Standardization of joint attention and its clinical application by longitudinal survey

我们编制了由共同注意行为、运动技能和语言三个项目组成的婴儿期发育检查量表。现在我们可以通过检查表进行评分，因为它已经被标准化了。在本研究中，我们调查了婴儿期联合注意力的典型发育过程和自闭症的早期症状。1702名婴儿在8、10、12、14、16、18和36个月时使用我们的检查表进行纵向筛查。结果，结构方程模型分析表明，儿童联合注意的发展过程可分为跟随注意、跟随行为、操作注意和表征（符号）发展4个阶段。（1）联合注意力-1SD或更低;（2）不能对他人的痛苦产生陈述性的指向和反应;（3）不能对图画书中的图画命名，能自发地说出几个有意义的词;（4）独自行走，提示联合注意行为的发展具有层次性，本量表有助于孤独症儿童的早期发现和干预。

We have been developed the checklist, composing of the items on the behaviors of joint attention, motor skill and language for developmental check up in infancy. Now we could make a score by the checklist because it was already standardized.In the present study, we investigated the typical developmental process of joint attention in infancy and the early signs of autism.A thousand seven hundred and two infants were screened longitudinally at 8,10,12,14,16,18,and 36 months of age, using our checklist.As a result, a structural equation modeling indicated that the developmental process of joint attention had four stages ; following attention, following behaviors, operating attention, and developing the representation (symbol).Additionally, the behavioral features of 6 children, who were diagnosed as autism later, were found as follows; (1)-1SD or less score of joint attention, (2)not emerging declarative pointing and response to other's distress, (3)failing to denomination of the picture in the picture book and saying spontaneously a few meaning words, and (4)walking by oneself.These suggested that the behaviors of joint attention developed hierarchically and that our checklist would be helpful for early detection and intervention of children with autism.