Department of Psychology, College of Staten Island,City University of New York, New York, USA
* Corresponding author Email: firstname.lastname@example.org
Joint attention, or coordinated attention between social partners to share interest in entities, objects or events, is a core difficulty in autism. Reduced joint attention in infancy is predictive of an autism diagnosis while variations in joint attention among people on the spectrumpredict development across a range of domains. Joint attention comprises two types of behaviours, initiation of joint attention and response to joint attention, which may exhibit orthogonal but related patterns of development and associations with other domains. The aims of this review are 1) to compare two theoretical accounts of the origins of joint attention impairments in autism and 2) to examine evidence that response to and initiation of joint attention are both core difficulties across the lifespan in autism.
Joint attention may arise from understanding of others’ intentions (the social-cognitive theory of joint attention) or develop with increasing representational skills (the parallel and distributed processing model of joint attention). The lack of clear evidence that joint attention impairments arise from face-to-face difficulties, coupled with associations between joint attention and developmental level, provide more support for the parallel and distributed processing than the social-cognitive theory of joint attention.
Theorists speculate that initiation of joint attention is more of a core difficulty in autism than response to joint attention, partially because it may be more consistently impaired across the lifespan. However, response to joint attention may also be impaired across development when assessed with appropriate measures. Indeed, there is limited evidence that initiation of joint attention is more of a core deficit than response to joint attention in autism.
This review of the literature suggests that both response to joint attention and initiation of joint attention are central to development in autism spectrum disorder. The lack of strong evidence that dyadic atypicalities precede triadic ones is less consistent with the social-cognitive model than the parallel and distributed processing model of joint attention. Future research should examine potential bidirectional associations between response to and initiation of joint attention, non-social attention,reward sensitivity, social, linguistic and cognitive development.