Autistics & eye contact (it’s asynchronous)

Eye contact & neurotypical social norms

Many non-autistics are “obsessed” with eye contact. In fact, some even consider it to be the most important aspect of social communication.^[1]Gaze and eye contact: A research review (Kleinke, 1986) Based on research and anecdotes, here are some reasons why reciprocal eye contact is meaningful to allistics:

• It shows the other person you are interested, actively listening, and paying attention to them^[2]Human social attention: A new look at past, present, and future investigations (Birmingham & Kingstone, 2009)
• It can foster trust and build social connection with the other person, a mechanism that begins in infancy^[3]The role of eye-to-eye contact in maternal-infant attachment (Robson, 1967)
• It provides useful information about the other person’s feelings and thoughts^[4]Neural bases of eye and gaze processing: The core of social cognition (Itier & Batty, 2009)
• It is a way to share strong feelings like love and affection with another person^[5]Looking and loving: The effects of mutual gaze on feelings of romantic love (Kellerman et al., 1989)

Additionally, eye contact is effortless for allistics in most situations and doesn’t cause distress. Reciprocal eye contact seems to be a natural form of non-verbal communication.

It is also important to consider that these views are predominant in Western neurotypical culture, but they are not universal. For example, East Asian cultures do not engage in as much eye contact as Western cultures. In Japan, an individual who engages in eye contact can be perceived as angrier, unapproachable, and unpleasant.^[6]Attention to Eye Contact in the West and East: Autonomic Responses and Evaluative Ratings (Akechi et al., 2013)

Since eye contact is often seen as such an influential component of non-verbal communication, it tends to get a lot of attention within autism research and diagnosis.

Why is eye contact different for autistics?

For many autistics, reciprocal eye contact is the opposite of natural or effortless. In fact, when we engage with it, it is a very deliberate act and can often cause us distress. This is because the majority of autistics experience eye contact as a form of hyperarousal. We often describe it as:^[7]How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts (Trevisan et al., 2017)

1. Experiencing an adverse reaction: We feel fear, anxiety, pain, threat, etc.
2. Feeling invading: It can feel violating, overly intimate, etc.
3. Causing sensory overload: It’s too intense or overwhelming, there’s too much visual information, etc.
4. Socially confusing: It feels awkward, unnatural, embarrassing, difficult to interpret in the other person, etc.

Researchers have tried to summarize these findings into more comprehensive categories. Here are the most prominent theories:

Gaze aversion

This theory is based on the aversive experience associated with eye contact. It explains that we deliberately avoid eye contact to prevent experiencing the negative feelings caused by eye contact, like anxiety.^[8]Affective response to eye contact and face recognition ability in children with ASD (Joseph et al., 2008)^[9]Affective-motivational brain responses to direct gaze in children with autism spectrum disorder (Kylliäinen et al., 2012)^[10]How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts (Trevisan et al., 2017)

The gaze aversion model is supported by studies that find that when looking at eyes, emotion-processing regions of the brain, such as the amygdala, are more active for autistic individuals compared to neurotypicals.^[11]Gaze fixation and the neural circuitry of face processing in autism (Dalton et al., 2005)^[12]Look me in the eyes: constraining gaze in the eye-region provokes abnormally high subcortical activation in autism (Hadjikhani et al., 2017) One study also showed that autistic children show more arousal when directly looking at faces compared to neurotypical children.^[13]Skin conductance responses to another person’s gaze in children with autism (Kylliäinen & Hietanen, 2006)

Social motivation

The social motivation model^[14]The Social Motivation Theory of Autism (Chevallier et al., 2012) (also known as the hypoarousal model) suggests that due to our neurology, autistics do not find facial social information as “rewarding” as neurotypicals do.^[15]Reward processing in autism (Zeeland et al., 2010)^[16]How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts (Trevisan et al., 2017) It is thought that through experiencing the positive social experiences associated with eye contact, neurotypicals learn to seek out more eye contact. This learning is driven by brain activity in the amygdala and other brain regions that process faces. Some studies have found that in autism, since the amygdala does not respond the same way, our brains don’t learn to make the same strong associations between eye contact and positive social interactions.^[17]Social interest and the development of cortical face specialization: what autism teaches us about face processing (Grelotti et al., 2002)^[18]Developmental deficits in social perception in autism: the role of the amygdala and fusiform face area (Schultz et al, 2005)^[19]Abnormal ventral temporal cortical activity during face discrimination among individuals with autism and Asperger syndrome (Schultz et al., 2000)^[20]Experimental manipulation of face-evoked activity in the fusiform gyrus of individuals with autism (Perlman et al., 2011)^[21]Face processing occurs outside the fusiform ‘face area’ in autism: evidence from functional MRI (Pierce et al., 2001)^[22]Understanding the nature of face processing impairment in autism: insights from behavioral and electrophysiological studies (Dawson et al., 2005)

Mind-blindness^[23]Mindblindness: An essay on autism and theory of mind (Baron-Cohen, 1997)

Since eye contact is not natural for autistics, many of us may not know what sort of information we can get from engaging in eye contact.^[24]How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts, Trevisan et al., 2017) The classic view of this theory touches upon the belief that autistics lack empathy or theory of mind. My interpretation of this theory is that it’s another instance of the double-empathy problem. Autistics don’t typically use eye contact as a means to advance social interactions and gather information thus we can fail to see why it might be useful. On the flip side, neurotypicals depend on eye contact to build social connections thus assume that our difficulties in social interactions can partly be explained by our lack of eye contact.

Audiovisual integration

One major issue with the above theories is that they don’t account for the sensory overwhelm many of us experience during eye contact. Based on their interviews with autistic individuals and their own take of the scientific literature, one study proposed an additional audiovisual integration theory.^[25]How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts (Trevisan et al., 2017) They suggest that during conversation, the combination of auditory (verbal conversation) and visual (facial/eye contact) information is too much to process at once and can lead to sensory overwhelm.^[26]Sensory integration and the perceptual experience of persons with autism (Iarocci & McDonald, 2006)^[27]Audiovisual speech integration and lipreading in autism, Smith & Bennetto, 2007)^[28]Multisensory temporal integration in autism spectrum disorders (Stevenson et al., 2014)^[29]First-hand accounts of sensory perceptual experiences in autism: a qualitative analysis (Jones et al., 2003) Autistics improve our information processing and save our energy when we reduce the amount of sensory information we receive by avoiding eye contact.

How is eye contact different for autistics?

Eye contact research methods

There is a common misconception that all autistics avoid eye contact all the time and that this explains many of the reasons we struggle with social interactions. This belief may exist partly because research is predominantly being conducted in laboratory settings and with children, and we measure eye contact based on how much we look at a picture of a face. More recently, there has been a push to improve the validity of eye contact research by using realistic scenarios, such as measuring eye contact during a real interaction between two people.^[30]How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts (Trevisan et al., 2017)^[31]Investigating social attention: A case for increasing stimulus complexity in the laboratory (Birmingham et al., 2012)^[32]Neural correlates of eye contact and social function in autism spectrum disorder (Hirsch et al., 2022)

One new study using real social interactions actually found that there is no difference between the gaze of neurotypical and autistic children! They further showed that, unlike popular belief, shared gaze does not relate to shared attention.^[33]Children with ASD establish joint attention during free-flowing toy play without face looks (Yurkovic-Harding et al., 2022) Another study using live interactions in adolescents showed that autistics respond to eye contact with real faces differently than with pictured faces.^[34]Attention to live eye contact in adolescents with autism spectrum disorder (Kikuchi et al., 2022) These newer studies call into question whether scientific literature actually understands how eye contact functions for autistics and how it compares to neurotypical eye contact.

In fact, other recent findings show that many of us do engage in eye contact, but the major difference is that our eye contact is asynchronous.

Asynchronous eye contact

Research in non-autistics shows that when two people converse, their eye contact periodically synchronizes, signifying shared attention.^[35]Eye contact marks the rise and fall of shared attention in conversation (Wohltjen & Wheatley, 2021) In contrast, autistics don’t usually sync eye contact. For example, to reduce sensory overload, many autistics will make eye contact when talking, but not when listening. One explanation for this pattern of behaviour is that due to sensory overload, it is more difficult to concentrate on auditory information while also looking at someone’s eyes.^[36]How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts (Trevisan et al., 2017)^[37]First-hand accounts of sensory perceptual experiences in autism: a qualitative analysis (Jones et al., 2003) As one study points out, this is particularly detrimental to interactions with neurotypicals because eye contact is most socially expected when listening.^[38]How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts (Trevisan et al., 2017)

Asynchronous neural activity

This asynchronicity also applies to our brain activity. For two neurotypicals performing eye contact, a region of their brain–the dorsal parietal cortex–syncs activation patterns. In contrast, the dorsal parietal cortex in autistic individuals does not sync activity.^[39]Neural correlates of eye contact and social function in autism spectrum disorder (Hirsch et al., 2022) Interestingly, this reduction in neural activity seems to correlate with the social differences listed in typical autism diagnosis measures. The more a study participant identified with diagnostic traits relating to social communication and social interaction, the less neural activity they found in the dorsal parietal cortex.

These results imply that eye contact in autism is fundamentally different than in non-autistics—both behaviourally and neurologically. Therefore, it makes sense that eye contact is included in the diagnostic criteria for autism. It is listed under “deficits in nonverbal communication.”^[40]American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA (American Psychiatric Association, 2013)

Alexithymia and eye contact

Interestingly, alexithymia appears to be another factor that influences eye contact. You can read more about Alexithymia and autism in our Suffering from Alexithymia article but broadly speaking, alexithymic individuals struggle to identify and describe feelings and facial expressions. It is a common co-occurring condition for many neurodivergent conditions, with an estimate of 50% of the autistic population also having alexithymia.^[41]Investigating alexithymia in autism: A systematic review and meta-analysis (Kinnaird et al., 2020)

One theory is that the reason that eye contact is difficult for most but not all autistics is that alexithymia may mediate this experience. Research shows that irrespective of autism, alexithymia appears to play a role in avoidance of other people’s eyes.^[42]Looking at the eyes interferes with facial emotion recognition in alexithymia (Fujiwara et al., 2018) Specifically, alexithymic individuals show a reduced preference for facial eye regions, and increased focus on the nose and mouth.

Since alexithymia occurs in the general population at an estimated rate of 5%^[43]Investigating alexithymia in autism: A systematic review and meta-analysis (Kinnaird et al., 2020), this theory may also explain why some non-autistics also struggle with eye contact.

How does eye contact affect our social interactions?

The generalized bad news is, if you’re trying to engage with neurotypicals, not engaging in reciprocal eye contact can negatively impact those social interactions.^[44]The potential effectiveness of social skills groups for adults with autism, (Howlin & Yates, 1999) Since it’s considered a social norm, when someone avoids eye contact, there is often the assumption that the individual is not listening, not caring, not interested, or not wanting to connect with others.

The good news is, if you’re trying to engage with another autistic, most of us don’t adhere to these social norms and would rather not make eye contact with you either! Being able to communicate authentically is one reason why it is important for autistics to have neurodivergent relationships.

Eye contact & masking

If you have been masking your whole life, you may not even be aware that eye contact is uncomfortable for you until you realize that for most neurotypicals, there are no ”mental gymnastics” needed to perform eye contact. For example, here are some things that I do personally to engage in eye contact via masking:

• I look at someone’s eyes, count to 3, then give myself an “eye contact break” until I’m ready for another round
• I look at someone’s mouth/nose/forehead instead of directly at their eyes
• In a group setting, I choose the people that I am the most comfortable with and make eye contact with them but not with everyone
• I “blur my vision” or let my eyes go out of focus when I look at someone’s eyes

The thing that all these tricks have in common is that they are very calculated and deliberate. I consciously use these strategies and am hyperaware of how they are working. Even if there are times when I don’t find eye contact uncomfortable, it is still something that I am always conscious of.

Do you relate to any of these masking tricks? If you are a masker, what do you do to cope with forced eye contact? Or are you an autistic who engages in eye contact voluntarily?

Should we force eye contact?

Most of us have never been given the choice to decide whether we want to engage in reciprocal eye contact. Often, societal expectations decide for us. We were likely forced to “fix” our lack of reciprocal eye contact by our parents, caregivers, therapists, and teachers. This is especially true in childhood since interventions aimed at increasing eye contact is one of the main “treatments” for autism.

As a result, many of us have been masking and engaging in neurotypical eye contact our whole lives, even when it has led to negative consequences like autistic burnout. We can recognize the harm that interacting in inauthentic ways can cause us, especially when it’s forced, and we can also recognize that in a particular situation, masking may be the best choice for us to keep ourselves safe in the moment.

Above all, it’s important for us to promote inclusion and to support our fellow autistics who do not engage in eye contact. Embracing neurodiversity includes accepting all forms of communication styles. Here at Embrace Autism, we strive to create spaces where everyone is able to feel safe enough to communicate authentically—no eye contact necessary! /joke because this is a website so there are no face-to-face interactions.