Joint Attention: How to Engage in Joint Attention with Your Child

Joint attention uses shared gaze and/or behaviors to communicate with a social partner. Joint attention is an important developmental skill that helps develop a child’s social language. This social developmental skill shows that a child is not only interested in objects in their environment, but in people too.

Joint attention usually first occurs between a child and their caretaker. A child can indicate, to their caretaker, their interest in an object or activity through gaze. A child can also use gestures such as pointing to engage their social partner in communication.

Social referencing: occurs when a child looks at an object, then back to the caretaker to see their reaction to the object

Milestones of Joint Attention

  1. 2 Months: taking turns with looks, noises, and/or mouth movements
  2. 6 Months: following caretakers gaze
  3. 8 Months: pointing
  4. 9 Months: gestures and social referencing
  5. 12 Months: point intentionally
  6. 12-14 Months: direct attention through pointing and then looking back at caretaker

Tips for engaging your child in joint attention

  • Follow your lead: Use vocal engagement to have your child share enjoyment with you. Pointing to an object such as a ball or a toy will teach your child to share in your enjoyment.
  • Establish your child’s interest: experiment with different toys, books, or movement activities (ex: tickling). Discover which activities seem to get your child’s attention best.
  • Reinforce Proximity: reinforce your child’s interest by engaging them in an activity. Place the toy or walk away from the activity a couple of feet. To reengage the child wait for them to come towards you and engage you before beginning the activity again.
  • Level of engagement: have your child increase their level of engagement with you
    1. Looking directly at you or the object
    2. Reaching for the object
    3. Pointing for the object
    4. Pointing at the object and looking at you
  • Increase the amount of time the child is engaged
  • You choose: Interest your child in a variety of activities and toys to open their interest in an activity that is something of your choosing.

 Rachel Weiser, MS, DT

Developmental Therapist

Additional References:

https://www.speechandlanguagekids.com/establishing-joint-attention-therapy-for-children-who-arent-tuned-in/

https://www.youtube.com/watch?v=1Ab4vLMMAbY

5 Dog Days of Summer Activities!

http://brooklandpark.net/bp/2016/06/16/sprinkler-sunday-northside-childrens-house/

As summer nights grow longer I’m sure some families are looking forward to the start of the school year (or just tired of the same outdoor games). While handing over a tablet is a quick fix, Jessie highlighted research in her latest blog connecting increased screen time with expressive language delays.

 

Here are some ideas to incorporate Developmental Therapy into your summer games. (hint: you don’t need to buy all brand-new toys, use what you have!)

  1. Bubbles are great for everyone! Blow bubbles and talk with your child about size concepts (large and small). This is also a great opportunity to engage your child in joint attention and practice turn taking with the bubbles.
  2. Sights and sounds; take a trip to the zoo and make a family day out of learning. If you’ve already checked the zoo off your summer list, take a walk and discuss what you see and hear (dogs, birds, trucks, cars, and construction equipment).
  3. Lake Michigan; with our close proximity, this allows countless summer activities to enjoy with your family. Sand sculpting increase creativity, tactile sensory building, and hand-eye coordination. Building with friends and family also supports teamwork and promotes positive social interactions. Include pretend play during sand time, the more enthusiastic you are about playing the more your child will want to play! Have a kiddo who wants to keep their feet on the ground? No problem…. try boat, car, busses, and truck watching. Have discussions with your child about what you see to develop vocabulary and increase word retrieval. Incorporate colors, sounds, sizes, and anything you can think of. Don’t forget the SPF!
  4. Sprinkler/water table; a kid favorite to keep cool all summer! Grab the sprinkler out and let the kids play for gross motor and body awareness. Water table activities are great to improve fine motor skills, promote cause and effect awareness, and sensory regulation. Incorporate different objects into the table along with different friends to practice social emotional play and turn-taking. If you don’t have a water table…no problem! Use any size plastic storage container, fill it with water, and let the fun begin!
  5. Pretend play is something that can be utilized anywhere: driving in the car, playing at the playground, and at home. Use themes that your child already enjoys and has an understanding of (pirates, dragons, PowerRangers, princesses, anything!) Be enthusiastic…if you aren’t excited to use a hairbrush as a phone your child won’t be either. Don’t be afraid to talk out loud and explain what you are doing to your child (they won’t know what you are using the props for unless you tell them). Use concepts they know already, have them take their toy car and drive around to pick up grandma to make cookies in the kitchen. Using empty household items makes a child feel accomplished and proud to take part in family routines.

Kelly Scafidi, MSW, LCSW, DT

Attention: What is Appropriate?

All parents are concerned with their child’s attention span. As therapists, we always hear “His attention is so short!” “She bounces from toy to toy all day long!” “He is just so busy!”So, what really is a typical attention span?

Below is a loose guide to think about when considering attention in small children when they’re playing independently. They should be expected to attend for a bit longer when engaging with an adult, as we help keep their attention!

0-12 months: The littlest of babies should be able to play with a single toy for at least a minute or two (if you’re lucky!). Remember, they’re soaking in their new environment, so they’ll have the shortest of attention spans!

12-24 months: These exploring toddlers should be able to attend to a toy or activity for at least two minutes. As these new walkers start to explore and get into EVERYTHING, this may be a bit shorter, but two minutes can be expected once they’re sturdy on their feet.

24-36 months: These older toddlers should be able to attend for three to four minutes. Again, this should be longer when playing with peers or an adult.

3-5 years: These kiddos should be able to attend and play for about five to ten minutes without adult supervision.

 

Tips on increasing attention:

  • Encourage structured activities* at least once a day…after some movement!

Get those wiggles out before a structured activity! The best time to complete a learning activity would be when the child is well regulated. Being expected to sit all day and focus is difficult for an adult – it’s even harder for a child wanting to explore this whole new world!

*A structured activity is something that has a clear beginning and end: reading a book, completing a puzzle, or simple board games.

  • Limit distractions

No wonder these kids bounce around the room – many children’s toys tend to take over the ENTIRE room! Help your child clean up and put things away to limit distractions of other toys. You may need to hide away highly preferred toys, as needed, while completing your structured activities.

  • Turn off the TV and limit use of tablets and phones!

Screens aren’t the enemy- however many tv shows and videos on YouTube are so fast moving, the children don’t want to slow down for toys. Not only do screens impact children’s language development (see Jessie’s blog from last week!) but it also impacts their attention span.

For more information on attention and TV exposure: https://usatoday30.usatoday.com/educate/college/healthscience/articles/20040411.htm

  • Is a task too hard?

Is the activity at hand too difficult? While it is up to us as caregivers and your child’s first teachers to introduce new activities and skills, we need to build upon the skills they already possess. A child can’t be expected to sort objects by color if they are unable to match colors! Take skills they already have mastered and just push a little more, providing modeling, as well as visual and verbal cues.

  • Children should want to get up and explore!

It’s perfectly normal for small children to not want to stay in one place for a long time – period. They are curious, want to explore, and move – this is how they start to learn about the world! Just like anything else in life, balance is key. Get out there and explore with them!

Kimberly Shlaes, MAT, DT
Director of Developmental Therapy Services

Making Transitions Easier for the Child and Caregiver!

Are you having trouble getting your child to transition between activities, tolerate a diaper change, or simply cooperate in his/her daily routine? Children’s early learning experiences are created through their caregivers, requiring the children to navigate their worlds through imitation and by following their caregivers’ specific directions. Around the age of 15 months old, children attempt self-direction and prefer to exercise independence and control. With that said, children often become more defiant of adult direction and may start to experience more difficulties with transitions. As caregivers, we want to make sure we continue to offer children control in order to help them better adjust to the demands placed on them. Below are some suggestions to use for helping your child in a transition process:

  1. Give your child verbal warnings before moving to another activity (e.g. putting on their shoes)
  • For example, give children a two-minute warning before they need to stop playing and put on their shoes. Even though they won’t understand the concept of two minutes, it will get them used to a verbal warning, which will precede the transition. Caregivers can also then give a second warning of one minute, offering the child a total of two warnings in total before they are required to transition.
  1. Give your child options during the transition.
  • Once you begin the process of putting on their shoes, caregivers can ask the children which pair of shoes they want to wear, ultimately offering two pairs that are acceptable to wear. This not only has the children comply with adult direction but also gives them the control back in choosing the options.

Caregivers can apply these two strategies to every transition! It is normal that children will require some time to adjust to the guidelines but stay consistent and changes will come!

Brittany Hill, MS, MSW, LSW, DT

Is My Child Ready for Potty Training?

All parents are looking forward to the day that diapers are no more! You may be ready for your child to be using the toilet, but is he? Here are a few things to keep in mind when asking yourself “Is my child ready to lose the diapers and start using the potty?”

  1. Your child indicates that their diaper is dirty. Whether it is touching/pulling at their diaper or saying “poop!” after a bowel movement, your child needs to be able to show you that they are aware of the uncomfortable feeling “down there”.
  2. Their diaper is dry for longer periods of time (at least two hours) and their bowel movements are predictable. This shows that they are starting to have bladder and bowel control. If your child is dry after a nap, they are demonstrating bladder control during this time (overnight may take a little longer!).
  3. Your child shows an interest in your toileting. Children love imitating adult behavior! Just like playing dress up in your clothes and going to “work” or pretending to talk on the phone, they may show an interest in what you do in the bathroom. Use this to your advantage! Answer questions and allow them to join you in the bathroom.
  4. Your child can follow multistep directions. There are a few steps that go into using the toilet (go to bathroom, pull down pants, sit on potty…). Once your child demonstrates that they can follow a few directions (“pick up your toy, put it in the toy box, close the lid, and come back!”), they may be receptively ready to start potty training.
  5. Your child can pull their pants down and up (it’s ok if they need a little help!) This one is a little more obvious – if they cannot pull their pants down, they will have an accident! While you’ll be there to help at first, the goal is for your child to meet their own needs. But beware – once they figure this out, you may have a little nudist on your hands!

Remember, every child is different! It is a normal process in child development and we all move at our own pace. If you push it and your child is not yet ready, it may backfire and they may fight you on it! Look for their signs that they are ready…not your idea of when they “should” be potty trained!

Kimberly Shlaes, MAT, DT
Director of Developmental Therapy Services

Do you have a picky eater on your hands?

Mealtimes can be stressful for parents when children refuse to eat the food on their plate. It is common for parents to worry about their children not eating, which often means parents will try to accommodate the children by making more than one meal. Children grow up and learn how to exercise their power by making their own decisions. With this easy-to-follow food chart, children will not only be able to choose their meals but will lend for a more consistent schedule for the entire family.

Weekly Meal Chart:

Start by creating a weekly chart including each day of the week. Begin by picking one meal to chart, which can include the most difficult meal for the child. Parents can then print off a number of foods, with the pictures, that the child enjoys. For example, if the family chooses breakfast, the parents can print out pictures of foods that the child usually eats, including oatmeal, cereal, fruit, etc. At the beginning of each week, help the child pick out which food to put on each day. This action will give the child the power of choosing the food and give the parents a visual reminder of what food will be eaten on each day.

Once the chart is filled out, put in on the refrigerator as a visual reminder for the entire family. Parents should make sure to stay consistent with the chart and only offer the food listed for the day. If the child refuses to eat the meal presented, put the food aside and allow the child to take a break. The child may become upset and need some time to calm down with some toys. Once calm, parents can remind the child that he/she can eat the food when ready. Usually, children will give in to the food after they see that the parents are only offering the one meal without other choices. It may be difficult for parents and child to adjust to the chart in the beginning, as the child is used to getting more options, but the more the parents stay consistent with the system, the faster the child will learn the routine.

Brittany Hill, MS, MSW, LSW, DT