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Joint Attention – a precursor of “theory of mind”

A special phenomenon in blind children?

Focus: Early Intervention

Topic: Research

Anette Ingsholt

Psychologist,  ph.d.


National Institute for Blind and Partially Sighted Children and Youth

Kystvejen 112

4400 Kalundborg


+45 5957 0100



In this paper I will focus on the phenomenon of joint attention. I start with an account of the history, the definition of the phenomenon and its use in normal sighted children. Then I try to transfer[i] this phenomenon to blindborn children and finish with some comments about why it is important to be aware of this special phenomenon in counselling parents and caretakers of blind children. The aim of my paper is to reach an awareness of why it is important to engage in joint attention in interaction with blind children.

The paper is based on a project made in Denmark in the group of counsellors in early intervention. The phenomenon has been focused in discussions in order to comprehend the perspectives of the concept combined with detailed analyses of videotapes of dyads of blind children and their parents.

The project is part of a Nordic project.


Joint attention is not a new behaviour. Normally, it develops quite naturally in normal sighted children. So, it was just considered as part of normal behaviour in normal social development.  Yet, the consequences of directing focus in 1970’es toward interaction of infants and toddlers and their parents were that elements of social development were observed in details. In this process the interest of joint attention was aroused. Since then, the special phenomenon of joint attention has been treated as an important element in the social development, perhaps, because it was considered e.g. to be an essential precursor of the development of theory of mind. Because of this connection to “theory of mind” joint attention was not considered only as an element in social development but were also treated from a cognitive perspective. This combined social cognitive perspective turned the concept of joint attention into a much more complex phenomenon.

Therefore today, the definition of joint attention has its roots in the functional behaviour and in more complex theories concerning origin and development.

Much research of joint attention has been made on basis of sighted children where visual contact and visual behaviour have been the essential elements in descriptions and evaluations of joint attention. In relation to blind children, therefore many questions arise, e.g. how does blind children acquire and develop joint attention, how are we able to estimate when they have success in making joint attention, how do we stress the development and strengthen the development of this behaviour in especially the blind child etc.

Origins of joint attention

In fact, we don’t know what the motivation is for making joint attention. But we know, that “the need to share objects of our attention with others” is special for the human race. When a normal little child successfully has obtained joint attention, often, an expression of joy including active smiling is the reaction.

Some debate is centred on which fundamental basis this strong social need for sharing objects of attention with others originate. Is it an inborn capacity, some pre-programmed capacities that have been developed on predetermined stages in normal development or is it learnt forms of behaviour? Here, I have chosen just to mention the debate, and not to go further into it.

In joint attention, the use of language and sight are some of the most important aids. Of those two especially sight has been in focus in the research of joint attention. This makes it a more challenging and complicated task to study behaviour of joint attention in children, where exactly this aid is missing. Fortunately, language is also an important aid in developing and practising behaviour of joint attention

Joint attention is not present as a full functioning phenomenon at the time of birth but gradually it develops through early forms to more convincing forms of behaviour of joint attention. Three essential capacities of attention have to be developed before a child is able to participate in social interaction with appropriate behaviour of joint attention. Thus, the child has to demonstrate a) a need to share focus of attention with others, b) to be able to follow and to find another person’s focus of attention and c) to be able to monitor another person’s focus of attention.

Different forms of social behaviour are considered to be signals of development of the three components. The intensive research of social interaction in the last decades has made time schedules for normal development of many of these forms of social behaviour of infants and toddlers.

To share focus of attention with others

The sharing of focus of attention with a partner is the basis of all skills of joint attentions.  The need of sharing is shown in these skills.

For example, it has been found, that children about nine month of age begin to use forms of behaviour where the child active offers an object to a parent or e.g. requests a special object by making a demanding pointing to the object.

Other forms of behaviour of attention of this category is seen, when a child looks at the face of another person, while the child is playing with an object, has completed a task, has pointed at something, or is in an uncertain situation. 

Social referencing is another important behaviour. Here the child tries to identify the emotional reaction of the parent towards e.g. a certain object or act of the child. Afterwards, the child is using the emotional information to decide how he next is going to act in relation to the object. Often the child assumes the same emotional states that the parent has shown. Children seem to have developed this form of behaviour around 12 months of age.

Some researchers take behaviour - in situations as mentioned above - as signals for the child’s ability to perceive their parents as an intentional acting person, who either likes or dislikes the object, they both are looking at. Somehow the child understands, that the state of the parent is different from the one the child has not yet formed. 

Blind children

In general, blind children are considered as sharing fewer experiences with others than sighted children normally do.  For example, they use proto-declarative acts less.

In relation to social referencing they can’t use the visual way to make this but have to depend on reactions from others in forms of e.g. comments to their acts and situation. This is a much more uncertain situation which may influence their curiosity, their learning and motivation to get involved in new situations.

To follow others’ focus of attention

Many studies of joint attention have been based on the use of the visual sense.

An episode of joint attention involves that the child studies or monitors the attention of his partner in some degree. Changing the visual focus from object, to parent, back again to object and vice versa is a way to do this. It will mean to follow the line of regard of the parent to the goal and eventually then check out, by looking at the parent that the goal has been found.

This capacity is developed in children in the age period between 2-14 months of age.

Through this form of behaviour the child shows an understanding, that other persons may have their own interests and behaviour of attention, which can be observed and followed by the child.

Blind children

The parent has to show or to tell the blind child where the parent’s focus of attention is in a given situation. To guess and follow the parent’s focus of attention is difficult, if the parent is not telling about it.  The blind child is not able to follow the parent’s line of regard and find the visual target.  The parents have to talk about what it is in the surroundings that there has caught their interests here and now, if the blind child shall have a chance to follow the eventually changes in the parent’s focus of attention.  In this way, the blind child has to have information about others’ focus of attention. The blind child himself has to be curious, has to ask, if verbal language is available. There are not many possibilities for a blind child actively to follow the focus of attention with another person, if they are not helped.

But also the parents have difficulties in following the blind child’s focus of attention. The parent has e.g. normally difficulties in interpreting the attitude of attention of the blind children based on facial expressions and the body language of blind children. Often, this makes it difficult to observe where the blind child’s focus of attention is located. 

It is much easier to locate a focus of attention by help of sight, eye orientation and direction than to locate an auditory focus of attention by help of orientation of face, body and ears. A careful analysis of the behaviour and reactions of the blind child in the situation is therefore necessary to decide if joint attention is present.  Cues have to be found in e.g. reach-out movements (more or less diffuse), sound making, emotional expressions, tactile contact etc. Such observations require, that the observing person is able to detect the imprecise expressive signals of the blind child. But often the parents do not see these small signals.

Furthermore you have to get some signs telling, that the blind child knows, that the parent’s focus of attention is directed towards the same object as the child’s before you can be sure, that joint attention is established.

When verbal language is available, it is much easier through the content of language to decide if joint attention is at hand.

To monitor another person’s focus of attention

The last capacity is the capacity to monitor another person’s focus of attention.  This is normally developed in the period from 8-12 months of age.  In this period the child actively starts to influence the behaviour of the parent and to catch or in other way manipulate another person’s attention. The child begins e.g. to use nonverbal gestures as an aid to monitor the attention of other persons towards an object the child himself is interesting in.  These gestures are separated into two different forms: The proto-imperative and the proto-declarative gestures.

When verbal language symbols emerge it is also possible to tell others to which aspect in a given situation the focus of attention is directed.  By this it is possible to give more precise information e.g. to specify a special interesting propensity or function of an object.

The goal of the child is by help of language to influence another person to adopt a special orientation of attention. Language symbols are also a help for the child to find out which aspect of an object the parent’s focus of attention is directed.

Some researcher

see a connection between the language acquisition in the 12-14 month old children and an understanding of other persons as intentional acting persons. Here  

“at least some” intentional control of attentive behaviour is necessary.

Blind children

The blind child monitors the focus of attention of other persons by use of sounds, movements of body and hands, emotional expressions and protests. Also by manipulating a chosen object it is e.g. in some extend possible for a blind child to monitor the parent’s focus of attention.

When sight is missing joint attention is more difficult to acquire or is acquired differently. In general the blind child has some difficulties in handling the above mentioned acts involving sharing, following and monitoring other person’s focus of attention. 

Definition of joint attention

Now, it is time to turn to a more ”exact” definition of joint attention.

The definitions of joint attention are divided into two forms of definitions. One, where the visible forms of behaviour in the triad define the existence of joint attention and, another more complex form, where the concept of joint attention is connected to theoretical explanations or interpretations of questions about the origin or cognitive pre-conditions. The colourful picture is completed, when furthermore the role of joint attention is brought into the discussion as basis for development of “Theory of mind”.

In an episode of joint attention the focus of attention of both the child and the parent are directed to the same object or phenomenon.  Both are aware of the target of own focus of attention but at the same time they are also both aware of the target of their partners focus of attention – and both understand that they have the same target. In their minds they make a comparison between their own perceived target and their perceived target of the partners focus of attention. 

We are not able to observe this cognitive process of understanding that takes place in the minds of respectively child and parent. In order to find episodes of joint attention we have to look for visible signs of the above-mentioned understanding in the behaviour of child and parent.

The focus of attention of both, the parent and the child, is at the same time turned against the same object. In the dialogue between child and parent it must be possible to find one or more signs, which show that the child has an understanding of the focus of attention of the parent, - and where also the knowledge is present that this focus is the same as the child’s focus.  This understanding is often shown in the visual behaviour of the sighted child but can also be shown by vocal or verbal expressions, body language, facial expressions and the acts made by the child and his parent. It is the last mentioned forms of behaviour we have to observe in a triad with a blind child.

In an episode of joint attention the child has to change the focus of attention from object, shortly to parent and then again to the object while he continues the activity that is going on.  It is not necessary in conscious understanding of joint attention to make a visible action directly to the parent but the understanding of joint attention can be interpreted in e.g. facial expressions, prosody and, body language in the child. It is important to stress that when the child has reached joint attention, this observation is based on an active act from the child.

There has to be timing between the acts of respectively the parent and the child in the interaction.

The child has to coordinate his focus of attention on the object and the parent at the same time. Similarly, at the same time the parent has to coordinate his focus of attention at the child and the object. Both of them have to be attentive to the same object and to each other.

Some researchers has mentioned, that joint attention is only present, when the episode has an extended duration (e.g. duration of 2 seconds)

Besides all this a cognitive pre-condition has also to be present in the child (and the parent).  This is a capacity to act intentionally and at the same time be able to understand, that also other persons act intentionally.

It means that there is an understanding - in the individual, and also in the child - for the participation of the other partner as a person who intentionally perceives a certain aspect in the surroundings that is the same aspect he himself has or one which can be turned into the same.

Examples of joint attention in blind children will be demonstrated in videotape.


When can we expect joint attention?

Many of the elements connected to behaviour of joint attention is observed in the behaviour of  normal children in the age of aproximately 12 months or in the stages afterwards.  Therefore it is generally agreed that joint attention is seen in the early forms of behaviour after 12 months of age.

This has a link to the development of the system of attention. The development of the system of attention necessary in joint attention has not been completed before this age. Around 12 months of age the capacity to keep both attention on parent and object at the same time is developed.  Before 12 moths of age the child is only able to have his focus of attention centred either on the object, the parent, his own act or anything else inside or outside the dyad.  After 12 moths of age normally a child is able to focus on both object and the parent at the same time.  At the same time also a change in the development of the child takes place from primary to secondary intersubjectivity.

Therefore, it is generally agreed, that there are no incidents of joint attention in the age period from birth to 9-12 months of age, but a good deal of pre-joint attentional behaviour are observed in forms of precursors or fundamental skills upon which the behaviour of joint attention is developed.

The periods afterwards are separated in two periods of development.

The first episodes of joint attention is observed in the triads, but first in the ages of 15-18 moths of age such behaviour is observed more frequently.

Why do I accentuate joint attention in the counselling?

The work in early intervention is divided into two task when it comes to the phenomenon of joint attention. The first is to work directly with the individual blind child in order to provide opportunities in which elements in joint attention can emerge and be developed further. The second is to work with the parents in order to provide an understanding for the importance of episodes of joint attention.

Why is joint attention so important?  Joint attention is a cognitive understanding made visible in some social acts. Joint attention provides elements of a fundamental understanding of the intentions of other persons, an understanding of others thinking mirrored in the “theory of mind”- theories. 

To understand and to interpret the intentions of others is an essential part of social interaction and therefore a necessary part of social togetherness for a whole lifespan.

In the work of counselling the establishment and development of joint attention is important for the social life of the blind. But in counselling of parents it is also important to have knowledge about the elements in the pre-joint attentional period. This is important because knowledge gives possibilities for providing the frames in which behaviour of pre-joint attention can be cultivated and grow. The precursors are to be found in situations where the blind child and his parent are interacting. The parent is here able through own acts, comments, use of voice, tactile contact etc. to stress that she is attentive to the child, to his acts and to his focus of attention. Through the parent’s comments sounds, contacts etc. the child is able to get a growing understanding of the parent as an active partner who is aware of and able to follow the child in his activities. Even if the child is occupied of own activities most of the time, he will in short intervals change focus of attention to his parents and receive her attentiveness before he continues in his own acting.  It is through the child’s   interaction with his parent – also in the early periods that experiences are created which leads towards genuine episodes of joint attention.

It is not easy for a blind child to develop and reach genuine episodes of joint attention.  Sighted children are able to combine visual information with real life experiences. They are able to use sight as an aid to signal understanding to other people. The blind child has to use cognitive capacities to reach to an understanding of the intentions of others and to reach to a cognitive understanding of minds. Blind children depend on the combination of cognitive thinking and experiences in real life. They have no alternative.  For the blind child it is hard work to reach and develop a phenomenon as joint attention.  They are not able to get visual information, which can lead them to intuitively developed cognitive conclusions. The blind children are in a greater extension depending on other people awareness of their problems in getting information.  For some blind children this process is hard to master but it has been shown in the development of normal functioning blind children that it can be done.

[i] This transfer is linked to videotape. Therefore this paper and the performance at the conference is not exactly the same.


Anette Ingsholt

Psychologist, Ph.d.            

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