Joint engagement is associated with greater development of language and sensory awareness in children with autism

Abstract The effect of joint engagement in 2- to 6-year-old children with ASD was investigated in the largest and the longest observational study to-date. Parents assessed the development of 12081 children quarterly for three years on five subscales: receptive language, expressive language, sociability, sensory awareness, and health. Longer duration of time spent with an adult actively involved in the same activity was associated with improved trajectory of receptive language, expressive language, and sensory awareness. On the annualized basis, the high-joint-engagement group (3 hours or more of joint engagement per day) improved their combinatorial receptive language 1.4-times faster (p=0.0019), expressive language 1.5-times faster (p<0.0001), and sensory awareness 1.5-times faster (p=0.0248) than the low-joint-engagement group (1 hour or less joint engagement per day). The difference in the sociability and the health scores at the end of 3-year study was insignificant. This study confirms the importance of ASD children spending more time with adults actively involved in the same activity and highlights the need to include joint engagement as a target for intervention with this population. Lay summaryParents of 2- to 6-year-old children with ASD assessed the development of 12081 children quarterly for three years. Longer duration of time spent with an adult actively involved in the same activity was associated with improved developmental trajectory. This study confirms the importance of ASD children spending more time with adults actively involved in the same activity and highlights the need to include joint engagement as a target for intervention with this population.