Joint attention, a foundational nonverbal social-communicative milestone that fails to develop naturally in autism, was promoted for three toddlers with early-identified autism through a parent-mediated, developmentally grounded, researcher-guided intervention model. A multiple baseline design compared child performance across four phases of intervention: focusing on faces, turn-taking, responding to joint attention, and initiating joint attention. All toddlers improved performance and two showed repeated engagement in joint attention, supporting the effectiveness of developmentally appropriate methods that build on the parent-child relationship. A complementary qualitative analysis explored family challenges, parent resilience, and variables that may have influenced outcomes. Intervention models appropriate for toddlers with autism are needed as improved early identification efforts bring younger children into early intervention services.

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A randomized controlled trial was conducted to evaluate effects of the Joint Attention Mediated Learning (JAML) intervention. Toddlers with autism spectrum disorders (ASD) aged 16-30 months (n = 144) were randomized to intervention and community control conditions. Parents, who participated in 32 weekly home-based sessions, followed a mediated learning process to target preverbal social communication outcomes (social visual synchrony, reciprocity, and responding and initiating forms of joint attention) throughout daily interactions. The analysis found post-intervention effects for all outcomes, with all except initiating joint attention sustaining 6 months post-intervention. Findings support the value of very early intervention targeting explicitly social functions of preverbal communication and of promoting active engagement in the learning process for both toddlers and parents.

This review examines how recommended practices for toddlers with autism spectrum disorders (ASD) are integrated into interventions in the first generation of research targeting toddlers with ASD. The purpose was not to review intervention effectiveness, which is addressed in other reviews; rather, it was to assess reported intervention methods in relation to principles distilled from early intervention policy and validated practice guidelines for toddlers and families. These principles include family-centered and family-supportive practice, natural environments, promotion of active child participation in learning, and functional and systematic practices that consider developmental readiness and unique variations in learning. A small minority of reported interventions (5 of 27) fully addressed each principle, revealing a substantial gap between principles and intervention research practices. The most pronounced gaps concerned natural/inclusive environments and family-centered/family-supportive practices. Recommendations for future research are presented.