Establishing Joint Attention with your Autistic Child

Joint attention refers to a person’s ability to engage in focusing on an object or activity with another person. Most often it is first noticed when an infant follows the gaze of his parent or caregiver and participates in giving attention to an object with the adult. For example, when a parent is holding their child, and directs their own gaze toward a window, the typically developing child will follow the adult’s gaze and give joint attention to the window. Joint attention is a noted deficit in children with autism, and is often the earliest indicator that a child may receive a spectrum diagnosis.

Joint attention is imperative to establish for optimal communication development. A child with autism has extreme difficulty shifting focus to external stimuli, including other people and their feelings. They may not be initially capable of recognizing interactions, relational impact or social cues. Joint attention is the first piece of the puzzle in this regard. Often, it is overlooked in the course of treatment unless a therapist steps in to recommend working on it. Joint attention is often a stage of infant development for typically developing children. If a five year old child or even ten year old child with autism displays significant impairments in communication or awareness of others, joint attention must be a starting place for therapeutic intervention.

Establishing joint attention skills are very difficult. They require calculated practice and intense focus. The caregiver and therapist must work as a team to make this establishment. The first attempts might fail, and fail again. Steps must be small and victories must be reinforced. The first steps toward establishing joint attention involve gaze pairing. The caregiver focuses on an object in the room, and prompts the child to shift attention to the object. It is often best to start with a preferred object that the child will likely take an interest in observing. Noises are also good ways to attract the attention for the child with autism. The caregiver can produce a familiar or even unfamiliar noise and prompt the child to take notice. Often the child will ignore these external factors of his environment. Continued prompting and reinforcement will help the child shift attention.

Once initial joint attention is established with a shift in focus, interaction can begin to take place. Floortime therapy refers to this as “back and forth” play. Tickling, bubble blowing and other play time activities are ideal for initial engagement. These are safe, preferred activities for children with autism. Take an interest in the child’s interests and gradually shift them toward other activities and objects.

Joint attention is the basic building block for communication. Many children with autism become absorbed into their internal world, making joint attention establishment a hard battle to fight. The longer these children spend in their internal world, the harder it becomes to draw them out of it. Joint attention maintains the surface awareness of others that is required for external interactions. Ideally, joint attention becomes regular practice for clients with autism and their families.

Successful joint attention reduces stimming behaviors and anxiety. Many children with autism are prone to meltdowns due to sensory overload. This often happens when the child spends a great deal of time absorbed in the internal world, and then is bombarded with a trip to the grocery store where the external factors are unfamiliar and intense. Without the ability to interact with the external environment, the child with autism develops fewer pro-social behaviors, communication capabilities and successful interactions. Dedication to developing this critical skill on the part of the parents or caregivers makes a huge difference for the child with autism.

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