What is Joint Attention?
One of the primary deficits noted in most children with autism is joint attention. Joint attention is a skill that you primarily see around 9-10 months in typically developing children. You would see this when a child purposefully directs his/her focus of attention with another person or on an object of attraction. An example of this can be when a baby makes eye contact, coos, or smiles at their mother. The term joint attention is also referred to as a Dyadic behavior or triatic behavior. Dyadic behavior references the social interaction between two people (smiling, cooing, eye contact, etc.), whereas triatic behavior references the social interaction between the two people and something in the environment.
In other words, this would be when a child and his/her mother are paying attention to the same thing intentionally and for social reasons. For example, when the mother is reading her child a story about the zoo, the child may respond by looking up at his mother and pointing to the picture of the lion in the book followed by “look,” and then looking back at the book to show her what he sees. Joint attention refers to the relationship of when someone references something in the environment and checks in with the other person who is near them to see if they are also engaged with what they see in order to share that same experience. Experiencing the same events and commenting on the event, such as “Oh, I see that lion in the picture,” can be reinforcing to the other person as well.
The most important piece in joint attention is the eye contact that is made when the child is looking back and forth between the item and the person near them. Eye contact is often accompanied by gestures, points, or when the child physically walks (or runs) up to the other person to show them the item, which may also be accompanied by a comment.
How one might teach joint attention:
We usually see joint attention begin in the following sequential order for children:
eye contact between child and another person
the child bringing and showing the other person the item
child responding to another person’s point
child initiating pointing to an item
Most of the time, it is easier to teach responding to joint attention than it is to teach the initiation for joint attention. This is because when teaching to respond to joint attention, there is a clearer discriminative stimulus to follow the point to an object followed by the eye contact; especially when there is a more concrete reinforcer present.
When responding to a joint attention bid, the adult would initiate joint attention by pointing and looking towards the item in the room while saying something. You will use the point as the prompt, you would say “(child’s name) look,” then point at the item that you are looking at. When the child looks back at you, that’s when you can praise: “You saw the (name of item)!” Social comments or reinforcing physical interactions such as tickles following each independent response will help to increase this behavior. You can then gradually fade out the point prompt. However, it might be challenging to fade out the prompt for some children. In that case, teaching the child to respond to a gaze shift instead may be easier since the eye is a much more subtle discriminative stimulus.
One technique to teaching this could be to use an item/toy that can turn on an off. For example, using a remote-control car could be a great way to get the child to look at the car moving since the child will be able to see it and hear something new happening in their environment. A way you could fade the prompt would be to start with a short delay to turn on the toy, whether the child looked or didn’t look, and systematically increase the time that the child waited before he/she turned on the toy (the prompt).
When initiating a joint attention bid, the child will be the one to make the expected look. Initiating joint attention is purely social, so we begin by teaching eye contact to access a reinforcer, which can then build into responding to the joint attention chain. Everything about the relationship is the same as described above, except the child is the one initiating the bid by looking at and pointing to the item. As stated, this usually occurs after responding to joint attention is taught.
Annie Prchal , M.S., BCBA
Minneapolis, MN
Tuesday, November 10, 2020