S. EZELL ET AL.
Gesturing appeared to increase from both intervention condi-
tions (imitation and contingent responsivity) to the spontaneous
play phases The considerable intragroup heterogeneity (high
standard deviations) may have masked potential group diffe-
rences, especially given the combining of the referential look-
ing and gaze-following behaviors. A larger sample would en-
able further examination of the specific gesturing behaviors and
whether any differences exist between communicative and in-
strumental gestures (Loveland & Landry, 1986). Some have
referred to these as initiating joint attention behaviors and initi-
ating regulating/requesting behaviors. Also, with a larger sam-
ple, comparisons could be made between those children who
used gestures and those who did not. Alternatively, this result
may be consistent with the finding that children with autism are
less inpaired in gesturing than other joint attention behaviors
(Mundy & Sigman, 2006).
Research supports the perspective that imitation serves two
functions (Nadel, Revel, Andry, & Gaussier, 2004; Uzgiris,
1981). Nadel et al. (2004) refer to these as communication and
learning. The present study supports this position by expanding
on previous studies that showed increased distal (attention) and
proximal (touching) social behaviors during and after imitative
interactions (Escalona et al. 2002; Field et al., 2001). The pre-
sent study demonstrates that imitating preschoolers with autism
elicits more joint attention behaviors.
Although there is ample evidence that children with autism
have joint attention deficits, these deficits are not universal and
are more evident in the imitation of joint attention than in re-
sponse to the joint attention of others. (Charman et al., 1997).
Some have argued that an imitation deficit disrupts the deve-
lopment of joint attention behavior (Rogers & Pennington,
1991). However, Nadel (2006) suggests that the lack of imita-
tion may be the result of how this capacity has been researched
in children with autism.
Caution must be taken regarding the interpretation and gene-
ralization of these results beyond this age group or to apply
them to children with other developmental disabilities or lan-
guage impairments. Also, joint attention was assessed by only
three behaviors thereby limiting the generalization of these
findings to this definition of joint attention. Future studies
might include additional joint attention behaviors. Further re-
search is also needed to determine the effects that imitating
nonverbal children with autism may have on language devel-
opment. Other suggestions for future research include further
examination of joint attention behaviors and other behaviors
related to the development of language including the child’s
recognition of being imitated and the child’s initiation of novel
behaviors. Another possible investigation might be the exami-
nation of the relations between imitation, practice effects, and
the child’s development of joint attention behaviors. Nonethe-
less, the results of this study suggest an association between
social-affective and communicative behavior. They also indi-
cate that imitating preschoolers with autism may be an effective
intervention for at least increasing two of the joint attention
behaviors observed in this study including gaze following and
gesturing to the adult.
Acknowledgements
We would like to thank the researchers who conducted the
original play sessions with the children (Tory Field and Brenda
Lundy) and the children who participated in the play sessions.
Additional gratitude is also extended to Lissette Medina who
assisted with the manuscript. This paper was completed in par-
tial fulfillment of the Ph.D. in clinical psychology by the first
author.
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