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Should We Insist on Eye Contact with People who have Autism Spectrum Disorders
Contributed By Rozella Stewart
When and whether students who have autism spectrum disorders should be required to make eye contact is a controversial issue. It is possible to become very confused about this issue when one works with a number of different—usually very different—students who have autism.
Some people who have autism actively avoid eye contact and appear confused and anxious when it occurs. Some seemed to make eye contact relatively early but later reported they were actually looking at something that fascinated them (such as their reflection in one's eyeglasses). When cued "Look at me," some make eye contact that recipients experience more as a staring gaze than as a communicative exchange. Some gradually learn to make eye contact and to read simple meanings that they have come to understand through experiences with what happens to them when a particular person's eyes have a specific look.
Mothers often report that their family member who has autism watches his mother's eyes and, having had experience with certain looks before, anticipates what is coming next. Few mothers report having a sense of sharing mutually meaningful socioemotional messages through such encounters. Some folks who have autism gradually learn to think about social expectations around eye contact and to make an effort to use it periodically. Many appear to become more adept at making eye contact as comfort and competencies in social situations increase. Some report that their ability to make eye contact depends on context. For example, when an individual is comfortable and feeling relatively competent, he may be able to tolerate such exchanges. When in confusingly complex, overloading and other anxiety prompting situations, the same individual may overtly avoid eye contact. Some individuals appear to use eye contact from a young age; it is difficult to determine the extent to which those individuals are able to read subtle social messages that are typically conveyed via the eyes. Many seem to become more comfortable with eye contact, as well as better at reading some of the messages, over time. Few, it seems, report that eye contact ever becomes a really useful means for either receiving or sharing mutually understood messages. Few appear to feel confident concerning their abilities to read messages that may be conveyed via the eyes of various people in their lives.
In determining where we stand in the midst of ongoing controversy, it seems reasonable to consider what our purposes for expecting or "requiring" eye contact really are. Having defined our purposes, we need to ponder whether those purposes are best served by strategies that we employ.
Educators have been taught that it is essential to get individuals' attention before beginning instruction and to recapture attention to task when peoples' demeanors suggest that their attention is waning. To accomplish this task, teachers often first attempt to get attention by cuing "Look at me." They also often assume that they have individuals' attention when they "get eye contact" and that those who do not conform cannot be paying attention. Thus, when individuals who have autism seem to avoid looking into the eyes of teachers and others with whom they interact, the strategy that comes most naturally and is often pursued quite intently is the verbal cue "Look at me." If an individual who has an autism spectrum disorder fails to respond within what is viewed as a reasonable length of time, the cue may be repeated more forcefully. If the person still fails to look as directed, misinterpretations of why the person isn't "complying" may fuel futile power struggles that only frustrate everyone concerned and further thwart the abilities of individuals with autism to respond. Whether requesting eye contact is a wise approach to focusing attention depends both on the person who has autism and on circumstances surrounding the expectation.
Sometimes getting an individual to "make eye contact" becomes a high priority that falls under the rubric of "compliance and direction following" training. Individualized education programs often include objectives such as "will make eye contact when requested 80% of the time". Some goals and objectives seem to be stated in context of assumptions that students with autism spectrum disorders have sufficient understanding of social conventions to make routine judgments about where, when, and with whom eye contact is appropriate and expected and/or that they are consistently able to spontaneously initiate and selectively maintain eye contact in social situations. As an example, consider an objective that states, "Will increase eye contact when in social situations with peers. Student will make eye contact X number of times every 10 minutes when involved in shared activities." Folks who write and strive to achieve such goals and objectives may be as naive in their understanding and interacting with individuals who have autism as individuals with autism are naive at understanding and using social conventions. We need to re- examine assumptions that undergird choices among instructional/interactive strategies, to define purposes that we hope to accomplish, and to candidly assess whether hoped-for outcomes are being met. While attempting to maximize adaptive behaviors on the part of individuals who have autism spectrum disorders, we too must adapt when observed responses clearly indicate that our purposes are not being achieved.
A number of "higher functioning" folks who have autism have described difficulties with making eye contact. One of the more humorous explanations was shared over lunch with a brilliant, well- educated, 45-year-old man who has Asperger's Syndrome. With a mixture of cynicism, good humor and pleading for understanding, he discussed his difficulty with making eye contact, but even more to the point, with expectations that he "read" and respond to the subtle socioemotional messages conveyed via the eyes. In summarizing his message, he said, "If you insist that I make eye contact with you, when I'm finished I'll be able to tell you how many millimeters your pupils changed while I looked into your eyes."
Several individuals who have autism have described similar difficulties, if not such analytical approaches. Some candidly share exasperation with folks who insist on eye contact while demonstrating considerable ignorance concerning ways interactive sensory, motor, social and emotional anomalies impact one's abilities to orient and make sense of environments and expectations. People who have autism spectrum disorders have difficulty with reading even the most overt social cues in context. They have extraordinary difficulty with reading more subtle body language, including messages often conveyed via the eyes. In addition to difficulties with attending to and interpreting information that is embedded in social context, some have great difficulty with attending to and coordinating two sources of sensory input at once. For example, astute teachers often observe that a student with autism "looks out the window all the time, just doesn't appear to be paying attention at all, but then can tell me everything I said." It appears likely that the described student has difficulty with coordinating listening and looking behaviors and, perhaps, with receiving and processing information coming in from multiple sensory channels. Insisting that he make eye contact might well render him unable to take in and store auditory input. Or... he may be able to coordinate looking and listening in some situations but not in others. Educators who are relatively unfamiliar with autism are often understandably perplexed by inconsistencies evident in an individual's response patterns. There appears to be a natural inclination to assert that, "if he could do it in that situation, I know he can do it in the other...".
In fact, learning styles of students who have autism spectrum disorders, as well as of other students, vary tremendously across tasks. We adults often view dissimilar tasks as if they were similar or even the same. Once learning (change within the individual) has occurred, subsequent tasks, though they appear similar, are never the same. Learning builds on prior learning and each successive challenge occurs in context of change that has occurred in response to past challenges. Each subsequent learning task is assimilated in context of changed comfort levels, values, attitudes, and/or behavioral competencies affected by prior experience. Each new task, even though it appears similar to us, is likely to be perceived as a new challenge to a person who has autism. There are many reasons why we simply cannot assume that because an individual with an autism spectrum disorder did something a month ago, a week ago, or yesterday, he can also do it today. This "leap of faith", as opposed to efforts to better understand possible difficulties that the person may be having, too often characterizes attitudes regarding individuals' abilities to make eye contact either spontaneously or "on demand."
Figuring out how different individuals take in, store, coordinate, plan and execute behavioral responses, as well as what may detract from this process, and how they perceive the actions of others, involves both art and science. If we are lucky (and, hopefully, also skilled facilitators of learning), instructional efforts impact behavior in ways that render subsequent tasks and expectations easier than initial trials. Consider the individual who looks out the window with apparent disinterest (if not to "get someone's goat") but later demonstrates that he knows the basics of what was going on and has, indeed, memorized auditory input. Given familiarity and some acquired agility with the auditory information he has learned and having achieved greater comfort, he may (or may not) now be able to make eye contact in context of that familiar body of information for some individually idiosyncratic length of time. However, whether he intuits anything meaningful during that encounter is more than a rhetorical question. We don't know what he sees; we should probably suspect that messages he is reading, if any, are very different from those we think we are conveying.
|"Eye contact is something that I have always had trouble with. It does not come naturally to me and I do not appreciate having to give it all of the time, especially to people that I do not know. All of the stress that is put on doing it makes me more nervous, tense, and scared. Doing it also assumes that I can read the message in another person's eyes. Don't count on it! I can look at a person's eyes and not be able to tell what they are saying to me...|
|...as a child, my eye contact was much worse than it is right now. People without autism could not understand why I would not look them in the eye... just because I am not making eye contact with you does not mean that I am not listening to you or paying attention to you. I can concentrate better not having to keep eye contact at the same time. I tell people, 'You have a choice. Do you want a conversation or do you want eye contact? You will not get both unless I am comfortable with you and do not have to concentrate so much on the eye contact'."|
When developing strategies aimed at focusing and maintaining attention on the part of folks who have autism spectrum disorders, we need to consider idiosyncratic ways that individuals take in and process information. We need to recognize how conventional social expectations may, in fact, interfere with learning for some. Guiding individuals in focusing and engaging in tasks specifically related to the activity at hand is often more effective than trying to obtain attention through eye contact and then expecting that the person can quickly shift attention to a set of task-related stimuli. When, where, with whom, and whether to insist on eye contact with people who have autism spectrum disorders remains controversial. But... the need to define the purposes we wish to achieve through our instructions and expectations, and to assess (through individuals' responses) whether those purposes are being served is clear. Eye contact is a very social, almost intimate, type of interaction. When, whether, and why to insist that individuals engage in that exchange are questions that, to answer wisely, require ongoing scrutiny, understanding, and flexibility on the part of people who interact with folks who experience challenges common to autism spectrum disorders.
Bovee, J.P. (1999). My experiences with autism and how it related to "Theory of Mind" - Part 1. Advocate, 32(5), 18-19.
Stuart, R. (2000). Should we insist on eye contact with people who have autism spectrum disorders. The Reporter, 5(3), 7-12.