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A Brief Review
There are many myths and stigmas around eye contact in relation to autism. Many caregivers have heard from professionals, friends, or family, “Your child makes eye contact, so they do not have autism.” This observation alone is not always a viable screening measure, and identifying if a child or adult meets the criteria for autism is actually much more complex. Eye contact itself can be complex.
When evaluating someone for autism, how eye contact is used is more important than whether or not it is used. This is referred to as “modulating eye contact”. Oftentimes, even when a child makes eye contact with a caregiver, the caregiver feels that meaningful socioemotional messages are not conveyed (Stewart, R). Psychologists closely observe how eye contact is paired with language and other social skills during an evaluation. In combination with assessments such as the Autism Diagnostic Observation Schedule- Second Edition, reviewing developmental history, previous reports, and examining social interactions, the quality of one’s eye contact is then considered to help determine if an autism diagnosis is appropriate.
Different qualities of eye contact can include:
Duration: Eye contact is present, but it is either prolonged or too brief for the situation.
Indirect Focus: Eye focus is on another part of the face, typically the nose or forehead, instead of direct eye-to-eye contact.
Feature Curiosity: Eye contact is present, but the intention is to fixate on a facial feature or object around another person’s eyes that fascinates them on the face, such as a pair of glasses.
Instruction Following: Eye contact is present, but it is strictly used to follow a request from an authority figure rather than it being a natural behavior. Caregivers may teach a child to maintain eye contact for social politeness.
Just as the presence of eye contact does not rule out autism, a lack of eye contact does not guarantee that someone is autistic. If a child is not making eye contact, it is important to consider other cultural components, anxiety, and any other factors that may play into an aversion to, or difference with, eye contact.
Many caregivers wonder if interventions for poorly or inconsistently modulated eye contact are needed for autistic individuals to be successful. “Treatments” or therapies are not always necessary and may depend on how their eye contact impacts daily living or social skills. Further, asking an autistic child to make eye contact or to work on certain “atypical” aspects of their interactions is a controversial issue. Unfortunately, many autistic individuals encounter demands to follow “typical” social communication standards, such as making eye contact, from the time they start school, authority figures often associate a child not making eye contact with them and not paying attention. Many times, autistic individuals are reprimanded for this have reported these instances as a persistent cycle of exhaustion.. Some autistic adults report that, after learning more about social expectations over time, including eye contact, they now choose to make an effort to use it despite it not being their first instinct to do so. Others report that they have grown to feel more comfortable with making periodic eye contact. On the other hand, some autistic children and adults report that when they are told or forced to make eye contact, it is physically painful or overstimulating (Stewart, R).
Identifying the differences in eye contact and whether or your child may be autistic can be overwhelming, especially when stigma, misinformation, and conflicting ideas are prevalent. Please contact us at (404)390-1322 if you have additional questions about eye contact and autism or wish to schedule an autism evaluation.
Stewart, R. “Should We Insist on Eye Contact with People Who Have Autism Spectrum Disorders?”. Indiana University Bloomington, Indiana Institute on Disability and Community. https://www.iidc.indiana.edu/irca/articles/should-we-insist-on-eye-contact-with-people-who-have-autism-spectrum-disorders.html#:~:text=Some%20folks%20who%20have%20autism,competencies%20in%20social%20situations%20increase.