ERIC ED581235: Brief Report: Joint Attention and Information Processing in Children with Higher Functioning Autism Spectrum Disorder

2016·2.2 MB·English

by  ERIC

JAutismDevDisord(2016)46:2555–2560
DOI10.1007/s10803-016-2785-6
BRIEF REPORT
Brief Report: Joint Attention and Information Processing
in Children with Higher Functioning Autism Spectrum Disorders
Peter Mundy1,2 • Kwanguk Kim3 • Nancy McIntyre1 • Lindsay Lerro1 •
William Jarrold4
Publishedonline:9April2016
(cid:2)SpringerScience+BusinessMediaNewYork2016
Abstract Theory suggests that information processing Introduction
during joint attention may be atypical in children with
Autism Spectrum Disorder (ASD). This hypothesis was Research on joint attention has played a significant role in
tested in a study of school-aged children with higher defining critical features of the social-cognitive develop-
functioningASDandgroupsofchildrenwithsymptomsof ment of children with Autism Spectrum Disorders (e.g.
ADHD or typical development. The results indicated that Mundy et al. 2009). The term ‘social-cognition’ is often
the control groups displayed significantly better recogni- used to refer to behavioral measures indicative of mental
tion memory for pictures studied in an initiating joint processes involved in inferring the intentions, beliefs, or
attention (IJA) rather than responding to joint attention emotionsofanotherperson.However,thisisonlyonefacet
(RJA) condition. This effect was not evident in the ASD ofsocial-cognition.Anothervitalcomponentofthesocial-
group.TheASDgroupalsorecognizedfewerpicturesfrom cognition that is especially pertinent to joint attention
theIJAconditionthancontrols,butnottheRJAcondition. research refers to changes in stimulus coding effects that
Atypical information processing may be a marker of the occur as the result of social-attention coordination (e.g.
continued effects of joint attention disturbance in school Edwardsetal.2015;Mundy2016;KimandMundy2012).
aged children with ASD. Recognitionofthisaspectofsocial-cognitionhasemerged,
inpart,frommountingevidencethattheexperienceofjoint
Keywords Joint attention (cid:2) Information processing (cid:2) attentioninfluencesandinsomecaseenhancesencodingof
Social cognition (cid:2) Autism Spectrum Disorder visual stimuli and words in infancy (e.g. Hirotani et al.
2009; Kopp and Lindenberger 2011; Striano et al. 2006)
and adults (e.g. Bayliss et al. 2013; Bo¨ckler et al. 2011;
Boothbyetal.2014;FrischenandTipper2004;Linderman
et al. 2011; Kim and Mundy 2012).
The effect of joint attention on stimulus encoding was
illustratedinarecentstudyofKimandMundy(2012)who
observed that stimulus encoding and subsequent recogni-
tionmemoryforpictureswasenhancedinoneoftwotypes
& PeterMundy
of virtual joint attention conditions in adults. Specifically,
[email protected]
picture encoding was more positively affected when an
1 SchoolofEducation,UniversityofCalifornia(UC)Davis, avatar followed the participants gaze shifts to stimuli,
OneShieldsAve.,Davis,CA95825,USA ratherthanwhenparticipantsfollowedthegazeshiftsofan
2 MINDInstitute,UniversityofCalifornia(UC)Davis,Davis, avatartopicturesonstudytrials.Theformerconditionwas
CA,USA an analogue of the experience of initiating joint attention
3 DivisionofComputerandSoftwareEngineering,Hanyang bids (IJA), while the latter condition was analogous to
University,Seoul,Korea responding to joint attention bids (RJA). Kim and Mundy
4 NuanceCommunicationsInc.,Sunnyvale,CA,USA (2012)concludedthattheexperienceofbeingtheobjectof
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attentionoftheavatarduringvirtualIJAhadadifferentand HFASD,ADHDandTDgroupsdidnotdifferinmeanage:
morepowerfuleffectonrecognitionmemorythanRJAdid 11.4 years (2.1), 12.2 years (2.3) and 11.8 years, respec-
in adults. This pattern of results and conclusion is consis- tively. However, the groups did differ on IQ, F (2,
tent with other observations that adults are sensitive to 83) = 4.67, p\.025, eta2 = .09 with the HFASD and
beingtheobjectoftheattentionofothers,andthatthistype ADHD groups lower than the TD group: 103.6 (15.2),
of ‘‘gaze-leading’’ has an important impact on cognition 101.1, (15.1) and 112.6, (14.1) respectively. Intellectual
(Bayliss et al. 2013; Boothby et al. 2014; Edwards et al. level was estimated with the Wechsler Abbreviated Scales
2015). of Intelligence (Wechsler 2011) and group differences in
The study by Edwards et al. (2015) also reported IQ were covaried in all group comparisons.
observations that are relevant for the study of Autism Children with ASD and children with elevated symp-
Spectrum Disorders (ASD). In that study, individual dif- toms of ADHD were recruited from the MIND Institute
ferences in the impact of initiating joint attention, or gaze research participant tracking system, as well as from local
leading, on information processing was lower for people schools. ASD symptom presentation was confirmed with
who self-reported more symptoms of the Broad Autism parent report on the Social Communication Questionnaire
Phenotype(BAP)inasampleoftypicaladults.Itisalsothe (SCQ, Berument et al. 1999),means = 21,4.9,2.3 for the
casethatASDindividualdifferencesinthedevelopmentof ASD, ADHD, and TD groups, as well as the Autism
initiatingjointattentionarerelatedtoproblemsinlearning Spectrum Symptom Questionnaire (ASSQ, Ehlers et al.
from and with other people (e.g. Kasari et al. 2008), and 1999), means = 18, 7.5, 1.8 respectively. The ASSQ has
theory has suggested that differences in the influence of been validated on a large sample for the identification of
jointattentiononinformationprocessingcontributestothe ASD inhigherfunctioningchildren(Posserud etal. 2006).
link between joint attention and learning problems in AnADHDclinicalcontrolsamplewasrecruitedtocontrol
affected children (Mundy 2016; Mundy et al. 2009). forthepossibilitythatADHDsymptomcomorbidityinthe
Given these observations, this study was designed to ASD group could account for group differences on an
examine the possible effects of joint attention on infor- information processing measure. ADHD symptoms were
mationprocessinginhigherfunctionchildrenwithASDin confirmed with parent report on the Conner-3 (Conners
order to better understand the role of joint attention in the 2010). The two clinical groups displayed comparable
learning problems of affected children. A virtual joint scores on Total Conner’s ADHD symptoms, but signifi-
attention information processing paradigm was used to cantly differed from the TD group, F (2, 82) = 31.2,
examine three predictions related to hypothesis that joint p\.001. The mean T-scores were, ASD = 71.4 (13.9),
attention affects information processing differently in ADHD = 74.9 (12.4), and TD = 49.1 (9.1). To examine
children with ASD. The first was that typical children and the effects that individual differences in memory on task
adolescents would display evidence of enhanced informa- performance the participants were also assessed on the
tion processing in IJA relative to RJA conditions as pre- Wide Range Assessment of Memory and Learning
viously observed intypical adults(KimandMundy2012). (WRAML2, Sheslow and Adams 2003). The TD group
The second hypothesis was that many children with ASD displayed significantly better performance on the Total
would not display the level of enhanced information pro- memory score, 111 (13.1), than did the ASD group, 99.3
cessing in the IJA condition exhibited by typical children. (15.6),andtheADHDgroup 100(13.4),F (2,82) = 5.18,
The third hypothesis was that the lack of enhanced infor- p\.01.
mation processing in the context of IJA would be specific
to ASD rather than a phenomenon associated with the Procedures
general attention problems exhibited by a clinical control
sample of children with elevated ADHD symptoms. The participants were presented with a virtual reality
paradigm(Fig. 1)thatismorefullydescribedinStudy2of
Kim and Mundy (2012). Two blocks of 12 RJA picture
Methods study trials (24 studied pictures) and two blocks of 12 IJA
trials (24 pictures) were presented in one of two counter-
This research was conducted in compliance with the balancedordersstartingeitherwithablockofRJAtrialsor
appropriate university Institutional Review Board, and a block of IJA trials (e.g. RJA Block 1, IJA Block 1, RJA
written consent and assent was obtained from parents and Block2,IJABlock2).IntheRJAcondition,childrenwere
participants before gathering any data. directedtomakeeyecontactwithanavatar,thenfollowthe
Thirty-two 9- to 13-year-olds with HFASD, 27 children gaze direction of an avatar to the left or right to view a
with high ADHD symptoms, and 23 children with typical picture that they studied for 1 s. At the beginning of each
development (TD Group) participated in this study. The trial the avatar ‘‘waited and responded’’ to mutual gaze
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Fig.1 Illustrationoftheheadmounteddisplayusedtogatherdatain with permission from Frontiers.org, Frontiers in Human Neuro-
thevirtualjointattentionconditions(leftpanel)andillustrationofthe science,KimandMundy2012,Vol.6,inaccordwiththeopenaccess
avatar’s and participants eye movements in the IJA condition (right guidelinesofthejournal)
panela)andintheRJAcondition(rightpanelb).(Figurereprinted
from participant (a fixation of 300 ms) and shifted ‘‘her’’ gazeintheRJAcondition,orinattentiontothefaceofthe
gazeleftorright.Theparticipants’gazeshiftinthecorrect Avatar in either condition. The preliminary analyses also
direction triggered a 1 s appearance of a picture to the left revealed no effects of study stimulus presentation order.
and right location (houses, faces, or abstract patterns). There were also no significant correlations (r) between
Different pictures from the same category appeared in total WRAML memory scores and IJA or RJA correct
correct and incorrect left/right locations on each trial. The recognition (hit) scores for the ASD group (.30, .24), the
IJA condition was similar except the child was told to ADHDgroup(.01,.05),ortheTDgroup(.28,.07),andno
choose which side of the avatar to look. After the partici- differences in WRAML correlation with IJA or RJA hit
pants’ shift of gaze the pictures would appear and the scores within groups.Theseanalysesrevealednoevidence
avatar would follow the child’s line of regard. After the thatindividual differencesinworkingmemorycontributed
participantreturnedtomidlineonallIJAandRJAtrialsthe to the pattern of group differences observed in this study
avatar shifted gaze to midline following a 400 ms delay. (see below).
This allowed the participant to see the avatar return ‘‘her’’ Two MANCOVAS, controlling for IQ, were conducted
gaze to the midline in order to emphasize the participants’ separatelyforpicturerecognitionsoresassociatedwith the
experience of ‘‘gaze leading’’ or ‘‘gaze following’’ on IJAandRJAstudyconditions.Inthefirstofthesea3(DX
trials. Groups) by 2 types of scores (IJA Correct Hits and IJA
Thirty-six test trials were presented immediately after False Positive % picture recognition scores) analysis
the last study trial. The test trials paired equal numbers of revealed a significant DX Group by Type of IJA score
‘‘familiar’’ pictures studied in the IJA and RJA conditions interaction, Wilks’ Lambda = .84, F (2, 83) = 7.74,
(18 pictures per condition) paired with novel pictures. p\.001, eta2 = .16 (see Fig. 2a1). Planned follow-up
Correct hits and false alarms (errors of commission) were analyses indicated that the DX Groups differed on IJA-
scored for each test trial and summed for test trials asso- Correctscores,F(2,83) = 8.26,p\.001,butnotonIJA-
ciated with each condition. The dependent measures were FPscores,F(2,83) = 1.53,p[.20.Pairwisecomparisons
the percentage of pictures correctly recognized in con- (Tukey) revealed that the HFASD group had lower IJA-
junction with each condition as well as the percentage of Correct recognition scores than did the ADHD sample
false positive (FP) errors of commission recognition for (p\.05) or the TD sample (p\.05), however the latter
each condition. two groups did not significantly differ. Additional planned
repeatedmeasureanalyseswithineachgroupindicatedthat
the TD and ADHD samples displayed significantly higher
Results IJA-Correct scores than RJA-Correct scores, F (1,
22) = 37.83, p\.001, eta2 = .63, F (1,27) = 9.91,
Preliminary analyses indicted there were no diagnostic p\.004, eta2 = .27. However, there was no evidence of
group differences in attention (fixations or duration of this difference in the IJA-Correct and RJA-Correct scores
study time) to pictures in either condition, or in following in the HFASD sample, F (1, 34) = .08. This pattern of
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Fig.2 aTheDiagnosticGroup
differencesinpercentageof
correctpicturerecognitionin
theIJAcondition(IJA-Hit,left
panela)andthepercentof
errorsofcommissionforIJA
(IJA-FP,rightpanela).bThe
DiagnosticGroupdifferencesin
percentageofcorrectpicture
recognitionintheRJA
condition(RJA-Hit,leftpanel
b)andthepercentoferrorsof
commissionforRJA(RJA-FP,
rightpanelb)
results was consistent with the hypothesis thatthe HFASD trials. This observation is consistent with the hypothesis
sample was less likely to exhibit effects of IJA on infor- that joint attention affects stimulus encoding (e.g. Bayliss
mationprocessingcomparedtoatypicalorclinicalcontrol et al. 2013; Becchio et al. 2008; Boothby et al. 2014;
sample. The specifics of this pattern of results were Edwards et al. 2015; Frischen and Tipper 2004; Kopp and
observed in analyses that included full scale IQ as a Lindenberger2011).Thisjointattentioneffectmaybepart
covariate. of human social-cognition across the lifespan (Mundy
A three Diagnostic Groups by 2 types of scores (RJA 2016; Mundy et al. 2009), however, too little is currently
Correct Hits andRJA FalsePositive %picturerecognition know currently to be certain about the mechanism under-
scores) did not reveal evidence of a main effect of Diag- lying this phenomenon. Moreover, the validity of virtual
nosticGroups,F(2,83) = .42,p\.70,oraDXGroupby realityparadigmsforelicitingsocialcognitiveprocessesis
typeofRJAscoreinteraction,Wilks’Lambda = .96,F(1, notyetclear.Nevertheless,thedataareconsistentwithone
83) = 1.56, p[.22. hypothesispositsthatbeingtheobjectofattentionofothers
triggers a subcortical arousal network that leads to
enhanced cortical information processing (Senju and
Discussion Johnson2009).Anotherpossibilityisthatinitiationofjoint
attention activates self-referenced processing to a greater
The results of this study provide observations about the degree than RJA, and this results in activation of a neural
nature of joint attention and its roles in autism spectrum networkthatenhancesinformationprocessing(Mundyand
development. Like the effects previously observed with Jarrold 2010). These and other hypotheses may guide
adults (Kim and Mundy 2012), children and adolescents future research future research to determine the mecha-
withtypicaldevelopmentaswellaschildrenwithelevated nisms by which joint attention enhances human informa-
symptoms of ADHD displayed evidence of enhanced tion processing.
stimulus information processing and recognition memory A second major observation was that atypical informa-
during the experience of virtual IJA relative to RJA study tion processing during joint attention may be a clinically
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JAutismDevDisord(2016)46:2555–2560 2559
specific feature of the childhood development of ASD, at constitute one more piece of evidence that atypical infor-
least among higher functioning children. That is tosay the mation processing during joint attention is a feature of
atypicalpatternofinformationprocessingresponsetojoint ASD (Falck-Ytter et al. 2015), as well as the BAP (Ed-
attention was observed in the ASD sample, but not in an wards et al. 2015; Zhao et al. 2015). These observations
IQ-matchedsampleofchildrenwithADHD.Moreover,the support assertions and predictions of the information pro-
atypical pattern of information processing was observed cessingmodelofjointattentioninthedevelopmentofASD
even though there were no diagnostic group differences in (Mundy 2016; Mundy and Jarrold 2010; Mundy et al.
followingthegazedirectionoftheavatar,fixatingtheface 2009).However,thepicturehereisfarfromcomplete.For
of the avatar, or attending to the study pictures. Thus, the example,theresultsofthecurrentstudyreportnoeffectsof
atypicalpatternofinformationprocessingwasevidenteven RJA on information processing in school-aged children.
thoughtheHFASDchildrenappearedtoengageinthejoint Other observations, however, have suggested that RJA
attention behaviors in much the same way as the control informationprocessingeffectsmaybeobservedinyounger
samples. Attention of any kind is inextricably linked to children (Falck-Ytter et al. 2015), or in older individuals
information processing (e.g. Sperling and Weichselgartner with different measures of information processing (Zhao
1995), this includes joint attention (Mundy 2016). When et al. 2015).
thisfacetofjointattentionisrecognizedandmeasured,the In the final analysis, the results of this study do not
lifespaneffectsofjointattentiononpeopleaffectedbyASD provide a complete answer to any one question. However,
may becomemore apparent. they do make an important contribution to the theoretical
This study is not the first to suggest that joint attention and empirical impetus for more research on the effects of
does not elicit typical levels of information processing in jointattentiononstimulusencodingandlearningintypical
childrenwithASD.Falck-Ytteretal.(2015)examinedRJA development,aswellasinthedevelopmentofschool-aged
in3-year-oldchildrenwithASDandcomparisongroupsof children affected by ASD.
children with other developmental disabilities or typical
development. The children with ASD did not differ from Acknowledgments ThisstudywassupportedbyNationalInstitute
ofMentalHealthGrant1R21MH085904,VirtualRealityandSocial
thecontrolgroupsinfollowingthegazeofasocialpartner
Skills in Autism (P. Mundy, PI); Institute for Educational Sciences
to objects. However, the duration of fixation times during
Grant IES R324A110174 (P. Mundy), Virtual Reality Applications
social-attention coordination to the objects were signifi- forAttentionandLearninginChildrenwithAutismandADHD;and
cantlyshorterforthegroupwithASDthanforthecontrols. theUCDavisDepartmentofPsychiatryLisaCappsEndowmentfor
ResearchonNeurodevelopmentalDisordersandEducation.
Falck-Ytter et al. (2015) concluded that these results sug-
gestedthatthegroupwithASDwasmoreweaklyengaged
Author Contribution I would like to submit a brief paper titled,
in processing information about the objects in response to ‘‘Short Report Joint Attention and Stimulus Processing in Autism
RJAbidsthanwereothergroupsofchildren.Theywenton Spectrum Disorders’’, for consideration for publication in J.A.D.D.
Theauthorsofthepaperinclude:PeterMundy,SchoolofEducation
tospeculatethatanattenuatedprocessingbiasinRJAmay
andtheMINDInstitute,UCDavis,Davis,CA,USA;KwangukKim,
negatively affect learning opportunities in children with
SchoolofEducation,UCDavis,Davis,CA,USA;NancyMcIntyre,
ASD. School of Education, UC Davis, Davis, CA, USA; Lindsay Lerro,
In addition, Zhao et al. (2015) have observed an effect SchoolofEducation,UCDavis,Davis,CA, USA;andWilliamJar-
rold, School of Education, UC Davis, Davis, CA, USA. Two of the
of gaze following, or RJA, on information processing that
authors have changed their affiliations since the completion of data
is associated with the Broad Autism Phenotype or BAP.
collection for this study. Kwanguk Kim is now in the Engineering
Adults with more symptoms of ASD did not display the College,HanyangUniversity,Seoul,Korea.WilliamJarroldisnowat
gaze-cuing attention-directing effects when a stimulus the Natural Language Understanding Laboratory, Nuance Commu-
nications,Sunnyvale,CA,USA.
appeared longer after gaze cues (800 ms), but adults with
lower BAP symptoms did respond to gaze cues to longer
CompliancewithEthicalStandards
delayed stimuli. However, both high and low BAP adults
responded comparably to gaze cues with short stimulus Conflict of interest P. Mundy declares that he has no conflict of
interest. K. Kim declares that he has no conflict of interest.
onset intervals of 200 ms. This important finding suggests
N. McIntyre declares that she has no conflict of interest. L. Lerro
that the direction of cuing information and/or valence of
declaresthatshehasnoconflictofinterest.W.Jarrolddeclaresthathe
shifts of eye-gaze is weaker, or degrades more quickly, hasnoconflictofinterest.
among people who display more evidence of the BAP.
However, the basic mechanism of gaze-cuing is intact, Ethical Approval All procedures performed in studies involving
humanparticipantswereinaccordancewiththeethical standardsof
regardless of the relative presence of the BAP.
theinstitutionaland/ornationalresearchcommitteeandwiththe1964
Thus, the observations and conclusions of this paper do Helsinkideclaration anditslateramendmentsorcomparableethical
not describe an isolated phenomenon. Rather, they standards.
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Informed Consent Informed consent was obtained from all indi- attention and play interventions. Journal of Consulting and
vidualparticipantsincludedinthestudy. ClinicalPsychology,76(1),125–137.
Kim, K., & Mundy, P. (2012). Joint attention, social cognition and
recognitionmemoryinadults.FrontiersinHumanNeuroscience
SpecialTopic:TowardsaNeuroscienceofSocialInteraction,6,
References
172.doi:10.3389/fnhum.2012.00172.
Kopp,F.,&Lindenberger,U.(2011).Theeffectsofjointattentionon
Baron-Cohen, S. (1995). The eye-direction detector (EDD) and long-terms memory in 9month-old infants: An event related
sharedattentionmechanism(SAM):Twocasesforevolutionary potentialstudy.DevelopmentalScience,14,660–672.
psychology. In C. Moore & P. Dunham (Eds.), Joint attention: Linderman,O.,Pines,N.,Rueschemeyer,S.,&Bekkering,H.(2011).
Itsoriginsandroleindevelopment(pp.41–60).NewYork,NY: Grasping the others’s attention: The role of animacy in action
Erlbaum. cuingofjointattention.VisionResearch,51,940–944.
Bayliss,A.,Murphy,E.,Naughtin,C.,Kritikos,A.,Schilbach,L.,& Lord,C.,&Jones,R.(2012).Re-thinkingtheclassificationofautism
Becker, S. (2013). Gaze leading: Initiating joint attention spectrumdisorders.JournalofChildPsychologyandPsychiatry,
influence s eye movements and choice behavior. Journal of 53,490–509.
ExperimentalPsychology:General,142,76–92. Mundy, P. (2016). Autism and joint attention: Developmental,
Becchio, C., Bertone, C., & Castiello, U. (2008). How the gaze of neuroscience, and clinical fundamentals. New York City, NY:
other influences objects processing. Trends in Cognitive GuilfordPub.Inc.
Sciences,12,254–258. Mundy, P., & Jarrold, W. (2010). Infant joint attention, neural
Berument,S.,Rutter,M.,Lord,C.,Pickles,A.,&Bailey,A.(1999). networks and social cognition. Neural Networks, 23(8),
Autism screening questionnaire: Diagnostic validity. British 985–997.
JournalofPsychiatry,175,444–451. Mundy, P., Sigman, C., & Kasari, C. (1994). Joint attention,
Bo¨ckler, A., Knoblich, G., & Sebanz, N. (2011). Giving a helping developmental level and symptom presentation in autism.
hand:effectsofjointattentiononmentalrotationofbodyparts. DevelopmentandPsychopathology,6,389–402.
Experimentalbrainresearch,211(3–4),531–545. Mundy, P., Sullivan, L., & Mastergeorge, A. M. (2009). A parallel
Boothby, E., Clark, M., & Bargh, J. (2014). Shared experiences are and distributed-processing model of joint attention, social
amplified.PsychologicalScience,25,2209–2216. cognitionandautism.AutismResearch,2,2–21.
Conners, K. (2010). Conners (3rd ed.). North Tonawanda, NY: Posserud,M.,Lundervold,A.,&Gillberg,C.(2006).Autisticfeatures
MultihealthSystems. in a total population of 7–9year-old children assessed by the
Edwards, S. G., Stephenson, L. J., Dalmaso, M., & Bayliss, A. P. ASSQ (Autism Spectrum Screening Questionnaire). Journal of
(2015).Socialorientingingazeleading:Amechanismforshared ChildPsychologyandPsychiatry,47,167–175.
attention.ProceedingsoftheRoyalSocietyofLondon:SeriesB. Senju, A., & Johnson, M. H. (2009). The eye contact effect:
Biological Sciences, 282(1812), 20151141. doi:10.1098/rspb. Mechanisms and development. Trends in Cognitive Sciences,
2015.1141. 13(3),127–134.
Ehlers,S.,Gillberg,C.,&Wing,L.(1999).Ascreenquestionnairefor Sheslow,D.,&Adams,W.(2003).Wide-rangeassessmentofmemory
Aspergerssyndromeandotherhigh-functioningautismspectrum and learning (2nd ed.). Lutz, FL: Psychological Assessment
disorder in school age children. Journal of Autism and Devel- Resources.
opmentalDisorders,29(2),129–141. Sperling, G., & Weichselgartner, E. (1995). Episodic theory of the
Falck-Ytter, T., et al. (2015). Brief Report: Lack of processing bias dynamics of spatial attention. Psychological Review, 102,
for object other people attend to in 3-year-olds with Autism. 503–532.
Journal of Autism and Developmental Disorders, 45(1), Striano, T., Chen, X., Cleveland, A., & Bradshaw, S. (2006). Joint
987–1904. attentionsocialcuesinfluenceinfantlearning.EuropeanJournal
Frischen, A., & Tipper, S. (2004). Orienting attention via observed ofDevelopmentalPsychology,3,289–299.
gaze shifts evokes longer term inhibitory effects: Implications Wechsler, D. (2011). Wechsler abbreviated intelligence scale. San
for social interaction, attention andmemory. Journal of Exper- Antonio,TX:PearsonPublishers.
imentalPsychology:General,133,516–533. Zhao,S.,Uono,S.,Yoshimura,S.,&Toichi,M.(2015).Isimpaired
Hirotani,M.,Stets,M.,Striano,T.,&Friederici,A.D.(2009).Joint joint attention present in non-clinical individuals with high
attentionhelpsinfantslearnnewwords:Event-relatedpotential autistic traits? Molecular Autism, 6, 67. doi:10.1186/s13229-
evidence.NeuroReport,20(6),600–605. 015-0059-3.
Kasari, C., Paparella, T., Freeman, S., & Jahromi, L. B. (2008).
Language outcome in autism: Randomized comparison of joint
123