[Exploring joint attention processes in young children with autism spectrum disorder].

OBJECTIVES: Symptoms in autism, a neurodevelopmental disorder, appear at an early age. Research consensus shows impairments in communication and especially joint attention, defined as the capacity to intentionally share attention between two persons or a person and an object. Recent studies in autism spectrum disorder (ASD) focus on infants' processes associated to joint attention, such as visual and auditive regulation, attentional engagement and social motivation. The present research's objective is to examine the role of these factors in joint attention.

METHODS: A group of 50 children with ASD, aged 21 to 50 months, were selected. They went through a clinical assessment which included evaluations of development and symptoms, a scale measuring auditive and visual regulation; a grid elaborated to quantify motivation behavior towards a person and an object in two different engagement states: alone or with an adult and finally a measure of the child's capacity to disengage from an object. A joint attention score was obtained with the Early Communication Scale for Children (ECSC). Results show: (1) an effect of visual regulation on joint attention, (2) a relation between visual regulation and joint attention partially mediated by motivation. Our results clarify the nature of the relationship between visual regulation and joint attention, with motivation modulating visual regulation in its relation to joint attention, (3) a relation between attentional disengagement and joint attention. Visual regulation, social and non-social motivation and attentional disengagement are all associated to joint attention. A clinical measure of motivation behaviors for children with ASD has been created and can be applied in clinical settings, as it is adapted to young children with ASD symptomatology and enriches diagnosis.

CONCLUSIONS: Statistical analyses of our clinical observations suggest a mediation model highlighting the influence of motivation in the mechanisms underlying joint attention. The measurement of processes and mechanisms associated with social communicative skills at a very early age, here motivation and attentional disengagement processes associated with joint attention, help include these factors in early intervention programs.