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Encouraging Joint Engagement with Children with ASD

 

Lauren Lowry
Hanen SLP and Clinical Staff Writer

Learning how to interact with other people is the most important goal for young children with autism spectrum disorder (ASD). Children learn to communicate during the everyday interactions they have with their caregivers. So, the more they engage with the important people in their life, the more opportunities they have to learn valuable communication skills.

In addition to knowing how to interact face to face with people, children need to learn to share their attention between people and objects during their interactions. In typical development, this emerges in a predictable way [1]:

  • During the first couple of months, babies pay attention to people when they are face-to-face with them
  • Between five to six months, babies start paying attention to objects in their environment
  • When caregivers notice this, they start to join in while their baby is exploring and playing with objects. This results in the development of something called joint engagement.
Joint engagement happens when a child and his caregiver interact with the same object over a period of back-and-forth turns [2]

When joint engagement first develops, the child and caregiver pay attention to the same object and take turns playing with it and doing actions with it, but the child doesn’t actively respond to the caregiver’s actions or words [1]. However, the child is aware of the adult and there is an unspoken understanding that the two of them are engaging together with the same thing.

Over time and with more experience, the child starts to acknowledge the caregiver by making eye contact and using gestures, such as pointing to something or giving the caregiver an object while playing. These interactions become more and more enjoyable for the child and he learns that including people in his play with objects can be a lot of fun!

The child may or may not use language during joint engagement, and the interaction might not last very long. The key feature of joint engagement is that the child and caregiver have both focused their attention on the same object, and have an awareness of each other’s participation.

A note about joint engagement…

You may have heard the term joint attention. While the terms “joint engagement” and “joint attention” are sometimes used interchangeably, they are two different things.

Joint engagement refers to a period of time when an adult and child are interacting together while focussed on the same object.

Joint attention is a specific skill that involves directing someone’s attention with eye contact and gestures and/or language in order to share a moment with that person (e.g. Looking back and forth between a person and an object while pointing, as if to say “Hey, look at that!” or “Did you see that?!”)

Joint engagement and children with ASD

Children with ASD have difficulty with joint engagement. It’s challenging for them to pay attention to both an object and a person while interacting. Because of this, they end up spending a lot of their time playing with toys on their own, without people [3]. This means that they are missing valuable opportunities to interact and communicate.

Why is joint engagement important for communication development?

When children learn to pay attention to an object and their caregiver at the same time, it signals a very important step forward in their development. One of the main ways children learn to understand and say new words is by hearing adults talk about objects that the children are playing with or looking at. Seeing or handling the object or doing an action while the adult talks about it helps the child match the words to what they mean.

There are many other important skills that children learn through joint engagement, including how to:

  • Take back-and-forth turns
  • Shift their gaze between an object and the adult
  • Imitate the adult’s actions
  • Follow instructions
  • Use gestures, sounds or words while playing
  • Play with a toy in new ways
  • Interact for longer periods of time
  • Have fun while playing with people and objects at the same time
The amount of time infants spend in joint engagement with their mothers predicts the infants' early gestures and communication.

Research has shown a strong link between joint engagement and communication development. In fact, the amount of time infants spend in joint engagement with their mothers predicts the infants' early gestures and communication [4]. Because it’s so critical for communication development, finding ways to encourage joint engagement with children with ASD is an important goal.

Recent study: parent responsiveness promotes joint engagement

A recent study [2] showed that when parents of children with ASD are responsive during their interactions, their children tend to initiate joint engagement with them.

Being “responsive” means that the parent:

  • Allows the child to choose the activity
  • Waits for the child to send messages and then responds
  • Doesn’t try to take over or lead the interaction
  • Is positive and fun while playing

These researchers also found that when the children were the ones to initiate joint engagement with their parents (versus their parents being the ones to start the interaction), these interactions lasted longer and the children used more social skills while interacting (like paying attention, imitating, and using eye contact to send messages).

Encourage joint engagement by being responsive

It can be tempting to take the lead and give a child a lot of direction if he is hard to engage or prefers to play alone. By being responsive though, joint engagement happens with less effort and more naturally. When you follow the child’s lead and build an interaction around his interests, he will be motivated to play with you, the interaction will last longer, and you are likely to have more fun together!

Here are some tips to help you encourage joint engagement by being responsive:

  • Observe the child the first step to promoting joint engagement is to observe what the child is looking at and what he is doing. You need to figure out what’s caught his attention at the moment. He will be most motivated to interact with you if you join his activity instead of introducing something new.

  • Join in – Get down to the child’s level, face-to-face so you can keep observing him, and find a way to playfully join in. The child might not like it if you start touching a toy he is already playing with. So sometimes it’s easiest to just sit nearby and observe quietly for a few moments. Then, you might take a piece of the toy and take a quick turn with it. For example, place one block on the tower the child is building, or push one of the cars down the ramp for a moment. In this way, you are joining in but not interfering too much at first. Eventually, when the child has more experience playing with you in this way, taking turns with the same pieces becomes easier.

  • Copy the child’s actions – If you’re not sure how to join in, a good strategy is to copy whatever the child does with the toy. Then wait and observe what he does next, and then copy him again. Try to keep taking turns together and keep the interaction going. Use simple language to talk about the toy and the actions you are both doing.

  • Keep following the child’s lead – Avoid the temptation to show the child how to use the toy or draw his attention to something else. Keep observing him and his interests, being playful and attentive. Pause and wait after you take a turn to see what he does next. Respond to him if he communicates in any way.

  • Have fun! – If you are playful when you join in, it’s more likely the child will enjoy himself and want to keep the interaction going. He’ll also realize that including people while he plays with objects can be really fun!

It’s important to keep your expectations realistic. If the child rarely participates in joint engagement, don’t expect the interaction to last very long, or for him to use eye contact or send messages. Initially, the idea is for the child to stay in the interaction for a few moments and allow you to participate with him and the toy. Eventually, once he is used to engaging in this way, you can expect more, such as a quick glance between you and the toy, or perhaps he’ll hand you a toy to show you it’s your turn. Maybe the interactions will last a little longer, or maybe they’ll be short but happen more frequently. Better still, maybe he’ll show you that he enjoys interacting this way by smiling and laughing as you play together.

Remember, joint engagement depends on the child’s motivation to stay in the interaction. This means that it must begin with the child’s interest. By following the child’s lead, closely observing him, and playfully joining in, you can set the stage for joint engagement and lots of fun!

Note: For some children with ASD, it’s very difficult to allow an adult into their play with objects. If the above tips don’t encourage joint engagement with your child, you may need a few more ideas to get an interaction started. Additional strategies to encourage joint engagement can be found in the More Than Words® guidebook.

References

  1. Hahn, L. J., Brady, N. C., Fleming, K. K., & Warren, S. F. (2016). Joint Engagement and Early Language in Young Children with Fragile X Syndrome. Journal of Speech, Language, and Hearing Research, 59, 1087–1098.
  2. Patterson, S. Y., Elder, L., Gulsrud, A., & Kasari, C. (2014). The association between parental interaction style and children’s joint engagement in families with toddlers with autism. Autism, 18(5), 511-518.
  3. Bottema-Beutel, K., Yoder, P. J., Hochman, J. M., & Watson, L. R. (2014). The Role of Supported Joint Engagement and Parent Utterances in Language and Social Communication Development in Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 44(9): 2162–2174.
  4. Carpenter, M., Nagell, K., & Tomasello, M. (1998). Social Cognition, Joint Attention, and Communicative Competence from 9 to 15 Months of Age. Monographs of the Society for Research in Child Development, 63(4), pp. i-174.