Joint Attention–Based Occupational Therapy Intervention in Preschoolers With Autism Spectrum Disorder: A Randomized Controlled Trial

Abstract Importance: A viable occupational therapy program based on joint attention is needed to ensure that children with autism spectrum disorder (ASD) lead lives in which they interact socially. Objective: To explore the benefit of a joint attention–based occupational therapy program offered simultaneously with the usual special education program (USEP) compared with USEP alone. Design: Randomized controlled study, including pre-, post-, and follow-up testing. Setting: Special education and rehabilitation center. Participants: Twenty children with ASD in the study group, M = 4.80 yr (SD = 0.78 yr), and the control group, M = 5.10 yr (SD = 0.73 yr), were included. Intervention: All children received USEP (2 sessions/wk for 12 wk). Joint attention–based occupational therapy was applied to the study group in addition to USEP (3 sessions/wk for 12 wk). Outcomes and Measures: The Social Communication Questionnaire (SCQ), Autism Behavior Checklist (ABC), and Motor-Free Visual Perception Test–4 (MVPT–4) were implemented. Results: The study group had a statistically and clinically significant improvement in SCQ, ABC, and MVPT–4 scores after the intervention (p < .001). The control group did not show statistically significant improvement in measurements (p > .05). The mean values of SCQ–Total, ABC–Total, and MVPT–4 variables measured at 3-mo follow-up were significantly different than preintervention (p < .05). Conclusions and Relevance: Joint attention–based intervention, including a child-centered approach, can improve social communication, reduce ASD-related behaviors, and improve visual perception. What This Article Adds: This study emphasizes the importance of occupational therapy with a holistic perspective, based on joint attention, in terms of increasing the effectiveness of special education programs attended by children with ASD and reinforcing visual perception, communication, and positive behaviors in children with ASD.