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Autism and Eye Contact

Missing Social Signals
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Young children with autism do not avoid eye contact on purpose, found a new study by researchers at Marcus Autism Center, Children's Healthcare of Atlanta, and Emory School of Medicine.

Instead, they make less eye contact because they miss the significance of social information contained in others' eyes.

While reduced eye contact is a well-known symptom of autism spectrum disorder, used in early screening and diagnostic instruments, why children with autism look less at other people's eyes has not been known.

This study, reported in the American Journal of Psychiatry, helps answer that question. "This is important because we're disentangling very different understandings of autism," says Jennifer Moriuchi, an Emory graduate student. "Depending on why you think children with autism are making less eye contact, you might have different approaches to treatment and different ideas about the brain basis of autism."

Two explanations have been proposed: One, that children with autism avoid eye contact because they find it stressful or negative. The other, that children with autism look less at others' eyes because social cues from the eyes are not perceived as particularly meaningful or important.

The new research, conducted on the day children were first diagnosed, shows that young children with autism do not actively avoid eye contact.

Together with Drs. Ami Klin and Warren Jones, Moriuchi studied how 86 two-year-old children with and without autism paid attention to other people's eyes. Children with autism watched a series of carefully made videos. "Before each video, we flashed a small picture to capture the child's attention, and when they looked to where the picture had been, they found that they were either looking directly at another person's eyes or looking away from the eyes," Moriuchi says. "When we did this repeatedly, we found that young children with autism continued to look straight at the eyes. Like their peers without autism, they didn't look away from the eyes or try to avoid the eyes in any way."

When varying levels of socially meaningful eye contact were presented, however, children with autism did look less at others' eyes than their peers without autism did.

This isn't meant to contradict the personal experiences of adults and older children with autism who report feeling anxious in response to eye contact, the researchers say. "For children with autism, social signals can be confusing," Jones says. "And as children grow up to be adults, those signals can become even more challenging to understand. This research highlights the opportunity to target the right underlying concerns as early as possible."

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