Pointing and Autism: Understanding the Connection

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Pointing is a part of everyday life. Almost everyone uses their fingers to point to something they want or a direction they need to head. It’s an essential part of child development as it helps children learn important nonverbal communication skills.

Struggling with finger-pointing gestures can be common for children who may be on the autism spectrum and may be an early sign. However, there are ways parents and caregivers can teach their autistic children how to effectively use finger-pointing to communicate.

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What does pointing mean?

In its simplest use, finger-pointing is a universal gesture that can communicate wants, desires, and needs or draw someone’s attention. My son can’t speak, so he often uses finger-pointing gestures to let me know when he wants a snack or drink. He may also point outside to let me know if he wants to go out to play or go for a ride in the car.

It’s one of many effective communication skills that help people relay information when they can’t speak or think of the correct word to describe a situation. There are two main types of finger-pointing gestures: declarative pointing and imperative pointing.

Declarative pointing

Children may use declarative pointing for joint attention. They may try to draw their parent’s attention to a desired object, like pointing to a plane when they see it in the sky. It’s often used to share excitement, interest, and information about a subject.

Child pointing to something in the distance https://www.autismparentingmagazine.com/pointing-and-autism/

Imperative pointing

This is when a person points to a desired object in hopes of obtaining it. When my son points to a snack or towards the outside to play, it is an example of imperative pointing because he wants me to help him get something he wants.

Pointing as a developmental milestone

Pointing is considered one of the most significant milestones of the first year of child development. Most children begin index finger pointing around 12 months to 18 months old. 

Finger-pointing is usually one of the first communicative intentions in typically developing children.

There are three main reasons children point in early development. These reasons include:

  • Communication – This is a way for the child to express interests, engagement, and curiosity.
  • Joint attention – When children and parents pay attention to the same object, children may use a pointing gesture to learn and build relationships.
  • Labeling objects – Children may point to an object so adults can label it. This allows them to learn the words as they develop verbal communication skills.

Pointing with autism spectrum disorder

Pointing gestures can be important in helping recognize early potential signs of autism spectrum disorder. A lack of pointing is often associated with a potential autism diagnosis.

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When my younger son was being screened for autism, one of the tests involved pointing. While I’ve demonstrated how he uses imperative pointing, he still doesn’t point in a declarative manner, and we are more than seven years beyond his diagnosis.

While it’s clear that a lack of a finger-pointing gesture by nearly 18 months can be a sign of autism, it should be noted it’s not a definite sign, so screenings will need to be done. 

Regardless of diagnosis, there are ways to teach your child how to point their fingers to communicate with you.

Ways to teach pointing to children with autism spectrum disorders

If your child with autism spectrum disorder struggles with gestural communication, like finger-pointing, there are ways you can teach them to point for communication.

There are six ways to teach index finger pointing to children:

  • model pointing,
  • shaping pointing,
  • games,
  • making choices,
  • behavioral reinforcement, and 
  • diverting emotional responses.

Model pointing

This is when a parent teaches their children with autism when and how to point. Parents point in front of children in meaningful situations to teach them. Using the repetitive pointing gesture can help children with autism learn it as a new skill.

Shaping pointing

This type of pointing helps when the child uses their entire body to point. The adult will help the child develop finger-pointing gestures by physically helping them raise their arm and shape their index finger. This is best used when a child requests something and must be done often.

A parent holding their child's fingers https://www.autismparentingmagazine.com/pointing-and-autism/

Games

If your child is having trouble with the index finger pointing, games and activities can be used to encourage the gesture while making it a fun learning experience.

Some games can include trying to get the child to point out a part of their body, blowing bubbles and encouraging the child to pop them, or finger painting.

Making choices

You can encourage children with autism spectrum disorder to point by offering choices and asking which they want. This is something I was able to do with my son to encourage imperative pointing.

This option can be used with both model and shape-pointing guidelines. It can also foster decision-making, which is another area where children with autism may struggle.

Behavioral reinforcement

Children require regular reinforcement for many behaviors, including pointing. This is true whether they are on the spectrum or are typically developing children. Reinforcements can require quick responses so the child knows pointing gestures help them communicate.

Diverting emotional responses

If a child is having an emotional response, it may be necessary to divert them so they can communicate meaningfully. This can include pointing gestures as an effective form of nonverbal communication when emotions may make it harder to use their words.

Other ways to support communication development in autistic children

As your autistic children continue to develop, you may need to support other forms of communication beyond pointing gestures. They may continue to struggle with language development, much like my son has, but these methods can help address their issues.

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Pretend play, visual supports, the picture exchange communication system or PECS, and social stories can help your child as they develop language skills.

Parents can also enroll their children in speech and language therapy to help address their communication needs.

My son attends speech therapy weekly, and the therapist works with him using an AAC device to mimic words for him. This has led to increased index finger pointing as he needs to use his finger to press the correct button on his device.

Lack of pointing as a key to early intervention

Not pointing by the age of 18 months could be an early sign of autism, but knowing this can help parents get early intervention for their child and possibly lead to an early diagnosis. Working with your children with autism sooner can help them effectively communicate verbally and nonverbally.

If you think your child may be missing important milestones or may be on the spectrum, seeking professional help may ease your mind. These professionals can help you recognize what milestones may be missed and guide you to important screenings that can lead to a diagnosis.

You are your child’s biggest and most important advocate. Recognizing these signs can help you get them the assistance they need.

FAQs

Q: Can a baby point and still be autistic?

A: While a lack of pointing can be a sign of autism, it is not a definitive one. Children with autism can point, and neurotypical children can experience a lack of pointing.

Q: At what age does autism show?

A: Many children with autism begin showing symptoms between 12 months and 18 months old. However, some start showing signs as late as 24 months old. Despite these early ages for showing signs, the average age of diagnosis in the United States is five years old.

Q: Can you tell if a baby has autism?

A: While it’s impossible to tell if a baby definitely has autism, there are signs to watch out for that may indicate autism spectrum disorders. These signs include avoiding eye contact, not responding to name, repetitive movements, not smiling, and delays in motor development, language, and nonverbal communication.

Q: What are autistic hand gestures in babies?

A: Babies with autism may use certain hand gestures, including hand flapping, wiggling, wrapping, or tapping. There’s also a hand gesture known as bird wings, where the child will bend their elbows while letting their hands hang loosely beside them. It is called bird wings because it resembles a bird taking flight.

Resources

Camaioni L, Perucchini P, Muratori F, Parrini B, Cesari A. The communicative use of pointing in autism: developmental profile and factors related to change. European Psychiatry. 2003;18(1):6-12. doi:10.1016/S0924-9338(02)00013-5 https://www.cambridge.org/core/journals/european-psychiatry/article/abs/communicative-use-of-pointing-in-autism-developmental-profile-and-factors-related-to-change/1071C131F38E17B5FCBAAA99C3CD08FD

Sansavini Alessandra , Guarini Annalisa , Zuccarini Mariagrazia , Lee Jessica Zong , Faldella Giacomo , Iverson Jana Marie. Low Rates of Pointing in 18-Month-Olds at Risk for Autism Spectrum Disorder and Extremely Preterm Infants: A Common Index of Language Delay? Front. Psychol., 09 October 2019, Sec. Developmental Psychology, Volume 10 – 2019 – https://doi.org/10.3389/fpsyg.2019.02131

Zhiyong Wang, Kai Xu, and Honghai Liu. 2019. Screening Early Children with Autism Spectrum Disorder via Expressing Needs with Index Finger Pointing. In Proceedings of the 13th International Conference on Distributed Smart Cameras (ICDSC 2019). Association for Computing Machinery, New York, NY, USA, Article 24, 1–6 https://doi.org/10.1145/3349801.3349826

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