Joint attention occurs when two people share interest in an object or event and there is understanding between the two people that they are both interested in the same object or event. Joint attention should emerge around 9 months of age and be very well-established by 18 months of age.

Why are we concerned about joint attention when we work with children with autism?

– Because it provides a critical foundation for social, cognitive, and language development.

– Because this is something that is very hard for almost all children with autism to do.

STRATEGIES

Here some strategies to build toward establishing joint attention:

– Focus on faces/develop eye contact.    

To develop joint attention and social referencing, your child should be encouraged to look at you. For many children with autism, this is especially challenging.

Some parents have found success by:

•  having their child wear sunglasses at first,
• holding up their hands at their eyes like they were looking through binoculars at the time when they want their child to look at them,
• trying different positions (maybe the child on his/her back, looking up from the floor),
•  trying different distances (maybe your child can look at you from 5 feet away but not two feet away),
• putting stickers on their faces or wearing funny hats, and/or
•  looking in the mirror together to get eye contact instead of having the child look directly at their face.

Focus on play and turn-taking.

Work on becoming play and turntaking partners with your child:

 a) With objects (blocks, dolls, trucks, books, ball, toy house, coloring, etc.)

 b) During the daily routine (getting dressed, riding in the car, getting ready for bed, taking a bath, looking in the mirror, etc).

 c) With you (gentle rough-housing games like playing “airplane” or ring around the rosey, pat-a- cake, tickling, peek-a-boo, making faces, hide and seek, etc.)

Focus on pointing.

• Teach your child to comment (this is one way joint attention is initiated) by encouraging him/her to point to show an object of interest. Example: There is a toy truck.
• Shape the child’s fingers into a point, touch his/her pointed finger to the truck, and say “truck!” Throughout the day, use the word “look” and then point to show objects of interest. When your child looks, bring the object back to you and label it.
• Give your child the object to play with and join in the play too. Point/touch what you are talking about rather than pointing to things across the room or even to things out of reach. Move your finger from your child’s face to an object, saying “look.”

Focus on encouraging your child to shift attention from what he/she is playing with to what you have.

(In other words, helping your child respond to you when you show him/her something new – and then you both have your attention on the new object/toy together – joint attention!):

-First, as your child is engaged with a toy, you take your child’s hand and place it on a second toy. Both toys remain available to your child. What is hoped for is that your child will pay some attention to the second toy, even if he/she goes back to playing with the first.

If your child does play with the second toy, you give your child some verbal praise. Try to be very animated – give a big “WOW” or make a silly face, etc. as just saying “good job playing with the blocks” might not be enough of a reinforcer.

If your child does not play with the second toy, you should gently physically prompt your child to play with it briefly and then give the animated verbal praise.

 -Second, do the same procedure as outlined above except, this time, hold the second toy in front of your child and tap on it to gain attention.

 -Third, do the same procedure as outlined above but do not take your child’s hand and do not tap on the second toy. Instead, say “look at the ____ I have.”

– Focus on creating situations for your child to initiate a request for you to look at something that interests him/her.

Try rearranging the environment, bringing in something new or different – anything to shake things up that might then encourage your child to want to get someone’s attention to then show what has changed.

Every child is different and it may take some time to figure out so never lose hope.