Intersubjectivity

A meeting of the minds

Intersubjectivity has been identified as a universal deficit in individuals with ASD.  It is a scientific term used to describe the developmental process that children go through with their parents to begin to understand how to navigate the world.  Through this relationship, children learn to interpret and borrow their parent's perspective in thinking about day to day events and challenges.  They pay attention to and monitor how their parent analyzes, evaluates and reacts to changes in the world.  

Broken down, literally, the term "inter" is defined as happening between people and the term "subjectivity" is defined as one's unique thoughts, perceptions, feelings and memories. 

It is critical to look at typical development when addressing autism to identify where the child is on the developmental track. Developmental milestones are stepping stones to the next level.  Without the foundation in place, it will be impossible to move forward.   

There are five identified stages of intersubjectivity.  Primary intersubjectivity occurs between 3 and 9 months of age in typically developing children.  It can only be established once parent and child are able to engage in co-regulation.  The only goal is to establish an "us" where the child is both taking a role in an interaction and is invested and cares about his or her partner's reaction.  An example of this is a game of peek a boo. 

Peek a boo is a good example of primary intersubjectivity as the only reward for the child is the interaction.  A younger child would be less able to take on a physical role but is able to actively participate through smiling and cooing, providing the parent with the information needed to continue the interaction.  

Secondary intersubjectivity occurs between 9 and 15 months and is often referred to as the beginning of joint attention.  A more sophisticated process than the previous stage, the relationship moves from just "you and me" to "you, me and it."  During this stage, the child becomes interested in sharing and comparing subjective reactions to external objects.  Children are motivated to share experiences of what they see, hear, feel, taste and smell with their parents. 

This stage of development is critical for the child to begin to understand other people's perspectives and to later develop empathy, a characteristic often lacking in individuals with ASD.

The third level of intersubjectivity is yet more sophisticated as not only is the child successfully interacting and seeking parent's perspective about outside stimuli, but the child can also understands their partner's intended action.  This stage occurs between 15 and 24 months. Think of it as the time in a typically developing child's life where he or she becomes very motivated to help with chores around the house.  This is when a child will begin being intrinsically motivated to help parents as they are successfully able to figure out on their own what they would be able to do to be helpful in many different situations.

The forth level of intersubjectivity is a much more complex process. Children who are 24 to 36 months try to balance the way they are feeling about external things and how their parents feel about the same things.  Otherwise known to many as the terrible two's!  Before reaching this stage, if a parent says "Yuck!" to an object, a child who has learned to value and trust their parent's perspective will likely agree.  Once the child has reached stage four, they realize that they may feel differently and generate their own opinion.  They may look at the "yucky" object again and come up with their own decision as to whether or not it actually is yucky. 

Parents of neuro-typical two year olds can tell you that it becomes very evident when a child reaches this stage.  They no longer take mom and dad's perspective without question.  Children begin to challenge opinions as well as limits and are often very expressive about their own opinions.  Although difficult, it is important for parents to understand what an important developmental stage this is.

Often times in an RDI program, as the child moves through the intersubjective stages, parents are able to determine the difference between the child tantruming to avoid uncertainty, which we often see in autism  and tantrums that are developmentally appropriate and indicate an understanding of self and others.

The fifth stage of intersubjectivity is the ability of a child to integrate experiences over time.  So what does that mean? This is the stage that all parents of a child with ASD long for.  It is a conversation with another person about a past experience and planning for the future.  It is about reminiscing, not only about the event but the feelings associated with it.  The feelings of oneself and others as well and how they relate to one another.  An example would be, "Wasn't it so funny when John tripped over Tara's bag on the bus?  He got so mad at her.  I kind of felt bad for laughing because he was so mad, but he didn't get hurt so it was funny." 

In stage five, children are able to take their previous experiences and apply them to plans for the future.  All the children that witnessed the above example will be more mindful of other people's bags in the aisle as well as being sure to remove their own.  This type of thinking occurs so quickly, we often don't even notice it is happening. 

Many parents, when thinking about their child with ASD want to start here.  They want their child to be able to tell them about their field trip in school.  We can teach a child to provide a rundown of what happened from beginning to end but if the child is unable to integrate his or her feelings as well as other people's feelings and perspectives, we are only compensating for the child's lack of ability in this stage of development.  It is critical to look at the previous stages of intersubjectivity before expecting this level of understanding about conversations and relationships from a child with ASD. 

The good news is this can be restored.  Parents need to be aware and understand that this is a primary deficit in autism.  If the therapy you choose for your child does not address this or merely seeks to compensate for areas where your child is lacking, you should be actively seeking ways to incorporate this developmental process into your child's life.