Eye Contact in Autistic Children: What and What not to do?

Speech Therapy
Eye Contact in Autistic Children: What and What not to do?

“Can eye contact be overlooked, when it is a component of prelinguistic skills?”

“What methods can I use to improve a child’s eye contact?”

These are some of the frequently asked critical questions by therapists and parents. In this blog I aim to help you understand:

  • Why is there so much emphasis on eye contact?
  • Why do autistic children find it hard to make eye contact?
  • What are the current research findings?
  • Will an autistic child be able to maintain eye contact at all?

 

To start with let us understand the importance of eye contact. I have listed at least five of them here for you in the context of social communication and interaction.

  1. Helps the child understand if the other person is looking at him or her.
  2. Direct eye contact with the speaker facilitates the anticipation to be taught or told to do something.
  3. It helps follow the speaker’s gaze and referential pointing - in other words, look at what the speaker is looking at or where they are pointing.
  4. Activates fast and automatic facial processing which helps in social communication. Basically, it helps identify the emotions and interests of other people.
  5. Has an overall positive impact on arousal and motivation.

So many benefits of eye contact, right? This is why clinicians often work on eye contact by sticking stickers or wearing masks on their faces or other strategies.

Unfortunately, we aren’t taught the underlying neural mechanisms that make it hard for our kids to give the desired eye contact.

Firstly, many autistic children use PERIPHERAL vision which makes the world around them appear fragmented. Consequently, it can be difficult for them to centrally focus and look at you during a conversation; and

Secondly, our facial expressions are dynamic and unpredictable which can increase anxiety levels in autistic children.

Recent research findings show a direct correlation between eye contact and increased subcortical pathways' activation (Hrish et al., 2022). This results in elevated anxiety levels, which can further lead to fear and problem behaviours in autistic children.

It is not true that autistic individuals don’t want to make eye contact or they are not interested in people; rather, it is a way to decrease unpleasant excessive arousal stemming from overreaction to the subcortical system that they prefer not to look into the eye.

This is why I say, working directly on a child’s eye contact must be avoided. Instead, we ought to engage meaningfully with our autistic children on what deeply motivates or interests them. This builds a sense of relatedness and give us their trust. When we become safe stimuli or people who are non-threatening, we eventually become their INTEREST. When we become their interest, they may even begin to look at us!

Eye contact must not be the goal or end result, rather building a relationship with the child must be.

 

By,

Chitra Thadathil

Speech Language Pathologist

Founder & Director

Dimensions Centre for Child Development

 

 

 

References

  1. Hadjikhani, N., Åsberg Johnels, J., Zürcher, N.R. et al.Look me in the eyes: constraining gaze in the eye-region provokes abnormally high subcortical activation in autism. Sci Rep 7, 3163 (2017). https://doi.org/10.1038/s41598-017-03378-5.

 

  1. Hirsch J, Zhang X, Noah JA, Dravida S, Naples A, et al. (2022) Neural correlates of eye contact and social function in autism spectrum disorder. PLOS ONE 17(11): e0265798. https://doi.org/10.1371/journal.pone.0265798

 

 

 

 

 

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