Look me in the eyes

Eye contact is a powerful human behavior. Not only is vision by far our most dominant sense, its development in our evolutionary history is one of the key functions that sets us apart from other animals. From across the room, across the street, or across a field we can read a lot about someone’s intentions in a split second.  Friend or foe? Safe or Dangerous? Interested or disinterested?

John Medina in his book Brain Rules points out:  “As babies begin to understand cause and effect relationships, we can determine how they pay attention by watching them stare at their world. The importance of this gazing behavior cannot be underestimated. Babies use visual cues to show they are paying attention to something –even though nobody taught them to do that. The conclusion is that babies come with a variety of preloaded software devoted to visual processing.”

So when such an important part of being human doesn’t seem to be working properly, what’s up?

Eye contact has long been a hallmark of autism. This is partly because it’s one of the earliest signs of autism (and has spurred a generation of anxious new mothers staring into their infants eyes), but also because it’s a symptom of autism that’s easier for people to notice.  Eye contact is such an important part of human behavior that we quickly become aware when we are around someone who doesn’t engage in typical social eye contact.  It’s hard to read that person, it’s more difficult to understand their intentions. We may even start to think we can’t trust them or they’re not being truthful.

So if eye contact is part of our genetic history and maybe even a preloaded behavior before we are born, why do children and adults with autism often not use eye contact the way others do? This has been a question with lots of debate over the years.

Do people with autism tend not to look others in the eye because it is unpleasant or they are disinterested?

How we answer this question is important to how we understand autism and inform how we might go about treating it.

The “gaze-aversion” hypothesis suggests that individuals on the autism spectrum are generally uncomfortable with the amount of eye contact others make. Some older children and adults on the spectrum report that eye contact makes them nervous, anxious, or generally uncomfortable.  Said simply:  It feels weird, so they don’t do it.

Alternatively, the “social disinterest” hypothesis speculates that individuals with autism neurologically have less need or desire for social interaction and thus are not interested in looking others in the eye and communicating on this kind of social level.  Said simply:  Connecting with you is not high on their to-do-list.

It is important to note that there are many people with autism who would reject one hypothesis or the other (and sometimes both). As the saying goes, if you have met one person with autism you have met one person with autism. However, science is slowly providing some answers to these questions.

A study published last November used eye-tracking technology to study how toddlers use eye contact in social situations. The study compared children diagnosed with autism, children with other developmental challenges, and children on a typical developmental trajectory. The results found that the two groups not on the autism spectrum made eye contact that was correlated to the emotional content of the adult in the room. When the emotional energy warranted eye contact, the children tended to make eye contact.  The children with autism however, did not change their eye contact patterns based on the other person in the room or their emotional expressions. 

It seems that the toddlers with autism made eye contact when they wanted to and it didn’t much matter what the other person in the room was doing.

This would seem to suggest that eye contact differences may be more about social disinterest. Children with autism might not have the same needs for social interaction and the social interests they do have aren’t expressed through eye contact.

There’s lots more to be discussed about this- including the role of anxiety in autism and how that might contribute to discomfort with eye contact. Some have argued that changes in how we use eye contact are not evidence of a deficit but instead signs of changing times. When one considers how often we are looking into someone’s eyes versus a camera, phone, or some other digital device- perhaps our friends on the autism spectrum are a step ahead of the rest of us.

These findings should also encourage us to consider the many other ways love and connection are expressed between humans and to remember that expressing needs differently doesn’t mean the needs themselves don’t still exist.