Table of ContentsView AllTable of ContentsDiagnosing AutismEye Contact Is PainfulOther CausesWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Diagnosing Autism
Eye Contact Is Painful
Other Causes
When to See a Provider
The lack of eye contact is due to a condition known asalexithymia, a term used to describe trouble feeling emotions. Current research suggests that only around 50% of autistic people have alexithymiaand that one in 10 people in the general population have it as well.
While alexithymia is more common in autistic people, it can also occur with major depression, schizophrenia, post-traumatic stress disorder (PTSD), stroke, Alzheimer’s disease, and many other psychological or neurocognitive disorders.
This article discusses how eye contact factors into an autism diagnosis. It explains how eye contact is different in many autistic people and the reasons why an autistic person may avoid eye contact.
Nikola Stojadinovic / Getty Images
Diagnosing Autism By Eye Contact
While a lack of eye contact may be a feature of autism, it is not “diagnostic” of autism. A person can have autism with no signs of alexithymia—and look you straight in the eye.
Signs That Your Child Has Autism
Eye Contact In Autism
Research shows autistic individuals respond to eye contact differently than their non-autistic counterparts.
Scientists at Yale University used brain scans to compare reactions to eye contact among autistic people and non-autistic people. The study found eye contact prompted activity in different regions of the brain in each group.
Another study used an electroencephalogram (EEG) to study brain activity in relation to eye contact. Researchers found that neurotypical children have a stronger response to a direct gaze than a downcast gaze. Autistic children, however, had a stronger response to a downcast gaze than direct eye contact.
According to the study authors, these findings may indicate that autistic children:
Autistic Adults Say Eye Contact Is Painful
Additional research shows autistic adults often experience physical discomfort when making eye contact. Negative physical symptoms associated with eye contact in autistic people include:
The study also found that many autistic people find eye contact invasive, distracting, and confusing. Some reported eye contact should be reserved for intimate relationships and trusted people.
What’s more, the study authors noted autistic adults often find processing verbal information more difficult when making eye contact. In other words, a lack of eye contact does not mean an autistic person isn’t paying attention.
Forcing an autistic person to maintain eye contact can actually take away from their focus.
Most adults in the study said they understood that society deems eye contact important. However, they expressed confusion over how much eye contact is appropriate. Many use strategies to fake eye contact, such as looking just above the person’s eyes.
Other Reasons a Child May Avoid Eye Contact
A lack of eye contact does not always mean a child is autistic. A child can avoid eye contact because they:
Autism and Sensory Overload
When To Seek an Autism Evaluation
The lack of eye contact on its own does not mean a person is autistic. This is especially true in infants who may not make eye contact but will generally turn their heads in the direction of a person’s face.
However, you may want to investigate autism if your child is under age 3, lacks eye contact,andexhibits any of the other following traits:
If your child displays these behaviors, talk to your medical provider. You may be referred to adevelopmental pediatricianorpsychologistfor an evaluation.
Summary
A person who avoids eye contact is not necessarily autistic, but avoiding eye contact is a quality many autistic people have. Autistic people may not understand the importance neurotypical people place on eye contact or find the experience of making eye contact uncomfortable.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kinnard E, Steward C, Tchanturia K.Investigating alexithymia in autism: a systematic review and meta-analysis.Eur Psychiatry.2019 Jan;55:80–89. doi:10.1016/j.eurpsy.2018.09.004Koppelberg P, Kersting A, Suslow T.Alexithymia and interpersonal problems in healthy young individuals.BMC Psychiatry.2023;23:688. doi:10.1186/s12888-023-05191-zAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM-5).Hirsch J, Zhang X, Noah JA, et al.Neural correlates of eye contact and social function in autism spectrum disorder.PLoS One. 2022;17(11):e0265798. doi:10.1371/journal.pone.0265798Lauttia J, Hlminen TM, Leppanen JM, et al.Atypical pattern of frontal EEG asymmetry for direct gaze in young children with autism spectrum disorder.J Autism Dev Disord. 2019;49(9):3592-3601. doi:10.1007/s10803-019-04062-5Trevisan DA, Roberts N, Lin C, Birmingham E.How do adults and teens with self-declared autism spectrum disorder experience eye contact? A qualitative analysis of first-hand accounts.PLoS One. 2017;12(11):e0188446. doi:10.1371/journal.pone.0188446Uono S, Hietanen JK.Eye contact perception in the West and East: a cross-cultural study.PLoS One. 2015;10(2):e0118094. doi:10.1371/journal.pone.0118094Jones EJ, Gliga T, Bedford R, Charman T, Johnson MH.Developmental pathways to autism: a review of prospective studies of infants at risk.Neurosci Biobehav Rev. 2014;39:1-33. doi:10.1016/j.neubiorev.2013.12.001Additional ReadingKikuchi Y, Akechi H, Senju A, et al.Attention to live eye contact in adolescents with autism spectrum disorder.Autism Res. 2022;15(4):702–11. doi:10.1002/aur.2676
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kinnard E, Steward C, Tchanturia K.Investigating alexithymia in autism: a systematic review and meta-analysis.Eur Psychiatry.2019 Jan;55:80–89. doi:10.1016/j.eurpsy.2018.09.004Koppelberg P, Kersting A, Suslow T.Alexithymia and interpersonal problems in healthy young individuals.BMC Psychiatry.2023;23:688. doi:10.1186/s12888-023-05191-zAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM-5).Hirsch J, Zhang X, Noah JA, et al.Neural correlates of eye contact and social function in autism spectrum disorder.PLoS One. 2022;17(11):e0265798. doi:10.1371/journal.pone.0265798Lauttia J, Hlminen TM, Leppanen JM, et al.Atypical pattern of frontal EEG asymmetry for direct gaze in young children with autism spectrum disorder.J Autism Dev Disord. 2019;49(9):3592-3601. doi:10.1007/s10803-019-04062-5Trevisan DA, Roberts N, Lin C, Birmingham E.How do adults and teens with self-declared autism spectrum disorder experience eye contact? A qualitative analysis of first-hand accounts.PLoS One. 2017;12(11):e0188446. doi:10.1371/journal.pone.0188446Uono S, Hietanen JK.Eye contact perception in the West and East: a cross-cultural study.PLoS One. 2015;10(2):e0118094. doi:10.1371/journal.pone.0118094Jones EJ, Gliga T, Bedford R, Charman T, Johnson MH.Developmental pathways to autism: a review of prospective studies of infants at risk.Neurosci Biobehav Rev. 2014;39:1-33. doi:10.1016/j.neubiorev.2013.12.001Additional ReadingKikuchi Y, Akechi H, Senju A, et al.Attention to live eye contact in adolescents with autism spectrum disorder.Autism Res. 2022;15(4):702–11. doi:10.1002/aur.2676
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kinnard E, Steward C, Tchanturia K.Investigating alexithymia in autism: a systematic review and meta-analysis.Eur Psychiatry.2019 Jan;55:80–89. doi:10.1016/j.eurpsy.2018.09.004Koppelberg P, Kersting A, Suslow T.Alexithymia and interpersonal problems in healthy young individuals.BMC Psychiatry.2023;23:688. doi:10.1186/s12888-023-05191-zAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM-5).Hirsch J, Zhang X, Noah JA, et al.Neural correlates of eye contact and social function in autism spectrum disorder.PLoS One. 2022;17(11):e0265798. doi:10.1371/journal.pone.0265798Lauttia J, Hlminen TM, Leppanen JM, et al.Atypical pattern of frontal EEG asymmetry for direct gaze in young children with autism spectrum disorder.J Autism Dev Disord. 2019;49(9):3592-3601. doi:10.1007/s10803-019-04062-5Trevisan DA, Roberts N, Lin C, Birmingham E.How do adults and teens with self-declared autism spectrum disorder experience eye contact? A qualitative analysis of first-hand accounts.PLoS One. 2017;12(11):e0188446. doi:10.1371/journal.pone.0188446Uono S, Hietanen JK.Eye contact perception in the West and East: a cross-cultural study.PLoS One. 2015;10(2):e0118094. doi:10.1371/journal.pone.0118094Jones EJ, Gliga T, Bedford R, Charman T, Johnson MH.Developmental pathways to autism: a review of prospective studies of infants at risk.Neurosci Biobehav Rev. 2014;39:1-33. doi:10.1016/j.neubiorev.2013.12.001
Kinnard E, Steward C, Tchanturia K.Investigating alexithymia in autism: a systematic review and meta-analysis.Eur Psychiatry.2019 Jan;55:80–89. doi:10.1016/j.eurpsy.2018.09.004
Koppelberg P, Kersting A, Suslow T.Alexithymia and interpersonal problems in healthy young individuals.BMC Psychiatry.2023;23:688. doi:10.1186/s12888-023-05191-z
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM-5).
Hirsch J, Zhang X, Noah JA, et al.Neural correlates of eye contact and social function in autism spectrum disorder.PLoS One. 2022;17(11):e0265798. doi:10.1371/journal.pone.0265798
Lauttia J, Hlminen TM, Leppanen JM, et al.Atypical pattern of frontal EEG asymmetry for direct gaze in young children with autism spectrum disorder.J Autism Dev Disord. 2019;49(9):3592-3601. doi:10.1007/s10803-019-04062-5
Trevisan DA, Roberts N, Lin C, Birmingham E.How do adults and teens with self-declared autism spectrum disorder experience eye contact? A qualitative analysis of first-hand accounts.PLoS One. 2017;12(11):e0188446. doi:10.1371/journal.pone.0188446
Uono S, Hietanen JK.Eye contact perception in the West and East: a cross-cultural study.PLoS One. 2015;10(2):e0118094. doi:10.1371/journal.pone.0118094
Jones EJ, Gliga T, Bedford R, Charman T, Johnson MH.Developmental pathways to autism: a review of prospective studies of infants at risk.Neurosci Biobehav Rev. 2014;39:1-33. doi:10.1016/j.neubiorev.2013.12.001
Kikuchi Y, Akechi H, Senju A, et al.Attention to live eye contact in adolescents with autism spectrum disorder.Autism Res. 2022;15(4):702–11. doi:10.1002/aur.2676
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