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

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.