Joint attention in Down syndrome: A meta-analysis

Abstract

Background: Some studies have indicated that joint attention may be a relative strength in Down syndrome (DS), but other studies have not.

Aim: To conduct a meta-analysis of joint attention in DS to more conclusively determine if this is a relative strength or weakness when compared to children with typical development (TD), developmental disabilities (DD), and autism spectrum disorder (ASD).

Methods and procedures: Journal articles published before September 13, 2016, were identified by using the search terms "Down syndrome" and "joint attention" or "coordinating attention". Identified studies were reviewed and coded for inclusion criteria, descriptive information, and outcome variables.

Outcomes and results: Eleven studies (553 participants) met inclusion criteria. Children with DS showed similar joint attention as TD children and higher joint attention than children with DD and ASD. Meta-regression revealed a significant association between age and joint attention effect sizes in the DS vs. TD contrast.

Conclusions and implications: Joint attention appears to not be a weakness for children with DS, but may be commensurate with developmental level. Joint attention may be a relative strength in comparison to other skills associated with the DS behavioral phenotype. Early interventions for children with DS may benefit from leveraging joint attention skills.

Keywords: Autism spectrum disorder; Behavioral phenotype; Down syndrome; Joint attention; Language development; Meta-analysis; Social development.