• One-year-old Tommy is playing with his hands. His mother gently touches the back of his hands and imitates his movements so he can feel it, which communicates, "I see you playing with your hands."
  
  
• Two-year-old Juan is pulling bells on a mobile. His sister touches his fingers and the bell, which communicates, "Let’s play together."
  
  
• Three-year-old Joanna is splashing in her bath. Her father puts his fingers under her hands and splashes, which communicates, "You’re splashing, that’s fun!"
  
  
• Five-year-old Derek is banging a drum. A friend places his hands right beside Derek’s so they are touching and bangs the drum, which communicates, " That looks like fun, can I do it too?"
  
  
• Seven year old Alexis is feeling the vibration of the dishwasher. Her mother puts her hand right beside Alexis’ so they are touching, which communicates, "The dishwasher is on. Can you feel it?"
  
  
• Ten-year-old Francisco is handling a large seashell. His teacher puts two fingers slightly under Francisco’s hand and feels the shell, which communicates, "Wow, this is cool! It's bumpy."
  
  
• Twelve-year-old Mai Ling is petting her dog. Her brother places his hand right beside hers and pets the dog, which communicates, "Can I pet Archie too? He is a good dog."

1. Many factors (e.g., age, physical and cognitive abilities, family culture and experience) will influence a child’s reaction to attempts to engage him or her in mutual tactile attention.
   
   
2. Mutual tactile attention requires sensitive, non-disruptive, and non-controlling touch that follows the child’s lead by focusing on what the child is doing.

• Mutual tactile attention enables a communication partner to demonstrate interest in what the child is doing in a way that the child can perceive.
  
  
• Mutual tactile attention can be used to expand the child’s level of participation in an activity by including additional actions and/or objects.
  
  
• Mutual tactile attention provides a foundation for the development of conversational turn taking.

• Mutual tactile attention may be uncomfortable for the communication partner and the receiver because of differences in their age, gender, relationship, culture, and experiences.
  
  
• The use of touch that is selected poorly or used inappropriately may startle, annoy, or confuse the child.
  
  
• Mutual tactile attention may interrupt the child’s focus on and involvement with the activity.
  
  
• What the communication partner is trying to communicate through mutual tactile attention may not be clear to the child.

• Begin by using the type of touch that the child prefers and is the least intrusive. For instance, if the child likes to play on the slide and accepts the sides of his hands being touched, then when he is sitting on the slide, put a hand beside his and keep it there while he slides down. This is communicating, "I see you sliding. You like it a lot."
  
  
• Touch an object that the child likes and is handling. Slide a finger under the child’s fingers as if to say, "I see what you’re doing. Can I join you?"
  
  
• Once the child has accepted your interaction and you are both engaged in the activity, introduce slight changes (e.g., you are both playing with play dough and poking your fingers in it, start making "a snake" by rolling it out with your hand right beside the child’s hand so they are touching).
  
  
• Use speech and/or tactile sign to name what you have touched or done together.
  
  
• Be careful not to control the child’s movements

Mutual Tactile Attention is a synthesis of information from the Project SALUTE’s focus groups, National Advisory Committee, staff activities, and a review of relevant literature such as the following bibliography.