An fMRI study of joint attention experience
Introduction
Joint attention is a process whereby two individuals attend to the same object because one is checking, monitoring, or following the focus of attention of the other. It is an early cognitive skill to emerge; infants will look in the direction of other people's head and eye movements at about 6 months of age (Scaife and Bruner, 1975), and by the age of 18 months they will reliably follow the gaze of others (Butterworth and Jarrett, 1991). It may therefore be an important developmental precursor to other social and cognitive abilities.
In particular, joint attention processes may constitute cognitive precursors to higher level mental state attribution such as that concerned with understanding false belief (Baron-Cohen, 1994, Gopnik et al., 1994, Mundy, 1993). In a longitudinal study, joint attention at 20 months positively correlated with measures of theory of mind collected between 3 and 4 years of age (Charman et al., 2001).
A number of lines of evidence also suggest that joint attention may be an important precursor to the development of language abilities: onset consistently precedes the emergence of referential language in the second year of life; the ability to engage attention jointly during naturalistic infant–mother interactions predicts infants' word comprehension and word production (Carpenter et al., 1998); joint attention bids measured between 6 and 18 months make a unique contribution to language development at 30 months (Morales et al., 2000); and gaze following, which is an important component of joint attention, predicts vocabulary between 1 and 2 years (Morales et al., 1998).
Joint attention skills are notably poor in autism and severity of joint attention impairment predicts the outcome of this disorder (Dawson et al., 2002). In one study (Charman et al., 1997), 12 children with symptoms of autism at 20 months (whose diagnostic status was subsequently confirmed) switched gaze less often between a toy and an experimenter to share aspects of a situation with the experimenter. Children with autism are impaired in their comprehension and production of protodeclarative pointing (pointing aimed at sharing interest with another rather than aimed at requesting objects), and they also seem unable to use the direction of gaze of a person to infer what the person wants (Baron-Cohen, 1989, Baron-Cohen, 1995). They are significantly less likely to check the focus of attention of an experimenter in ambiguous situations compared to control groups (Phillips et al., 1992). However, it appears that these children do possess the ability to compute the direction of another person's gaze and thus to understand what a person is looking at (Leekam et al., 1997, Leekam et al., 2000). Recently, children with autism have been shown to be able to use eye direction cues to equal advantage to controls (Kylliainen and Hietanen, 2004, Senju et al., 2004) in reducing their reaction times in responding to a lateralized cue. Rather, it seems they fail to spontaneously follow the direction of gaze of another person with eyes and head turned toward an object (Leekam et al., 2000)—they fail to join in with the other person's attentional focus. This experiment has been largely incorporated into the Autism Diagnostic Observation Schedule (Lord et al., 2000), where joint attention items discriminate well between children with autism and those with other clinical problems.
If gaze detection is functioning normally in autism, it may be that it is another component of the joint attention process that is functioning abnormally in autism. As well as being involved with the detection of another individual's attentional direction, joint attention is also concerned with the tendency to switch gaze between an object and a person, and to direct the attention of another (Leekam et al., 1997, Phillips et al., 1992, Swettenham et al., 1998). Notably, the tendency to direct attention and the ability to (spontaneously) monitor attentional direction are both impaired in autism, suggesting that they could both be affected by a common mechanism, possibly that are concerned with integrating them in the formation of a representation of joint attention. Baron-Cohen, 1994, Baron-Cohen, 1995 proposed the existence of a modular ‘Shared Attention Mechanism’ (SAM), which could serve such an integration function, suggesting that this would be an integral part of a ‘theory of mind’ mechanism.
In examining the neural correlates of joint attention, there is now strong evidence for specialized neural mechanisms serving gaze and eye movement perception (Baron-Cohen et al., 2001, Hoffman and Haxby, 2000, Jellema et al., 2000, Perrett et al., 1989, Puce and Perrett, 2003, Puce et al., 1998, Wicker et al., 1998). At a higher cognitive level of processing, Wicker et al. (2003) investigated the neural correlates of attributing emotion secondary to gaze processing. Yet, to our knowledge no functional neuroimaging paradigm has been used to investigate integrating information from gaze perception with executed gaze direction at the level of forming a representation of joint attention itself. If joint attention is a cognitive precursor to ‘theory of mind’ capacity, this may involve similar neural substrate such as ventromedial frontal cortex. In this study, we developed video clips (Fig. 1) that engendered an experience of joint attention in observers who watched them. The joint attention condition was contrasted with a very similar but nonjoint attention condition, where the model's gaze moved equally as often but was always directed elsewhere. This has allowed us to investigate the neural substrate of joint attention at the level concerned with integrating gaze-direction information from the self and another individual.
Section snippets
Materials
We hypothesized that there would be neural structures more active during joint attention than during a control situation when attention was directed to differing locations. To create these situations, we constructed a number of video clips by positioning a model behind a silk screen, with the video frame showing their head in the top two thirds and the screen in the bottom third. A red dot projected onto the screen moved horizontally and randomly between four points spaced evenly apart. The
Results
First we identified areas of activation in the joint condition compared to rest and nonjoint condition compared to rest (Fig. 2; Table 1, Table 2). Both conditions, as expected, caused activation of the posterior aspect of the superior temporal gyrus and frontal eye fields. These are likely to be associated with detection of attentional direction and the preparation and execution of eye movements, as the moving dot changed position. Other areas were also activated, including subcortical areas,
Discussion
One of the largest clusters of activation specific to joint attention was centered around the ventromedial frontal cortex in an area associated with ‘theory of mind’ function. The 265-voxel cluster identified with a center at coordinates x = 2, y = 33, and z = 40 is in a region consistently associated with ‘theory of mind’ (Castelli et al., 2000, Castelli et al., 2002, Fletcher et al., 1995, Frith, 2001, Frith and Frith, 2000, Gallagher and Frith, 2003, Gallagher et al., 2000) as well as
Acknowledgments
We are especially grateful for financial support from the National Alliance for Autism Research, to Stuart Duncan and Iain Harold for their work on stimulus preparation, and to David Lovell, Duncan Stewart, and the other volunteers for their help with conducting this experiment.
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