When a toddler points at something in their environment, our first reaction is to look at what they are pointing at. This is a form of initiating joint attention. Joint attention is an early-developing social-communicative skill in which two people use gestures and gaze to share attention with respect to objects, events, or a topic of interest. It involves the ability to gain, to maintain, and to shift attention. Joint attention acts as a referencing tool that uses shared eye gaze (visually focusing on the same thing) and/or gesture for communication. This skill plays a critical role in both social development and language development. The more a child points the greater the intention to engage in communication.
Some common examples of joint attention include:
Looking at books together
Showing a toy or piece or artwork
Pointing up in the sky to show you the airplane flying by
Pointing to show you something of interest in the environment
In typically developing children, joint attention generally starts to emerge around 9-12 months. If a child is not initiating bids for joint attention at 18-months you should consult a professional as a lack of joint attention is a core feature of autism spectrum disorder (ASD).Research has differentiated children with ASD, and other developmental disabilities based on joint attention.
Several skills are important for joint attention to occur. Not only do these skills help an individual to get their wants and needs met, but they are also necessary for appropriate interactions and meaningful relationships. Some of these skills include the following:
Orienting and attending to a social partner
Shifting gaze between people and objects
Sharing emotional states with another person
Following the gaze and point of another person
Being able to draw another person’s attention to objects or events for the purpose of sharing experiences
Specifically, many children with autism spectrum disorder exhibit the following challenges around joint attention:
Responding to eye contact of others
Following points from others
Shifting attention/gaze from toy to adult
Using declarative points
The good news is that it is possible to improve joint attention in autistic children and should be an early target of intervention programs, as joint attention is associated with better language outcomes, as well as higher outcomes in the areas of cognition, symbolic play, and social skills.
Some easy ways to encourage the development of joint attention and pointing include:
Face to Face Interaction at Your Child’s Level
A large part of joint attention and engagement includes eye contact. As adults it is easy for us to tower over our children making eye contact more challenging. If you have ever tried having a conversation while behind another person then you know first-hand how much more difficult it is to connect and have an interaction. By positioning our bodies in such a way that allows us to be face-to-face and nose to nose at our child’s level we are setting the occasion for improved engagement. We can position ourselves by laying on our stomachs when playing on the floor or seating our child in a child sized chair while we sit on the floor as needed to encourage an eye gaze shift between toys, objects and us.
Model & Encourage Pointing
Contact pointing is a precursor to the development of distal pointing and involves isolating an index finger to point to items by touching them. Pointing to pictures of items in a book is an example of a contact point and is a great place to practice and model pointing. For children that have a difficult time isolating their index finger to point, try the following:
Practice using their index finger to poke holes in Play-Doh
Practice using their index finger to pop bubbles
Practice using their index finger to finger paint
Practice using their index finger to push buttons on toys
Draw a happy face on their index finger and encourage them to show
Once your kiddo can isolate their index finger and point to pictures in books, you can start encouraging distal pointing. Begin by modeling pointing to items of interest that are in proximity. Other ways to encourage distal pointing by:
Offering choices while holding out options
Placing desired toys/items in view, but out of reach
Hanging items from the ceiling or on the walls that interest your child
Follow Your Child’s Lead
As adults we know that we are more likely to engage in activities that we enjoy, and the same can be said about children. To increase engagement and joint attention we need to follow our child’s lead. This starts with simply sitting back for a moment to stop and notice what it is that our child is interested in. Then we can join in the interaction by imitating what our child says or does. Once we get the interaction going and our kiddo shows interest in an object, we can point to the object while narrating what it is that the child wants (“You want the ball. Big blue ball.”) or by describing what they are doing (“You are pushing the car.”).
Show High Interest Objects
Using objects/toys of high interest (e.g., a remote-control car, a toy that lights up, etc.), point to the object and say, “Look”. When your kiddo looks, reinforce their behavior by activating the toy. If your child does not look, bring the object/toy closer and prompt the child to “look.” If they still do not look, activate the toy but only for 1-2s. Repeat by providing another teaching opportunity to practice the skill.
Using a puppet, have the puppet “eat” the child’s hands, feet, tummy, or pretend food. After each turn, wait for your child to look at the puppet and back to you prior to each consecutive turn. Be sure to be face-to-face at the child’s level while holding the puppet up close to your face to encourage eye gaze shifts.
Most children will generally start pointing to objects on their own. By modeling and setting up your interactions in such a way that fosters joint attention and pointing, you can help pave the way for this important developmental milestone. If your little one is not pointing by 15 months or starting to use gestures by 12 months you should talk to your pediatrician.