Parent Strategies for Joint Attention in Toddlers and Preschoolers with Autism
- Andrea Burgio-Murphy, Ph.D.
- Aug 22
- 10 min read
Joint attention – the shared focus of two people on an object or event – is a fundamental social-communication skill that often emerges in infancy. For typically developing children, joint attention skills (e.g. following a point or gaze, showing toys to others) appear by around 6–9 months of age[1].
In children with autism spectrum disorder (ASD), however, joint attention is a core challenge, with many toddlers showing limited eye contact and failing to follow or initiate shared interests – often one of the first recognized signs of autism[2]. Because joint attention is strongly linked to language and social development[3][4], helping young children with autism build joint attention skills is a critical priority in early intervention.
This article explores evidence-based strategies that parents can use – both in everyday home routines and through structured interventions – to foster joint attention in toddlers and preschoolers with autism. We present research-backed approaches, practical tips, and comparisons of key intervention programs, all tailored for families seeking to support their child’s social engagement and communication.
Understanding Joint Attention and Its Importance
Joint attention refers to the ability to purposely coordinate attention with another person around a shared point of reference[5]. It involves two people intentionally focusing on the same thing at the same time, for social reasons – for example, a parent points to a plane in the sky and the child looks up at it, then back at the parent, as if to say “I see it too!”[6]. This seemingly simple skill actually represents a complex social-cognitive milestone. It requires the child to recognize that another person is directing their attention and to share interest or enjoyment with that person. Joint attention behaviors are typically categorized into two forms:
· Responding to Joint Attention (RJA): The child responds to another’s bid for attention. For instance, when a parent says “Look at the puppy!” and points, the child follows the point or gaze to look at the puppy[7]. RJA also includes responding to someone else’s gestures or eye contact by looking at the object/event indicated.
· Initiating Joint Attention (IJA): The child initiates shared attention by getting someone else to notice something. For example, the child makes eye contact with a parent and then points to a toy or brings an object to show them[8]. This is done not to request something, but purely to share interest or enjoyment.
In typical development, infants begin to follow others’ points or gazes and engage in protodeclarative gestures (pointing to show, not just to ask) before they talk[1]. These early joint attention behaviors are crucial for learning. Through joint attention, children learn the value of communication, practice taking turns, and start to understand others’ perspectives (a foundation for theory of mind)[9]. Notably, research has found that strong joint attention skills in the early years predict better outcomes later. Children who frequently engage in joint attention tend to develop more advanced spoken language and social skills as they grow[4][3]. In fact, longitudinal studies show that a toddler’s joint attention abilities (both responding and initiating) can predict language competence and social functioning years later[10].
Simply put, joint attention is a catalyst for language, play, and social learning.
For children with autism, however, joint attention can be profoundly impaired. Young autistic children often do not orient to others’ points or eye gaze and rarely point things out just to share interest[11][12]. They might lead an adult by the hand to an item they want (a request) but may not look back at the adult’s face or show a toy just for interaction. This lack of shared attention means fewer opportunities to learn from others – e.g. missing out on learning words when a parent labels something they’re both looking at, or not seeing a parent’s emotional reaction to an event.
Over time, delays in joint attention contribute to delays in language development[13][14]. Indeed, joint attention deficits are so characteristic in autism that they are considered a diagnostic hallmark[2].
Why focus on joint attention early?
The toddler and preschool years (roughly ages 1–5) are a critical window for intervention. During this period, the brain is highly plastic, and foundational social-communication skills are emerging. Encouragingly, research shows that young children with autism can learn joint attention skills with intervention, and doing so yields cascading benefits. For example, one longitudinal study found that teaching joint attention and play skills to autistic preschoolers led to significantly better language abilities later on, which in turn predicted better social skills and academic performance in school[15]. In other words, improving joint attention in early childhood can set the stage for improved communication and social development long-term[16]. Given these high stakes, experts emphasize starting joint attention interventions as early as possible, ideally in toddlerhood or the preschool years, to capitalize on developmental readiness and to support later outcomes[17][13].
The Parent’s Role in Joint Attention Intervention
When it comes to teaching joint attention, parents and caregivers are central – especially for toddlers and preschoolers. In early intervention, it’s widely accepted that parents should be actively involved as partners or even as the primary interventionists[18]. There are several reasons why parent-mediated strategies are so important at this age:
· Natural Learning Opportunities: Young children spend most of their time with caregivers, and their “teachable moments” occur throughout daily routines and play. A therapist might see a child for a few hours a week, but a parent can embed interactions across meals, playtime, bath time, and other activities. This allows for many more repetitions and practice opportunities for joint attention skills in a natural context[19]. Parents can capitalize on things that spontaneously capture the child’s interest (“Look, a big truck outside!”) in the moment, providing immediate joint attention learning that a clinic setting can’t always simulate.
· Generalization and Consistency: Skills taught in therapy need to carry over to real life. When parents are implementing strategies at home, children practice joint attention across different settings and people, which helps them generalize the skill beyond the therapy room[19]. Also, a parent who is trained in joint attention strategies can reinforce skills consistently throughout the week, preventing regression and strengthening the child’s learning.
· Intensity of Intervention: Several studies have noted that intervention intensity (“dosage”) is a key factor in treating core autism challenges like joint attention[20]. Parent involvement naturally increases intensity – for example, a parent who learns strategies can use them daily, effectively delivering many hours of intervention informally. This high density of practice can be critical for progress[21].
· Empowerment and Family Engagement: When parents learn to support their child’s communication, it can increase their sense of efficacy and reduce feelings of helplessness. Many parent-training programs report that caregivers feel more in control and optimistic when they have tools to engage their child. (It’s worth noting, however, that taking on the role of “therapist” can also add stress for some parents, so support and balance are important[22][23].)
Combining Professional Therapy with Home Strategies: The ideal approach is often blended – a professional (such as a speech-language pathologist, occupational therapist, or autism specialist) works with the child and coaches the parents, and parents use strategies during everyday interactions[24]. Research confirms that this combination is effective: therapists and parents together can successfully foster joint attention in young children with autism by using evidence-based behavioral and developmental techniques[24].
In fact, a number of studies and clinical trials have specifically focused on coaching parents to improve their child’s joint attention, with positive results (as we’ll explore below).
In summary, parents of toddlers and preschoolers with ASD are not just observers of therapy – they are key participants. By learning evidence-backed strategies and weaving them into home life, parents can create a rich, supportive environment for joint attention growth. Below, we first outline practical home-based strategies parents can use in daily life, followed by formal intervention programs that involve parents as implementers or partners in therapy. All approaches discussed are evidence-based, drawing on research in the field of early autism intervention.
Home-Based Strategies to Encourage Joint Attention
Parents can do a great deal at home to nurture joint attention skills during everyday routines and play. The following are evidence-based tips and strategies – drawn from research and expert clinical practice – that families can use to help their toddler or preschooler learn to engage, share, and communicate. These strategies align with approaches used in validated parent-mediated interventions, and they can be applied informally throughout the day.
1. Follow Your Child’s Lead in Play. One of the most powerful ways to build joint engagement is to enter the child’s world and join whatever activity currently interests them[25]. Rather than redirecting the child to your own agenda, observe what they are focused on – whether it’s lining up cars, knocking over blocks, or spinning a lid – and participate alongside them. By doing so, you become a part of their play narrative, which naturally increases eye contact and shared enjoyment.
2. Get Face-to-Face and Eye Level. Physical positioning can make a big difference in encouraging joint attention. Whenever possible, come down to your child’s eye level during interactions[27]. Instead of talking from across the room or towering above, sit on the floor or kneel so that your face is directly in the child’s line of sight. This makes it easier for your child to look at you and shift gaze between you and an object – a key component of joint attention[28].
3. Be a Animated, Warm Model of Joint Attention. Children learn social behaviors by watching and imitating caregivers, so make sure you’re providing a strong model of joint attention yourself[30]. This means demonstrating the behaviors you want to see: frequently point to interesting things, make comments, use facial expressions, and show objects to your child with an expectant gaze.
4. Respond and Encourage Every Attempt to Communicate or Share. Importantly, treat any action your child makes toward you or an object as meaningful, and respond to it enthusiastically. This strategy is rooted in the idea of responsiveness – a style of interaction shown to predict better language outcomes in children with ASD[34][35]. Practically speaking, it means catching even subtle signals of interest and turning them into shared moments.
5. Imitate Your Child’s Actions and Sounds. A powerful way to enter a child’s world and capture their interest is imitation – essentially, copying what your child is doing in a playful manner. Research shows that when adults imitate young children with ASD, it can increase the children’s attention to the adult and spur more social interaction (a strategy known as Reciprocal Imitation in therapy)[40].
6. Use Fun Social Games and Routines (“People Games”). Some of the richest opportunities for joint attention come from interactive play without toys, or what we might call “people games.” These are simple, repetitive games like Peek-a-Boo, Tickle games, Chase, Ring-Around-the-Rosy, or Singing action songs (e.g. “Itsy Bitsy Spider”), which involve turn-taking, anticipation, and plenty of eye contact.
7. Incorporate Gestures and Nonverbal Cues in Everyday Interactions. Since joint attention is largely a nonverbal skill at first, use plenty of gestures, pointing, and eye gaze in your daily communication.
8. Share Books and Pictures Together. Book-sharing is one of the most powerful everyday activities to foster joint attention and language simultaneously[48]. You don’t have to read the book’s text word-for-word – in fact, for many toddlers with ASD, it’s more effective to make the book interaction interactive rather than a straight read-through. Try “picture walking” through a book: look at each page’s pictures and point to and label things: “Look, I see a dog on this page… where’s the dog? There! The dog is eating. Do you see the dog?”[48][49]. Encourage your child to point by asking prompting questions (“Can you find the cat?”) and pause to let them respond.
By consistently using these home strategies, parents can create an environment rich in opportunities for joint attention. It’s important to be patient and persistent – a child with autism may not immediately respond to a point or start showing things to you overnight. However, with repetition and reinforcement, you may start to see small changes: more fleeting eye contact, more checking back, maybe a new point or shared smile. Each of those is a victory to be praised and built upon. Remember to keep interactions fun and motivating for your child – we want them to want to engage with others. And any time your child does initiate engagement (by looking at you, bringing you a toy, pointing something out), reward it with your full attention and positivity. Those moments are the foundation on which larger joint attention skills grow.
Sources:
· Vollmer, E. (2023). Encouraging Engagement: Improving Joint Attention for Children on the Autism Spectrum. TherapyWorks Blog – tips on modeling, following child’s lead, imitation, etc.[81][40]
· Braddock, B. (n.d.). Joint attention and autism. Autism Speaks ATN – expert advice on fostering joint attention (responding to child’s interest, using gestures, sharing books)[36][48]
· Paparella & Freeman (2015). Methods to improve joint attention in young children with autism: A review. Journal of Developmental Pediatrics – overview of 10 years of joint attention intervention research (RCTs and single-case studies)[82][52]
· Murza et al. (2016). Joint attention interventions for children with ASD: a meta-analysis. Int J Lang Commun Disord – found overall significant benefits of explicit JA interventions[53]
· Ingersoll (2012). Improving initiations of joint attention in young children with autism through Reciprocal Imitation Training. – showed increases in IJA with specialist-led imitation training[74]
· Kasari et al. (2008, 2014). Studies on JASPER – numerous RCTs demonstrating that targeting JA and play (via therapist or parent delivery) improves those skills and sometimes language[83][59]
· Green et al. (2010); Pickles et al. (2016). PACT trial (UK) – parent communication training improved parent-child interaction and child social initiation frequency[69]
· Carter et al. (2011). RCT of Hanen More Than Words – parent training led to increased parent responsiveness; some child communication gains moderated by child characteristics[72][73]
· Dawson et al. (2010). Early Start Denver Model – intensive early intervention yielding gains in IQ and adaptive behavior in toddlers with ASD[62][61]
· UNC “ASAP” Project (Wetherby et al.) – notes that teaching joint attention in preschool leads to better language and social outcomes[16].
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