Driven from distraction: How infants respond to parents’ attempts to elicit and re-direct their attention

Caregiver encouragement to act on objects is related with crawling infants' receptive language

The progression from crawling to walking in infancy is associated with changes in infant language development. One possible explanation for such change is the infant's language environment. Prior research indicates that caregivers use more action directives with walking infants compared to crawling infants, but the relations of such parental speech with infant vocabulary is unknown. Here, we present findings from day-long home audio recordings (Study 1) and laboratory observations (Study 2) of same-aged crawling and walking infants to explore how caregiver language, specifically action directives, were associated with parent reported infant vocabulary size. Findings in both studies indicated that caregiver action directives were associated with crawling, but not walking infants' receptive vocabulary sizes. Specifically, action directives about objects occurring when the infant and caregiver were not jointly engaged were associated with higher receptive vocabulary scores for crawling infants, but no such pattern was found for walking infants. The replication of results in distinct samples with different research methodologies strengthens the findings. Taken together, these studies demonstrate that caregiver social engagement specific to infant motoric development is related with infant language learning.

The operationalization of coordinated attention and the relations to language development: A meta-analysis

Using a structured literature search and meta-regression procedures, this chapter reports a study that sought to determine whether the associations between coordinated attention and language are moderated by operationalizations of coordinated attention, study design, and other participant characteristics. Studies were located using database searches. This resulted in 46 reports or datasets, 464 effect sizes representing 1,482 participants. Meta-regression was used to answer research questions regarding potential moderators of the effects sizes of interest, which were Pearson's r values quantifying the association between coordinated attention and language assessments. In the final models, we observed that overall effect sizes were significantly above zero, suggesting robust effects across variables of interest. Age when coordinated attention was measured was a significant moderator, suggesting that the relations between coordinated attention and language was stronger when coordinated attention was measured at earlier ages. Interestingly, the longitudinal gap duration between coordinated attention measurement and language assessment was a significant moderator suggesting that the relation between coordinated attention and language was stronger when the longitudinal gap duration was longer. We conclude the meta-analysis by suggesting the phenomena of interest-dynamic coordinated visual attention between infant and caregiver-is robust across operationalizations and has predictive value for concurrent and future language abilities.

The slow emergence of gaze- and point-following: A longitudinal study of infants from 4 to 12 months

Acquisition of visual attention-following skills, notably gaze- and point-following, contributes to infants' ability to share attention with caregivers, which in turn contributes to social learning and communication. However, the development of gaze- and point-following in the first 18 months remains controversial, in part because of different testing protocols and standards. To address this, we longitudinally tested N = 43 low-risk, North American middle-class infants' tendency to follow gaze direction, pointing gestures, and gaze-and-point combinations. Infants were tested monthly from 4 to 12 months of age. To control motivational differences, infants were taught to expect contingent reward videos in the target locations. No-cue trials were included to estimate spontaneous target fixation rates. A comparison sample (N = 23) was tested at 9 and 12 months to estimate practice effects. Results showed gradual increases in both gaze- and point-following starting around 7 months, and modest month-to-month individual stability from 8 to 12 months. However, attention-following did not exceed chance levels until after 6 months. Infants rarely followed cues to locations behind them, even at 12 months. Infants followed combined gaze-and-point cues more than gaze alone, and followed points at intermediate levels (not reliably different from the other cues). The comparison group's results showed that practice effects did not explain the age-related increase in attention-following. The results corroborate and extend previous findings that North American middle-class infants' attention-following in controlled laboratory settings increases slowly and incrementally between 6 and 12 months of age. RESEARCH HIGHLIGHTS: A longitudinal experimental study documented the emergence and developmental trajectories of North American middle-class infants' visual attention-following skills, including gaze-following, point-following, and gaze-and-point-following. A new paradigm controlled for factors including motivation, attentiveness, and visual-search baserates. Motor development was ruled out as a predictor or limiter of the emergence of attention-following. Infants did not follow attention reliably until after 6 months, and following increased slowly from 7 to 12 months. Infants' individual trajectories showed modest month-to-month stability from 8 to 12 months of age.

Variability in infant social responsiveness: Age and situational differences in attention-following

Attention following (AF) is a cornerstone of social cognitive development and a longstanding topic of infancy research. However, there is conflicting evidence regarding the development of AF. One reason for discrepant findings could be that infants' AF responses do not generalize across settings, and are influenced by situational factors. Theories of AF development based on data collected in laboratory paradigms might skew our understanding of infants' everyday AF. To reveal more generalizable patterns of infant AF development, we compared healthy, North American infants' (N = 48) AF developmental trajectories between a controlled laboratory paradigm and a naturalistic, home-based, parent-directed paradigm. Longitudinal micro-behavioral coding was analyzed to compare individual infants' AF between the two settings every month from 6 to 9 months of age. We aimed to (1) examine longitudinal development of infant AF in two settings; (2) compare AF development between settings, and (3) explore differences in adult cueing behaviors that influence AF. We found that longitudinal trajectories of AF differed between home and lab, with more AF at home in earlier months. Additionally, AF at home was related to maternal cueing variables including bid duration and frequency. These results have implications for the assessment of infants' developing social attention behaviors.

Embedding Play to Enrich Physical Therapy

Play is an active process by which an individual is intrinsically motivated to explore the self, the environment, and/or interactions with another person. For infants and toddlers, engaging in play is essential to support development across multiple domains. Infants and toddlers with or at risk of motor delays may demonstrate differences in play or challenges with engaging in play activities compared to typically developing peers. Pediatric physical therapists often use play as a modality to engage children in therapeutic assessment and interventions. Careful consideration of the design and use of physical therapy that embeds play is needed. Following a 3-day consensus conference and review of the literature, we propose physical therapy that embeds play should consider three components; the child, the environment, and the family. First, engage the child by respecting the child's behavioral state and following the child's lead during play, respect the child's autonomous play initiatives and engagements, use activities across developmental domains, and adapt to the individual child's needs. Second, structure the environment including the toy selection to support using independent movements as a means to engage in play. Allow the child to initiate and sustain play activities. Third, engage families in play by respecting individual family cultures related to play, while also providing information on the value of play as a tool for learning. Partner with families to design an individualized physical therapy routine that scaffolds or advances play using newly emerging motor skills.

Physiological arousal explains infant gaze following in various social contexts

Gaze following (GF) is fundamental to central aspects of human sociocognitive development, such as acquiring language and cultural learning. Studies have shown that infant GF is not a simple reflexive orientation to an adult's eye movement. By contrast, infants adaptively modulate GF behaviour depending on the social context. However, arguably, the neurophysiological mechanisms underlying contextual modulation of GF remain somewhat unexplored. In this study, we tested the proposition about whether the contextual modulation of infant GF is mediated by the infant's heart rate (HR), which indicates the infant's physiological arousal. Forty-one 6- to 9-month-old infants participated in this study, and infants observed either a reliable face, which looked towards the location of an object, or an unreliable face, which looked away from the location of an object. Thereafter, the infants watched a video of the same model making eye contact or not making any ostensive signals, before shifting their gaze towards one of the two objects. We revealed that reliability and eye contact acted independently to increase HR, which then fully mediates the effects of these social cues on the frequency of GF. Results suggest that each social cue independently enhances physiological arousal, which then accumulatively predicts the likelihood of infant GF behaviour.

Physiological arousal explains infant gaze following in various social contexts

Gaze following (GF) is fundamental to central aspects of human sociocognitive development, such as acquiring language and cultural learning. Studies have shown that infant GF is not a simple reflexive orientation to an adult's eye movement. By contrast, infants adaptively modulate GF behaviour depending on the social context. However, arguably, the neurophysiological mechanisms underlying contextual modulation of GF remain somewhat unexplored. In this study, we tested the proposition about whether the contextual modulation of infant GF is mediated by the infant's heart rate (HR), which indicates the infant's physiological arousal. Forty-one 6- to 9-month-old infants participated in this study, and infants observed either a reliable face, which looked towards the location of an object, or an unreliable face, which looked away from the location of an object. Thereafter, the infants watched a video of the same model making eye contact or not making any ostensive signals, before shifting their gaze towards one of the two objects. We revealed that reliability and eye contact acted independently to increase HR, which then fully mediates the effects of these social cues on the frequency of GF. Results suggest that each social cue independently enhances physiological arousal, which then accumulatively predicts the likelihood of infant GF behaviour.

Why the parent's gaze is so powerful in organizing the infant's gaze: The relationship between parental referential cues and infant object looking

Parental scaffolding such as looking at and showing objects has long been considered to be helpful for early attention and language development. However, relatively little is known about how parental social multimodal cues work alone or together in guiding an infant's attention toward the referent items. The present study aims to document the dynamics of social referential input during an interactive play session and specify the different types of social cues in directing infant attention. Forty-three parent-infant dyads (infants aged from 5.0 to 18.0 months) in the U.S. completed a short play session recorded by head-mounted camera with eye-trackers. The present findings suggest that joint attention between parent and infant toward the same referent item often co-occurred with other referential input. Infants were more likely to maintain sustained attention to an object under the circumstance that the parent looked at the same item and named it explicitly. This was not the case when parent object looking accompanied other utterances, like "Look!" or the child's name. The present study highlights the importance of multimodal referential input, which sets up enriched opportunities for children to become sensitive to social input and develop sustained attention for further learning.

Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda

Autism spectrum disorder (ASD) impacts an individual's ability to socialize, communicate, and interact with, and adapt to, the environment. Over the last two decades, research has focused on early identification of ASD with significant progress being made in understanding the early behavioral and biological markers that precede a diagnosis, providing a catalyst for pre-symptomatic identification and intervention. Evidence from preclinical trials suggest that intervention prior to the onset of ASD symptoms may yield more improved developmental outcomes, and clinical studies suggest that the earlier intervention is administered, the better the outcomes. This article brings together a multidisciplinary group of experts to develop a conceptual framework for behavioral intervention, during the pre-symptomatic period prior to the consolidation of symptoms into diagnosis, in infants at very-high-likelihood for developing ASD (VHL-ASD). The overarching goals of this paper are to promote the development of new intervention approaches, empirical research, and policy efforts aimed at VHL-ASD infants during the pre-symptomatic period (i.e., prior to the consolidation of the defining features of ASD).

Infants' abilities to respond to cues for joint attention vary by family socioeconomic status

The influence of socioeconomic variability on language and cognitive development is present from toddlerhood to adolescence and calls for investigating its earliest manifestation. Response to joint attention (RJA) abilities constitute a foundational developmental milestone that are associated with future language, cognitive, and social skills. How aspects of the family home environment shape RJA skills is relatively unknown. We investigated associations between family socioeconomic status (SES) -both parent education and family percentage of the federal poverty level (FPL)- parent depressive and anxiety symptoms and infant RJA performance in a cross-sectional sample of 173 infants aged 8-18 months and their parents from a variety of socioeconomic backgrounds. Results suggest that, correcting for age and receptive language, infants in families with greater economic resources respond to relatively less redundant, more sophisticated cues for joint attention. Although parent depressive and anxiety symptoms are negatively correlated with SES, parent depressive and anxiety symptoms were not associated with infant RJA. These findings provide evidence of SES-related differences in social cognitive development as early as infancy, calling on policymakers to address the inequities in the current socioeconomic landscape of the United States.

The Role of Common Ground on Object Use in Shaping the Function of Infants' Social Gaze

Although infants' social gaze has specific communicative functions, it remains unclear what they are. In this conceptual analysis paper, we provide a theoretical framework for the study of the functional aspects of eye gaze in early childhood. We argue that studying the communicative functions of infants' eye gaze involves three premises: the centrality of the object, the importance of common ground on object use, and the role of parental interpretations. The ability to communicate intentionally begins when infants start referring to external objects. Beyond dyadic - infant-parent - emotional sharing, infant social gaze within the infant-parent-object triad becomes an increasingly complex communicative modality. As the predominant type of communicative referents in infancy, objects are thus central to early communication. Although they have affordances, objects are used in conventional ways shared between users (i.e., common ground). Parents transmit to infants the socio-cultural use of objects, which infants progressively learn and master. Accordingly, we argue that within early triadic interactions, the communicative function of infants' eye gaze is shaped by the knowledge that the infant and the parent share on the socio-cultural use of the referent (i.e., the object). Importantly, before young children develop their ability to convey clear communicative functions, including with eye gaze, the interpretations and responses that parents provide to infants' early communicative acts play a major role. Relying on these premises, we argue that when referring to objects for which the infant and the parent share common ground, the function of the infant's social gaze becomes communicatively meaningful for the parent. The knowledge on the communicative referent (i.e., the object) shared between the infant and the parent thus shapes the course of communicative behavior, constitutes and reflects the interactive function of gaze, and cues parents into tailoring their communicative response according to the infant's developmental needs. Through this theoretical framework for the study of the communicative function of infant eye gaze, an emphasis is put on the key role that socio-materiality plays in early communicative development.

Understanding the role and function of maternal touch in children with neurodevelopmental disabilities

During the first years of life, maternal touch can serve different functions including facilitation of child's gaze orientation to faces which is a key precursor for social attention. Although children with neurodevelopmental disability (ND) may have reduced social skills, the role of maternal touch in contributing to gaze orientation to maternal face has not been explored in previous research. In the present study, we investigate the functions of maternal touch in dyads of mothers and children with ND, compared to dyads of children with typical development (TD). Micro-analytic 2-s coding of maternal touch (i.e., affectionate, playful, facilitating, holding, no touch) and children's gaze orientation (i.e., mother-oriented, object-oriented, non-oriented) occurred during 5-minute interactions between mothers and their 12-to-24-month-old ND and TD children. Dyads were paired for children chronological age and sex. Mothers of children with ND used more touch - especially facilitating and holding types -, compared to mothers of TD peers. Children with ND exhibited more non-orientated gaze compared to TD counterparts. Playful touch associated with increased mother-oriented gaze in children with ND, whereas affectionate and holding touch associated with greater mother-oriented gaze in TD children. Findings suggest that specific types of touch support children's attention to social partners.

Do, say, learn: the functions of mothers' speech to infants

We examined the functions of mothers' speech to infants during two tasks - book-sharing and bead-stringing - in low-income, ethnically diverse families. Mexican, Dominican, and African American mothers and their infants were video-recorded sharing wordless books and toy beads in the home when infants were aged 1;2 and 2;0. Mothers' utterances were classified into seven categories (labels/descriptions, emotion/state language, attention directives, action directives, prohibitions, questions, and vocal elicitations) which were grouped into three broad language functions: referential language, regulatory language, and vocalization prompts. Mothers' ethnicity, years of education, years living in the United States, and infant sex and age related to mothers' language functions. Dominican and Mexican mothers were more likely to use regulatory language than were African American mothers, and African American mothers were more likely to use vocalization prompts than were Latina mothers. Vocalization prompts and referential language increased with mothers' education and Latina mothers' years living in the United States. Finally, mothers of boys used more regulatory language than did mothers of girls. Socio-cultural and developmental contexts shape the pragmatics of mothers' language to infants.

Environmental Learning of Social Cues: Evidence From Enhanced Gaze Cueing in Deaf Children

The susceptibility to gaze cueing in deaf children aged 7-14 years old (N = 16) was tested using a nonlinguistic task. Participants performed a peripheral shape-discrimination task, whereas uninformative central gaze cues validly or invalidly cued the location of the target. To assess the role of sign language experience and bilingualism in deaf participants, three groups of age-matched hearing children were recruited: bimodal bilinguals (vocal and sign-language, N = 19), unimodal bilinguals (two vocal languages, N = 17), and monolinguals (N = 14). Although all groups showed a gaze-cueing effect and were faster to respond to validly than invalidly cued targets, this effect was twice as large in deaf participants. This result shows that atypical sensory experience can tune the saliency of a fundamental social cue.

Hand-Eye Coordination Predicts Joint Attention

The present article shows that infant and dyad differences in hand-eye coordination predict dyad differences in joint attention (JA). In the study reported here, 51 toddlers ranging in age from 11 to 24 months and their parents wore head-mounted eye trackers as they played with objects together. We found that physically active toddlers aligned their looking behavior with their parent and achieved a substantial proportion of time spent jointly attending to the same object. However, JA did not arise through gaze following but rather through the coordination of gaze with manual actions on objects as both infants and parents attended to their partner's object manipulations. Moreover, dyad differences in JA were associated with dyad differences in hand following.

Eyes versus hands: How perceived stimuli influence motor actions

Many studies showed that biological (e.g., gaze-shifts or hand movements) and non-biological stimuli (e.g., arrows or moving points) redirect attention. Biological stimuli seem to be more suitable than non-biological to perform this task. However, the question remains if biological stimuli do have different influences on redirecting attention and if this property is dependent on how we react to those stimuli. In two separate experiments, participants interact either with a biological or a non-biological stimulus (experiment 1), or with two biological stimuli (gaze-shifts, hand movements)(experiment 2) to which they responded with two different actions (saccade, button press), either in a congruent or incongruent manner. Results from experiment 1 suggest that interacting with the biological stimulus lead to faster responses, compared to the non-biological stimulus, independent of the response type. Results from experiment 2 show longer reaction times when the depicted stimulus was not matching the response type (e.g., reacting with hand movements to a moving object or gaze-shift) compared to a matching condition, while especially the gaze-following condition (reacting with a gaze shift to a perceived gaze shift) led to the fastest responses. These results suggest that redirecting attention is not only dependent on the perceived stimulus but also on the way how those stimuli are responded to.

The developmental trajectory of attentional orienting to socio-biological cues

It has been proposed that the orienting of attention in the same direction as another’s point of gaze relies on innate brain mechanisms which are present from birth, but direct evidence relating to the influence of eye gaze cues on attentional orienting in young children is limited. In two experiments, 137 children aged 3–10 years old performed an adapted pro-saccade task with centrally presented uninformative eye gaze, finger pointing and arrow pre-cues which were either congruent or incongruent with the direction of target presentations. When the central cue overlapped with presentation of the peripheral target (Experiment 1), children up to 5 years old had difficulty disengaging fixation from central fixation in order to saccade to the target. This effect was found to be particularly marked for eye gaze cues. When central cues were extinguished simultaneously with peripheral target onset (Experiment 2), this effect was greatly reduced. In both experiments finger pointing cues (image of pointing index finger presented at fixation) exerted a strong influence on saccade reaction time to the peripheral stimulus for the youngest group of children (<5 years). Overall the results suggest that although young children are strongly engaged by centrally presented eye gaze cues, the directional influence of such cues on overt attentional orienting is only present in older children, meaning that the effect is unlikely to be dependent upon an innate brain module. Instead, the results are consistent with the existence of stimulus–response associations which develop with age and environmental experience.

Putting the "Joy" in joint attention: affective-gestural synchrony by parents who point for their babies

Despite a growing body of work examining the expression of infants' positive emotion in joint attention contexts, few studies have examined the moment-by-moment dynamics of emotional signaling by adults interacting with babies in these contexts. We invited 73 parents of infants (three fathers) to our laboratory, comprising parent-infant dyads with babies at 6 (n = 15), 9 (n = 15), 12 (n = 15), 15 (n = 14), and 18 (n = 14) months of age. Parents were asked to sit in a chair centered on the long axis of a room and to point to distant dolls (2.5 m) when the dolls were animated, while holding their children in their laps. We found that parents displayed the highest levels of smiling at the same time that they pointed, thus demonstrating affective/referential synchrony in their infant-directed communication. There were no discernable differences in this pattern among parents with children of different ages. Thus, parents spontaneously encapsulated episodes of joint attention with positive emotion.

Development of adaptive tool-use in early childhood: sensorimotor, social, and conceptual factors

Tool-use is specialized in humans, and juvenile humans show much more prolific and prodigious tool-use than other juvenile primates. Nonhuman primates possess many of the basic motor and behavioral capacities needed for manual tool-use: perceptual-motor specialization, sociocultural practices and interactions, and abstract conceptualization of kinds of functions, both real and imagined. These traits jointly contribute to the human specialization for tool-using. In particular, from 2 to 5 years of age children develop: (i) more refined motor routines for interacting with a variety of objects, (ii) a deeper understanding and awareness of the cultural context of object-use practices, and (iii) a cognitive facility to represent potential dynamic human-object interactions. The last trait, which has received little attention in recent years, is defined as the ability to form abstract (i.e., generalizable to novel contexts) representations of kinds of functions, even with relatively little training or instruction. This trait might depend not only on extensive tool-using experience but also on developing cognitive abilities, including a variety of cognitive flexibility: specifically, imagistic memory for event sequences incorporating causal inferences about mechanical effects. Final speculations point to a possible network of neural systems that might contribute to the cognitive capacity that includes sensorimotor, sensory integration, and prefrontal cortical resources and interconnections.

Frontolimbic neural circuitry at 6 months predicts individual differences in joint attention at 9 months

Elucidating the neural basis of joint attention in infancy promises to yield important insights into the development of language and social cognition, and directly informs developmental models of autism. We describe a new method for evaluating responding to joint attention performance in infancy that highlights the 9- to 10-month period as a time interval of maximal individual differences. We then demonstrate that fractional anisotropy in the right uncinate fasciculus, a white matter fiber bundle connecting the amygdala to the ventral-medial prefrontal cortex and anterior temporal pole, measured in 6-month-olds predicts individual differences in responding to joint attention at 9 months of age. The white matter microstructure of the right uncinate was not related to receptive language ability at 9 months. These findings suggest that the development of core nonverbal social communication skills in infancy is largely supported by preceding developments within right lateralized frontotemporal brain systems.

Environmental Influences on Joint Attention in Great Apes: Implications for Human Cognition

In humans, cultural differences in advanced social cognition have been well demonstrated. In tasks pertaining to theory of mind, for instance, individuals pass standard assessments of false-belief understanding at substantially different ages in different cultural environments. Less well-studied are more basic sociocognitive capacities, such as joint attention, which are held by many to constitute the foundational skill set for advanced sociocognitive reasoning. Here, we review the striking group differences in joint attention displayed by great apes as a consequence of being raised in different cultural environments, including wild habitats, institutional settings such as zoos and biomedical research centers, and home-rearing or language-training settings. Like humans, apes develop tactics for joint attention that are adaptive to the particular environments of their early rearing experiences. Great apes serve as animal models for environmental influences on sociocognitive capacities in our own species.

Predicting social impairment and ASD diagnosis in younger siblings of children with autism spectrum disorder

Later-born siblings of children with autism spectrum disorder (Sibs-ASD) are at elevated risk for social impairments. Two putative predictors of later social impairment-measures of responding to joint attention and weighted triadic communication-were examined in a sample of 43 Sibs-ASD who were followed from 15 to 34 months of age. Results revealed that initial level of responding to joint attention and growth rate of weighted triadic communication predicted the degree of social impairment at the final measurement period. Additionally, both predictors were associated with later ASD diagnosis. In contrast, unweighted triadic communication, age of entry into the study, and initial language level did not predict later social impairment. The importance of considering social outcome as a continuous variable in prospective studies of Sibs-ASD is discussed.

The sequential relationship between parent attentional cues and sustained attention to objects in young children with autism

This study examined the sequential relationship between parent attentional cues and sustained attention to objects in young children with autism during a 20 min free-play interaction session. Twenty-five parent-child dyads with a preschool child with autism participated. Results indicated that (a) parent attentional cues that maintained the child's focus of attention were more likely to support child sustained object attention than parent attentional cues that redirected the child from his or her focus of attention or introduced a new focus of attention (d = 4.46), and (b) parent attentional cues that included three or more parent behaviors were more likely to support child sustained object attention than parent attentional cues that included one or two parent behaviors (d = 1.03).