One of the biggest struggles Ruby has had is her attention, more specifically her joint attention.  Joint attention means when your child is sharing interest with an object or activity with another person, they are engaging in something with another person. An attention span is different. This can include tasks completed alone, with no social interaction. For example, a child can be really interested in legos and like to build things and have great concentration and attention on the task.  That is wonderful, but if they are always doing it alone, they are missing out on the social learning that could occur with a playmate. 

It is even better if the child is able to play near someone, even if they are not playing together. This is known as parallel play, they are still doing their own thing, just near another child.

What is best is if a child is actively engaging with another person, such as building something and are actively including the person in the process. This is joint attention, their attention is on each other and the task at hand. This is an important skill because when children are engaged in joint attention learning happens naturally. With joint attention the child is able to learn about social cues, problem solving, creativity, how to solve conflict, general information about life, and just the enjoyment of socially interacting with others.

Gaining Attention with Preferred Activities

Ruby loves to look at books. She enjoys the pictures and the autonomy of looking at them at her leisure. This is something that she likes doing at home, school, anywhere really. When she reads she doesn’t talk about the characters or what is going on in the story. She doesn’t’ come up to me to show me something she finds interesting. She just quietly looks at the pages. This is definitely a preferred task, however not a very social one. So how do I turn it to become a social activity where there is joint attention?

Initially when I say, “Ruby let’s read that book!”, she would often drop the book and leave. Even though this is a preferred activity, it is not the way she prefers it. So I try something new. Instead of just reading the words, I do lots of funny voices dramatically, even act it out. Even if she has already walked away, this tactic will often bring her back in. then she is not just looking at the pictures (a task done alone), she is looking at my face and watching me (joint attention). To expand on this I can get her involved. “Oh no the boy is so sad” (fake crying). “Can you show me sad?”. Or, “Let’s go save the princess, come on Ruby!” and get up and save the princess. Making things come alive and including movement really helps to gain and keep her joint attention.

DIR/Floortime

One of the best therapies we have done with Ruby that focused on joint attention was DIR/Floortime. This therapy approach is not as well known, but for us it was life-changing.  It is a play based therapy that taught us how to help Ruby be regulated (in the right frame of mind to engage with us), to get her to engage with us (joint attention), and to build games with her that she could learn and play more in the future with us.  See a guest post from our DIR/Floortime therapist here!

One of the big strategies in DIR/Floortime is through play. We would start playing a game and try to engage Ruby in that game with us. It was hard for her because Ruby didn’t really understand the rules of most games, so we started with more basic games that didn’t have a lot of rules and taught it to her. Once she learned a game (like chasing her brother around the room and tickling him and chasing him again), we were able to introduce language and she would start to use some!  I saw when she was engaged in joint attention she was more able to use her words.  Amazing!

If you are interested in this therapy seriously there are a lot of free resources, here is a good place to start. Or if you wanted to get in contact with a licensed DIR/Floortime therapist to learn more, click here. I only share this because we have seen such a difference first hand and as the they say, “I would recommend it to family and friends!”

Building Attention

Before a child can engage in joint attention, if they are not regulated then it’s not going to happen.  This was something I knew nothing about until we had Ruby.  This delves into the sensory processing system. Basically if a child is dis-regulated, they are not going to be able to engage in joint attention or learning.  What do I mean by regulation?  Think about being extremely upset by something that happened (say you just had a terrible fight with a significant other) and you are sitting in a math class.  How much of the math concepts are you really learning?  Probably not much.  You may be catching bits and pieces as you go over in your mind the fight while feeling the anger raging inside.  You are dis-regulated (not in the right frame of mind to engage in learning).  I’m not saying that when kids are dis-regulated that they are angry, just that when they are dis-regulated that it is hard for them to engage in joint attention and learning. Here is another post talking about sensory processing.

So how do I know if my child is regulated and ready to interact?

Here are some questions to ask yourself:

  1. Are they responding to their name?
  2. Are they making eye contact with you when you are talking to them?
  3. Are they calm? (Not running round aimlessly, not upset, not hangry).

If the answer is no, then you can still interact, but there is some work you have to do before you can get their joint attention.  Here are somethings to try to help them get regulated.

How To Help Regulate

Are Their Basic Needs Met?

How well can you concentrate and do things that are challenging for you when you are hungry?  Or tired? Or have to go to the bathroom?  It is the same for your child.  If you want to work on joint attention, make sure they aren’t hungry.  Give them a snack or a drink.  Snack time is also a great way to engage your child.  If you give them goldfish, start playing with the fish for with them and make eating a fun game!

How about their emotional state? Are they scared? When Ruby sees a vacuum she is terrified. If I used one then wanted to have meaningful engagement with her right after she would not be able to do it because would still have anxiety. Here we would want to do calming activities to help regulate before engaging. See ideas for calming activities here!

Start With What They Are Interested In 

If your child is regulated it’s time to start engaging! One of the best ways is to start with what they are interested in. My daughter loves the TV show PJ Masks.  So I got masks of the characters online, we made capes and we do imaginative play with those characters. I am usually the villain trying to take over the world and Catboy (Brandon) and Owlette (Ruby) try to thwart my diabolical plans. During play I tell Ruby what to do, like owl wing wind to blow me away, to help her be apart of the game. Then other times she will do these things on her own and really be apart of the story! This is really exciting because imaginative play is something that is a hard concept for her, which is common for children with autism. But by finding something she is interested in she is willing to try something challenging.

Now Ruby will initiate playing PJ Masks because she loves it!  The social reward of playing the game with us is motivating to her. And with this motivation we are able to build on her imaginative skills, joint attention, problem solving skills, mimicking, and playing in group (with brother).  Because she is interested in the activity, she stays with the activity longer and has so much fun!

Introducing Movement

Pillow smash is one of our favorites.  You sit the child on the couch and count to three, or say ready set go, and then smash them with a pillow [obviously not on the face :)] and repeat.  These kinds of repetitive games help them know what to expect, wakes up their bodies, and helps to get them engaged.  And it’s really fun!  When we play with Ruby, you could see her eye contact improve, she would be anticipating the next smash and the smashing helped her to regulate. Once you repeat this a few times, try saying one, two, ……. and waiting for the child to make a noise or say three, something to show they are communicating to you that they want the game to continue.  If the child doesn’t say anything but is still engaged, you can fill in the blank after a few seconds and continue the game. It’s a great way to get sensory input, and since the game is pretty simple it’s easy for them to catch on and really enjoy the game. Now Ruby will ask for pillow smash! This is amazing because she is asking to socially engage with us, which is always what we want.

Get Down on Their Level

If your child is playing with some figurines by themselves and you call their name and no response, get down on the floor with them and play.  It can be helpful to start with short repetitive games with the figurines.  For example, say the child is playing with Winnie the Pooh figures, and is just looking at them.  Sit across from your child (sitting across rather than next to help to encourage joint attention) and grab the Tigger.  “Oh Tigger bounces so high! Bounce bounce CRASH!” and have the Tigger crash to the ground.  Wait for a few seconds for the child to absorb this and do it again.  Hopefully you will see the gleam in your child’s eye saying “this is so amazing!”.  After a few times if the child is sucked into the game, this means you have their attention, their joint attention 🙂 Once they are sucked into the game, change it up (no one wants to repeat the same thing 30 times, including your child).  So maybe do a bounce bounce, and have him land on your head! It helps to be overly dramatic in your expressions to keep a child’s attention.  “Oh no he landed on my head! Ahh he is stuck!  What should we do?!” 

As their engagement increases try to increase their participation in the game rather than just being an observer.  The more involved they are, the more opportunities they will have to practice language, problem solving skills, learning social cues, and the longer the joint attention will last. Some kids want to be more involved but aren’t quite sure what to do and need a model.  “Oh help me get him unstuck!  Here pull him off of my head. Pull, pull, puuuuuull!!!”

Joint attention is a muscle that kids have to build.  For some kids this can be exhausting.  So making it fun and exiting for them will help motivate them to build this muscle.  Consistently trying to engage your child throughout the day will also help to increase this muscle.  As they increase their ability to have joint attention during things they like to do, they will be able to increase their ability to have joint attention during activities they may not prefer (like math homework).  So keep at it parents, helping to increase this joint attention will be a foundation for your child to interact with the world, gain language and social skills, and to have fun!

Much love,

Amanda and Ruby

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