The Effects of Joint Attention Interventions for Young Children With Autism Spectrum Disorder: A Meta-analysis

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Abstract
This meta-analysis examined the post-intervention effects of joint attention interventions on children's joint attention skills and other outcomes for young children with autism spectrum disorder (ASD), as well as identifying characteristics associated with improvements in children's joint attention skills. We searched four databases in February 2025. Randomized controlled trials (RCTs) of joint attention interventions for children with ASD under five years old were included. Risk of bias was assessed using the Risk of Bias 2.0 tool. Effects were synthesized using multivariate random-effects model meta-analysis using robust variance estimation. Eighteen RCTs with 1,165 child participants were included in this meta-analysis. We found improvements in joint attention skills (g = 0.53, 95% CI [0.34, 0.72]) with substantial heterogeneity. Child's chronological age and joint attention types were found statistically moderating the effect on children's joint attention skills. We also found improvements in play (g = 0.33, 95% CI [0.04, 0.63]), and autism symptomatology (g = 0.70, 95% CI [0.13, 1.26]). This meta-analysis of 18 RCTs showed that joint attention interventions effectively improved joint attention skills in young children with ASD. Younger children showed greater improvements than older children. Larger effects on responding to joint attention were observed comparing to other types of joint attention. While positive effects on play skills and autism symptoms were observed, these findings require cautious interpretation due to methodological limitations. Results support joint attention interventions as beneficial for improving developmental outcomes in young children with ASD.

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