This randomized controlled trial provides promising data on the specificity and generalizability of joint attention and play interventions for young children with autism. Future studies need to examine the long-term effects of these early interventions on children's development.

This study reports results of a randomized controlled trial aimed at joint attention (JA) and symbolic play (SP) in preschool children with autism, with prediction to language outcome 12 months later. Participants were 58 children (46 boys) with autism between 3 and 4 years of age. Children were randomized to a JA intervention, an SP intervention, or control group. Interventions were conducted 30 min daily for 5-6 weeks. Assessments of JA skills, SP skills, mother-child interactions, and language development were collected at 4 time points: pre- and postintervention and 6 and 12 months postintervention by independent testers. Results indicate that expressive language gains were greater for both treatment groups compared with the control group, and results could not be explained by differences in other interventions in which children participated. For children beginning treatment with the lowest language levels, the JA intervention improved language outcome significantly more than did the SP or control interventions. These findings suggest clinically significant benefits of actively treating JA and SP skills in young children with autism.

Objective This study examines the cognitive and language outcomes of children with an autism spectrum disorder (ASD) over a five -year period after receiving targeted early interventions that focused on joint attention and play skills. Method Forty children from the original study (n = 58) had complete data at the five year follow up. Results 80% of children had achieved functional use of spoken language with baseline play level predicting spoken language at the five -year follow- up. Of children who were using spoken language at age eight years, several baseline behaviors predicted their later ability, including earlier age of entry into the study, initiating joint attention skill, play level, and assignment to either the joint attention or symbolic play intervention group. Only baseline play diversity predicted cognitive scores at age eight. Conclusions This study represents one of the only long term follow up studies of children who participated in preschool early interventions aimed at targeting core developmental difficulties. The study findings suggest that focusing on joint attention and play skills in comprehensive treatment models is important for long term spoken language outcomes.

Prevalence of children with emotional or behavioral disorders (EBD) is a critical component in the discussion of underidentification of children served in special education. This discussion has previously focused almost exclusively on point prevalence or the number of children with EBD presumably needing services at any single point in time. Cumulative prevalence, on the other hand, is the number of children who have had EBD at some point in their lives before high school graduation. In the authors’ review of both types of prevalence, they found that estimates of the latter far exceed those of the former, significantly highlighting the service gap that exists between prevalence estimates and special education identification. Even when point prevalence is limited just to children with moderate or severe disorder, special education identification in the emotional disturbance category appears restricted to less than the bottom tenth of all children in need. Implications for special education are discussed, including issues around underidentification, misidentification, underservice, and related issues concerning children with EBD.

Parents, professionals, and researchers have been concerned about the most appropriate placement for children with mental retardation. To shed light on the efficacy of integration, 36 studies were reviewed on the academic and social attainments of school-age children with mental retardation. Results show that children in general education classes do not attain social acceptance ratings at as high a level as do their typically developing peers. When comparing children with mental retardation in general education and special education classrooms, integrated students perform better than their comparable segregated students on measures of academic achievement and social competence. Other variables are discussed that might affect child outcomes, and related recommendations are given for future research.

In three studies, children with Down syndrome were presented with emotion recognition tasks designed to tap their knowledge of simple emotions, their ability to label emotions, and their understanding of emotions from simple, story-based contexts. Results indicate that young children with Down syndrome perform similarly to typical controls matched on MAs of approximately 3 years. However, by developmental age of 4 years, children with Down syndrome performed worse than both MA-matched typical children and children with non-Down syndrome types of mental retardation. Although the MAs of children with Down syndrome increased over 2-years, their emotion recognition abilities did not. Taken together, findings suggest both etiological and developmental differences in the emotion recognition abilities of children with Down syndrome.

Statistical learning is characterized by detection of regularities in one's environment without an awareness or intention to learn, and it may play a critical role in language and social behavior. Accordingly, in this study we investigated the electrophysiological correlates of visual statistical learning in young children with autism spectrum disorder (ASD) using an event‐related potential shape learning paradigm, and we examined the relation between visual statistical learning and cognitive function. Compared to typically developing (TD) controls, the ASD group as a whole showed reduced evidence of learning as defined by N1 (early visual discrimination) and P300 (attention to novelty) components. Upon further analysis, in the ASD group there was a positive correlation between N1 amplitude difference and non‐verbal IQ, and a positive correlation between P300 amplitude difference and adaptive social function. Children with ASD and a high non‐verbal IQ and high adaptive social function demonstrated a distinctive pattern of learning. This is the first study to identify electrophysiological markers of visual statistical learning in children with ASD. Through this work we have demonstrated heterogeneity in statistical learning in ASD that maps onto non‐verbal cognition and adaptive social function.

Lay Abstract This study follows 40 children who were participants in a randomized controlled early intervention trial (Kasari et al., 2006, 2008, 2012) from early childhood (2–5 years of age) to elementary school age (8–10 years). The growth trajectories of social-communication and language outcomes in these children were estimated based on 5 time points during that period. The children were grouped by diagnosis at the last follow-up (Autism, ASD, No Diagnosis) and by their original treatment group assignment (Joint attention, Symbolic Play, Control), and differences between these groups evaluated. Results showed that joint attention skills of coordinated joint looking and showing increased over time and pointing to share interest increased over the first year measured and decreased thereafter. These trajectories were influenced by both original treatment assignment and diagnostic status at the follow-up. In addition, a cross-lagged panel analysis suggests a causal relationship between early pointing and later language development. This study highlights the longitudinal and developmental importance of measures of early core deficits in autism and suggests that both treatment and ASD symptomatology may influence growth in these skills over time. Scientific Abstract This study follows 40 children who were participants in a randomized controlled early intervention trial (Kasari et al., 2006, 2008, 2012) from early childhood (2–5 years of age) to elementary school age (8–10 years). To fully utilize the available longitudinal data, the general linear mixed model (GLMM) was the primary analytical approach. The growth trajectories of joint attention skills (pointing, coordinated joint looking and showing) and expressive language outcomes in these children were estimated based on 5 time points during the measurement period. The children were grouped by diagnosis at the last follow-up (Autism, ASD, No Diagnosis) and by their original treatment group assignment (Joint Attention, Symbolic Play, Control), and differences between these groups evaluated. Results showed that joint attention skills of coordinated joint looking and showing increased over time and pointing to share interest increased over the first year measured and decreased thereafter. These trajectories were influenced by both original treatment assignment and diagnostic status at the follow-up. In addition, a cross-lagged panel analysis revealed a causal relationship between early pointing and later language development. This study highlights the longitudinal and developmental importance of measures of early core deficits in autism and suggests that both treatment and ASD symptomatology may influence growth in these skills over time.