Eye Contact Should Feel Good for Kids with Autism

This morning during a training session with therapists, I led a discussion about the nuances of teaching “eye contact” to our autistic student. We came to three important conclusions:

1) Eye contact should not be so narrowly defined as only eye-to-eye contact.

Instead, children with autism should be encouraged to look at and to watch a person’s entire face including their mouth, eye brows, nose and other facial features.

In many therapies, students are expected to look directly into therapists’ eyes on command: “Look at me. Look.” A child who looks up at their face but not exactly into the therapist’s eyes will not be praised and will often be physically guided to do so. The problem with this narrow perspective is that it is not necessarily natural, even for typically developing toddlers. Especially for children 0-3 years old, while they most definitely seek and track other’s eyes, and especially those of his parents, they also spend a good amount of time studying other facial features Importantly, toddlers and infants learn about communication and language production by watching mouths, eye brows and hand gestures all of which provide information about the nuances of the dialogue. Speech and language pathologists will confirm that a good portion of language is learned by watching and imitating mouth movements. By limiting or forcing a child with autism to look only directly at eyes, we are limiting/ inhibiting/ slowing down their communication learning and language acquisition.

2) Eye contact should not be forced or physically manipulated

Instead, you should make a positive association between eye contact and having autonomy/ control along with a positive relational experience.

When a therapist holds a child’s chin turning his head to make the child look at her, the child loses his autonomy. He is controlled rather than being in (his own) control. He may have a negative experience, having his chin moved against his will, that becomes associated with making eye contact. The next time eye contact is requested, the negative associations of losing control and being physically forced may be triggered. This is behavioural science 101. Avoidance is sure to follow.

When a therapist withholds an item that a student wants, perhaps up by his eyes, to force the student to look then eye contact has been ‘manipulated.” Getting what is wanted is made conditional on looking at the therapist. The child learns that giving what is wanted to someone else can be used as leverage to get something you yourself want. (Giving freely as a kindness and courtesy is not a part of this system unfortunately.) Since making eye contact and observing others is a behaviour / a habit that can be extremely beneficial for a student to learn by, it is in the therapists’ and students best interest to encourage children with autism to enjoy looking at others simply out of curiosity and interest – observing just to watch, to see what is happening, to understand…not only when an adult is forcing or manipulating them to do so.

3) Eye contact should not only be associated with demands and reprimands.

Instead, a child should experience as many occasions as possible of looking at another person’s eyes and face and feeling loved, accepted and praised.

Like a teeneager walking into the house after school who avoids contact with his parents’ eyes knowing if he looks at them they’ll ask him about the chores he hasn’t done, children with autism learn early on that eye contact with an adult is associated with a demand. “Look at me so I can ask you to do something.” I have observed dozens of therapy sessions where eye contact between the child and therapist is only ever associated with either a demand or with the child being reprimanded and judged. “Look at me when I’m talking to you! Don’t do that again!” Given this association, it is easy to understand why the students don’t generalize looking more often at others outside of therapy sessions.

Of course we want a child’s attention when we are talking about important and serious stuff. But we should equally engage eye contact and observation behaviour when we are communicating affection, praise, positive affirmations, and love. Ask you child or student with autism to look at you and immediately smile. Don’t make a request or demand of them to smile back or to answer a question. Just let them see you smiling. Invite them to look a little bit longer than usual. Allow them time to become interested in your smile, your lips, teeth, and eyes. If they do look for longer than usual, praise them for their interest. Again, don’t make a demand, simply celebrate and acknowledge the eye contact that you received. Do this over and over many times a day. This will establish many positive associations between eye contact and other people’s faces.