Building Joint Attention With a Baby or Toddler

Joint attention is the shared focus of two or more people on the same object or event, such as a baby following a parent’s look toward a dog, or a toddler pointing to show you a bus. Its parts are following someone’s gaze, pointing and showing, and adults support it by naming what a child is already watching.

What you’ll learn

• What joint attention is made of, and the order its parts tend to appear in
• What studies have found about joint attention and early language
• Everyday habits, games and books that build it
• How joint attention relates to autism, and who to ask

How Do You Build Joint Attention With Babies and Toddlers?

Joint attention, as the American Speech-Language-Hearing Association (ASHA) defines it, is a focus two or more people share, and ASHA’s guidance names the skills inside it: shifting gaze between people and objects, following another person’s gaze and point, and drawing another person’s attention to an object or event.

The everyday advice from the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) comes down to a few small habits: describe what your baby is looking at, answer a point with words, point out interesting things yourself, and talk about the pictures in a book your child is touching or looking at. Back-and-forth games, such as passing a toy between you, add turn-taking to the shared focus.

The habit to begin with is the first one: notice where your child is already looking and put a few words to it. Every one of these habits fits into time you already spend together, and all of them work with whatever is in the room.

Looking, Pointing and Showing: When Each Part Appears

Joint attention comes together from several skills, and the sources place each one in its own age band. ASHA says every child develops in a unique way, even within one family, and notes that the ages at which skills appear can vary, for instance with linguistic diversity or neurodiversity, and that cultural and linguistic factors can affect how relevant a benchmark is. Carpenter, Nagell and Tomasello, following infants from 9 to 15 months, found these social understanding skills, joint attention among them, appeared in a reliable order across the group.

In ASHA’s benchmarks and milestones, which chart early speech and language development, the parts show up in roughly this order:

• Birth to 12 months. Following a caregiver’s gaze, sharing attention, using gestures to ask for things and to direct attention, vocal turn-taking before words, and simple games such as peekaboo.
• 10 to 12 months. Pointing, waving, and showing or giving objects.
• 12 to 18 months. Bringing objects to show a caregiver, and asking for things by pointing and making sounds. ASHA’s milestones for 13 to 18 months add pointing to comment or to get information.

The CDC defines its milestones as things most children, 75 percent or more, can do by a certain age. Among those milestones are lifting arms to be picked up by 9 months, waving bye-bye by 1 year, showing you an object they like and pointing to ask for something or get help by 15 months, and, by 18 months, pointing to show you something interesting. All of these gestures belong to how babies communicate before words.

Joint Attention and Early Language: What Studies Found

In a 1986 study in Child Development, Tomasello and Farrar looked at 24 mothers and their 15- to 21-month-olds. During moments of joint attention the mothers used more utterances, shorter sentences and more comments, and held longer conversations, than outside those moments, and the words mothers used for objects during joint attention were related to the children’s language development.

Carpenter, Nagell and Tomasello found a related pattern in infants followed from 9 to 15 months. Across the group, the time infants spent in joint engagement with their mothers, and how often mothers talked about what the infant was already looking at, went together with the infants’ later use of gestures and words.

A 2016 review by Bottema-Beutel in Autism Research pooled 71 reports covering 1,859 autistic and 1,835 non-autistic children. The link between joint attention and language was stronger in the autistic group, and stronger for responding to joint attention, meaning following another person’s look or point, than for other kinds. All three studies describe associations across groups, so joint attention and language tend to travel together, but none of this shows that one causes the other or says what a particular child will do.

Building Joint Attention Into an Ordinary Day

Everyday joint attention begins with whatever your child has already chosen to look at, and it fits into the meals, walks, baths and play you already share.

• Name what your child is looking at. The CDC’s example is “red, round ball,” a few words about the thing that has caught your baby’s eye.
• Answer a point with words. Babies point to ask for things, the CDC notes, so say what your child is pointing at and hand it over when you can.
• Point things out yourself. A truck, a bus or an animal gives you something to point at, and the CDC says this helps a baby pay attention to what others are “showing” through pointing.
• Use your own gestures and gaze. ASHA lists modeling gestures and eye gaze among the adult habits that encourage language, so look and point toward things as you talk about them.
• Respond to each attempt. ASHA also lists responding directly to whatever your child is trying to tell you with a look, a gesture or a sound.

From clinical practice

Both the research and the everyday advice from the CDC and the AAP start in the same place: whatever the child is already looking at, with words put to it. Following into a child’s focus is the first step.

The instinct runs against it. Setting out to build joint attention, a parent tends to steer the child’s eyes toward something chosen in advance, such as a picture, a toy or a thing the parent hoped to name.

When a Child Doesn’t Look Where You Point

Following a point is one of the parts ASHA names, and the sources place it among skills that come together over many months. If your child does not look where you point, start from your child’s side instead: follow your child’s gaze, name what is there, and keep pointing things out as they come up. More everyday habits that help a toddler talk start from the same place.

Games and Books That Build Joint Attention

Back-and-forth games give a baby and an adult one thing to watch together and a rhythm of turns. The CDC suggests games such as “my turn, your turn,” passing a toy back and forth, and, for toddlers, games in which both of you have a part to play. Peekaboo and pat-a-cake both appear in the CDC’s milestone lists for the first year.

Shared books work in a similar way. The AAP, on its HealthyChildren.org site, suggests naming and pointing to the pictures your baby is touching or looking at, and following your baby’s lead if your baby wants to turn to a different page. The CDC adds that reading with a baby can simply be talking about the pictures, suggests talking about them in simple words with toddlers, and lists looking at a few pages in a book with you among its milestones by 18 months.

Joint Attention Differences and Autism

ASHA lists differences in joint attention among the social communication differences seen in autism. The CDC’s examples of social communication characteristics related to autism include, by 15 months, not sharing interests with others, for instance not showing you an object they like, and by 18 months, not pointing to show you something interesting. The list also includes avoiding or not keeping eye contact, and, by 12 months, using few or no gestures, for instance not waving goodbye.

The CDC attaches two cautions to that list: autistic children may not show all, or any, of the behaviors on it, and some people who are not autistic show a few of them. No single item on the list settles anything about one child. If you have any concern about your child’s development, the CDC’s advice is to contact your child’s doctor, and how the two relate is covered in speech delay and autism.

Common Questions From Parents

What Is Joint Attention?

In ASHA’s definition, joint attention means two or more people sharing a focus on the same object or event. A baby shows it by following someone’s gaze or point, and a toddler by pointing at something, or holding it up, to bring another person’s attention to it.

When Do Babies Start Pointing to Show Things?

Pointing to show something interesting appears in the CDC’s milestones by 18 months, and ASHA’s milestones for 10 to 12 months include pointing, waving and showing objects. Ages vary between children, and ASHA notes that culture and language can shape how well a benchmark fits.

Why Does Joint Attention Matter for Talking?

Studies of groups of children find the two go together. Mothers talk more and comment more during moments of shared focus, and the words they use then relate to children’s language development. Both findings are associations across groups, and neither can say what any one child will do.

What Games Help Build Joint Attention?

Back-and-forth games such as peekaboo and pat-a-cake, and what the CDC calls “my turn, your turn,” passing a toy between you. For toddlers, the CDC suggests games where each player has a role, and talking about the pictures in a shared book works much the same way.

Is Trouble With Joint Attention a Sign of Autism?

Not by itself. ASHA counts joint attention differences as part of autism’s social communication picture, but the CDC notes that autistic children may not show every listed sign, and some non-autistic people show a few. Raise any concern with your child’s doctor.

What If My Child Does Not Look Where I Point?

Follow your child’s gaze instead, and name whatever your child is watching. Following a point is one part of joint attention, and the CDC suggests pointing out things like a bus or a dog, which helps a baby notice what others are showing.

Reviewed by Monica d’Errico-Franklin, M.S., CCC-SLP

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