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As a developmental specialist and independent evaluator of infants and toddlers in early intervention, I get to see a wide range of adorable kiddos on a weekly basis. One thing that amazes me in infants is how early the skill of joint attention develops. Most children will have mastered the skill of joint attention including the skill of pointing (to indicate an interest, want or need) by age 12 months.

TEIS Family Digest May 2015

What is joint attention? It is when two people share a common interest in an experience or object such as a toy. For example, you shake a rattle near your 9 month old baby and they wiggle and squeal with delight as they look towards the sound of the rattle and then they smile and look back to you as if to say “That’s was fun, do it again Dad!”. Or when your 14 month old toddles out into the backyard and hears an airplane overhead and her eyes widen as she looks toward you and points towards the airplane as if to say “Wow, Mom did you see the airplane too???” Children develop joint attention very early in life, long before they are able to verbally express their feelings. This shift of eye gaze from an object to a person in order to include that other person in on the experience is the magic of joint attention and it is a very important skill because it is a pre-cursor needed for developing spoken language.

Tailgating pack n play

Toddlers who do not have joint attention and who are not using gestures such as pointing to communicate in a give and take fashion with their caregivers will most likely be exhibiting developmental delays in their speech and language as well as their social/interactional skills. Lack of joint attention is also a very early indictator of autism spectrum disorder. Children without joint attention are “missing” the enjoyment and connection with adults and often use adults simply as a means to an end. It is a red flag for me, when I ask a parent of a toddler “How long can your son play without demanding your attention?” and a parent answers “They can play alone for hours!”. This might sound like the child has a great attention span, right? But developmentally, attention span in toddlers is very short (about 2-3 minutes with a single toy  & 10 minutes without engaging an adult or sibling in play, for a 2 year old child). So while we expect toddlers to play and explore on their own inside their home for short periods, it is very typical for your toddler to want to engage you in some way, such as bringing you a toy, showing you a toy, gesturing towards you or a toy or simply looking back to you for reassurance during their play.

Children who lack joint attention, may play for long periods without ever engaging anyone by using gestures, eye gaze or vocalizations. They may get certain wants and needs met by using adults as a means to an end, rather than showing enjoyment in the social give and take of the experience. For example, a 16 month old child wants his cup of milk on the counter but cannot reach it, and instead of pointing and looking towards his mom and making a sound to indicate to her that he wants his cup, he simply takes her by the hand without meeting her eye gaze, focuses solely on the cup itself and drags her to the cup and she sees it and she hands it to him. Mission accomplished, but there was no real engagement or social interaction involved in that exchange. Another example would be, you offer a pop up box to a 10 month old, you demonstrate how the toy works by pushing one of the buttons and making an animal pop up, your child touches the box, touches the button on the toy, turns the box over, but does not look to you as if to say “Do that again” or “I need help”. Joint attention means a child has mastered meaningful non-verbal communication and this needs to come well before mastering verbal communication. Children must learn that eye gaze and gestures can be used to get wants and needs met before they will learn to use words to get wants and needs met.

So, what are some ways to encourage and teach joint attention with your child?

-From birth onward play face to face with your baby so that your baby can develop and increase her eye contact with you. Hold your baby facing you, or sit on the floor in front of your baby’s bouncy seat to engage with them visually and verbally.

-Initiate games which involve joint attention and gestural imitation such as peek-a-boo, pat-a-cake and so-big. Help your child by using hand over hand to guide them through motions until they can do it independently. Reinforcing these types of games helps your child learn that gestures are meaningful ways to communicate.

-create opportunities for joint attention during play, such as you drop a ball into a container and it makes a loud thud, then look to your baby to see if he meets your gaze with wonder and surprise at the noise he has just heard. Hand him a ball and say “your turn, you put the ball in”, help him if he cannot do it on his own, but when his ball drops, check if looks to you with surprise again and reinforce him by saying “you did it, you put your ball in!” and “now it’s my turn again”. This back and forth type play reinforces joint attention and is a pre-cursor to sharing for older kids.

-Roll a ball back and forth on the floor with your child. When your child rolls the ball back to you, pause, and see if he looks towards you or points to you as if to say “hey, roll it back to me, Dad!” and then continue to reinforce verbally “Oh, you want me roll in again? Here it comes!”

-When outdoors, point out novel things to your child so that he learns to point out novel things to you. “Look, Cole, did you see the bunny rabbit under the bush?”, and next time he may point or gesture towards something like a leaf blowing in the wind or even just look towards you and back to the leaf as if to ask “Did you see that leaf too, Mom?” That is your cue to verbally say “Oh, you see a leaf! It’s blowing in the wind, that is so funny!”

If you have concerns about your child’s eye contact, lack of gesturing/pointing or his/her interest in social games & experiences, call Early Intervention to schedule a developmental evaluation. In Allegheny County, PA call the Alliance for Infants and Toddlers 412-885-6000. If your child is eligible for services request TEIS as your service provider.

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