Whalen Christina, Schreibman Laura
Autism Spectrum Therapies, Los Angeles, CA 90034, USA.
J Child Psychol Psychiatry. 2003 Mar;44(3):456-68. doi: 10.1111/1469-7610.00135.
Deficits in joint attention are considered by many researchers to be an early predictor of childhood autism (e.g., Osterling & Dawson, 1994) and are considered to be pivotal to deficits in language, play, and social development in this population (Mundy, 1995). Although many researchers have noted the importance of joint attention deficits in the development of children with autism (e.g., Mundy, Sigman, & Kasari, 1994) and have called for intervention strategies (e.g., Mundy & Crowson, 1997), few studies have attempted to target joint attention. In this study, joint attention behaviors were taught to children with autism using a behavior modification procedure.
A multiple-baseline design was implemented to evaluate intervention effects. The following target behaviors were included in the intervention: 1) Responding to showing, pointing, and gaze shifting of adult; 2) Coordinated gaze shifting (i.e., coordinated joint attention); and 3) Pointing (with the purpose of sharing, not requesting). Generalization to setting and parent, follow-up sessions, and social validation measures were also analyzed.
Joint attention behaviors were effectively trained and targeted behaviors generalized to other settings. In addition, positive changes were noted by naive observers using social validation measures.
Integrating joint attention training into existing interventions may be important for children with autism. In addition, training parents in these techniques may help to maintain joint attention skills outside of the treatment setting.
许多研究人员认为共同注意缺陷是儿童自闭症的早期预测指标（例如，奥斯特林和道森，1994年），并且被认为是该人群语言、游戏和社交发展缺陷的关键因素（芒迪，1995年）。尽管许多研究人员已经注意到共同注意缺陷在自闭症儿童发展中的重要性（例如，芒迪、西格曼和卡萨里，1994年），并呼吁采取干预策略（例如，芒迪和克劳森，1997年），但很少有研究尝试针对共同注意。在本研究中，使用行为矫正程序向自闭症儿童教授共同注意行为。
采用多基线设计来评估干预效果。干预包括以下目标行为：1）对成人的展示、指物和目光转移做出反应；2）协调的目光转移（即协调的共同注意）；3）指物（目的是分享，而非请求）。还分析了向不同场景和家长的泛化、随访以及社会效度测量。
共同注意行为得到有效训练，目标行为泛化到其他场景。此外，使用社会效度测量的非专业观察者注意到了积极变化。
将共同注意训练纳入现有干预措施对自闭症儿童可能很重要。此外，对家长进行这些技术的培训可能有助于在治疗环境之外维持共同注意技能。
