Joint Attention in Autism: Join Them, Don't Force It
Joint attention in autism doesn't need eye contact or a toy at the table. Here's how joining a child's movement and interests builds real connection instead.
I've been a speech therapist for almost 25 years. I can't count the kids who glanced at me once, then spent the rest of the session making it very clear they'd rather I wasn't there. I used to take it personally.
Then I started asking a different question. Not "How do I get this child to communicate?" but "What are they already communicating that I keep missing?"
Here's the short answer: joint attention in autism doesn't require eye contact or a shared toy at the table. It can happen while running, banging, rocking, or playing "I'm gonna get you." When you join what a child already loves and put words to it, connection follows. And every response while you model tells you what to assess next.
Susan Golubock, our founder, is an autistic retired occupational therapist, and she changed how I understand autism. In this conversation, she shares two stories from her own life that explain this better than any framework could.
Watch it first if you can. Then keep this post as your planning notes for your next session.
What does "limited engagement" really mean in autism?
Most of the time, "limited engagement" means limited engagement with our activity, our pace, or our expectations, not with the world. A child who ignores your toy, then spends ten minutes lining up objects or exploring textures, is deeply engaged. Just not with what you chose.
Pulling you to the door, bringing you a container, moving away, vocalizing: these are all communicative acts. We tend to miss them because they aren't speech.
Before you decide what to teach, learn how this child experiences their world. If you've been working harder and harder to get a reaction, our post on "Why trying harder to engage rarely works".
Why don't forced requests build functional communication?
Setting things up so a child has to ask, like holding back a toy until they request it, often fails because it demands communication without giving a reason to relate. Functional communication starts with wanting to connect with someone.
Susan watched this play out in a preschool. Teachers put a little girl's shoes on a high shelf so she'd have to ask for them before going home. What that girl did next is the moment Susan realized she was autistic herself.
Susan's approach was simpler. She'd say "Show me," then start parallel play, which means doing the same thing beside the child without directing it. Eventually the child notices. Sometimes they reach over to correct how she's doing it, and that's connection.
When we force | When we join |
Hold the item until they ask | Name what they want: "You want outside." |
Bring them back to the table | Move with them and narrate |
Change our words to keep it interesting | Use the same words in the same moments |
Require eye contact | Count shared rhythm, anticipation, and play |
Say "use your words" | Respond to every attempt |
How do you build joint attention with a child who won't stop moving?
Move with them, and talk about what you're doing together. Joint attention, meaning two people sharing focus on the same thing or experience, can happen while you're both climbing, banging, or rocking.
Movement doesn't automatically mean dysregulation. It may be exactly what helps a child's nervous system feel organized and alert. If we keep redirecting them to the table, we may be removing the thing that's helping them take part.
I have a kiddo right now who bangs everything. So I bang too: "Boom, boom, boom. Loud! Fast. Slow." He looks at me like, Whoa, what is she doing? That look is joint attention.
With another client who wanted nothing to do with me, I tried "I'm gonna get you." He gave me a huge smile and said, "Tickles." I got eye contact I never asked for.
6 steps to join instead of force
These six steps give you a starting point for any session where a child seems uninterested in you. Susan and I walk through them at the end of the video.
Observe first. What do they seek out, what do they avoid, and what brings them joy?
Follow their interests. Find a way to take part without controlling it.
Support sensory needs. Movement and regulation can be the first part of your session. Our post on [INTERNAL LINK: /post/regulation-in-speech-therapy — slug to confirm — "making regulation part of speech therapy"] explains why that still counts as communication work.
Respond to all communication. "Oh, you want to go outside." If they had the words, they would have used them, so let's retire "use your words."
Model without expectation. Offer the word, show the gesture, or model on their AAC device (augmentative and alternative communication, like a speech-generating app), with no response required.
Watch for small changes in connection. Do they come back to you? Anticipate a routine? Bring you something to repeat?
What should you look for while you model functional language?
Every time you model a word and wait without requiring anything, the child's response is assessment data. Modeling tells you what they already do, what they're reaching for, and what's getting in the way.
Watch for a progression. A pull to the door becomes "Ah" for outside, because you said "outside" every single time they pulled you there. That shift is the thing you're looking for.
What you see while you model | What it tells you | What to model next |
Pulls you to the door, brings you things | Strength: already communicating with intent | Name it every time: "Outside." |
Watches you, comes back to you, corrects your parallel play | Strength: noticing you; connection is forming | Keep joining, then add a brief turn |
Smiles or tenses up before "I'm gonna get you" | Strength: holding a language routine in memory | Keep the routine and words the same |
Tries a sound or gesture inside the routine | Potential strength: emerging with your support | Accept it, respond, and model the word again |
Can't make the gesture yet | Barrier: body awareness; unready for signs or words | Build body awareness and keep naming |
Keeps moving and doesn't look your way | Possible barrier: sensory needs come first | Support the body first, narrate as you go |
No response isn't a failed probe. It tells you which barrier to support before you expect output.
FAQs: Joint Attention in Autism
Q: Does joint attention require eye contact? A: No. Joint attention means two people sharing focus on the same thing or experience. For many autistic children that looks like shared rhythm, movement, anticipation, or banging something together. Eye contact may show up on its own once the child feels connected, but it shouldn't be the requirement.
Q: What is parallel play in autism therapy? A: Parallel play means doing the same activity beside a child without directing it. If they're lining up blocks, you line up blocks too. Over time many children start noticing you, watching what you do, or even correcting you. That noticing is the start of connection.
Q: How do I model language without pressuring a child to respond? A: Narrate what you're both doing, using the same simple words each time: "Up, up, up. Down!" Offer words, gestures, or AAC models with no response required. Kids often take language in long before it shows up as output, sometimes weeks or months later.
Q: What should I say instead of "use your words"? A: Name the message you saw: "Oh, you want to go outside." Then respond to it. If a child had the words, they would have used them. Acknowledging every attempt tells them their communication works, which makes them more likely to keep trying.
Q: How do I assess functional communication in a child who doesn't use words yet? A: Model functional words during what the child already loves, then watch. Do they pull you, bring you things, anticipate a routine, or try a sound or gesture? Sort what you see into strengths, potential strengths, and barriers like sensory needs or body awareness. That tells you where to start.
Start with what they're already doing
Joint attention in autism grows from joining, not forcing. Watch what a child loves, take part in it, and put the same words to it again and again. Connection comes first, and communication builds on it.
You don't need a bag of materials. Your body and theirs are enough.
Watch the full conversation with Susan. Hear the shoes story, her take on screens, and the story about her own childhood that explains why we start with connection.
Then try the Quick Trial Assessment with one child this week and see what you notice that you didn't notice before.
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