilities 28; 289-316, 2016) and Muzammal and Jones (Journal of Developmental and Physical Disabilities 29; 203-221, 2017) to teach JA, requesting, and SR. In general, intervention procedures consisting of prompting and reinforcement were effective in teaching requesting, SR, and JA skills to children with ASD. However, not all children acquired each skill, and all children required individualized procedures to acquire some skills. We report the process of deciding how to modify intervention and discuss considerations for practitioners when planning intervention that may improve children's performance.

Narrative: Why It's Important, and How It Works

Behavior analysts have said little about narrative and storytelling, emphasizing instead the functional/pragmatic aspects of verbal behavior. Nevertheless, these are ubiquitous human activities, and they are important to understand. Stories are prominent in essays on social issues, fund-raising appeals and political speeches, and they are the bedrock of theater. Foundational narratives are at the roots of major religions and of conflicts between them, and narrative has been proposed as an organizing basis for psychological wellbeing as well as a source of empathetic reactions. The ongoing process of reading or hearing a good story entails interlocking relations between establishing stimuli and their related, differentiated reinforcing consequences, with a story's coherence providing a key to its reinforcing effects. What are the behavioral principles that underlie the repertoires involved in all this? Behavior analysts have defined and studied some-the basic verbal classes, of course, although temporally extended sequences require some adjustments in these. Intraverbal behavior needs to be parsed into sub-categories to delineate highly varied sequences such as occur in paraphrase and translation. These two, along with imitation, generalized imitation and re-telling of stories, entail a salient role of complex invariance. The terms pliance and tracking help to balance the roles of speaker and listener, and to account for joint attention, which appears important in early verbal development. Transfer and transformation of function are additional ubiquitous processes, addressed through stimulus equivalence, relational frames, and other higher-order operants, especially naming, which entails the fusion of speaking and listening. Finally, we should consider ways in which a behavioral understanding of narrative can serve both behavior analysis and its surrounding culture.

Development of Communication in Infants: Implications for Stimulus Relations Research

Early forms of stimulus-response relations are learned by infants to communicate with caregivers. The infant communication abilities begin with the learning of eye gazing, joint attention, social referencing, and naming, among others. Learning to engage in these early communication skills facilitates the development of more advanced phenomena seen in equivalence class formations and derived relational responding research. This article discusses evidence of early communication skills that are often required for the emergence of other, more complex forms of stimulus-stimulus relations. We emphasize the importance of establishing these types of operants early in infancy and their implications for developmental research on stimulus relations.

A Bibliographic Tribute to Jack Michael

"In the late 1950's, Jack Michael, a bright but irritating young psychology instructor, moved from the Universities of Kansas to Houston to Arizona State. Along the way he befriended two nontraditional students, protected them through their Ph.D. programs, and turned them loose on the world: Teodoro Ayllon…and Montrose Wolf…" (Risley, 2001, p. 267). So begins Risley's chapter on the origins of applied behavior analysis. For almost 50 years, Jack Michael provided a model for us to "talk like Skinner" and to analyze behavior as Skinner would. For this, he has been widely respected and revered. The purpose of this bibliography is to explain to new and familiar readers alike Jack's contributions to the field of behavior analysis in areas of his primary focus: (a) behavioral function taxonomy, (b) motivation, (c) reinforcement, (d) response topographies, (e) multiple control, (f) duplic and codic verbal behavior, and (g) teaching. Throughout, we weave his role in the field's history and his leadership in its expansion, as these have been additional areas of significant contributions. Above all, we wish to highlight Jack's work, in bibliographic and narrative form, in a way that expresses a heartfelt tribute on behalf of his students and others whom he influenced to learn about psychology as a natural science and to think and talk like Skinner.

Social Referencing and Children with Autism

During social referencing, infants as young as 6 months of age look to others when confronted with unfamiliar or unexpected events in the environment and then respond to these events based on affective cues of the parent or caregiver (e.g., smiling and frowning). Social referencing is important for early communication and language development. Unfortunately, social referencing repertoires are limited or completely lacking in children with autism. Despite these documented social deficits, little research has focused on ameliorating social referencing deficits. The purpose of this paper is to present a behavior-analytic conceptualization of social referencing and the implications for ameliorating social referencing deficits of children with autism.

Common and Intraverbal Bidirectional Naming

Naming has been defined as a generalized operant that combines speaker and listener behaviors within the individual. The purpose of this paper is to reintroduce the concept of naming and its subtypes, common and intraverbal, distinguish it from other terms such as the tact relation, and discuss the role of naming in the development of verbal behavior. Moreover, a taxonomical change is proposed. The addition of the qualifier bidirectional would serve to emphasize the speaker-listener bidirectional relation and serve to distinguish the technical term from its commonsense use. It is hoped that this paper will inspire future basic and applied research on an important extension of Skinner's analysis of verbal behavior.

Effects of tangible and social reinforcers on skill acquisition, stereotyped behavior, and task engagement in three children with autism spectrum disorders

Children with autism spectrum disorders (ASDs) are more likely to engage in inappropriate play (e.g., stereotypy, repetitive behavior) with their preferred items given as reinforcers. Considering the stereotyped behavior is a core characteristic of ASD aimed to reduce, it is necessary to identify alternative reinforcers that does not encourage problematic behavior as well as is still effective. In this respect, the present study evaluates a possible alternative reinforcer: social interaction. The study compared the effects of preferred tangible and social reinforcers on skill acquisition, stereotyped behavior, and task engagement during the instruction period in three children, 3-8 years of age, with ASDs. This study had two phases: in the first phase, preference assessments and reinforcer assessments were conducted to identify the most highly preferred items and relative preferred type of reinforcers. In the second phase, teachers taught the target skills using two different reinforcers and the three dependent variables were compared between two reinforcer conditions. The results suggest that the reinforcers were equally effective; however tangible reinforcers resulted in high levels of stereotyped behavior. The results indicate that social reinforcers can be efficient reinforcers for the population. The study discussed making an efficient reinforcement decision for individuals with ASD.

Evolution of research on interventions for individuals with autism spectrum disorder: implications for behavior analysts

The extraordinary success of behavior-analytic interventions for individuals with autism spectrum disorder (ASD) has fueled the rapid growth of behavior analysis as a profession. One reason for this success is that for many years behavior analysts were virtually alone in conducting programmatic ASD intervention research. However, that era has ended. Many investigators from other disciplines are now carrying out large-scale intervention studies and beginning to report successes of their own. The increasing number and range of studies has the potential to improve services for individuals with ASD, and it challenges behavior analysts to intensify their research efforts.

The establishing operation and teaching verbal behavior

Twenty years ago Michael (1993) refined and extended the concept of the conditioned establishing operation (CEO). With this paper he updated his previous treatment of the topic (Michael, 1982) by providing terminological refinements and conceptually clear descriptions of the reflexive and transitive CEOs. In the 20 years since the publication of that paper there has been an increase in the application of CEOs as independent variables in the teaching of verbal behavior in applied setting. The purpose of this paper is to provide a brief overview of clinical applications of the EO to the teaching of verbal behavior during the last 20 years.

Acquisition of social referencing via discrimination training in infants

This experiment investigated social referencing as a form of discriminative learning in which maternal facial expressions signaled the consequences of the infant's behavior in an ambiguous context. Eleven 4- and 5-month-old infants and their mothers participated in a discrimination-training procedure using an ABAB design. Different consequences followed infants' reaching toward an unfamiliar object depending on the particular maternal facial expression. During the training phases, a joyful facial expression signaled positive reinforcement for the infant reaching for an ambiguous object, whereas a fearful expression signaled aversive stimulation for the same response. Baseline and extinction conditions were implemented as controls. Mothers' expressions acquired control over infants' approach behavior for all participants. All participants ceased to show discriminated responding during the extinction phase. The results suggest that 4- and 5-month-old infants can learn social referencing via discrimination training.

Stimulus overselectivity four decades later: a review of the literature and its implications for current research in autism spectrum disorder

This review of several topics related to "stimulus overselectivity" (Lovaas et al., J Abnormal Psychol 77:211-222, 1971) has three main purposes: (1) To outline the factors that may contribute to overselectivity; (2) to link the behavior-analytical notion of overselectivity to current nonbehavior-analytical research and theory; and (3) to suggest remedial strategies based on the behavior-analytical approach. While it is clear that overselectivity is not specific to autism spectrum disorder (ASD) and also that not all persons with ASD exhibit overselectivity, it is prevalent in ASD and has critical implications for symptoms, treatment, research, and theory. Weak Central Coherence and Enhanced Perceptual Functioning theories are briefly considered. The research areas addressed here include theory of mind, joint attention, language development, and executive function.

Endurance of Multiplication Fact Fluency for Students With Attention Deficit Hyperactivity Disorder

This study examines the relationship between a critical learning outcome of behavioral fluency and endurance, by comparing the effects of two practice procedures on multiplication facts two through nine. The first procedure, called whole time practice trial, consisted of an uninterrupted 1 minute practice time. The second procedure, endurance building practice trials, had three 20 second practice trials. A total of 3 students with attention deficit hyperactivity disorder participated. Results indicated that multiplication facts with the endurance building practice trials produced more efficient learning when compared to the whole time practice trial procedure for all 3 participants. Additionally, results show that even with the amount of practice time being equal, 1 minute in both conditions, on average participants practiced 30% more problems with the endurance building practice trials procedure than they did with the whole time practice trial procedure.

Using video modeling to teach reciprocal pretend play to children with autism

The purpose of the present study was to use video modeling to teach children with autism to engage in reciprocal pretend play with typically developing peers. Scripted play scenarios involving various verbalizations and play actions with adults as models were videotaped. Two children with autism were each paired with a typically developing child, and a multiple-probe design across three play sets was used to evaluate the effects of the video modeling procedure. Results indicated that both children with autism and the typically developing peers acquired the sequences of scripted verbalizations and play actions quickly and maintained this performance during follow-up probes. In addition, probes indicated an increase in the mean number of unscripted verbalizations as well as reciprocal verbal interactions and cooperative play. These findings are discussed as they relate to the development of reciprocal pretend-play repertoires in young children with autism.

Teaching Discrimination of Adult Gaze Direction to Children with Autism

Three young children diagnosed with autism did not reliably locate objects in the environment on the basis of an adult's gaze shifts. A training program designed to teach gaze following used the activation of remote controlled mechanical toys as both prompts and consequences. Over several training sessions, toy activation was progressively delayed following the adult's gaze-shift cues. All of the children eventually came to anticipate the toy activation and locate the target object on the basis of the adult's gaze-shift cue alone. Discrimination of another person's gaze direction is discussed in relation to joint attention deficits in children with autism.

Teaching children with autism to respond to and initiate bids for joint attention

A multiple baseline design across 3 children with autism was used to assess the effects of prompting and social reinforcement to teach participants to respond to an adult's bid for joint attention and to initiate bids for joint attention. Participants were taught to respond to an adult's bid for joint attention by looking in the direction of an object at which the adult pointed, by making a comment about the object, and by looking back at the adult. Additional training and reinforcement were needed to teach the participants to initiate bids for joint attention. Findings are discussed in terms of the social relevance of teaching children with autism to respond to and initiate bids for joint attention.

Functional training for initiating joint attention in children with autism

The present study aimed to examine the controlling variables for initiating joint attention (IJA) in three children with autism. During the baseline, target objects were presented in a location where the child could see them, but the adult could not, and the emergence of IJA was assessed. Children with autism showed some IJA skills during the baseline, but none initiated pointing. In training, the motivating operation for IJA was manipulated by using each child's preferred materials as targets of joint attention. It was found that more frequent and functional joint attention behaviors were emitted following training. The present study suggests that difficulties in IJA in children with autism could be partly explained by restricted interests in children with autism.

Children With Autism Illuminate the Role of Social Intention in Word Learning

To what extent do children with autism (AD) versus typically developing children (TD) rely on attentional and intentional cues to learn words? Four experiments compared 17 AD children (M age=5.08 years) with 17 language- and 17 mental-age-matched TD children (M ages=2.57 and 3.12 years, respectively) on nonverbal enactment and word-learning tasks. Results revealed variability in all groups, but particularly within the AD group. Performance on intention tasks was the most powerful predictor of vocabulary in the AD group but not in the TD groups. These findings suggest that word learning cannot be explained exclusively by either attentional or intentional processes, and they provide evidence of a special role for intentional understanding in the vocabulary development of AD children.

Multiple effects of joint attention intervention for children with autism

Joint attention refers to an early developing set of behaviors that plays a critical role in both social and language development and is specifically impaired in children with autism. In a series of three studies, preschool teachers demonstrated the effectiveness of discrete trial instruction and pivotal response training strategies to teach joint attention to 5 children with autism (Study 1). Parents of 2 of the 5 children also taught joint attention at home and in the community (Study 2). Several additional dependent measures demonstrated collateral improvements in expressive language and social-communicative characteristics that were socially validated by parent raters (Study 3). Results are discussed with respect to the importance of addressing different forms of joint attention, the necessity to extend intervention to naturalistic contexts and joint attention partners, the pivotal nature of joint attention, and whether intervention adequately addresses both the form and social function of joint attention.