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Early intervention increases reactive joint attention in autistic preschoolers with arousal regulation as mediator.

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Title: Early intervention increases reactive joint attention in autistic preschoolers with arousal regulation as mediator.
Authors: Bast, Nico (AUTHOR), Polzer, Leonie (AUTHOR), Raji, Naisan (AUTHOR), Schnettler, Luisa (AUTHOR), Kleber, Solvejg (AUTHOR), Lemler, Christian (AUTHOR), Kitzerow-Cleven, Janina (AUTHOR), Kim, Ziyon (AUTHOR), Schaer, Marie (AUTHOR), Freitag, Christine M. (AUTHOR)
Source: European Child & Adolescent Psychiatry. Oct2025, Vol. 34 Issue 10, p3161-3174. 14p.
Subjects: Treatment of autism, Statistical models, Child psychopathology, Arousal (Physiology), Research funding, Prompts (Psychology), Statistical sampling, Eye movement measurements, Neurodiversity, Randomized controlled trials, Descriptive statistics, Early intervention (Education), Attention, Odds ratio, Communicative disorders, Research, Research methodology, Social skills, Asperger's syndrome, Factor analysis, Patient monitoring, Data analysis software, Confidence intervals, Pupil (Eye), Behavior therapy, Eye movements, Sensitivity & specificity (Statistics), Facial expression, Biomarkers, Social skills education, Children
Abstract: Reactive joint attention (RJA) describes shared attention on a cued target. This key ability is attenuated in autistic compared to non-autistic preschoolers with low cognitive ability, and thus trained during early intervention. We evaluated the development of RJA in matched autistic preschoolers within a randomized controlled trial of the naturalistic developmental behavioral intervention A-FFIP (intervention [n = 32] versus early intervention-as-usual [EIAU, n = 28]), which is further compared to non-autistic preschoolers (n = 52). A screen-based eye-tracking paradigm assessed RJA at baseline, after 12 months (end-of-intervention, 78% retention), and after 36 months (follow-up, 44% retention). Corresponding pupil size changes were utilized to investigate arousal as a mediator in RJA group differences. Generalized linear mixed models were applied to compare RJA likelihood between groups and assessment timepoints. Across timepoints, RJA likelihood was lower in autistic versus non-autistic preschoolers (ORs = 0.07–0.27). The A-FFIP - but not the EIAU group - showed an increase in RJA likelihood at end-of-intervention (OR = 1.52) and follow-up (OR = 2.38). Across both autistic groups, an increase in RJA likelihood after 12 months predicted improved social responsiveness at 36-months follow-up (β = -1.22). A higher baseline pupil size within trials was associated with a lower RJA likelihood (β = -0.32) and mediated the autistic group difference on RJA likelihood in a causal mediation analysis. The A-FFIP early intervention increased eye-tracking derived RJA in autistic preschoolers up to two years after end of intervention, which likely cascaded on improved social responsiveness. Arousal regulation is outlined as a promising mediating mechanism. [ABSTRACT FROM AUTHOR]
Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Early intervention increases reactive joint attention in autistic preschoolers with arousal regulation as mediator.
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  Data: <searchLink fieldCode="AR" term="%22Bast%2C+Nico%22">Bast, Nico</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Polzer%2C+Leonie%22">Polzer, Leonie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Raji%2C+Naisan%22">Raji, Naisan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schnettler%2C+Luisa%22">Schnettler, Luisa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kleber%2C+Solvejg%22">Kleber, Solvejg</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lemler%2C+Christian%22">Lemler, Christian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kitzerow-Cleven%2C+Janina%22">Kitzerow-Cleven, Janina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kim%2C+Ziyon%22">Kim, Ziyon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Schaer%2C+Marie%22">Schaer, Marie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Freitag%2C+Christine+M%2E%22">Freitag, Christine M.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Child+%26+Adolescent+Psychiatry%22">European Child & Adolescent Psychiatry</searchLink>. Oct2025, Vol. 34 Issue 10, p3161-3174. 14p.
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  Data: Reactive joint attention (RJA) describes shared attention on a cued target. This key ability is attenuated in autistic compared to non-autistic preschoolers with low cognitive ability, and thus trained during early intervention. We evaluated the development of RJA in matched autistic preschoolers within a randomized controlled trial of the naturalistic developmental behavioral intervention A-FFIP (intervention [n = 32] versus early intervention-as-usual [EIAU, n = 28]), which is further compared to non-autistic preschoolers (n = 52). A screen-based eye-tracking paradigm assessed RJA at baseline, after 12 months (end-of-intervention, 78% retention), and after 36 months (follow-up, 44% retention). Corresponding pupil size changes were utilized to investigate arousal as a mediator in RJA group differences. Generalized linear mixed models were applied to compare RJA likelihood between groups and assessment timepoints. Across timepoints, RJA likelihood was lower in autistic versus non-autistic preschoolers (ORs = 0.07–0.27). The A-FFIP - but not the EIAU group - showed an increase in RJA likelihood at end-of-intervention (OR = 1.52) and follow-up (OR = 2.38). Across both autistic groups, an increase in RJA likelihood after 12 months predicted improved social responsiveness at 36-months follow-up (β = -1.22). A higher baseline pupil size within trials was associated with a lower RJA likelihood (β = -0.32) and mediated the autistic group difference on RJA likelihood in a causal mediation analysis. The A-FFIP early intervention increased eye-tracking derived RJA in autistic preschoolers up to two years after end of intervention, which likely cascaded on improved social responsiveness. Arousal regulation is outlined as a promising mediating mechanism. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1007/s00787-025-02738-1
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      – Code: eng
        Text: English
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      – SubjectFull: Treatment of autism
        Type: general
      – SubjectFull: Statistical models
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      – SubjectFull: Child psychopathology
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      – SubjectFull: Early intervention (Education)
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      – SubjectFull: Children
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      – TitleFull: Early intervention increases reactive joint attention in autistic preschoolers with arousal regulation as mediator.
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