Autism, Eye Contact, Neurodiversity, Social Language, Speech Language Pathology

Teaching the Purpose of Eye Contact

“He doesn’t look at me when I talk to him”… One of the most common phrases we hear from parents or teachers when doing and autism evaluation. Goals for teaching eye contact are found frequently on Individualized Education Plans and this is often practiced by making cues (visually by pointing or a picture card, or verbally by saying “look at me”) over and over again in hopes of generalization. But I want to challenge you to take a step back beyond the isolated skill/action of looking at someone and determine why we even need eye contact in the first place.

What Is Eye Contact & Why Is It Important?

Eye contact is defined as the act of looking directly into one another’s eyes. It is one of the first skills a child masters, around the age of 2 months. By the time a child turns one year old, they should be using this skill to engage in and share information with others.

Eye contact is a nonverbal form of communication that helps the listener and speaker communicate what they are thinking about and feeling. It also helps up figure out what is happening around us.

Research has found many benefits with eye contact in building/maintaining relationships:

  • Eye contact plays a critical role in helping create strong parent-child relationships. (Mirenda et al., 1983)
  • Eye contact is a prerequisite of the development of Theory of Mind in early childhood.
  • Eye contact increases a persons willingness to complete a request. (Gueguen & Jacob, 2002)
  • Eye contact improves the accuracy and efficiency of completing multi-step tasks. (Clark & Krych, 2004)
  • Eye contact influences a listener’s perception of a speaker’s intelligence. (Murphy, Hall, & Colvin, 2003)

In children with Autism:

Ninety percent of children who do not develop joint attention (the ability to follow someone’s eyes to see what they are looking at and know what they are thinking about) by the age of one are diagnosed with autism (Jones and Carr, 2004- Thinking About You Thinking About Me). However many books and articles, and studies have described eye contacts as a stressor that often distracts them from the conversation. One research study even showed that looking at faces (particularly ones displaying intense emotions) overstimulate the subcortical brain (“Eye Contact May Overstimulate Brains of People With ASD” 2017).

Teaching a Child Eye Contact

I want to challenge you to get away from the “look at me” strategy and truly try to focus on the purpose of eye contact. Research has shown that combining social-cognition interventions is the best way to support children in becoming problem solvers and using the necessary social skills in a variety of settings (Nowell, Watson, Boyd, & Klinger 2019).

Before you begin: Observe. Do they show emotions through their eyes? Do they do “eye rolling” to show disinterest? Can they follow your eyes or do they need you to also point and say “look”? How often do they look to your face during a conversation?

Once you have an idea of where the child is at:

  1. Start by having the child observe their surrounding. Who is there? Where are they? Have them list the things he sees and notices.
  2. TEACH: Talk to the child(ren) about WHY we need eye contact. Tell them that their eyes have a job: to figure out what people are thinking and feeling.
  3. Have the child practice following the eye gaze of others. If this is difficult, first say “look” while you are looking at the object. If the child still can’t figure it out point them in the direction. Once the child is able to master this ask them what you might be thinking (e.g. If you are looking at the window you may be wishing you were outside playing).
  4. Practice sharing emotions through the eyes. Charades is a great way to play with this skill and using social scenarios is another option. Take turns having the child guess the emotion but also showing the emotion. A mirror may help with this!
  5. Talk about the differences in eye contact if you are the listener vs. speaker. Listeners need to remained focused on the speaker’s face so they show they are paying attention. However, the speaker can let their eyes move a bit, especially when they are trying to formulate their thoughts.
  6. Try out their new skills by looking at pictures and movie clips. Pictures will be easier because they are static. Have them look at the person in the picture/movie and identify what they are looking about and make guesses on their thought. If it’s a movie, continue playing the clip and see if they guessed correctly (yep! using this eye gaze is an important step to predicting).

This likely won’t speed up the process of the child learning eye gaze but hopefully you will find it deepens their true understanding of why we need eye contact. Teaching the purpose of the skill will make it more likely they will use eye contact across a variety of settings, instead of just with your or in the therapy room with no hopes of generalization.

References

  • Clark, Herbert H., and Meredyth A. Krych. “Speaking While Monitoring Addressees for Understanding.” Journal of Memory and Language, vol. 50, no. 1, 2004, pp. 62–81., doi:10.1016/j.jml.2003.08.004.
  • “Eye Contact May Overstimulate Brains of People With ASD.” The ASHA Leader, vol. 22, no. 10, 1 Oct. 2017, pp. 12–12., doi:10.1044/leader.rib2.22102017.12.
  • Guéguen, Nicolas, and Céline Jacob. “Direct Look Versus Evasive Glance and Compliance With a Request.” The Journal of Social Psychology, vol. 142, no. 3, 2002, pp. 393–396., doi:10.1080/00224540209603907.
  • Mirenda, Patricia L., et al. “Gaze Behavior: A New Look at an Old Problem.” Journal of Autism and Developmental Disorders, vol. 13, no. 4, 1983, pp. 397–409., doi:10.1007/bf01531588.
  • Murphy, Nora A., et al. “Accurate Intelligence Assessments in Social Interactions: Mediators and Gender Effects.” Journal of Personality, vol. 71, no. 3, 2003, pp. 465–493., doi:10.1111/1467-6494.7103008.
  • Nowell, Sallie W., et al. “Efficacy Study of a Social Communication and Self-Regulation Intervention for School-Age Children With Autism Spectrum Disorder: A Randomized Controlled Trial.” Language, Speech, and Hearing Services in Schools, vol. 50, no. 3, 12 July 2019, pp. 416–433., doi:10.1044/2019_lshss-18-0093.
  • Turkstra, Lyn S. “Looking While Listening and Speaking.” ASHA Wire, 1 June 2014, pubs.asha.org/doi/pdf/10.1044/1092-4388(2005/099).
  • “Why Is It Hard for People with Autism to Make Eye Contact?” Autism Speaks, 17 July 2015, http://www.autismspeaks.org/expert-opinion/why-it-so-hard-someone-autism-make-eye-contact?gclid=EAIaIQobChMIttPXpNTT6AIVgYTICh1s2QWvEAAYASAAEgJITPD_BwE.
  • Winner, Michelle Garcia. Thinking about You, Thinking about Me: Teaching Perspective Taking and Social Thinking to Persons with Social Cognitive Learning Challenges. 2nd ed., Think Social Publishing, 2007.
  • Winner, Michelle Garcia. Why Teach Social Thinking?: Questioning Our Assumptions about What It Means to Learn Social Skills. Think Social Pub., 2013.

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