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This is to certify that the
thesis entitled

JOINT ATTENTION BEHAVIORS IN 14-MONTH-OLD
TODDLERS OF LOW-INCOME FAMILIES

presented by

Tiffany L. Martoccio

has been accepted towards fulfillment
of the requirements for the

Master of degree in Child Devel0pment
Arts

 

 

  

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Date

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JOINT ATTENTION BEHAVIORS IN 14-MONTH-OLD TODDLERS OF LOW-
INCOME FAMILIES

By

Tiffany L. Martoccio

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF THE ARTS

Child Development

2010

ABSTRACT

JOINT ATTENTION BEHAVIORS IN l4-MOTH-OLD TODDLERS OF LOW-
INCOME FAMILIES

By
Tiffany L. Martoccio

The purposes of this study were to examine the relationship between: 1) parent-
child interactions and 14 month-old children's joint attention behaviors; 2) joint attention
behaviors at 14 months and cognitive outcomes at ages 24 and 36 months; and 3) joint
attention behaviors at 14 months and expressive language at 24 months. A secondary
analysis of data from the "local" Michigan component of the Early Head Start Research
and Evaluation (EHSRE) Project/ Pathways Project was completed. Participants (n = 139
parent-child dyads) reflected a low-income, Early Head Start eligible sample.
Hierarchical multiple regression analyses revealed that the quality of parent-child
interactions predicted 14 month joint attention. While joint attention did not significantly
account for variance in predicting cognitive abilities, it did significantly predict later
expressive language at 36 months. Results suggest the role of early parent-child
interaction in children’s early joint attention as well as the importance of early to late
language development in toddlers. This study highlights the potential role Early Head
Start programs and other child development programs have in promoting early

development of non-verbal cues, specific to joint attention behaviors.

ACKNOWLEDGEMENTS
I would like to acknowledge the advice and guidance of Dr. Esther Onaga, committee
chairperson. I would also like to thank the members of my graduate committee for their
assistance and suggestions; specifically, Dr. Holly Brophy-Herb for her expertise on this
topic and encouragement and Dr. Robert Griffore for his guidance throughout this
process. I would also like to express my gratitude to the Early Head Start Research and

Evaluation (EHSRE) Project for allowing me to analyze their data for this study.

iii

TABLE OF CONTENTS

LIST OF TABLES ............................................................................................................... v
LIST OF FIGURES ........................................................................................................... vi
CHAPTER ONE: INTRODUCTION .................................................................................. 1
CHAPTER TWO: REVIEW OF LITERATURE ................................................................ 8
CHAPTER THREE: METHODOLOGY .......................................................................... 17
CHAPTER FOUR: RESULTS .......................................................................................... 26
CHAPTER FIVE: DISCUSSION ...................................................................................... 38
REFERENCES .................................................................................................................. 44

iv

Table 1:

Table 2:

Table 3:

Table 4:

Table 5:

Table 6:

Table 7:

LIST OF TABLES

Conceptual and Operational Definitions for the Study Variables... ... .. . . ....6
Descriptive Statistics among the Study Variables .................................. 26
Intercorrelations among Study Variables ........................................... 27
Regression Analysis Predicting 14 month Initiating Joint Attention ........... 3O

Regression Analysis Predicting 24 month Cognitive Abilities ................... 32
Regression Analysis Predicting 36 month Cognitive Abilities ................... 34
Regression Analysis Predicting 24 month Expressive Language ............... 36

LIST OF FIGURES

Figure 1.1 : Conceptual Model ..................................................................... 5

vi

CHAPTER ONE: INTRODUCTION

Preverbal children use eye gaze and pointing to communicate with others.
Specifically, children learn to use eye contact to obtain information about another
person’s goal-directed behavior (Morgan, Maybery, & Durkin, 2003). These simple
gestures begin to develop between 8- and 9-months of age to direct or to respond to
others’ attention (Carpenter et al., 1998).

Raver (1996) defines coordinated joint attention as the “non-verbal or protoverbal
conversation between parent and child on a shared topic, such as an object or toy” (p.
227). Joint attention is a nonverbal social-communicative milestone in an infant’s
developmental trajectory (Mundy & Newell, 2007; Olafsen etal., 2006; Schertz & Odom,
2004), and is an important foundation in later language and cognitive skills (Hustedt &
Raver, 2002). Researchers investigate joint attention behaviors through “parents’ and
infants’ social interchanges while both partners jointly attend to, and play with, objects”
(Raver, 1996, p. 227). Infant affective sharing and social referencing are patterns of this
triadic attention of self, another person, and an outside object or event (Striano et al.,
2007). Current research indicates that infants develop intersubjectivity or coordinated
joint attention, through which they begin to realize that others have different intentions
and they must change behaviors to coordinate intentions between self and others (Mundy
& Newell, 2007; Trevarthen & Aitken, 2001).

Statement of the Problem

Many researchers have examined joint attention as it relates to infants’ cognitive

and language development (Sheinkopf et al., 2004). However, research focusing on this

relationship in the context of low-income families is lacking. Living in poverty serves as

a risk factor for delays in children’s cognitive and language outcomes (Hustedt & Raver,
2002). Parental interactions play an important role in children’s developmental trajectory;
however, that parent-child interactions in low-income families are often less positive.
Research suggests that responsive interactions between parents and children in low-
income families serve as a buffer against the risks that may develop from living in
poverty (Hustedt & Raver, 2002; Chase-Lansdale & Brooks-Gunn, 1995; Duncan,
Brooks-Gunn, & Klebanov, 1994; Huston, McLoyd, & Garcia C011, 1994). “High levels
of joint attention and reciprocity are associated with global ratings of maternal sensitivity
in low-income mother-infant dyads” (Hustedt & Raver, 2002, p. 114). Researchers also
found increased levels of joint attention to longitudinally predict improved cognitive
outcomes among high at-risk infants (Hustedt & Raver, 2002; Raver & Leadbeater, 1995;
Garner, Landry, & Richardson, 1991).
Rationale for the Proposed Research

The purposes of this study are to examine low-income families’ positive parent-
child interactions and how it contributes to their 14-month-old toddlers’ initiating joint
attention behaviors, and to examine initiating joint attention behaviors as a predictor of
cognitive and language outcomes at ages 24 and 36 months. From low-income families,
high risk infants may begin to demonstrate more simplistic joint attention skills by 9
months, such as responding to parent-child interactions. However, joint attention
behaviors that require higher mental processes, such as initiating a shared experience
with another person, may develop a little later than 9 months (Morgan, Maybery, &
Durkin, 2003). This assumption that joint attention behaviors involve mental processes

comes from the Theory of Mind Hypothesis (Morgan, Maybery, & Durkin, 2003). The

theory of mind hypothesis is a metarepresentation where mental states play a causal role
in behavior. Joint attention behaviors are fundamental to the development of higher
mental processes because in order to interact between self, other, and object the
understanding of mental state must be present. Theory of mind enables children to
develop their social-cognitive competencies, such as understanding attention or intention
in others that is one of the important foundations for joint attention behaviors to occur
(Morgan, Maybery, & Durkin, 2003). The rationale for this study is because low-income
children often experience poorer quality parent-infant interactions. Poor quality
interactions lead to less optimal development including joint attention. Joint attention is
key to later development and reflects higher level mental processes. We need to know
whether parenting contributes to early joint attention in infants from low-income families
because this information is critical to understanding pathways to healthy development.
We also need to understand what we do not know about these pathways for high risk
families.

Gibson and Rader (1979) once said that attention should be considered as
intentional perception. Infants use eye gaze and pointing to direct others attention to a
mutual focus. Children must be engaged in interaction with their parent or others to
demonstrate these occurrences. Poverty contributes to many of the risk factors of low
quality parent-child interactions. Toddlers from low income families who are in highly
engaged during parent-child interactions can effectively attain joint attention through
initiation of reciprocal bids with their mothers, for example, showing an object to a parent
then having the parent look at what their child is showing them (Raver, 1996). Children

in low-income families are at risk for later developments due to their economic hardship

(Raver, 1996). Among lower income parent-toddler dyads, parental sensitivity and
encouragement may play an especially important role in children’s behaviors. This
process may include parental sensitivity promoting engagement, then engagement
promoting joint attention, which later leads to joint attention promoting development.
Mediation models of the relations between environmental stress, parents’ caregiving, and
child outcomes demonstrate how parent-child interaction can serve as a protective factor
for children’s social development living in poverty (Huston et al., 1994; Raver, 1996).
Research shows that positive parent-child interactions (Schertz & Odom, 2007) with their
child increases children’s coordinated joint attention behaviors that later impacts
language (Markus et al., 2000; Toth, Munson, & Meltzoff, 2006) and cognitive abilities
(Charrnan et al., 2000; Mundy, Sigman, & Kasari, 1994; Tomasello, 1995). Since the
19903, researchers from different theoretical perspectives have studied joint attention.
Social cognition and language acquisition theories are associated with joint attention
skills (Baldwin, 1995; Carpenter et al., 1998; Claussen et al., 2002; Corkum & Moore,
1998; Morales, Mundy, & Rojas, 1998; Mundy & Neal, 2001; Sigman & Ruskin, 1999;
Ulvund & Smith, 1996). The current study focuses its hypotheses around these two
theories.

Conceptual Model

The conceptual model of the current study is developed around the previously
explained theories and a model by Schertz and Odom (2007) called the Parent-Mediated
Developmental Model. The Parent-Mediated Developmental Model is based on the
premise that when parents are highly engaged with their children, joint attention

behaviors begin to develop through parent-child interactions, which allows for later

language and cognitive abilities to emerge. This model hypothesizes that joint attention
abilities are important for children to communicate and socially interact with others
(Schertz & Odom, 2007).

Figure 1.1 illustrates how toddler’s joint attention is developed through parent and
child engagements and is a precursor for language and cognitive abilities in low-income
families adopted from the Parent-Mediated Developmental Model (Schertz & Odom,
2007). This figure includes the specific variables, parent and child interactions, joint
attention, cognitive development, and expressive language used in the current study. The
variables used in this model are explained in Table 1 to demonstrate how they are
conceptually and operationally defined in this study.

Figure 1.1 : Conceptual Model

 

Child Interaction
with Parent

 

 

 

 

Expressive
. Language

Child Joint Attention /

 

 

 

\ Cognitive Ability

 

 

 

 

Parent Interactions and
Behaviors with Child

 

 

 

Table 1

Conceptual and Operational Definitions for the Study Variables

 

Variable

Conceptual Definition

Operational Definition

 

Joint Attention

Child Interaction

Parent Sensitivity

Parent Interaction

Cognitive Ability

Expressive Language

Use of gestures and eye
contact to direct others’
attention to objects (Mundy
etaL,2007)

Child’s extents to show,
initiate, and/or maintain
interaction with parent, and
other social interactions
(Brady-Smith, F auth, &
Brooks-Gum, 2005)

Parenting behaviors
characterized by parents’
attendance to child’s cues
(Brady-Smith, Fauth, &
Brooks-Gunn, 2005)

Supportive and positive
parenting behavior during
engagements with child
(Sumner & Spietz, 1994)

Mental ability (Bayley,
l 993)

Spoken language (Fenson et
aL,2000)

MacArthur Communicative
Developmental Inventories:
Gestures. Measures when
child extends arm to show
you something he or she is
holding, reaches out and
gives you a toy he or she has
been holding, and points at
something interesting

Measures the frequency of
looking at the (eye contact)
parent to request engagement

Measures parents sensitivity
to their child during play
interactions, such as
acknowledging their child’s
actions or facilitating
engagements

NCAST: Parent Teaching
Behaviors. Measures parents
teaching episodes during
play with their child

Bayley’s Mental
Developmental Inventories.

Measures different cognitive
skills

MacArthur Communicative
Developmental Inventories:
Vocabulary Production.
Measures the quantity of
spoken words

 

Research Questions and Hypotheses

The purposes of this study were to examine the following research questions: 1)
Do parent and child interactions promote toddler initiating joint attention skills in low-
income families; 2) Do toddlers’ in low-income families who display more initiating joint
attention behaviors at age 14 months demonstrate higher levels of cognitive development
at 24 and 36 months of age; and 3) Do toddlers’ in low-income families who exhibit
more initiating joint attention behaviors at 14 months demonstrate higher levels of

expressive language at 24 months of age?

Hypothesis 1:

Toddlers will exhibit more initiating joint attention behaviors at 14 months when
their parents have demonstrated higher levels of sensitivity and interactions with their
child. Also, higher levels of child interactions will play a role in the increased display of
initiating joint attention.

Hypothesis 2:

Toddlers who display more initiating joint attention behaviors by 14 months will
demonstrate more optimal cognitive skills at 24 and 36 months as compared to toddlers
who exhibit fewer initiating joint attention behaviors at 14 months.

Hypothesis 3:

Toddlers who display more initiating joint attention behaviors by 14 months will
demonstrate more advanced expressive language development at 24 as compared to

toddlers who exhibit less initiating joint attention behaviors at 14 months.

CHAPTER TWO: REVIEW OF LITERATURE

Research on joint attention did not become widely prevalent until the 19708.
Around this time researchers recognized joint attention as an important area of
development in infants, but studies mostly focused on determining when joint attention
skills begin to emerge, as opposed to relations to other developmental skills in children
(Schertz & Odom, 2004; Bates, 1976; Bates, Camaioni, & Volterra, 1975; Scaife &
Bruner, 1975). Researchers also began conducting studies on parent-infant interactions
that foster the development of joint attention. Scaife and Bruner (1975) found that infants
follow the direction of other people’s gazes in the first year of life. The emergence of this
body of research raised questions regarding one of psychology’s classical cognitive
developmental theorists, Jean Piaget, and his notion of egocentrism in infants. Infant
egocentrism suggests that infants do not have the mental abilities to understand that
others may have different opinions and/or beliefs from their own (F ogel, 2009); however,
more current research reveals that infants do begin to understand this concept and display
it through focusing their attention on a joint object with another, known as joint attention
(Mundy & Newell, 2007; Olafsen et al., 2006; Schertz & Odom, 2004). In the 19805,
researchers further identified joint attention’s relevance, not only in typically developing
children, but in atypically developing children, and in the 19905 researchers began to
study joint attention from different theoretical perspectives, such as cognitive-perceptual,
language and social-affective theories (Schertz & Odom, 2004; Loveland & Landry,
1986; Mundy, Sigman, et al., 1986). Today, joint attention continues to be studied by
researchers as a major developmental milestone in human infancy. This literature

discusses the theoretical background on which this study is founded and provides a more

in-depth look at the definition of joint attention. Parent-child interactions will also be
explained in the realm of how they relate to later joint attention.

Theoretical Framework

Tomasello (1995) suggested that joint attention relates to children’s understanding
of others as intentional agents. This understanding that children grow through their
surroundings and mental states is known as social cognitive theory. Researchers have
described joint attention as a precursor of theory of mind, which is the ability to attribute
beliefs, desires, intentions, and knowledge to oneself and others (Schertz & Odom, 2004).
In a recent study, Wellman and colleagues (2008) examined stabilities between infant
social attention and later theory of mind, using both a five-item theory of mind scale and
a two task false belief (standard assessment for preschoolers’ theory of mind) composite
to measure later theory of mind abilities (Wellman et al., 2008). Results found that
measures of infant’s social attention significantly predicted later theory of mind

(Wellman et al., 2008).

The social cognition framework can be dated back to the beginning of the 19903
to theorists, such as Simon Baron-Cohen and George Butterworth. First, Baron-Cohen
(1995) developed the cognitive mechanisms theory. He believed that four cognitive
mechanisms, which are correlated to joint attention, develop in sequence in typically
developing infants. These mechanisms were intentionality detector, eye direction
detector, shared attention mechanism, and theory of mind mechanism (Baron-Cohen,
1995; Schertz & Odom, 2004). Second, Butterworth (1995) described the stages in
infancy of joint visual attention. First, he believed that at 6-months eye gaze emerges.

Second, at 12-months infants are able to locate, understand, and point to a target within

their visual field. Finally, at 18-months infants have the ability to locate target outside
their visual field. Butterworth’s theory was questioned by, Tomasello (1995) because of
the oversight of intentionality within his stages (Schertz & Odom, 2007).

Another theoretical framework that this study is focused around is the language
acquisition theory. Researchers hypothesized that joint attention is the foundation for
later language development (Markus et al., 2000; Toth, Munson, & Meltzoff, 2006). Joint
attention encounters provide an interactional environment that supports learning and gaze
following (Schertz & Odom, 2007). From this context children can later learn language
skills (Carpenter & Tomasello, 2000). Markus and colleagues (2000) state that gaze
following behaviors at 6-months predict receptive and expressive language at 18-months.
Carpenter and colleagues (1998) theorized that gaze following emerges between 8- and
10- months. Then, between 12- to 15- months infants begin to follow others eye gaze and
pointing. Finally, at 14- months imitative actions are exhibited and directing others
behaviors through declarative and imperative gestures, such as pointing and reaching
(Schertz & Odom, 2007). Smith, Mirenda, and Zaidman-Zait (2007) found that initiating
joint attention later predicted expressive vocabulary, which is a basis for hypothesizing

that higher levels of joint attention behaviors will predict better language scores.

Joint Attention Behaviors

Joint attention refers to more than two people looking at the same object. It is the
ability to synchronize this shared attention to an object with the understanding of the
other social partner’s intentions of the perceived object. Researchers hypothesize joint
attention to be a necessary precursor for cognitive skills, such as social referencing and

language acquisition (Striano et al., 2007). Joint attention behaviors fall into two

10

categories, responses to the proposals of others or spontaneous initiations. For a better
understanding of joint attention behaviors both responding to and initiating joint attention
are explained in this literature review, but only initiating joint attention behaviors are
measured in this study and what will be referred to as just joint attention.

Once joint attention fully develops in children it allows for other developmental
milestones to occur, such as language and cognitive abilities. This is not to say that
language and cognitive abilities will only occur if joint attention is present, but that joint
attention occurs at an early stage setting a foundation for later verbal and mental skills
(Toth et al., 2006). Joint attention reflects earlier forms of language and cognitive
abilities. When children want to communicate with others prior to acquiring language
skills they will point or use eye gaze to focus others attention to an object. Pointing and
eye gaze are components of joint attention. Children also learn to understand that others
have different intentions than their own, which may also be demonstrated by pointing or
eye gaze. Mundy and colleagues (2007) suggest that observations of joint attention
behaviors allow researchers to examine the development of mental processes that are
necessary for facets of human cognitive development. Communication and cognitive
understandings are facets of joint attention in early stages of development.

Responding to joint attention. The first category of joint attention behaviors
involves responding to another’s request. Responding to joint attention (RJA) behaviors,
such as gaze following, typically develop between 8 and 9 months, before the second
category of behaviors- initiating joint attention. RJA refers to “infant’s ability to follow
the direction of the gazes and gestures of others in order to share a common point of

reference” (Mundy & Newell, 2007, p. 269). Researchers study RJA behaviors by

11

pointing or looking at an object to see if the infant looks in the direction of the object.
Morales and colleagues (2000) conducted a study to examine infants’ responses to joint
attention propositions, such as pointing, gaze following, and vocalizing. The main focus
of this study was to observe individual differences of RJA behaviors at time points
between 6 and 30 months of age to see relations to vocabulary skills in the first two years
of the infant’s development. Results revealed that measures of RJA at all time points
between 6 and 18 months were significantly related to language outcome at 30 months.
RJA at 12 months was also significantly related to language outcome at 24 months. On
the other hand, later RJA measures at 21 and 24 months were not a significant predictor
of language at 30 months.

Initiating joint attention. Initiating joint attention (IJ A) begins to develop between
9 and 15 months of age (Siller & Sigman, 2008). IJA involves infants’ use of non-verbal
cues, such as gestures and eye contact to direct others’ attention to objects, events, and/or
themselves (Mundy & Newell, 2007). Mundy and Gomes (1998) found that initiating
joint attention was the best predictor of expressive language in young children. Strid and
colleagues (2006) conducted a study on 26 typically developing children’s nonverbal
communication at 14 months and cognitive abilities at 50 months. Results demonstrated
that initiating joint attention behaviors were positively related to general cognitive
performances at 4 years (Strid et al., 2006). Smith, Mirenda, and Zaidman-Zait (2007)
measured initiating joint attention behaviors with three gestures items (e. g. extends arm
to show you something he/she is holding, reaching out and gives you a toy or some object
that he or she is holding, and points with arm and index finger extended at something

interesting object or event) from the MacArthur Communicative Developmental

12

Inventories. They found a significant relation between expressive vocabulary
development over the first two years of life and initiating joint attention abilities. More
recent studies, found a strong correlation between IJA abilities and the diagnosis of
autism spectrum disorder. IJA behaviors are included within the current autism diagnostic
and screening instruments, specifically the standard Autism Diagnostic Observation
Schedule (ADOS) (Mundy & Burnette, 2005). In Module 1 (youngest children) of the
ADOS, both RJA and IJA behaviors are assessed. However, in Module 2, which is
designed for developmentally more advanced children, only IJA measures are included
(Mundy & Burnette, 2005).
Parent-Child Interactions

Infants gradually acquire the ability to coordinate attention with others when
wanting to share something of interest. Dodici and colleagues (2003) suggested that the
main element of parent-child engagement is joint attention. Children are more likely to
develop novel words when their parent demonstrates joint attention (Dodici et al., 2003).
Parents’ need to be sensitive, by initiating or acknowledging interactions with their child,
to ensure that this shared interest in an object is established by initiating joint coordinated
attention with their infants during toy play (Siller & Sigman, 2008). Vaughn and
colleagues (2003) found that parent encouragement at 9- months relates positively to the
development of initiating joint attention in 12-month-old infants. Siller and Sigman
(2002) state that in children with autism there is a correlation between parent
synchronization with the child’s focus of attention to higher levels of joint attention.
During toddlerhood, parents play a major role in the initiation of interactions with their

child, both child and parent contributions are significant. This positive parent-child

13

dyadic interaction leads to toddlers’ joint attention behaviors. Children must develop
social skills to participate in this interaction and parents need to reciprocate those social
gestures by being sensitive and supportive of their children during interactive situations.

Children develop social skills through highly stimulating interactions with others,
specifically, parents. From a social cognitive framework, children understand that others
mental state is different from their own and, from that, is able to socially engage with
others accordingly. When children adequately adjust their thinking to this framework
they begin to understand how to communicate their intentions with others. Meltzoff and
Brooks (2008) found that through self-experience children develop the understanding of
visual perception in others. Therefore, by actively interacting with others, children gain
the experience that when someone is looking at them and then to an object their
intentions are for the other person to look at what they are looking at or showing them.
Social behaviors are contributions by the child during interactions with their parent that
elicit joint attention bids. Even though children’s level of sociability is important during
interactions, parents still must contribute their own engagements to promote their child’s
joint attention behaviors.

Research suggests that parent sensitivity contributes to children’s social
development (Eisenberg et al., 2006; Kochanska & Knaack, 2003; Rothbart & Bates,
2006; Spinrad et al., 2007). In this study we look at joint attention and other parent-child
interactions that fall within the broader category of social development. During
toddlerhood, regulatory behaviors that involve behaviors for social situations are limited,
therefore, parents sensitivity rears better regulated children, who are later more socially

competent. Research also supports the relation between maternal sensitivity and

14

children’s understanding of the internal world (Ereky-Stevens, 2008). Parent sensitivity is
a component that contributes to more positive interactions with their child, thus allowing
for more optimal joint attention behaviors.

As noted, both parent and child interactions contribute to more positive
interactions that later elicit joint attention. However, less is known in the context of low-
income families. Research on at-risk populations, specifically low-income families, found
that poverty is a risk factor for infant’s later cognitive development (Raver, 1996).
Elements of poverty that may contribute to children’s development are low parental
education, teenage pregnancy, single parent household, parental unemployment, and
welfare status. Recently, research on low-income children’s development suggests that
responsive social engagement between parent and infant serves as a buffer against risks
posed by poverty (Hustedt & Raver, 2002; Chase-Lansdale & Brooks-Gunn, 1995).
Studies found “in both scaffolding and guided participation, parental competence is
clearly marked by sensitivity in providing consistent verbal and nonverbal cues, tailored
to the child’s developmental level, in order to assist the child in successfully solving a
problem” (Hustedt & Raver, 2002, p. 113). Hustedt and Raver (2002) conducted a study
on socioeconomically disadvantaged mother-infant dyads, and the relation between
scaffolding and levels of joint attention. Results showed that higher levels of constructive
verbal strategies initiated by mothers were positively related to joint attention (Hustedt &
Raver, 2002).

The existing literature provides sufficient evidence that joint attention behaviors
are significant predictors of children’s cognitive and language developments. However,

little empirical evidence looks at low-income families in the context of joint attention.

15

Hustedt and Raver (2002) demonstrate how low-income mothers can contribute to their
children’s joint attention behaviors by instruction during parent-child interactions. The
current study focuses on filling in some of those gaps that parent and child interactions

are optimal for toddler’s joint attention behaviors to occur low-income families.

16

CHAPTER THREE: METHODOLOGY

Research Design and Methods

This study is a secondary analysis of data from the "local" Michigan component
of the National Early Head Start Research and Evaluation (EHSRE) Proj ect/ Pathways
Project (Love et al., 2005). The EHSRE study was designed to provide a comprehensive
evaluation of the impacts of Early Head Start (EHS) programs on low-income families
and their young children. Families who had a family income of below the federal poverty
line were eligible to participate in the study. Through random assignment, families were
placed in the EHS program (52.5%) or in a comparison group (47.5%). The program
group received EHS services, which were designed to generally, focus on child’s
development and parenting. Families in the comparison group were free to access other
available support services. Data collection methods included parent interviews, direct
child assessment, and observations of parent-child interactions in the home. Data were
collected at children’s 14-, 24-, and 36-months birth-related assessment but trained staff.
Given the focus of this study on early joint attention behaviors and later outcomes,
analysis of parent-child interaction data will include the 14 month time point only.

The EHSRE Project data utilized in this study were collected between 1996 and
2001. Families were enrolled by programs through age 1. Participants resided in counties
in the Mid-west, reflecting rural areas and a moderate size city. Data were collected by
trained research staff during home-visits. Variables pertinent to the study hypotheses
were selected for this study. Data access and confidentiality forms were completed prior

to accessing data, and this study, a secondary analysis of the local component of the

17

EHSRE project, was approved by Michigan State University’s Institutional Review
Board.
Participants

Data reflected139 parent-child dyads from a total of 196 dyads that enrolled and
were eligible for the EHSRE project. Fifty-seven dyads were eliminated due to missing
data. Participants were randomly assigned to either a control or treatment group, but for
the purpose of this study were analyzed together. This study does not focus on the
effectiveness of the treatment, rather on the overall child development. However, due to
the nature of this sample the grouping variable is noted and analyzed as a covariate.

At enrollment into the EHSRE project, mothers were a mean age of 23.0 (SD =
5.0) years and children were a mean age of 2.2 (SD = 4.8) months. Mothers were
primarily Caucasian (79.4%), single (47.6%), had no more than a high school education
(75.8%), and were unemployed (30.4%). Of these low-income families, yearly gross
income median was $8,400 and averaged at $9,407 (SD = $5,779). The median was
calculated due to extreme outliers among the sample.
Measures

Joint attention. Initiating joint attention, one of the categories of the skills within
joint attention, refers to the ability to use direction of gaze and gestures to direct the
attention of others to spontaneously share experiences (Mundy et al., 2007). For this
study joint attention will be used to demonstrate initiating joint attention skills in
toddlers. Children’s gestures were assessed at 14-months using the MacArthur
Communicative Development Inventories (CDI; Fenson et al., 2000). The CDI as

reported by the parent, measures children’s prelinguistic and early language development.

18

These categorical variables, from the CD1, elicited one of these responses: often,
sometimes, or not yet and higher scores indicated the presence of more joint attention
behaviors. The three joint attention variables were recoded prior to computing the three
scores into one composite variable. Originally variables were coded as, (1) often, (2)
sometimes, and (3) not yet. By recoding these variables as, (3) often, (2) sometimes, and
(1) not yet, the direction of analyses changed, therefore producing accurate positive

beta ’s in the outputs. A total mean score was derived from the joint attention items.
Higher means indicated a higher number of joint attention gestures. The mean score was
8.71 (SD = .66; range between 5 and 9) and used in all of the final analyses. Smith,
Mirenda, and Zaidman-Zait (2007) demonstrated that within the child gestures category,
items including, extends arm to show you something he or she is holding, reaches out and
gives you a toy he or she has been holding, and points at something interesting, represent
initiating joint attention abilities. From a principle component analysis, these three
variables extracted loadings between .40 and .77. The remaining 9 items within the child
gesture subscale include conventional gestures, such as, shaking or nodding their head
yes/no, and were excluded in this study.

Child interaction. Child interaction with their mother is an in-home direct
observational measure. The purpose of the measure was to assess the extent to which the
child interacts with the mother and communicates positive regard and/or positive affect
during a semi-structured play interaction at 14-months. Mother and child were given
three bags of interesting toys and asked to play with the toys in sequence. No other
instructions were given to the mother. This is called the three bag task. This measure was

scored on a seven-point scale: (1) indicated a very low engagement and (7) indicated a

19

very high engagement. Videotapes were all coded by an independent research team, as
part of the EHSRE Project protocol. Coder reliability averaged about 90% at 14-months
(range of 83-97%) (Brady-Smith, Fauth, & Brooks-Gunn, 2005).

Parent sensitivity. Parental sensitivity was an in-home direct observational
measure, assessing the parent’s behavior with the child during a structured play task.
Similar to the child engagement variable, the parent and child were given three bags of
interesting toys and asked to play with the toys in sequence. This play task was
videotaped for later coding. Sensitivity includes behaviors such as acknowledgement of
the child’s affect, vocalizations, and activity; facilitating the child’s play; changing the
pace of play when the child seems under-stimulated or over-excited; and demonstrating
developmentally appropriate expectations of behavior. Scoring was based on a seven-
point scale: (1) indicated a very low sensitivity and (7) indicated a very high sensitivity.
The mean for this measure was 3.33 (SD = 1.34). Videotapes were all coded by an
independent research team. Coder reliability averaged about 90% at 14-months (range of
83-97%) (Brady-Smith, Fauth, & Brooks-Gunn, 2005).

Parent interaction. Maternal interaction during a semi-structured teaching task
was measured with the Nursing Child Assessment Teaching Scale (now known as the
Parent-Child Interaction-Teaching Scale; Sumner & Spietz, 1994). Mothers were asked to
teach their infants or toddlers an age-appropriate skill they have not already acquired. The
scale is comprised of four parent behavior subscales (Sensitivity to Cues, Response to
Distress, Social-Emotional Growth Fostering and Cognitive Growth Fostering) and two
child subscales (Clarity of Cues to the parent and Responsiveness to Caregiver). The

NCAST consists of 73 binary-scored items designed to assess mother-child interactions

20

observed during a teaching episode in the home. Parent total scores of the 50 items from
the parent scales were used in this study. Data collectors were trained by a certified
instructor and were required to reach a reliability of at least 90% on standardized
videotapes to be qualified to score the observation. The parent behaviors total had a good
overall reliability of a = .90. Each of the parent behavior subscales also had high
reliabilities (Sensitivity to Cues: a = .65; Response to Distress: a = .73; Social-Emotional
Growth Fostering: a = .70; and Cognitive Growth Fostering: a = .82).

Cognitive ability. At the 24 and 36 month time points, children’s cognitive
abilities were assessed with the Bayley Mental Development Index (MDI) Standard
Score of the Bayley Scales of Infant Development — Second Edition (BSID-II) (Bayley,
1993). The MDI assesses several types of abilities: sensory/perceptual acuities,
discriminations, and response; acquisition of object constancy; memory learning and
problem solving; vocalization and beginning of verbal communication; basis of abstract
thinking; habituation; mental mapping; complex language; and mathematical concept
formation (Bayley, 1993). The child is assessed on his/her ability to follow simple spoken
directions and on his or her spoken vocabulary during the assessment. For example, the
child is asked to build a tower of cubes; point to a block and a key; point to objects in
pictures when the assessor names them; name three objects in a picture book; match three
colors; imitate vertical and horizontal strokes; understand directions that include
prepositions; and recall geometric forms. The MDI was normed on a nationally
representative sample of children with a range of ages so that raw scores can be

converted to standardized scores with a mean of 100 and a standard deviation of 15

21

(Brady-Smith, F auth, & Brooks-Gunn, 2005). The test-retest reliability across 24 and 36
months was .68.

Expressive language. Toddler’s early expressive language and vocabulary skills
were assessed using the MacArthur Communicative Development Inventories (CDI) at
24 months (Fenson et al., 2000). The EHS dataset included the short-form version of the
MacArthur Communicative Development Inventories (F enson et al., 2000) and the
sentence complexity subscale. However, this study included vocabulary production only
because of the focus on expressive language. Vocabulary Production measures the

number of words in the child’s spoken vocabulary. Parents are asked whether the child

9’ ‘6 99 66

says each of 100 common early spoken words, such as “up, none, some,” or “does”
(Brady-Smith, Fauth, & Brooks-Gunn, 2005). Scores range from 0, if the child is not yet
speaking, to 100, if the child has used all of the words in speech. Each item is
dichotomously scores (yes/no) and a sum scores is derived.

C ovariates. The regression analyses included child age, maternal demographic
risk (maternal risk), and program condition as covariates. Child’s temperament is also
included as a covariate in the first hypothesis. Temperament was included as an
additional child sociability variable to see children’s display of social behaviors outside
of measures specific to child interactions with their parent. Past EHS analyses have
always included maternal risk, program condition, and temperament as covariates. They
were identified by the consortium as standard covariates. The following describes
maternal risk, program condition, and child’s temperament in more detail.

Maternal demographic risk. In this study, maternal risk is represented by a

composite variable of risk indicators measured at enrollment into the EHSRE project.

22

Indicators of risk were: low education (mothers who did not complete high school),
single parenthood, adolescent parenthood, unemployment, and welfare status. These
variables were dummy coded into dichotomous variables (1 = yes or 0 = no) and summed
into a composited risk variable. The scale ranges from 0 to 5 with a maximum score of 5,
indicating higher cumulative risk, and a minimum score of 0, indicating no risk.

Program condition. The program condition variable is coded as a binary
variable. Participants were randomly assigned into the EHS program (1) or into the
comparison group (0).

Child temperament. Children’s level of temperament was measured with
the Sociability subscale of the Emotionality, Activity, Sociability, and Impulsivity
(EASI) Temperament Survey (Buss & Plomin, 1984). The complete EASI is a parent
self-report measure about his/her child’s behavior characteristics in four areas. Sample
items on the sociability subscale include, He/She likes to be with people, and He/She is
very sociable. This subscale consists of five items. Respondents had a minimum score of
1 and a maximum score of 5. In the current sample, respondents had a mean score of 4.07
(SD=.77).

Data Analysis

Research hypotheses were tested by conducting a series of hierarchal multiple
regression analyses. In all models, child age, maternal risk, and program variables were
entered in the first step as covariates. With regard to hypothesis 1, better quality parent-
child interaction was expected to predict more joint attention behaviors in toddlers;
therefore, the regression model was designed to examine parent and child interaction as a

predictor of toddler joint attention behaviors at 14 months. Child temperament

23

(sociability) was included as a covariate in this model. Following entry of the covariates,
child’s interaction was entered next into this model. Mother’s sensitivity during a play
task and parent NCAST total interaction behaviors during the semi-structured teaching
task with the child were entered in the final step. Joint attention was the dependent
variable.

The second and third hypotheses reflected joint attention as the predictor variable
and parent-child interaction variables (child interaction, parent sensitivity, and parent
NCAST total) as covariates. In the second hypothesis, toddlers with more joint attention
behaviors at 14 months were hypothesized to have higher cognitive scores at 24 and 36
months. Bayley MDI scores were entered as the dependent variable and toddler joint
attention at 14 months was entered as the independent variable. In the model predicting
36 month cognition, the 24 month Bayley scores were controlled. Finally, the third
hypothesis stated that a higher number of joint attention behaviors at 14 months would
predict better expressive language scores at 24 months. Thus, after covariates were
entered, joint attention was entered in the final step. To provide information beyond the
statistical significance, effect sizes (adjusted R2) were calculated.

Missing Data

Cases were only eliminated if they did not contain information for the joint
attention (37 cases eliminated) and/or expressive language (20 cases eliminated) variable.
Therefore, all cases used in the data analyses included joint attention and expressive
language data; no data imputation was necessary in only those two particular variables.
The 57 cases described above were eliminated because they were missing data for two of

the primary variables for the study. Also, given that the expressive language came from

24

the same scale as the joint attention variable, these cases had to be deleted by default.
After eliminating those 57 cases, the amount of missing data for this study varied across
the other assessments (N CAST parent variable = 8 cases with missing data; parent
sensitivity variable = 24 cases with missing data, child interaction variable = 14 cases
with missing data; and MDI variables at 24 month = 31 cases with missing data, and at
36 month = 37 cases with missing data) with the exception of the temperament variable
that contained all data. The Expectation Maximization (EM) algorithm (Dempster, Laird,
& Rubin, 1977) was used for imputing missing values. An EM approach is considered an
effective approach when data is missing at random (Musil, Warner, Yobas, & Jones,
2002; Schafer & Graham, 2002). The EM method implements a maximum likelihood
(ML) approach to iteratively impute missing values by using expectation (E-step) and

maximization (M-step) algorithms (Musil, Warner, Yobas, & Jones, 2002).

25

CHAPTER 4: RESULTS

Preliminary Analysis

Means, standard deviations, and ranges are displayed in Table 2 to show the scale
of each measure in the study. Bivariate correlations were used to analyze relations
between predictor and outcome variables, and whether any predictor variables were
highly correlated (see Table 3). Correlations among covariates were also calculated to
analyze relations between the dependent variables and independent variables with the
covariates. Spearman correlations were used for program condition because it was not a
continuous variable. As for the other variables, which were all continuous, Pearson
correlations were used for analysis.
Table 2

Mean and Standard Deviations among the Study Variables

 

 

 

Measure M SD Range (Min. -Max. )

Joint Attention 8.71 .66 4 (5-9)
Temperament 4.07 .77 4 (1-5)

Child Interaction 3.79 .99 5 (1-6)

Parent Sensitivity 3.33 1.34 6 (1-7)
NCAST parent total 33.86 5.62 27 (15-42)
Cognition 24 83.44 13.90 77 (52-129)
Cognition 36 87.12 9.08 61 (52-113)
Expressive Language 24 43.91 31.07 99.5 (.5-100)

Note. n = 139.

26

Table 3

Intercorrelations among Study Variables

 

l 2 3 4 5 6 7 8 9 10 11

 

1. Childage -- -.01 .04 -.02 .02 .03 -.17* -.25** .02 .07 -.24**
2. Matrisk -- -.09 -.18* .06 -.17* -.12 -.18* .03 -.01 .13

3. Program -- .12 .20* .20* .00 .03 .09 .01 .18*
4. Joint Attention -- .17* .28* .30** .30* .17* .18* .24**
5. Temperament -- .09 .08 -.09 .08 .08 .19*
6. Child Interaction -- .28M .31** .15 .02 .10

7. Parent Sensitivity -- .23** .29**.26** .37**
8. NCAST Parent Tot -- .16 .21* .21 *
9. Cognition 24 —- .57** .42**
10. Cognition 36 -- .30**

11. Exp Lang 24 --

 

Note.n=139.
*p<.05, **p<.01.

Correlation analysis found no risk for multicollinearity among variables.
Associations from the correlation matrix were in the expected directions. Joint attention
was significantly related expressive language (r = .24). Joint attention was related to
cognitive abilities at both 24 and 36 months, however, r ‘s, .17 and .18, were very small.
Joint attention was also related to parent-child interaction variables, including parent
sensitivity (r ‘s ranging from .17 to .30). This relation demonstrates that parents who
interact more with their children tend to have children with more optimal joint attention

behaviors. Maternal risk was negatively associated with the quality of parent-child

27

interactions. Mothers who are at a higher risk for poverty tend to have less positive
parent-child interactions. The program variable was correlated to child interaction
behaviors with their parent (r = .20) and expressive language scores (r = .18). This means
that children’s expressive language scores and interactive behaviors with their parent
increased when they were in the EHS program condition group. Child’s temperament was
related to joint attention (r = .17) and expressive language (r = .19), thus, children who
tend to generally have a more sociable behavior have higher levels of joint attention and
expressive language later on.

For the final analyses, the four covariates were included in the four analyses with
the exclusion of temperament in the last three. Even though maternal risk and
temperament were the only covariates related to joint attention, they were left in the
model because, when removed, effect sizes slightly decreased. This decrease was also
similar to when child age and program condition, both not related to joint attention or
cognitive abilities were removed. By having some of the covariates uncorrelated to the
dependent variables and related to the independent variables there is a risk of removing a
systematic effect in the models. However, previous analyses of the EHS data included
these covariates. They do hold some effect in the final models of this study, which is why
they are included.

Results

Multiple regressions were used to test the study hypotheses and all analyses were

performed using SPSS 17.0. Tables 4 to 7 display the results of the models for all

dependent variables.

28

Hypothesis 1. A four-step hierarchical multiple regression analysis was
conducted, with toddlers joint attention as the dependent variable, and parent-child
interactions and parental sensitivity as the independent variables (see Table 4). The
independent variables were measured in two ways: a) a play task, and; b) a semi-
structured teaching task. Both contexts represent normal, salient contexts for parent-child
interactions in the home. Covariates included child age, maternal risk, program status,
and child temperament variables. Results suggested that overall the model was
significant, F (7, 131) = 5.19, p < .001, and accounted for 18% of the variance in

toddlers’ joint attention outcomes. With the addition of the parameter variables, child

Interactions, parent sensrtrvrty, and parent NCAST total, the R change was Significant,

and the addition of the parent sensitivity and parent NCAST total variables accounted for
additional 8% of the variance in joint attention outcomes. Among all predictor variables
in the final model, an examination of the regression coefficients indicated that only parent
behaviors with their toddler during a play task, B = .23, t (138) = 2.68, p < .01, and a semi
structured toy task, B = .20, t (138) = 2.40, p < .05, significantly predicted toddlers joint

attention behaviors at 14 months.

29

Table 4

Regression Analysis Predicting 14 month Initiating Joint Attention

 

 

 

Variable B SE B B R2 ARZ
Step 1 .O4* .06*
Child age -.00 .01 -.03
Mat Risk -.10 .05 -.17*
Program .22 .11 .17*
Step 2 .06* .02*
Child age -.00 .01 -.03
Mat Risk -.10 .05 -.18*
Program .18 .11 .13
Temperament .13 .07 .16
Step 3 .10** .05**
Child age -.00 .01 -.03
Mat Risk -.08 .05 -.15
Program .13 .11 .10
Temperament .12 .07 .14
Child Interact .15 .06 .22**
Step4 .18*** .09***
Child age .01 .01 .06
Mat Risk -.06 .05 -.10
Program .13 .1 1 .09
Temperament .1 3 .07 . 15
Child Interact .07 .06 .10
Parent Sensitiv .10 .04 .20*
NCAST P tot .03 .01 .23**
Note. n = 139.

*p < .05, **p< .01, ***_p < .001.

30

Hypothesis 2. Two multiple regressions with cognition scores at 24 and 36
months as the outcome variables were employed. In the first model, in which cognition
scores at 24 months were used as the dependent variable, a hierarchical multiple
regression analysis was conducted. Covariates were entered first and included the parent-
child interaction variables, and then joint attention was entered as the independent
variable next in the model (see Table 5). Results suggested that the overall model for
joint attention behaviors predicting cognition scores at 24 months was statistically
significant; however, the model did not account for a high percentage of variance (only
7%) in outcomes. Also, the joint attention coefficient was not significant. Parental
sensitivity appeared to drive this model and predicting more optimal cognition

development in toddlers.

31

Table 5

Regression Analysis Predicting 24 month Cognitive Abilities

 

 

 

Variable B SE B [3 R2 AR2
Step 1 -.01 .01
Child age .03 .25 .01
Mat Risk .46 1.01 .04
Program 2.87 2.38 .10
Step2 .08** .11**
Child age .26 .25 .09
Mat Risk 1.18 .99 .10
Program 2.28 2.31 .08
Child Interact .38 1.28 .03
Parent Sensitiv 2.90 .90 .28**
NCAST P tot .30 .22 .12
Step 3 .07* .00*
Child age .25 .25 .09
Mat Risk 1.24 1.00 .11
Program 2.08 2.34 .08
Child Interact .29 1.29 .02
Parent Sensitiv 2.77 .93 .27**
NCAST P tot .27 .23 .11
Joint Attention 1.23 1.92 .06
Note. it = 139.
** p <.01.

The second model included cognition scores at 36 months as the outcome

variable, joint attention as the independent variable, and child age, maternal risk, and

program variables as covariates (see Table 6). Similar to the previous model, this model

also included parent-child interaction variables as covariates, with the addition of

cognition scores at 24 months as a covariate. The overall model was statistically

significant, F (8, 130) = 9.80, p < .001 and accounted for 34% of variance. Child

interaction (B = -.16, t (138) = -2.03,p < .05), parent NCAST total (B = .17, t (138) =
2.17,p < .05), and cognition scores at 24 months (B = .52, t (138) = 6.98,p < .001) are

significant predictors of cognition scores at 36 months. However, child interaction was a

negative predictor of cognitive scores at 36 months. Jornt attention dld not change the R .

33

Table 6

Regression Analysis Predicting 36 month Cognitive Abilities

 

 

Variable B SE B B R2 AR2
Step 1 -.02 .01
Child age .14 .16 .07
Mat Risk -.06 .66 -.01
Program .63 1.56 .04
Step2 .10** .13**
Child age .35 .16 .19
Mat Risk .38 .64 .05
Program .62 1.50 .03
Child Interact -1.27 .83 -.14
Parent Sensitiv 1.90 .58 .28***
NCAST P tot .40 .15 .25**
Step 3 .34*** .24***
Child age .26 .14 .14
Mat Risk -.02 .55 -.00
Program -.15 1.28 -.01
Child Interact -1.40 .71 -.15*
Parent Sensitiv .91 .52 .14
NCAST P tot .29 .13 .18*
Cognition 24 .34 .05 .52***
Step 4 .34*** .00***
Child age .26 .14 .14
Mat Risk .01 .55 .00
Program -.26 1.30 -.02
Child Interact -1.45 .71 -.16*
Parent Sensitiv .85 .53 .13
NCAST P tot .28 .13 .17*
Cognition 24 .34 .05 .52***
Joint Attention .68 1.06 .05

 

Note. n = 139.
*p < .05, **p <.01,p < .001***.

34

Hypothesis 3. The final hypothesis states that more joint attention demonstrated at
14 months will predict higher expressive language at 24 months. A hierarchical multiple
regression analysis was conducted for this model (see Table 7). Joint attention variable
was used to predict expressive language scores at 24 months. The model included child
age, maternal risk, and program variables as covariate variables. Parent-child interaction
variables were included as covariates; however expressive language scores at 14 months
were excluded in this study as covariates because of the joint attention variable. The joint
attention measure was created from variables in the expressive language test at 14
months, so to eliminate any repeat variables expressive language scores at 14 months
were left out. Results of this model were statistically significant, F (7, 131) = 6.61, p <
.001, and accounted for 22% of the variance in expressive language suggesting that
higher levels of joint attention behaviors does predict better expressive language scores at

24 months.

35

Table 7

Regression Analysis Predicting 24 month Expressive Language

 

 

Variable B SE B l3 R2 ARZ
Step] .10*** .12***
Child age -1.65 .52 -.26**
Mat Risk 3.57 2.13 .14
Program 12.56 5.04 .20*
Step2 .21*** .13***
Child age -1.07 .52 -.17*
Mat Risk 5.12 2.05 .20*
Program 11.78 4.78 .19*
Child Interact -l .01 2.64 -.03
NCAST P tot .68 .46 .12
Parent Sensitiv 7.81 1.87 .34**
Step 3 .22*** .02***
Child age -1.12 .51 -.17*
Mat Risk 5.46 2.04 .21**
Program 10.67 4.80 .17*
Child Interact -1 .49 2.64 -.05
NCAST P tot .52 .47 .09
Parent Sensitiv 7.1 1 1.90 .31* * *
Joint Attention 6.63 3.93 .14

 

Note. it = 139.

*p < .05, **p < .01,p < .001***.

Summary

The results indicated that a higher quality of parent and child interactions related

to toddlers’ joint attention behaviors at 14 months. Parent-child interactions did not only

predict toddler’s joint attention at 14 months, but impacted the results of cognition and

expressive language developments at 24 and 36 months. Thus, toddler’s non-verbal

36

development, specific to joint attention is mainly affected by their interactions with their

parents.

37

CHAPTER FIVE: DISCUSSION
The purposes of this study were to examine parental sensitivity and parent-child

interactions in a low-income sample, and how they relate to children’s joint attention
behaviors at 14 months. Then examine how 14 months joint attention predicts later
cognitive and expressive language development at 24 and 36 months. Among these
hypotheses, there are low accounts for variance in each, a somewhat common
phenomenon in social and behavioral science research. The complexity and multiple
variables playing into language development suggest that future research delve into

identification of other key factors that might be salient.

The first hypothesis concerned parental sensitivity and parent-child interactions,
and how they related to joint attention at l4-months. The more optimal parent-child
social interactions were hypothesized to predict more joint attention behaviors. Research
shows that sensitive parenting environment promotes joint attention behaviors (Claussen
et al., 2002). Results from the current study indicated that toddlers exhibited more joint
attention behaviors at 14 months when their parents demonstrated higher levels of
sensitive parenting interactions. Findings are in line with prior research. For instance,
Dodici and colleagues (2003) suggested that the main element of parent-child interaction
is joint attention. High quality parent-child interactions are characterized by the inclusion
of joint attention behaviors in the play together. Findings also suggest that sensitive
parenting ensures that this shared interest in an object is established by initiating joint
coordinated attention with their infants during toy play (Siller & Sigman, 2008). Some
examples of parent sensitivity are, interacting with their child when they show them a toy

or acknowledging that they are trying to communicate with them.

38

Interestingly, hypothesis two, which stated that higher levels of joint attention
behaviors predict better cognitive development, was not supported by the results of this
study. Results showed that joint attention skills at 14-months did not significantly predict
cognitive abilities at 24-months. Even though joint attention did not predict cognitive
abilities in this study, there is a significant correlation (r ’s = .17 and .18) between joint
attention and both cognitive abilities, suggesting an underlying association between these
variables. Striano and colleagues (2007) found that the higher level of joint attention in
toddlerhood predicted later cognition in preschool. In the current study, cognitive abilities
were examined at 2 years rather than 4 years, which could be one of the reasons these
findings were not supported. Joint attention mainly supports the growth of children’s
theory of mind. By understanding that others have different intentions children begin to
manipulate situations to focus the attention of others on an object of interest, which
emerges from joint attention. In this study, the Bayley’s inventories focus on children’s
ability to apply instruction to a given task, rather than the ability to understand the
intentions of others. Children’s extent to engage with others significantly predicted
cognitive abilities at 36 months. However, the significance was negative. This
counterintuitive finding demonstrates that children who successfully complete a given
task are less likely to interact with others. One plausible reason might be that children in
this study may have the ability to complete a given task because they can ignore what is
going on around them allowing more concentration. Therefore, if they do not posses an
extent of social interactions with others at 14 months, then by 36 months they have
assimilated to this disengagement and may be focusing attention solely on instruction.

The effects of child engagement negatively predicting cognitive abilities did amplify

39

overtime. Results display that there was no significant effect at 24 months, and then by
36 months the extent of child interaction did impact cognition. Therefore, children who
are highly interactive with others at 14 months may lack the ability to concentrate in a
more demanding, instructional situation at 36 months. This may lead to later behavior
problems and ramifications for academic success in preschool.

The joint attention variables chosen for this study may be another explanation for
the lack of significant findings for the individual joint attention predictor. Toddlers’
cognitive behaviors may develop through other aspects of joint attention behaviors, such
as eye contact with parent while manipulating an object. Study variables were, extends
arm to show you something he or she is holding, reaches out and gives you a toy he or
she has been holding, and points at something interesting (Smith, Mirenda, & Zaidman-
Zait, 2007), thus not including all joint attention behaviors. These joint attention items
were taken from the MacArthur’s gestures scale, therefore, were not specific to studying
joint attention skills. An alternative assessment for studying joint attention in toddlers is
the Early Social Communication Scales (ESCS; Mundy et al., 2003). This is a valid and
reliable scale for accurately measuring every aspect of joint attention in children.

The results of the last hypothesis on joint attention performance and correlations
to expressive language displayed significance in the overall model. However, joint
attention was not a significant predictor. This final model accounted for a significant
amount of variance in the prediction of later expressive language. Children learn to
express their needs at a young age whether it is verbally or through communicative
actions, such as gestures. Mundy and Gomes (1998) concluded that initiating joint

attention predicts expressive language in young children. Smith, Mirenda, and Zaidman-

4o

Zait (2007) measured initiating joint attention behaviors with the same initiating joint
attention measure and found a significant relation between expressive vocabulary
development over the first two years of life and initiating joint attention abilities. The
current studies findings demonstrate that there is a significant relation between expressive
language and joint attention. This relation may be due to the variables coming from a
similar scale. However, it also may be that during toddlerhood children are using joint
attention behaviors to interact with their parent and once they acquire verbal skills they
may begin to incorporate them into these interactions.

Implications of this Study

It is made clear in this study that parent-child interactions promote toddlers joint
attention behaviors. The quality of parent-child interactions were significant predictors to
later cognitive and expressive language abilities. Joint attention skills did not contribute
any effects to the overall models. By studying joint attention at 14 months is an
implication to this study. Joint attention needed to be studied at an earlier age than 14
months to see any developmental trends in the grth of these skills overtime. Toddlers
in the current study mastered a majority of joint attention behaviors. Parent-child
interactions and parental sensitivity to their child’s behaviors played a more prominent
role than joint attention behaviors at children’s 14 month development.

From infancy to toddlerhood, children learn from their parents. A highly
interactive environment promotes these learning experiences where children can develop.
This is why environmental factors, specific to growing up in a low-income household,
must be studied in additional child contributions on their own development. In the current

study, maternal demographic risk was negative related to the quality of parent-child

41

interactions, which was a significant predictor of joint attention behaviors. Results from
this study suggest that in low-income families, quality parent child interactions play an
important role in the development of toddlers’ joint attention, a key developmental
milestone in toddlerhood. By providing a buffer children can interact with their parents in
a way where parents teach their children it is important to demonstrate joint attention
behaviors. In addition, joint attention may be a mediator for the developmental trend of
parent—child interactions predicting toddler’s joint attention, then later joint attention
predicting cognitive and expressive language abilities.
Implications for Future Research

F ollow-up studies with low-income sample must investigate these results for
generalizability. Future research may focus on developing a different variable to measure
joint attention skills at 14-months or examine it at an earlier stage. Developmentally, by
14 months, toddlers should regularly be demonstrating joint attention behaviors. Main
implications are to study joint attention early and examine the ways in which parent-child
interactions in low income families foster joint attention. The process by which
interactions promote joint attention behaviors are when parents positively support and are
sensitive to their child’s behaviors during interactions. Joint attention is central to
toddlers' emerging cognitive and language development (Smith, Mirenda, and Zaidman-
Zait, 2007), and parents should be encouraged to interact with their toddler and provide
optimal sensitivity in that environment for the emergence of toddler initiating joint
attention behaviors. However, low-income families lack the resources, such as promoting
a highly conducive parent-child teaching environment that allow for more optimal child

learning and growth. This may be that parents interact with their child on a more intimate

42

level that focuses on the sensitivity of the child’s needs. Early Head Start could play a
part in improving parental engagement behaviors for appropriate toddler initiating joint
attention to occur. Also, Schertz and Odom (2007) developed an intervention training
model that teaches parents how to promote joint attention behaviors in their infants. This
family centered approach used parent-child interactions as a medium for building on the
developmental rudiments of joint attention (Schertz & Odom, 2007). Researchers found
that this intervention improved toddlers’ joint attention behaviors. This training model
could also be implemented into a home-based intervention that focuses on child
development and parenting in a low-income family. In conclusion, this study sets the
groundwork for future studies that can be beneficial to the development of children
growing up in a low-income environment. The development of j oint attention in toddlers
is one of the most important skills for understanding the social world and how to
communicate in it. Parents interactions with their children promote these joint attention
skills, therefore, highly interactive teaching environment are important for children to
learn and develop later cognitive and language skills. Early Head Start can be a prime
setting to support low-income families to focus on these interactive techniques that can

provide a barrier for children growing up in high risk environments.

43

REFERENCES

Baldwin, M. W. (1995). Relational schemas and cognition in close relationships. Journal
of Social and Personal Relationships, 12(4), 547-552.

Baron-Cohen, S. (1995). Theory of mind and face-processing: How do they interact in
development and psychopathology? In D. Cicchetti, & D. J. Cohen (Eds),
Developmental psychopathology, vol. 1: Theory and methods. (pp. 343-356).
Oxford, England: John Wiley & Sons.

Bates, J. E. (1976). Effects of children's nonverbal behavior upon adults. Child
Development, 47(4), 1079-1088.

Bates, E., Camaioni, L., & Volterra, V. (1975). The acquisition of performatives prior to
speech. Merrill-Palmer Quarterly, 21 (3), 205-226.

Bayley, N. (1993). Bayley Scales of Infant Development, Second Edition. San Antonio,
TX: The Psychological Corporation.

Brady-Smith, C., F auth, R. C., & Brooks-Gunn, J. (2005). Early head start research and
evaluation project: Background and psychometric information for the child-parent
interaction rating scales for the three-bag assessment 14-, 24-, and 36-month
waves. National Center for Children and Families. Teachers College, Columbia
University. '

Buss, A. H., & Plomin, R. (1984). Temperament: Early developing personality traits.
Hillsdale, NJ: Erlbaum.

Butterworth, G. (1995). Origins of mind in perception and action. In C. Moore & P.J.
Dunharn (Eds.), Joint attention: Its origins and role in development, (pp. 29—40).
Hillsdale, NJ: Erlbaum.

Carpenter, M., & Tomasello, M. (2000). Joint attention, cultural learning, and language
acquisition. In A. M. Wetherby & B. M. Prizant (Eds), Autism spectrum
disorders (pp. 31—54). Baltimore: Brookes.

Carpenter, M., Nagell, K., & Tomasello, M. (1998). Social cognition, joint attention, and
communicative competence from 9 to 15 months of age. Monographs of the
Society for Research in Child Development, 63, (4, Serial No. 255), 1—142.

Charman, T., Baron-Cohen, S., Swettenham, J ., Baird, G., Cox, A., & Drew, A. (2000).

Testing joint attention, imitation, and play as infancy precursors to language and
theory of mind. Cognitive Development, 15, 481-498.

44

Chase-Lansdale, P.L., & Brooks-Gunn, J. (Eds.). (1995). Escape fiom poverty: What
makes a difference for children? New York: Cambridge University Press.

Claussen, A. H., Mundy, P. C., Mallik, S. A., & Willoughby, J. C. (2002). Joint attention
and disorganized attachment status in infants at risk. Development and
Psychopathology. 14, 279-291.

Corkum, V., & Moore, C. (1998). Origins of joint visual attention in infants.
Developmental Psychology, 34(1), 28-38.

Dempster, A., Laird, N., & Rubin, D. (1977). Maximum likelihood from incomplete data
via the em algorithm. Journal of the Royal Statistical Society: Series B
(Methodological). 39(1), 1-3 8.

Dodici, B. J ., Draper, D. C., & Peterson, C. A. (2003). Early parent-child interactions and

early literacy development. Topics in Early Childhood Special Education, 23(3),
124-136.

Duncan, G.J., Brooks-Gunn, J ., & Klebanov, P. K. (1994) Economic deprivation and
early childhood development. Child Development, 65 (2), 296-318.

Eisenberg, N., Cumberland, A., Spinrad, T., Fabes, R., Shepard, 8., Mark Reiser, M.,
Murphy, S. H., Guthrie, L., & Guthrie, I. (2006) The relations of regulation and
emotionality to children’s externalizing and internalizing problem behavior. Child
Development, 72 (4), 11 12-1134.

Ereky-Stevens, K. (2008). Associations between mothers' sensitivity to their infants'
internal states and children's later understanding of mind and emotion. Infant and
Child Development, 1 7(5), 527-543.

Fenson, L., Pethick, S., Renda, C., Cox, J ., Dale, P. S., & Reznick, J. S. (2000). Short-

forrn versions of the MacArthur Communicative Development Inventories.
Applied Psycholinguistics, 21, 95-1 16.

Fogel, A. (2009). Infancy: Infant, family and society, 5th edition. Comwall-on-Hudson,
NY: Sloan publishing.

Garner, P.W, Landry, S. H., & Richardson, M. A. (1991). The development of joint
attention skills in very-low-birth-weight infants across the first 2 years. Infant
Behavior & Development, 14 (4), 489-495.

Gibson, E. & Rader, N. (1979). Attention: The perceiver as performer. In G. Hale & M.

Lewis (Eds.). Attention and cognitive development. (pp. 103-141). New York:
Plenum Press.

45

Hustedt, J. T., & Raver, C. C. (2002). Scaffolding in low-income mother-child dyads:
Relations with joint attention and dyadic reciprocity. International Journal of
Behavioral Development, 26(2), 113-119.

Huston, A. C., McLoyd, V. C., & Garcia Cell, C. (1994) Children and poverty: Issues in
contemporary research. Child Development, 65 (2), 275-282.

Kochanska, G., & Knaack, A. (2003). Effortful control as a personality characteristic of
young children: Antecedents, correlates, and consequences. Journal of
Personality, 71 (6), 1087-1112.

Love, J. M., Kisker, E. E., Ross, C., Raikes, H., Constantine, J ., Boller, K., et al. (2005).
The effectiveness of Early Head Start for 3-year-old children and their parents:
Lessons for policy and programs. Developmental Psychology, 41(6), 885-901.

Loveland, K. A., & Landry, S. H. (1986). Joint attention and language in autism and
developmental language delay. Journal of A utism and Developmental Disorders,
16(3), 335-349.

Markus, J ., Mundy, P., Morales, M., Delgado, C. E. F., & Yale, M. (2000). Individual
differences in infant skills as predictors of child—caregiver joint attention and
language. Social Development, 9(3), 302-315.

Meltzoff, A. N. & Brooks, R. (2008). Self-experience as a mechanism for learning about
others: A training study in social cognition. Developmental Psychology. 44 (5),
1257-1265.

Morales, M., Mundy, P., Delgado, C. E. F., Yale, M., Messinger, D., Neal, R., et al.
(2000). Responding to joint attention across the 6- through 24-month age period

and early language acquisition. Journal of Applied Developmental Psychology,
21(3), 283-283.

Morales, M., Mundy, P., & Rojas, J. (1998). Following the direction of gaze and
language development in 6-months-olds. Infant Behavior & Development, 21 (2),
373-377.

Morgan, B., Maybery, M., & Durkin, K. (2003). Weak central coherence, poor joint
attention, and low verbal ability: Independent deficits in early autism.
Developmental Psychology, 39(4), 646-656.

Mundy, P. & Burnette, C. (2005). Joint attention and neurodevelopment. In F. Volkmar,
A.Klin, & R. Paul (Eds.), Handbook of Autism and Pervasive Developmental
Disorders, Vol. 3.3m. 650-681). Hoboken, NJ: John Wiley.

Mundy, P. & Gomes, A. (1998). Individual differences in joint attention skills in the
second year. Infant Behavior and Development. 21(3), 469-482.

46

Mundy, P., & Neal, R. (2001). Neural plasticity, joint attention and a transactional social-
orienting model of autism. International Review of Mental Retardation, 23, 139-
168.

Mundy, P., & Newell, L. (2007). Attention, joint attention, and social cognition. Current
Directions in Psychological Science. 16 (5), 269-274.

Mundy, P., Sigman, M., & Kasari, C. (1994). Joint attention, developmental level, and
symptom presentation in autism. Developmental and Psychopathology, 6, 389—
401.

Mundy, P., Sigman, M., & Kasari, C. (1994). The theory of mind and joint-attention
deficits in autism. In S. Baron-Cohen, H. Tager-Flusberg & D. J. Cohen (Eds.),
Understanding other minds: Perspectives from autism. (pp. 181-203). New York,
NY, US: Oxford University Press.

Mundy, P., Sigman, M. D., Ungerer, J ., & Sherman, T. (1986). Defining the social
deficits of autism: The contribution of non-verbal communication measures.
Journal of Child Psychology and Psychiatry, 27(5), 657-669.

Musil, C. M., Warner, C. B., Yobas, P. K., & Jones, S. L. (2002). A comparison of
imputation techniques for handling missing data. Western Journal of Nursing
Research, 24(7), 815-829.

Olafsen, K. S., Ronning, J. A., Kaaresen, P. 1., Ulvund, S. E., Handegard, B. H., & Dahl,
L. B. (2006). Joint attention in term and preterm infants at 12 months corrected
age: The significance of gender and intervention based on a randomized

controlled trial. Infant Behavior & Development, 29(4), 554-554.

Raver, C. C. (1996). Success at catching and keeping toddler's attention: An examination
of joint attention among low-income mothers and their 2-year-olds. Early
Development & Parenting, 5(4), 225-225.

Raver, C. C., & Leadbeater, B. J. (1995). Factors influencing joint attention between
socioeconomically disadvantaged adolescent mothers and their infants. In C.
Moore, & P. J. Dunham (Eds.), Joint attention: Its origins and role in
development. (pp. 251-271). Hillsdale, NJ, England: Lawrence Erlbaum
Associates, Inc.

Rothbart, M. K., & Bates, J. E. (2006). Temperament in children’s development. In W.
Damon, R. Lerner, & N. Eisenberg (Eds.), Handbook of child psychology volume
3, Social, emotional, and personality development (6th ed.). New York: Wiley.

Scaife, M., & Bruner, J. S. (1975). The capacity for joint visual attention in the infant.
Nature, 253(5489), 265-265.

47

Schafer, J. L. & Graham, J. W. (2002). Missing data: Our view of the state of the art.
Psychological Methods, 7(2), 147-177.

Schertz, H. H., & Odom, S. L. (2007). Promoting joint attention in toddlers with autism:
A parent-mediated developmental model. Journal of A utism and Developmental
Disorders, 37(8), 1562-1575.

Schertz, H. H., & Odom, S. L. (2004). Joint attention and early intervention with autism:

A conceptual framework and promising approaches. Journal of Early
Intervention, 27(1), 42-42.

Sheinkopf, S., Mundy, P., Claussen, A., & Willoughby, J. (2004). Infant joint attention
skills and preschool behavioral outcomes in at-risk children. Development and
Psychopathology. 16(2), 273-291.

Sigman, M., & Ruskin, E. (1999). Continuity and change in the social competence of
children with autism, Down syndrome, and developmental delays. Monographs
for the Society for Research in Child Development, 64, Serial No. 256.

Siller, M., & Sigman, M. (2008). Modeling longitudinal change in the language abilities
of children with autism: Parent behaviors and child characteristics as predictors of
change. Developmental Psychology, 44(6), 1691-1704.

Siller, M., & Sigman, M. (2002). The behaviors of parents of children with autism predict
the subsequent development of their children’s communication. Journal of A utism
and Developmental Disorders, 32, 77—89.

Smith, V., Mirenda, P., & Zaidman-Zait, A. (2007). Predictors of expressive vocabulary

growth in children with autism. Journal of Speech, Language, and Hearing
Research. 50, 149-160.

Spinrad, T. L., Eisenberg, N., Gaertner, B., Popp, T., Smith, C. L., Kupfer, A., Greving,
K., Liew, J ., & Hofer, C. (2007). Relations of maternal socialization and toddlers’
effortful control to adjustment and social competence. Developmental
Psychology, 43 (5), 1170-1186.

Striano, T., Stahl, D., Cleveland, A., & Hoehl, S. (2007). Sensitivity to triadic attention
between 6 weeks and 3 months of age. Infant Behavior & Development, 30(3),
529-529.

Strid, K., Tjus, T., Smith, L., Meltzoff, A. N., & Heimann, M. (2006). Infant recall

memory and communication predicts later cognitive development. Infant
Behavior & Development, 29, 545-553.

48

Sumner, G., & Spietz, A. (1994). NCAS T caregiver/parent-child interaction teaching
manual. Seattle: NCAST Publications, University of Washington, School of
Nursing.

Tomasello, M. (1995). Joint attention as social cognition. In C. Moore, & P. J. Dunham
(Eds.), Joint attention: Its origins and role in development. (pp. 103-130).
Hillsdale, NJ, England: Lawrence Erlbaum Associates, Inc.

Toth, K., Munson, J., Meltzoff, A. N., & Dawson, G. (2006). Early predictors of
communication development in young children with autism spectrum disorder:

Joint attention, imitation, and toy play. Journal of A utism and Developmental
Disorders, 36(8), 993-1005.

Trevarthen, C. & Aitken, K. (2001). Infant intersubjectivity: Research, theory, and
clinical applications. Journal of Child Psychology and Psychiatry, 42(1), 3-48.

Ulvund, S. E., & Smith, L. (1996). The predictive validity of nonverbal communicative
skills in infants with perinatal hazards. Infant Behavior & Development, 19 (4),
441-449.

Vaughn, A., Mundy, R, Block, J ., Burnette, C., Delgado, C., Gomez, Y., et a1. (2003).
Child, caregiver, and temperament contributions to infant joint attention. Infancy,
4, 603—617.

Wellman, H. M., Lopez-Duran, S., LaBounty, J ., & Hamilton, B. (2008). Infant attention

to intentional action predicts preschool theory of mind. Developmental
Psychology, 44(2), 618-618.

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