Autistic children are diagnosed because of challenges with social and communication interactions, as well as a tendency to engage in repetitive behaviors and to have a limited range of interests. Almost all autistic preschool-aged children have difficulty with joint attention and symbolic play.
When researchers have looked at what preschool skills are most predictive of how an autistic person will function when s/he is older, language skills are among the most important abilities. Children who have acquired the ability to use spoken language in order to communicate with others by the end of preschool face fewer academic challenges than children who are still nonverbal. Further, research tells us that if we teach joint attention and symbolic play skills to autistic children, they will develop better language and communication abilities. Alternatively, if we do not specifically teach joint attention and symbolic play skills, they will be unlikely to learn the skills, and their language development will not progress as well. So, joint attention and symbolic play are key skills that should be addressed for all autistic preschool-aged children.
Of course, preschool-aged autistic children generally have many needs, and a comprehensive intervention program that helps them develop in many areas is essential. The ASAP intervention is intended for use in preschool programs that are providing comprehensive educational services for autistic children.
The term “joint attention” describes what happens when two people pay attention to the same thing on purpose. Imagine, for example, that a teacher points to a picture book and says to a child, “Look at this book.” The child looks where the teacher is pointing, and they look at the book together. In this situation, the teacher and the child have engaged in joint attention. Children can also initiate joint attention. Imagine that you are out with your child and your child sees a dog. Your child might look up at you to see whether you also see the dog, and then look back at the dog again. This would also be joint attention – sharing attention to the dog on purpose.
Symbolic play involves pretending or using imagination. At a simple level, when a toddler pretends to stir in a bowl that is actually empty, she is pretending that there is something in the bowl. Or when a preschooler picks up a cardboard tube and swings it in front of him like a sword, he is pretending that the cardboard tube is something different from what it actually is. A kindergartner who swoops around pretending to be a superhero defeating the bad guys is also showing symbolic play skills.
This occurs when the child pretends that a toy/object feels a certain way (e.g., a hot plate of food) or moves a certain way (a bumpy car ride). Using pretend characteristics in play shows the child is furthering his/her understanding of pretend play and that s/he can pretend an object has a quality that is not actually present.
Domain: Play
Category: Symbolic
Context: Focused/1:1, Generalized/Group
This occurs when the child is engaged in a game or routine with another person, and that person stops the activity. Then, the child uses some form of communication, potentially gestures, vocalizations, verbalizations or gaze, to indicate that they want more of the game or routine. A signal for continuation after a brief pause shows that the child is beginning to understand that his/her actions can influence the actions of another person.
Domain: Social Communication
Category: Social Interaction
Context: Focused/1:1, Generalized/Group
This occurs when the child combines some type of gesture, such as pointing or reaching, and/or uses vocalizations while looking at that person to indicate that they want to continue a game or activity that has paused. This illustrates that the child is beginning to understand how to engage another person and that there is some shared enjoyment during a particular activity.
Domain: Social Communication
Category: Social Interaction
Context: Focused/1:1, Generalized/Group
This occurs when the child pretends to be another person or character in a play routine when another person suggests it. Taking on a role in play shows the child is beginning to understand that s/he can pretend to be someone other than him/her-self during play routines.
Domain: Play
Category: Symbolic
Context: Focused/1:1, Generalized/Group