Why studying Joint Attention in play matters: Lessons from Deafblindness

Dr Maria Nunez, Developmental PsychologistDr Maria Nunez

Maria Nunez is a developmental psychologist with research interests in early socio-cognitive development, autism, children with sensory impairments and developmental cognitive neuroscience.

“Joint Attention” (JA) refers to the spontaneous communication behaviours that children show around the first year of life where they produce gestures, exchange looks and coordinate their own attention with that of others in order to share something about the world. For example, a child who sees an aeroplane flying on the sky, looks at her mother, turns to look at it, points in the direction of the aeroplane and then looks back (smiling) at her mother, is showing a typical sequence of communication in JA.

Developmental psychologists have been studying infants’ Joint Attention for almost four decades. There are good reasons for this sustained interest. First, it shows a unique, species-specific, spontaneous ability in humans. Secondly, it shows a true milestone in communication that opens the possibility of sharing the world with others. Thirdly, JA serves as a developmental platform for other key socio-cognitive abilities and cultural learning that children acquire during the first years of their lives.

Despite the key role of JA in human development there has been surprisingly little research on the acquisition of JA attention through other sensory modalities. The sustained interest of developmental psychologists seems to have focused almost “blindly” on the visual modality and in the production of distal gestures such as pointing. Is visual JA the only route to access a shared sense of the world? If so, what do children with visual sensory impairments do to coordinate their attention and share the world with their parents and others? What if children are impaired in more than one sensory modality? What alternative routes to JA are there? Children with multi-sensory impairments certainly have the same human motivation to communicate and share the world with others –and so have their parents!

With those questions in mind, three years ago we started a research project that looked at JA in children with multi-sensory impairments. Fourteen families with young deafblind children took part in our study. During the study sessions we gave parents a box with sensory adapted toys and simply ask them to play with their children as they would normally do and recorded them while playing.

Here is one of the examples of what we observed between a mother and her child (profoundly blind and deaf). Mother and child are sitting on the floor facing each other. On the child’s left-hand-side there is the box with toys. The child touches one of the toys in the box with her left hand and explores it tactually; then she brings her mother’s hand to the toy, places her right hand on her mother’s chest and pushes it while vocalising with pleasure. The mother talks back to her (the child can feel her voice through her hand on the mother’s chest). The child responds by pressing again on her mother’s chest, vocalising and smiling.

However “sensory different” the child’s means to communicate are, this episode shows an example of JA between the child and her mother as perfect as the typical example in the beginning. The child brings her mother attention to the object tactually; instead of looking into her mother’s eyes, she brings the mother’s hand to the toy. Rather than looking at it together, they touch it together. Then, once the child knows that she has her mother attention on the toy she is interested in, she produces a contact communication gesture to share her excitement with her mother. Instead of pointing, she makes tactual contact with her mother’s body at the same time that they hold the object. Finally, like in the typical example, the child smiles and shows pleasure that she is also sharing with her mother.

This example, like others we found in the “play sessions” of our participants, is important for several reasons. First, it demonstrates that children with multi-sensory impairments can certainly use alternative sensory means to share attention and communicate about the world with their parents. Secondly, it shows that JA is not limited to the visual modality. In fact, if we analyse it carefully, we see that there are at least three sensory modalities involved; JA here is established tactually but it also makes use of proprioceptive information (feeling the vibration of the mother through her chest) and the child itself produces an auditory response (her vocalization) as part of the communication gesture.

Our participants were enormously heterogeneous (as the population of children with deafblindness is); this means that not all the children in the sample showed communication behaviours of JA itself.  However, they all showed different levels of communication that are pre-requisites of JA. When we look at the “play interactions” between these parents and children, we can place them at different stages that are also “typical” in terms of the stages that developmental trajectory that JA follows.

The whole description of the findings of the project can be found on the Sense website. Before closing this oldblog, however, I would like to highlight that studying JA in children with multi-sensory impairments has  “taught us” two main lessons. First, atypical sensory pathways to JA can fulfill typical functionality in regulating other’s attention and in communicating about the world. Secondly, almost ‘paradoxically’ the study of JA in multi-sensory impaired children shows that JA is a multi-sensory phenomenon. There are still many more to be learnt in how to bring these initial insights into some more practical applications that can help children with multi-sensory impairments and their parents to communicate more efficiently and, by doing so, scaffold their child’s development. Let’s hope that by ‘joining forces’ families, practitioners and researchers we can altogether start making some progress on this next step too.



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