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In the current study, concurrent and longitudinal associations between joint attention and other social communication abilities measured in a sample of infants with autism and related pervasive developmental disorders at age 20 months, and language and symptom severity at age 42 months, were examined. Extending the findings from previous studies, joint attention ability was positively associated with language gains and (lower) social and communication symptoms, and imitation ability was also positively associated with later language. Some specificity in the association between different aspects of joint attention behaviours and outcome was found: declarative, triadic gaze switching predicted language and symptom severity but imperative, dyadic eye contact behaviours did not. Further, although joint attention was associated with later social and language symptoms it was unrelated to repetitive and stereotyped symptoms, suggesting the latter may have a separate developmental trajectory. Possible deficits in psychological and neurological processes that might underlie the impaired development of joint attention in autism are discussed.<\/jats:p>","DOI":"10.1098\/rstb.2002.1199","type":"journal-article","created":{"date-parts":[[2003,3,13]],"date-time":"2003-03-13T17:47:06Z","timestamp":1047577626000},"page":"315-324","source":"Crossref","is-referenced-by-count":471,"title":["Why is joint attention a pivotal skill in autism?"],"prefix":"10.1098","volume":"358","author":[{"given":"Tony","family":"Charman","sequence":"first","affiliation":[{"name":"Behavioural and Brain Sciences Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK ()"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"175","published-online":{"date-parts":[[2003,2,28]]},"reference":[{"key":"p_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199305000-00019"},{"key":"p_2","unstructured":"American Psychiatric Association 1994 Diagnostic and statistical manual of mental disorders (DSM-IV) 4th edn. 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