The Acquisition and Generalization of Joint Attention and Symbolic Play Skills in Young Children with Autism

For children with autism, acquiring and generalizing new skills can be particularly difficult and may be affected by child characteristics. Forty-one preschool children with autism were recruited from an existing early intervention program and then randomized to one of two treatments, a targeted intervention for symbolic play skills or one for joint attention skills. Interventions involved Applied Behavior Analysis (ABA) approaches, in two teaching contexts that included similar prompt hierarchies, natural rewards (access to item), expansion, and corrective feedback. However, in the first ABA context, Naturalistic I, the children sat at the table. Components, such as scaffolding in play, greater pause times, and imitation of the child were included in the second ABA context, Naturalistic II. Mastery of children's first treatment goal was analyzed, and results indicate that children with autism generally acquired and mastered their first joint attention or symbolic play skill with the Naturalistic I approach before generalizing the skill to novel objects and activities to the Naturalistic II context. However, these findings are qualified by teaching domain and child characteristics. Overall, children had an easier time learning play skills than joint attention skills, but the mastery using the Naturalistic I methods was greater for play skills than for joint attention skills. Finally, children with higher mental and language ages reached performance mastery criteria faster than children with lower scores. These results suggest that teaching approach, type of skill, and child characteristics all affect mastery and generalization of joint attention and symbolic play skills.