Speech Pathology

Autism and Social Communication: How Joint Attention Builds Language

How social communication develops from birth to age 2, why joint attention matters most, and how Speech Pathology supports autistic children early.

Autism and Social Communication: How Joint Attention Builds Language
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Every child develops social communication in their own way, and that is especially true for autistic children. What we do know is that the early building blocks, eye contact, turn taking, and joint attention, shape how a child learns language. Understanding how these skills develop, and how they can develop differently in autistic children, helps families know when to seek support.

01 . What it is

What social communication actually is

Social communication is the part of language that is not about words. It is the eye contact, the shared smiles, the back-and-forth turns, the gestures, and the moments where two people share their attention on the same thing. These skills emerge long before a child says their first word, and they shape how language develops later.

For families of autistic children, social communication is often the area where differences first show up. A child might be hitting their physical milestones (rolling, sitting, walking) on time but be a little slower to look up when their name is called, or to point at things they want to share with you. Those moments are not problems in themselves. They are signals that social communication is developing in its own way.

The Speech Pathology Australia Autism Position Statement sets out that Speech Pathologists support autistic children to build communication skills across the lifespan, working alongside families and respecting each child’s individual developmental pattern (Speech Pathology Australia, 2022).

02 . Early milestones

How social communication develops from birth to 12 months

Before a baby says a single word, they are already doing the work of communication. The first year of life lays the foundation for everything that comes after.

Birth to 6 months. Babies look at their caregivers, imitate facial expressions, and focus their attention on one person or one object at a time. Speech Pathologists call this dyadic interaction (two-way attention between baby and caregiver). It is the foundation of social connection. Smiling back and forth between a baby and a parent teaches reciprocal turn taking, facial expression recognition, and the anticipation of what comes next.

6 to 12 months. Babies start to use their smiles and sounds to begin interactions, not just respond to them. Around this age they develop triadic interaction (three-way attention between baby, caregiver, and a third thing in the environment). The baby looks at you, then at a passing plane, then back at you, as if to say “did you see that?” This skill is the gateway to joint attention.

By 12 months, most typically developing children can share their attention with a caregiver and direct that caregiver’s attention to something they find interesting (Better Health Channel). When a child is interested in something and a parent shares that interest, the parent can name it, “there’s a plane”, and language begins.

03 . The hinge milestone

Joint attention is the milestone everything hinges on

Joint attention is the moment two people share their attention on the same thing and both understand they are sharing it.

Think about going to the movies with someone. Something funny happens on screen. You laugh, your friend laughs, and you look at each other. You both know you are sharing the joke. You are sharing joint attention. You are not sharing joint attention with the other people in the cinema, because even though they experienced the same thing, they did not experience it with you.

In communication development, this is the milestone everything hinges on. Once a child can share attention with a caregiver on a third object, language has a place to live. The caregiver can name the thing. The child can point at the thing. Vocabulary, gesture, and meaning build from that moment.

A 2018 review by Mundy in the European Journal of Neuroscience describes joint attention as central to how social understanding develops in the brain, beginning in the first months of life. The same review notes that differences in joint attention are characteristic of how development unfolds in autism.

For families, the practical signal is around 9 to 12 months. By 12 months, most children can:

  • Follow a caregiver’s gaze or point to look at something the caregiver is showing
  • Initiate sharing by pointing, holding up, or showing a caregiver something they find interesting
  • Alternate gaze between a caregiver and an object, looking at the thing, then at you, then back at the thing

Once a child can share attention with you on a third object, language has a place to live.

04 . Autism trajectory

How social communication develops in autistic children

Many autistic children develop joint attention in a different order. Paediatric Speech Pathologists working with families often see autistic children build these skills one at a time, in a different sequence to their typically developing peers.

A common pattern is that requesting develops before sharing. The sequence often looks like this:

  1. Directing attention to request without looking at the adult (for example, pulling a parent’s hand toward the fridge)
  2. Directing attention to request while alternating gaze between the adult and the thing they want
  3. Responding to joint attention, for example looking at something a parent points at
  4. Directing attention to share interests without looking at the adult
  5. Initiating joint attention and sharing gaze between the person and the object (for example, showing a parent something they like, looking at it, then looking back at the parent)

The pattern is “I want this” first, “look at this” later. Both forms of joint attention matter, but the order they develop in shapes how vocabulary and conversation build.

Autistic children build social communication. The building blocks just arrive in a different order, and understanding that order helps families know what to expect, what to celebrate, and what to ask a Speech Pathologist about.

05 . When to seek support

When to seek a Speech Pathology assessment

There is no single age that says “now is the right time” to see a Speech Pathologist. But there are signals that an assessment may help:

  • By 12 months, your child is not consistently sharing attention with you on objects, people, or events around them
  • By 12 to 15 months, your child is not pointing at things they want or things they find interesting
  • By 18 months, your child has fewer than five single words or has stopped using words they had before
  • By 24 months, your child has fewer than fifty single words or is not putting two words together
  • At any age, you have a gut feeling that communication is not building the way you expected

A Speech Pathology assessment looks at where a child is across receptive language (what they understand), expressive language (what they say), and social communication (how they share meaning with others). The assessment is not a diagnosis. It is a map of strengths and emerging skills, and a starting point for support if support is needed.

For autistic children, early assessment is particularly valuable because the developmental sequence is often different. A Speech Pathologist can identify which skills are building, which are emerging, and which are likely to need extra support. Speech Pathology Australia’s position is that all autistic people have the right to access timely, individualised, evidence-based assessment and support across the lifespan (Speech Pathology Australia, 2022).

If you would like to read more about how early language develops, our post on pre-linguistic skills and early language walks through the same milestones in a complementary way, and our guide to the six stages of play covers how play and communication grow together. To see how Optimum Health Solutions supports families through Speech Pathology, you can read more on our services hub.

CLINICALLY REVIEWED BY

Gayle Rogers

BAppSc (Speech Pathology), GradCertBA

HEAD OF CLINICAL DEVELOPMENT (SPEECH PATHOLOGY),
OPTIMUM HEALTH SOLUTIONS

With over 13 years of experience across Australia and the United Kingdom, Gayle has extensive experience working with participants with AAC and complex communication needs.

Gayle Rogers
Common questions

Frequently asked questions

Joint attention is the moment two people share their focus on the same thing and both understand they are sharing it. Autistic children often develop joint attention in a different order, learning to use it to request before they use it to share interest with another person.
A Speech Pathology assessment is worth considering if your child is not consistently sharing attention with you by 12 months, not pointing by 12 to 15 months, has fewer than five words by 18 months, or is not combining two words by 24 months.
No. Communication develops in its own way for every autistic child. Some autistic children develop spoken language on a typical timeline. Others use different communication paths, including gesture, picture supports, or assistive communication. A Speech Pathologist helps identify each child's communication strengths and what support, if any, may help.
Speech Pathologists assess social communication, receptive language, expressive language, and play. They work alongside families to build communication skills using evidence-informed, family-coaching approaches that respect each child's individual development. Speech Pathologists also support assistive and augmentative communication when spoken language is not the primary path.
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