BASIS FOR R&R AUTISM INTERVENTION



A key finding of recent research in the area of typical child development has been the identification of the pivotal role of joint attention and social referencing skills in the development of language, play, and emotional regulation ( Bloom, 2000Morales, Mundy, Crowson et al, 2005Mundy, Sigman, & Kasari, 1995 Rollins & Snow, 1998Rutherford, Young, Hepburn & Rogers, 2007). Indeed, social referencing and joint attention have been called "the foundation for all further communication and cultural learning"  (p.2, Carpenter, et. al., 1998).
The terms "social referencing" and "joint attention" are closely related. Here, we define social referencing as a person's ability to monitor another's behaviour, and adapt his/her own behaviour according to its effect. Joint attention refers to a person's ability to simultaneously attend to both another person and an object or event. Joint attention is one of the skills underlying social referencing.  The Autism Speaks video glossary is an excellent resource to see the difference between the social referencing of typical children and children with ASD.
 

Referencing is a core deficit in Autism Spectrum Disorders

Social referencing skills have been identified in a overwhelming number of studies as a core deficit in ASD ( Baron-Cohen, 1987 1989 1993 Baron-Cohen et. al. 1996 1997 Charman, 2003 Charman et. al. 1997 1998 2000 Dawson et. al. 1989 1998 2002 Kasari et. al. 1990 2001 2008 Mundy, 1995 Mundy et. al. 1993 1997 Whalen, 2003 ).  Since social referencing is such a foundation for typical development, some researchers have speculated that this may be the root cause of the challenges faced by persons with ASD ( Charman, 2003 Kasari, 2008 ).


Referencing is pivotal for Language Learning

Baldwin (1991)   studied typical 16-19 month olds to see how referencing would influence their learning of new words. When a child was looking at a novel object the adult sitting next to the child said a new word (i.e. "Toma! There's a toma!") The child only made the association with the new word and the object if the speaker was looking at that object. If the speaker was looking at another object, the child would follow the speaker's gaze and assume that this different object was the referent of the word. 

In addition to studies with typical children, a number of studies have identified the correlation between joint attention skills and language learning challenges in children with ASD.  Baron-Cohen et al. (1997)  replicated the  1991 Baldwin  study and noted that children with autism made significantly more errors than language and mental aged matched typical children and children with mental handicap.  That is they used the speaker's gaze significantly less than the other children. 

In  2003, Charman  studied young children with ASD and found "the greater the facility a child demonstrated in gaze switching [looking from a toy to an adult] during the active toy task at 20 months of age, the less severe were that child's social and communication symptoms at 42 months".  Mundy et. al. (1990)  also found that joint attention behaviours (alternating gaze, pointing, showing and gaze following) measured at 45 months were positively associated with language ability 12 months later in children with ASD.


Referencing supports Play

Social referencing has been found to play an important predictive role in how the development of children's play. Children with ASD seem to be particularly affected in their ability to engage in pretend play ( Charman et al, 1997 ). Recent evidence suggests that this may be directly related to autistic children's difficulties in the area of social referencing. For example,  Rutherford et. al. (2007)  conducted a longitudinal study of play development in typical, autistic, and developmentally delayed children. They found that joint attention was the only factor which successfully predicted the development of children's play. Other factors such as developmental level, executive function, and imitation skills had no predictive value.

Referencing facilitates Regulation

Social referencing has also been shown to allow typical children to perceive how others feel about situations, which in turn effects how they react to the situation.  Sorce et. al. (1985)  created a "Visual Cliff" to see how typical infants would use their mother's facial reactions to influence their behaviour.  Twelve month old infants were given the opportunity to crawl across a glass table top, which had another opaque table underneath. The infants crawled towards their mothers who were holding an interesting toy.  Half way across, the table under the glass top ended, which the infants perceived as a "cliff".  Virtually all of the infants referenced their mother's, and if their mother smiled, 90% of the infants crossed over the "cliff" but if their mother had an anxious or worried look, 100% of the infants turned back.

Reference and Regulate Autism Intervention

Despite these numerous and well-replicated research findings, rarely, if ever, do the conventional autism intervention approaches address the development of social referencing as a primary goal in a structured, developmentally-sound manner ( Kasari, 2008 ). R&R autism intervention bridges the gap between research and practice by providing a systematic, step-by-step approach to the development of social referencing for children with ASD. 

Of course, a well developed autism intervention plan must encompass the whole child and family. To this end, R&R consultants have experience and training in a number of other established practices in ASD intervention and use these tools when appropriate. We also value the input and expertise of our community partners in Speech Language Pathology, Occupational Therapy, Social Work, Supported Child Development, etc. in developing a comprehensive plan for the child and family. 

You can see R&R autism intervention by going to our  Video's page  and see the outcomes for our clients on our R&R autism intervention research page. 




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