Pointing is an important developmental milestone for young children. It helps them learn language, gives them a better understanding of their environment, and provides the ability to socialize with others in a meaningful way. Teaching pointing to your autistic child may be challenging, but it’s not impossible!
We’ve been working for over a year (and counting) on teaching Big A to point to objects. Our two-year-old toddler is diagnosed with autism spectrum disorder, and didn’t point in any situation: pictures in books, items of interest, or making choices. The lack of pointing and other gestures complicates communication issues, specially for non verbal toddlers with autism.
Now, after a year of hard work, he is sometimes pointing on his own and we’re working on generalizing this behavior.
Why Pointing Is Hard
First, there’s trying to figure out what to do with the finger. Pointing requires seeing an imaginary line from the finger to the object. Trying to line up the finger with the object can be hard for those just discovering their fine motor skills. And then there’s trying to communicate or figure out what someone else means by pointing. Is it a call for attention? A want? Or a command? These abstract concepts are hard for a toddler with autism spectrum disorder to grapple with.
That’s because there’s a particular skill needed to make pointing possible. It’s called joint attention, and it’s an ability that those with autism spectrum disorder commonly struggle with.
Joint Attention, Then Pointing
Joint attention is the ability to share attention with someone else about a particular object or event. It’s the look you exchange with your significant other over your fit-throwing toddler that says, “omg, do you see this drama?” Joint attention begins in the newborn stage when an infant looks at its caregiver while eating. The baby is sharing the comforting feeding experience with the caregiver via eye contact.
Because joint attention does not come naturally to Big A, we had to work with him on that first.
Teaching joint attention is a long process. Turn taking activities help. We turned every activity into a give-and-take. When we are pushing cars, I hold the car up in front of my face until he looks at me. Then I say, “Mommy’s turn! 1, 2, 3, go!” and push the car toward him. This forces a pause in to our activity and makes Big A look at me. Otherwise, it was just him and the car, his attention focused on the spinning wheels.
Once his joint attention was better established, Big A understood that we could look at an object together. Once Big A understood that we were looking at an object together, he realized he could ask me for the object we both were looking at. Then pointing made more sense to him.
How to Teach Toddler to Point
First off, Big A isn’t going to point at anything he isn’t interested in. I can bring in all the stuff, coordinate all the games, but if there’s no interest, there’s no learning. Therefore, I strive for child-led activities.
I try to step back and watch before teaching. Instead of barging into Big A’s play, flashcards in hand, I ease in to whatever he’s already doing.
Take It Further Away
Once I see what he’s interested in, I pull kind of a dick move. I move the toy away from Big A, far enough that he has to reach. As soon as he reaches (with an appropriately outraged grunt, sometimes tears) for the object I give it back and praise the reaching.
I place the toy farther and farther away throughout the interaction. That’s the hope, anyway. Often, especially in the beginning, a meltdown will derail efforts. Or Big A just won’t care about the toy anymore. It’s alright. Abandon ship, for the time being. Live to try another day.
The hope is to turn reaching into pointing.
But what if there’s no reaching and just crying? That happens, sometimes. Toddlers, amirite? Then it’s time to “tell, show, help.”
I tell my son, “Reach for it!” or “Where’s your pointer? Point to it!” If there’s no response (or Big A is too upset) then we reach or point hand-over-hand. Meaning I take his toddler hand in my hand, extend his pointer finger, and point towards the item in question.
This is probably the most important part of the entire process. I’m not exaggerating when I say that it took over a year for Big A to point. A year of going through the process day in and day out. Months and months of active and passive resistance to hand-over-hand modelling, then months of passive acceptance.
These months are long and patience can be short. Discouragement easily swoops in. All you have to do is persevere. I try not to measure success by whether or not Big A points. I’m measuring success by whether or not I keep trying.
Natural routines are great built-in times to reinforce pointing behavior (or any skill being taught, really). We take advantage of times like meals, baths, and diaper changes (things that happen multiple times a day) for practicing.
During mealtimes, I “tell, show, help” Big A to point to food, utensils, his cup, etc. Big A’s favorite bath toy is moved out of his reach during bath time.
Praise is a big part of reinforcement as well. The tiniest point, the smallest reach, elicits huge reactions from us. We clap and tell Big A what a good boy he is and how nice it is to know what he wants.
Now that Big A has started to point to pictures in books, we’re focusing on generalizing this behavior. When Big A points while reading, I’ll try to get him to reach for a toy or favorite food he wants right afterward. But, mostly, it’s about the perseverance. We have to keep doing what we’re doing and wait, maybe, several more months for Big A to point at other things. I try to keep my expectations out of it.
What skills are a struggle with your children and how do you help? Let me know in the comments below. Did you find this article helpful? Share it!
Read about how we help Big A with sensory issues here.