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Responsiveness to Joint Attention in Autism: Predictive Characteristics and Concurrent Mechanisms

Abstract

What are the developmental implications and underlying mechanisms of atypical responsiveness to joint attention (RJA) in autism? A longitudinal investigation of relations between individual differences in early childhood RJA and adult outcomes revealed associations between early joint attention and adult adaptive skills, symptoms and social functioning. Many of these associations were attributable to relations between RJA and subsequent changes in cognitive and linguistic skills which in turn predicted adult skills and symptoms. A second longitudinal study assessed relations between an eye-tracking measure of social responsiveness and gaze following administered in infancy and subsequent symptoms and diagnoses of autism. Social responsiveness, specifically interest in dyadic cues, but not gaze following was associated with subsequent autism diagnoses. A third study used eye-tracking and in-person assessments to examine three potential mechanisms underlying atypical gaze following in autism: impaired reflexive gaze cueing, difficulty integrating gaze and affect or reduced recognition of the referential significance of gaze. Reduced low- and high-level gaze following were associated with autism while difficulties with reference were related to developmental level rather than autism. No evidence of gaze and emotion integration was observed regardless of diagnosis. Thus, reduced RJA in autism may arise from low-level atypicalities in gaze following while impaired integration of gaze and affect and reduced understanding of reference may emerge with development. Together these studies imply that individual differences in dyadic and triadic aspects of social attention probably arise from low level mechanisms and have long-term implications for individuals with or at-risk for autism.

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