Limited or no eye contact is one of the most common symptoms of autism.
The Centers for Disease Control and Prevention (CDC) lists avoidance of eye contact as one of the potential “red flags” that can signify autism. This behavior can begin in infancy and continue through adulthood.
Behavioral interventions that focus on social and communication skills related to autism can improve this important nonverbal communication skill. With consistent therapy, children can learn how to be more comfortable with eye contact.
Lack of Eye Contact: A Possible Early Indicator of ASD
Autism can be formally diagnosed between the ages of 18 and 24 months. While the diagnosis is typically not considered stable until age 2, parents may notice symptoms of autism in babies as young as 6 months old.
Babies often start out making eye contact, but research shows that babies who are later diagnosed with autism regularly lose interest in making eye contact. This interest often declines between 2 and 6 months.
A lack of eye contact in babies as young as 6 months old can be an indicator of autism. It is not the only indicator, however. It needs to occur along with other signs.
Other Signs of Autism
Early indicators of autism in babies include:
- Little eye contact.
- Limited or no babbling.
- No pointing.
- Few smiles.
- Lack of response to name.
- Obsessive interest or focus in specific objects.
Not all babies develop at the same rate, so some may show one or more signs of autism at a young age and then “catch up” to their neurotypical peers by age 2 or so. As a result, lack of eye contact can be a warning sign and potential indicator of autism, but it is not definite proof of the disorder. Other signs and symptoms will need to be present too.
Autism screening should be done during well-child checkups. Pediatricians will conduct these screenings at both the 18-month and 24-month exams.
The earlier autism can be recognized and diagnosed, and interventions can begin, the better the long-term outcome for the child. If you notice any of the possible signs of autism, including lack of eye contact, speak to your child’s doctor.
Eye Contact Issues Progress With Age
Toddlers and young children with autism are often indifferent to making eye contact. They struggle with social communication, including nonverbal means of communicating, like eye contact.
A lack of eye contact persists into later childhood. Children with autism prefer to play alone, as they often reject cooperative play. They typically have difficulties with many forms of age-appropriate communication and socializing.
Autism is a lifelong disorder, and issues with making eye contact can persist into adulthood. Adults with autism often find eye contact to be stressful and will avoid it as a result. Therapy can help to address this issue.
Other Reasons for Limited Eye Contact
Autism is not the only reason that people struggle with maintaining eye contact. Lack of eye contact can also be a sign of social anxiety.
Someone who is anxious around others, shy, or lacks self-confidence may struggle to meet the eyes of other people. Stressful situations can also make individuals less likely to want to keep their heads up and look into someone’s eyes.
If you recognize eye contact as an issue for your child, take note of whether it is situational or if it something that persists all the time. Talk to your child’s doctor about your concerns.
Improving Eye Contact & Nonverbal Communication Skills With Therapy
With early interventions, including speech and language therapy, applied behavior analysis (ABA), and occupational therapy, children with autism can learn how to improve both verbal and nonverbal communication skills.
Studies show a potential neurological reason that eye contact is so difficult for people with ASD. Because of this, it is not ideal to try and “force” an autistic child to look into your eyes. Instead, behavior therapy can help to slowly and carefully build up a tolerance to eye contact and teach children that it is not as aversive as it seems.
ABA is an intervention that uses positive reinforcement to encourage specific behaviors. This can be helpful when teaching children the social implications and benefits of eye contact.
A therapist can gradually encourage the child to make eye contact, and then increase the duration of that contact over time. The therapist will reward the child for this positive behavior.
Behavior therapy can also teach families effective ways to communicate that are less stressful and support social growth.
While it might always be somewhat uncomfortable for a person with autism to make direct eye contact, therapy can greatly improve their ability to do so. This can help the person to succeed in adulthood in situations that require eye contact, such as job interviews.
- Signs and Symptoms of Autism Spectrum Disorder. (August 2019). Centers for Disease Control and Prevention (CDC).
- Autism Spectrum Disorder Fact Sheet. (March 2020). National Institute of Health (NIH) National Institute of Neurological Disorders and Stroke.
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- Eye Contact Is Aversive for Some Adults With Autism. (May 2017). Spectrum.
- Why Is It Hard for People with Autism to Make Eye Contact? (July 2015). Autism Speaks.
- Inability to Make Eye Contact: Autism or Social Anxiety? (February 2019). Psych Central.
- Why Do Those With Autism Avoid Eye Contact? (July 2015). Massachusetts General Hospital.
- Toddlers With Autism Don't Avoid Eye Contact, but Do Miss Its Significance. (November 2016). Emory Health Services.
- Unconscious Avoidance of Eye Contact in Autism Spectrum Disorder. (October 2017). Scientific Reports.
- Using Shaping to Teach Eye Contact to Children With Autism Spectrum Disorder. (May 2018). Association for Behavior Analysis International.