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Establishing Reciprocity

Reciprocity and Joint Attention are closely related skills.  When there is reciprocity between two people, they are intentionally interacting in a back and forth manner. For example, when you call your child and your child responds by looking at you or saying "What?" this is an example of reciprocity.  When your child requests a teddy and you respond by providing that toy, this is an example of reciprocity.  The reciprocal interaction can be extended into several exchanges as when

  1. your child comes to you crying 
  2. you say, "AW, HONEY, WHAT HAPPENED?"
  3. your child points to his bleeding knee
  4. you go and get a band aid
  5. your child grabs your hand before you try to wash his knee
  6. you say, "Daddy will be careful!"  
  7. your child asks "Be careful?"
  8. you say "I will be very, very, very careful"
  9. your child asks "Go doctor?"
  10. you say "Pretend daddy is a doctor"
  11. you pour some pretend liquid into a pretend glass
  12. your child watches what you are doing carefully
  13. you say,"this is knee medicine"
  14. your child takes the pretend glass from you and pretends to drink it
  15. your child grins at you
  16. you grin back.
It is Hard to Establish Joint Attention & Reciprocity

Sometimes, in the early days of working with a youngster who has any form of autism, I think that all the stars in heaven need to be aligned just right to make joint attention possible and at best, we get one back and forth reciprocal interaction.  We persist, showing the child little routines that are delightful and short (just one back and forth) and pretty soon, we hit upon the right combination and the child jumps in to play a game.

There are also moments when child looks straight at me and I feel that our emotions are aligned.  The child knows I am there.  He or she either likes or does not like what I am doing at that moment and communicates this clearly and intentionally. At that point, we are not only sharing attention, we are in a reciprocal interaction, because I have been waiting for this moment and I respond.  Often, as I show a parent how to respond to these moments of intentional communication, even if it is just a look or a gesture, parents say that they did not know this was the beginning of communication.  They think they are suppose to wait for something more.  Parents think they are waiting for a word and sometimes a word, plus "please".  The beginning of reciprocity is when a parent notices what a child does and responds.  If you as a parent notice moments of shared attention, when the child sees that you both are looking at the same thing, doing the same thing, feeling the same thing and responds to this, communication has truly begun.  This is real communication because it is not a child just repeating what he or she has been told to say but rather a moment of genuine social interaction.