What is Joint Attention and Why is it Important for Children with Autism Spectrum Disorders?

April 10, 2012

Joint attention is the shared focus of two individuals on an object or each other . Joint attention on  an object is achieved when one individual alerts another to an object by means of eye-gazing, pointing or other verbal or non-verbal indication. An individual gazes at another individual, points to an object and then returns their gaze to the individual (3 point gaze). Each individual must understand that the other individual is looking at the same object and realize that there is an element of shared attention.  The individual must display awareness that focus is shared between himself and another individual. If two individuals are simply looking at the same object, but not referencing each other, it is referred to as shared gaze. Shared gaze is the lowest level of joint attention.  Joint attention between people is a conversation-like behavior that individuals engage in. Adults and infants engage in this behavior starting at two months of age. Adults and infants take turns exchanging facial expressions and sounds.  The sole purpose of joint attention is to share an interesting object or experience with another person.

Joint attention is a necessary precursor skill for language and social-cognitive development.  It is important for the development social referencing, language acquisition and learning through modeling behaviors of others around you and other, later-emerging, skills, such as more complex expressive language, symbolic play, and theory of mind.

Children with Autism Spectrum disorders have a particular difficulty in their social relationships. Children with Autism often demonstrate a lack of or delays in joint attention skills.  Children with Autism are often more interested in and engaged by their own thoughts and sensations than by other people or even the outside world.  Social connections are more difficult to build and understand for children with Autism.  A lack of or a delay in joint attention skills can limit children’s ability to learn through imitation, develop play and social skills, and attend in a learning situation such as a classroom.  Children with Autism who display more intact joint attention skills exhibit better outcomes with respect to the development of cognitive, language, and symbolic play skills. Joint attention skills have a vital role in the development of children with autism spectrum disorders. Joint attention skills can be taught and addressed in a number of therapy models and approaches.

-Brandi Quinsay, MA, CCC-SLP


Communication: Just a Few Changes Make All the Difference……

January 25, 2012

By practicing the following changes in our style of communication, many children diagnosed with Autism and receptive/ expressive language delays may increase their language and social skills, peer interactions, expand play skills, and follow directions with greater confidence.

Eye level Contact: To increase social interaction and gain eye contact with your child, remember to kneel down to his/ her eye level. Face to face eye contact allows the child to see your whole face, imitate facial expressions, and respond to your verbal directions. This position also gives you an opportunity to put your arm around your child’s waist to face him toward you, touch his/her shoulders to gain attention, or model hand gestures with hand-over-hand assistance.

Tone of Voice: Your child might be sensitive to the pitch and tone of your voice. If your child covers his ears, winces, or looks away when you speak to him, practice lowering your tone of voice to a moderate level. When you are at your child’s eye level, speak slowly and clearly.  Use visual aids to enhance communication. For example; tap on the chair and say “Sit in the chair”, or show an item or a picture of where you want your child to go.

Exaggerated facial expressions/ hand gestures: If your child does not imitate your facial expressions and hand gestures, practice exaggerating your face and hand movements as a model. For example, when your child sees you from across the room, make a large happy face and big eyes. Wave your hands in a large swooping motion, as opposed to wiggling your fingers in tight/ small motions. A person standing next to your child can help him/ her respond by assisting to wave back in the same fashion.  Exaggerated facial expressions and hand gestures allows your child to feel the sensation of movement and encourage muscle memory, which promotes communication.

Body Proximity: Avoid speaking to your child when his back is to you. Often, children have difficulty filtering out the sounds in a room, and distinguishing a parent’s voice at the same time. Try moving close to your child and mirroring his position before speaking to him. For example if your child is on the floor playing with cars, join him on the floor. Gain his eye contact by bringing a toy to the side of your face, then speak to him/ her.

First____, Then_____…. When asking your child to follow directions, remember to keep your child’s motivation in mind. He/ she may not prefer to put on his shoes, for example. But if he/ she wants to go to the park, incorporate that as a reward in a two step direction. For example “First, put your shoes on. Then, we will go to the park.” A simpler version could be “First, shoes…Then, park.”

With a few adjustments, and a lot of practice, children diagnosed with Autism and receptive/ expressive language delays will learn new ways to respond to their environment, and expand their communication skills. Adults can offer the support a child needs by changing our communicative habits to meet the needs of children.


-April Kumlin, Speech and Language Pathologist Assistant