By Emily Leclerc | Waisman Science Writer
* Note: The Sterling lab uses identity-first language in response to the autism community’s growing preference for that style language. The language of this story reflects that preference. *
Attention is a key component of learning. Think of how hard it is to learn someone’s name if all you can think about is the eyelash on their cheek. The same can be said for language learning. “The attention piece is critical to language learning,” Marianne Elmquist, PhD, scientist in the lab of Waisman investigator Audra Sterling, PhD, says. Especially in infants and toddlers, attention plays a crucial role in their overall language development. For those with developmental disabilities like Down syndrome (DS) and autism, that attention component can be more challenging.
New research from the lab of Sterling, professor of communication sciences and disorders, found that kids with DS and autistic characteristics struggle with a skill called joint attention, indicating that they may have more communication challenges and language delays later in development. The study, The Impact of Autistic Traits on Joint Attention in Young Children with Down Syndrome During Mother-Child and Father-Child Interactions, was published in the American Journal of Speech Language Pathology.
Joint attention is when two people are paying attention to the same thing at the same time. A parent and a child playing with a toy together would be an example of joint attention. This skill is one of the foundational building blocks of language learning in young kids. “If kids are paying attention to something then they’re open to learning that word. They’re paying attention to it. They’re engaged in it,” Sterling says. “It is a great opportunity for a parent or caregiver or anyone to say the word and for the child to learn the meaning of it.” A child’s ability to engage in joint attention is an important predictor of later language outcomes and often a skill that is worked on first with clinicians.
Kids with DS typically have language delays in childhood and throughout their lifetime. The Sterling lab is particularly focused on understanding the causes of those delays in order to develop more effective interventions to support language learning in kids with DS. An important component to consider as part of that goal is how a co-occurring autism diagnosis might impact a child’s language learning. Autism has a higher prevalence in kids with DS and typically has an impact on a variety of social skills. “Joint attention is often a challenge for autistic individuals. If we have individuals with DS who might have co-occurring autism, do we see the same kind of challenge with joint attention? Or is that unique to autism?” says Elmquist. This new study sought to find out.
The study team worked with 15 children with DS and their two parents to look at how they engaged with joint attention and how they responded to parent-initiated joint attention. The researchers visited each family’s home to observe the child and parents’ interactions during play to measure their engagement and evaluate their display of autistic characteristics. Sterling and Elmquist found that the children who had more autistic characteristics initiated joint attention with their parents less often and were less likely to respond to parent-initiated bids for attention. “Our findings indicate that autistic characteristics do seem to play a role. Generally, they had less engagement and were seeking that engagement less,” Sterling says. This has important implications for that child’s long-term language development journey and their potential challenges in the future.
Additionally, Sterling and Elmquist observed that the mothers tended to engage in joint attention with their child more frequently than the fathers. But, the children responded equally to both parents. They were comfortable engaging with either parent. This indicates to Sterling and Elmquist that while the mothers may use joint attention more often, the fathers are likely supporting language development in other ways.
Understanding autism’s influence on a child with DS’s language development journey lays important foundations for building future interventions. While this study is small and preliminary, it provides a basis from which to launch further investigations. “This was a very small sample size so next we want to see if there is a similar pattern in a larger sample size,” Elmquist says. “That and joint attention is just one part of language learning. Understanding how autistic traits and Down syndrome influence each other across language learning mechanisms is a big question to tackle.”
This work is one step toward a much larger goal. Sterling and Elmquist have many follow-up questions to ask and more studies to plan. Because you can’t build something that can help others until you understand the challenge in its entirety. “Just because you have Down syndrome doesn’t mean that you have one specific language learning journey. We need to think broadly about what are all of the different aspects of development that are important in Down syndrome and for some kids, autism is going to play a role in development. And for some kids, it’s not,” Sterling says. “We are really starting to lay the groundwork for this larger long-term project of developing and tailoring interventions for kids with Down syndrome.”