Systematic longitudinal observations were made as typically-developing toddlers and young children with autism and with Down syndrome interacted with their caregivers in order to document how joint engagement developed over a year-long period and how variations in joint engagement experiences predicted language outcome. Children with autism displayed a persistent deficit in coordinated joint attention; children with Down syndrome were significantly less able to infuse symbols into joint engagement. For all groups, variations in amount of symbol-infused supported joint engagement, a state in which the child attended to a shared object and to language but not actively to the partner, contributed to differences in expressive and receptive language outcome, over and above initial language capacity. KeywordsAutism; Down syndrome; joint attention; language; parent-child interactionThe early development of joint engagement and the acquisition of language are usually intertwined. As infants acquire joint attention skills, they gain entrance into "primordial sharing situations" (Werner & Kaplan, 1963) that serve as "zones of proximal development" (Vygotsky, 1978) where caregivers can facilitate their introduction to symbols during affect-laden and intention-filled social interactions (Adamson, 1996;Hobson, 2000;Tomasello, 1995). Then, as the child acquires a vocabulary, the scope of joint engagement increasingly expands as the focus of shared attention is displaced from present objects to symbols that refer to them, to future and past events, and to internal states (Adamson & Bakeman, 2006). Developmental disorders may disrupt the mutual relation between joint attention and language. Problems sustaining joint attention may alter and even curtail a toddler's access to language facilitating interactions. For example, the early deficits in joint attention skills in young children with autism that have been documented in home videotapes (e.g., Baranek, 1999;Werner & Dawson, 2005), standardized tests (Lord, 1995;Mundy, Sigman, & Kasari, 1990; Wetherby, Watt, Morgan, & Shumway, 2007), screening questionnaires (Baron-Cohen et al., 1996;Robins, Fein, Barton, & Green, 2001), and laboratory-based studies (McArthur & Adamson, 1996;Sigman & Ruskin, 1999;Stone, Ousley, Yoder, Hogan, & Hepburn, 1997; see Leekam & Moore, 2001, for a review) likely play a pivotal role in their problems acquiring and using Correspondence concerning this article should be addressed to Lauren B. Adamson, Department of Psychology, Box 5010, Georgia State University, Atlanta, GA 30302-5010, USA. Electronic mail may be sent via Internet to ladamson@gsu.edu. NIH Public AccessAuthor Manuscript J Autism Dev Disord. Author manuscript; available in PMC 2010 January 1. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript language (Charman, 2004;Dawson et al., 2004;Happe, 1998;McDuffie, Yoder, & Stone, 2005;Sigman & Ruskin, 1999, Smith, Mirenda, & Zaidman-Zait, 2007Toth, Munson, Meltzoff, & Dawson, 2006). Thus, although older estimate...

Fifty-six children were observed longitudinally from 18 to 30 months of age interacting with their mothers during a Communication Play that contained 8 scenes designed to encourage interacting, requesting, commenting, and narrating. Of primary concern was how often symbols infused the child's states of engagement with people and objects and how experience in such symbol-infused states related to language acquisition. Findings indicate that symbols increasingly infuse joint engagement, and that both the timing and the trajectory vary widely among typically developing toddlers, especially during the last half of the 2nd year. Moreover, variations in amount of symbol-infused supported joint engagement may both be influenced by variations in the onset of language and contribute to differences in language facility at 30 months.

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A battery of 17 rating items were applied to video records of typically-developing toddlers and young children with autism and Down syndrome interacting with their parents during the Communication Play Protocol. This battery provided a reliable and broad view of the joint engagement triad of child, partner, and shared topic. Ratings of the child’s joint engagement correlated very strongly with state coding of joint engagement and replicated the findings that coordinated joint engagement was less likely in children with autism and symbol-infused joint engagement was less likely in children with Down syndrome. Ratings of other child actions, of parent contributions, and of shared topics and communicative dynamics also documented pervasive variations related to diagnosis, language facility, and communicative context.