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1. Mundy P, Sigman M, Kasari C, Yirmiya N: Nonverbalcommunication skills in Down syndrome children. ChildDev 1988; 59:235-249.

2. Wetherby AM, Yonclas DG, Bryan AA: Communicationprofiles of preschool children with handicaps: Implica-tions for early identification. J Speech Hear Disord 1989;54:148-158.

3. �� !"#$ J�� !"#$%&'()*+,-./

�� !"#$%&'(%)�*+,-./ 2003 �

4. Smith C, Fluck M: (Re-) constructing pre-linguistic in-terpersonal processes to promote language develop-ment in young children with deviant or delayed commu-nication skills. Br J Educ Psychol 2000; 70:369-389.

5. Mundy P, Gomes A: Individual differences in joint at-tention skill development in the second year. InfantBehav Dev 1998; 21:469-482.

6. Tomasello M: The role of joint attention in early languagedevelopment. Lang Sci 1988; 11:69-88.

7. Carpenter M, Nagell K, Tomasello M: Social cognition,joint attention, and communicative competence from 9to 15 months of age. Monogr Soc Res Child Dev 1998;63:1-143.

8. Corkum V, Moore C: Development of joint visual atten-tion in infants. In: Moore C, Dunham P, eds. Jointattention: Its origins and role in development, Hillsdale,NJ: Erlbaum 1995, pp 61-83.

9. Morissette P, Ricard M, Gouin-D'ecarie T: Joint visualattention and pointing in infancy: A longitudinal study ofcomprehension. Br J Dev Psychol 1995; 15:163-177.

10. Butterworth G, Cochran E: Towards a mechanism ofjoint visual attention in human infancy. Int J Behav Dev1980; 3:253-272.

11. Butterworth G, Grover L: Joint visual attention, manualpointing, and preverbal communication in humaninfancy. In: Jeannerod M, eds. Attention and perform-ance XIII, Hillsdale, NJ: Erlbaum 1990, pp 605-624.

12. Lempers JD: Young children's production and compre-hension of nonverbal deictic behaviors. J Genet Psychol1979; 135:93-102.

13. Desochers S, Morissette P, Ricard M: Two perspec-tives on pointing in infancy. In: Moore C, Dunham P,eds. Joint attention: Its origins and role in development,Hillsdale, NJ: Erlbaum 1995, pp 85-101.

14. Bates E, Camaioni L, Volterra V: The acquisition ofperformatives prior to speech. Merrill-Palmer Q 1975;21:205-224.

15. Bates E, Benigni L, Bretherton I, Camaioni L, Volterra

�� �� �� �

Tzu Chi Med J 2004 � 16 � No. 5OUQ �� !

V: Cognition and communication from nine to thirteenmonths: Correlational findings. In: Bates E, eds. Theemergence of symbols: Cognition and communicationin infancy. New York: Academic 1979, pp 69-140.

16. Zinober B, Martlew M: Developmental changes in fourtypes of gesture in relation to acts and vocalizationsfrom 10 to 21 months. Br J Dev Psychol 1985; 3:293-360.

17. Tomasello M: Joint attention as social cognition. In:Moore C, Dunham P, eds. Joint attention: Its originsand role in development, Hillsdale, NJ: Erlbaum 1995,pp 103-130.

18. Bruner J, Sherwood V: Thought, language and interac-tion in infancy. In: Call J, Galenson E, Tyson R, eds.Frontiers of infant psychiatry, New York: Basic Books1983, pp 38-55.

19. Mundy P, Sigman M, Ungerer J, Sherman T: Definingthe social deficits of autism: The contribution of non-verbal communication measures. J Child Psychol Psy-chiatry 1986; 27:657-669.

20. �� !"#$%&'()*+,-./01234564�� !"#$% 2000 �

21. Bruner J: From communication to language: A psycho-logical perspective. Cognition 1975; 3:255-287.

22. Carpenter M, Tomasello M: Joint attention, culturallearning, and language acquisition. In: Whetherby AM,Pirzant BM, eds. Autistic Spectrum Disorder: A trans-actional developmental perspective. Baltimore: Paul H.Brookes 2000, pp 31-53.

23. McEvoy R, Rogers SJ, Pennington BF: Executive func-tion and social communication deficits in young autisticchildren. J Child Psychol Psychiatry 1993; 34:563-578.

24. Mundy P, Kasari C, Sigman M, Ruskin E: Nonverbalcommunication and early language acquisition in chil-dren with Down syndrome and in normally developingchildren. J Speech Hear Res 1995; 38:157-167.

25. Morales M, Mundy P, Delgado CE, et al: Responding tojoint attention across 6-through 24-month age periodand early language acquisition. J Appl Dev Psychol2000; 21:283-298.

26. Delgado CE, Peter M, Crowson M, Markus J, Yale M,Schwartz H: Responding to joint attention and languagedevelopment: A comparison of target locations. JSpeech Lang Hear Res 2002; 45:715-719.

27. Mundy P, Sigman M, Kasari C: Joint attention, devel-opmental level, and symptom presentation in young chil-dren with autism. Dev Psychopathol 1994; 6:389-401.

28. Mundy P, Sigman M, Kasari C: A longitudinal study ofjoint attention and language development in autisticchildren. J Autism Dev Disord 1990; 20:115-128.

29. Cassidy SB: Prader-Willi syndrome. J Med Genet 1997;34:917-923.

30. �� !"#$!%&'!()*!�+,-./0 J��

������������������ 2003; 15:311-320 �

31. Landry SH: The development of joint attention in pre-mature low birth weight infants: Effects of early medicalcomplications and maternal attention-directingbehaviors. In: Moore C, Dunham P, eds. Joint attention:Its origins and role in development, Hillsdale, NJ:Erlbaum 1995, pp 223-250.

32. Ulvund SE, Smith L: The predictive validity of nonver-bal communicative skills in infants with perinatal hazards.Infant Behav Dev 1996; 19:441-449.

33. Caplan R, Chugani HT, Messa C, et al: Hemispherec-tomy for intractable seizures: Presurgical cerebral glu-cose metabolism and post-surgical non-verbalcommunication. Dev Med Child Neurol 1993; 35:582-592.

34. Caplan R, Guthrie D, Komo S, Shields WD, SigmannM: Infantile spasms: The development of nonverbal com-munication after epilepsy surgery. Dev Neurosci 1999;21:165-173.

35. Sigman M, Ruskin E: Continuity and change in the so-cial competence of children with autism, Downsyndrome, and developmental delays. Monogr Soc ResChild Dev 1999; 64:1-139.

36. �� !"#$%&'()*+,-./01234567�� !"#$%& 2003 �

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Tzu Chi Med J 2004 � 16 � No. 5 �� ! OUR

Nonverbal Communication Skills of Children with Developmental

Disorders

Ting-Yu Lin, Chung-Hsin Chiang1, Nai-Wen Guo, Chao-Ching Huang

2

Institute of Behavioral Medicine, Department of Pediatrics2, National Cheng Kung University, College of Medicine, Tainan,

Taiwan; Department of Psychology1, National Chung Cheng University, Chiayi, Taiwan

ABSTRACTNonverbal communication skills provide a vital foundation for subsequent language, social and cognitive developmentin young children. Young children with distinct forms of biologically-based developmental disorders display differentprofiles of development across nonverbal communication skills. Children with Prader-Willi syndrome display signifi-cantly delayed development in high-level nonverbal communication skills, while children with Down syndrome havea disturbance of nonverbal requesting skill development. In particular, children with autism manifest a profound dis-turbance of joint attention skill. Children with intractable symptomatic epilepsy have features similar to those of chil-dren with autistic disorder. Low-birth-weight premature infants display significant deficits in initiate joint attention.The differences in nonverbal communication skill characteristics in children with different etiologies of developmentaldisorders can provide a basis for specifically designed early intervention. The development of language skills can bepromoted more effectively through construction of an interpersonal framework of nonverbal communication skilldevelopment than through conventional interventions focusing directly upon language per se. Therefore, nonverbalcommunication skills are important not only in the evaluation of developmental characteristics but also in the design ofspecific early intervention programs for children with different etiologies of developmental disorders. (Tzu Chi MedJ 2004; 16:277-285)

Key words: nonverbal communication skills, developmental disorders, Prader-Willi syndrome, Down syndrome,

autism

Received: March 4, 2004, Revised: March 24, 2004, Accepted: April 8, 2004Address reprint requests and correspondence to: Dr. Chao-Ching Huang, Department of Pediatrics, National Cheng KungUniversity Hospital, 138, Sheng Li Road, Tainan, Taiwan