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Autism and Eye Contact

therapist and child playingLately I have been reading a lot of discussion about Autism and eye contact and during Emma’s Occupational Therapy it reminded me of this discussion.  Emma’s therapist was trying to explain the game of dominos.  Emma was sitting there with little expression and also not responding.  I asked Emma if she understood and her therapist prompted her to “ask for help”.  Emma started moving in her seat and did not respond verbally with the prompt.  I knew that Emma finds it quite confronting, even with Steve and I, to ask for help so I was interested to see what would happen next.  The therapist then said to Emma that she does not have to look in her eyes but just to look somewhere near her face.  With that suggestion Emma looked and asked for help.

This interaction reminded me about a post I say on Autism Discussion Page about eye contact.  I know for Emma eye contact causes anxiety and there has been some recent discussion about why we really prompt a person with an Autism Spectrum Disorder to make eye contact if it makes the person feel vulnerable?  Yes it is a “social” cue that we all learn but is it necessary?

Bill Mason discussion about Prompting Eye Contact is:

The best way to induce anxiety in children with autism is to prompt them to look at you. When many children are trying to listen to what you are saying, prompting them to look at your eyes will make them anxious and interfere with them being able to listen to you. There are three primary reasons for this:

1. Many children have auditory processing problems. Research has shown that people on the spectrum often look at your month. This would make since if they need to look at your month to better understand what you are saying.

2. Some children use peripheral vision to view things. For them, direct vision is too intense and overwhelming, so they look with their peripheral vision. When they are looking at you, they will appear to be looking away from you.

3. Many adults on the spectrum have told me that they become overwhelmed by the intensity of looking directly into your eyes. It feels very intimidating, very scary.

So forcing a child to look at you is not increasing their understanding, but often inhibiting it. It totally overwhelms and distracts them.

Like most all of us, looking at someone is much easier when we do it under our own volition. It is intimidating when someone prompts us to look at them. Same goes for all communication. We have found that children with ASD will look at you more frequently when indirectly invited to, not told to. Use the following tips and you find the child looking at you more often:

1. When talking to the child, position yourself so you are in front of him and at eye level. When your face is in his field of vision, it will get his attention better.

2. Use less words and more nonverbal language when communicating. Use more animated facial expressions, and exaggerated gestures to communicate. This invites the child to reference your face to obtain the information needed. Use words to augment your nonverbal language; while conveying most of information nonverbally. I animate my facial expressions which draws their attention.

3. When the child stops referencing you, try pausing briefly until he attention returns. Often the break in the interaction invites the child to check back with you to repair the breakdown.

So invite facial referencing, do not demand eye contact. And please do not grab and turn their face to you.

What is your thoughts about getting individuals with autism to make eye contact?