Increasing Joint Attention in Children With Autism Using Contingent Social Stimuli as Reinforcers

Joint attention is a critical skill that supports the development of early communication and language. This study examines whether joint attention responses of 5-6-year-old children with ASD can be increased using social stimuli without the use of tangible stimuli. We compared the efficacy of contingent social stimuli alone to the efficacy of social stimuli delivered with tangible reinforcers on increasing joint attention skills with children with ASD.

Using a single-subject multiple treatment reversal design (A₁ B A₂ C and A₁ C A₂ B), this study measured the joint attention responses (i.e., gaze shifting and pointing) in six participants. The treatment conditions were implemented in a counterbalanced order. The conditions included: (A₁) Baseline, (B) contingent delivery of social stimuli (smiles and praise), (A₂) reversal, and (C) contingent delivery of social stimuli in conjunction with tangible stimuli.

Data analyses were conducted by visual inspection and comparison of the percentage of correct responses between all four phases. All participants increased their joint attention responses in both treatment conditions compared to baseline and reversal phases. Contingent social stimuli delivered alone (without a tangible reinforcer) were sufficient to increase the gaze shifting and pointing responses of all children.

The present findings suggest that contingent social stimuli can provide practitioners with a practical and socially valid intervention for increasing responding to joint attention in children with ASD. The results underscore the importance of incorporating contingency learning principles within comprehensive developmental frameworks for joint attention interventions.