Evaluating the Feasibility and Effects of the Complexity Account of Treatment Efficacy (CATE) for Joint Attention Intervention with Children with ASD

Abstract

Much discussion in recent years has focused on the topic of Joint attention (JA) in children with autism spectrum disorders (ASD). The literature demonstrates the crucial role of JA in developing social-communicative competence in typically developing (TD) children (Meindel & Cannella-Malone, 2011; White et al., 2011). One specific JA skill that has been highlighted in the research is the use of gestural pointing for social purposes (Colonnesi et al., 2010). Children with ASD use few, if any, points to share interest with others about objects and events (Baron-Cohen, 1989; Carpenter et al., 2002). Consequently, deficit in JA pointing is a key early indicator of autism, even for infants as young as 12- months (Werner & Dawson, 2005). JA pointing can be considered a pivotal skill in development given that it predicts long-term language development (Colonnesi et al., 2010). Treatment of JA pointing for children with ASD has been promising (Jones, Carr, & Feeley, 2006; Kasari, Freeman, & Paparella, 2006), although often time intensive (Whalen & Schreibman, 2003). The efficient use of therapy time, especially during the early years, is of vital importance. The focus of this study is to investigate a novel, and hypothetically beneficial, approach to improving the efficiency of treatment focused on JA pointing for children with ASD. This novel approach to JA treatment, referred to as the Complexity Approach to Treatment Efficacy (CATE), is based on treatment efficiency demonstrated in other areas of intervention research (Gierut, Morrisette, Hughes, & Rowland, 1996; Thompson, Shapiro, Kiran, & Sobecks, 2003). In the present study, a hierarchy of non-verbal JA skills is constructed from least to most complex skills. Treatment of the most complex skill is then targeted in therapy to evaluate the feasibility and effects of this approach for children with ASD.