Joint attention is transformed repeatedly as young children acquire new ways to coordinate actions and represent events. This important developmental process is guided by caregivers who bring to interactions symbol systems and the ability and willingness to complement a child's actions. Difficulties negotiating shared engagement with caregivers may deprive a child full access to a context that is crucial for essential accomplishments, including the acquisition of language. The proposed studies in this revised competitive renewal application continue a productive research program that is charting variations in the development of joint attention after infancy. Our focus for the next cycle is on how parents support joint engagement as toddlers become increasingly competent symbol users and how this process is impacted by developmental disorders, including autism spectrum disorders, Down syndrome, and severe speech delay, which are characterized by deficits in joint attention skills and/or problems acquiring symbols and using language.
Three aims will be pursued. First, using an experimental study of the way mothers of typically-developing children, children with autism, and children with Down syndrome introduce novel words will be conducted to clarify how mothers create hot spots for language learning during periods of joint engagement. Second, new rating scales will be formulated for our standard observational procedure, the Communication Play Protocol, and used to investigate how the child's diagnostic group and language level affects the relation between the child and parent actions and the topics of their joint engagement. Third, two longitudinal clinical research studies will be performed to characterize more fully the development of joint attention in young children with developmental disorders and to discern how observations of how parents support a child's joint engagement may add to the prediction of diagnostic and language outcome. The first study observes 40 children with an autism spectrum disorder (ASD) and 40 children with a developmental delay at the time of initial diagnosis (18 to 24 months) and at 30 and 36 months in order to compare joint attention as it is rated during parent-child interactions, scored during standardized assessments with examiners, and reported by parents when they are asked about their child's behavior. Analyses will discern if ratings derived from observing children with parents, including those of parental support of symbol-infused joint engagement, will add to our capacity to predict diagnostic and linguistic outcome at 42 months of age. The second study is designed to explicate our recent finding that children with severe speech delay who participated in a parent-implemented augmented language intervention project significantly increased symbol-infused joint engagement from pre- (30 months) to post- (36 months) intervention. Parent actions during social interactions will be described to determine if they too changed during this time interval and whether changes in parent actions predict language outcome at 42 months of age. This research project will provide new observational methods for the study of joint attention, and it will further the formulation of theories of communication development that situate learning processes important to the acquisition of language and social cognition in early child-caregiver interactions. Moreover, it's early and expanded view of joint engagement during caregiver-child interactions in autism spectrum disorders and in other developmental disorders and its longitudinal analyses of the impact of joint attention problems on child outcome is relevant to public health efforts to formulate more effective early diagnosis and intervention strategies.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project (R01)
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Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
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Esposito, Layla E
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Georgia State University
Schools of Arts and Sciences
United States
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Adamson, Lauren B; Bakeman, Roger; Suma, Katharine et al. (2017) An Expanded View of Joint Attention: Skill, Engagement, and Language in Typical Development and Autism. Child Dev :
Hasni, Anita A; Adamson, Lauren B; Williamson, Rebecca A et al. (2017) Adding sound to theory of mind: Comparing children's development of mental-state understanding in the auditory and visual realms. J Exp Child Psychol 164:239-249
Özçal??kan, ?eyda; Adamson, Lauren B; Dimitrova, Nevena (2016) Early deictic but not other gestures predict later vocabulary in both typical development and autism. Autism 20:754-63
Özçali?kan, ?eyda; Adamson, Lauren B; Dimitrova, Nevena et al. (2016) Baby sign but not spontaneous gesture predicts later vocabulary in children with Down Syndrome. J Child Lang 43:948-63
Suma, Katharine; Adamson, Lauren B; Bakeman, Roger et al. (2016) After Early Autism Diagnosis: Changes in Intervention and Parent-Child Interaction. J Autism Dev Disord 46:2720-33
Adamson, Lauren B; Bakeman, Roger (2016) The Communication Play Protocol: Capturing Variations in Language Development. Perspect ASHA Spec Interest Groups 1:164-171
Dimitrova, Nevena; Özçal??kan, ?eyda; Adamson, Lauren B (2016) Parents' Translations of Child Gesture Facilitate Word Learning in Children with Autism, Down Syndrome and Typical Development. J Autism Dev Disord 46:221-231
Adamson, Lauren B; Bakeman, Roger; Brandon, Benjamin (2015) How parents introduce new words to young children: The influence of development and developmental disorders. Infant Behav Dev 39:148-58
Adamson, Lauren B; Bakeman, Roger; Deckner, Deborah F et al. (2014) From interactions to conversations: the development of joint engagement during early childhood. Child Dev 85:941-955
Visootsak, J; Hess, B; Bakeman, R et al. (2013) Effect of congenital heart defects on language development in toddlers with Down syndrome. J Intellect Disabil Res 57:887-92

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