Exploring Tactile Initiation of Joint Attention in Autistic Children

Initiation of joint attention (IJA) is often impaired in children who may be diagnosed with autism spectrum disorder (ASD). Traditionally, assessments of IJA have focused on visual and auditory means of communication. Recent research has expanded the understanding of joint attention to include tactile interactions. To investigate the early development of IJA in toddlers, particularly focusing on the differences in sensory modalities, we conducted a prospective study tracking 60 toddlers (30 males) up to 36 months of age, including 16 who were later diagnosed with ASD. We used videos taken during the administration of Communication and Symbolic Behavior Scales-Developmental Profile to code for IJA corresponding to different sensory modalities. During the second year of life, autistic children displayed lower frequencies of visual, auditory, and combined visual-auditory IJA compared to typically developing peers. Conversely, autistic children exhibited higher frequencies of tactile IJA. Notably, the frequencies of tactile IJA at 12 months were correlated with social symptoms at 24 months, showing a positive correlation across all participants and a negative correlation specifically within the ASD group. These results suggest that differences in the use of different sensory modalities of IJA may influence the development of future social communication abilities. Clinical Trial Registration: www.​chictr.​org.​cn, identifier ChiCTR2100049811, 2021–08-10.