Affectively-Align & Culturally Aware ABA Notebook

Eye contact is often considered a fundamental social skill, but for individuals with Autism Spectrum Disorder (ASD), it can be uncomfortable, distressing, or even painful (This is how I personally experience eye contact– it seriously feels physically weird, a literal goosebump happens along with complete mental distraction. I fail to listen while trying to hold a focused gaze!). Despite societal expectations, forcing eye contact can cause significant anxiety and contribute to traumatic experiences (Trevisan et al., 2017). Rather than insisting on this behavior, caregivers, family and educators should prioritize alternative communication strategies that respect neurodiversity. Research shows that many individuals with ASD process social information differently, making sustained eye contact overwhelming (Hadjikhani et al., 2017). By understanding these differences, we can create a more inclusive environments that do not equate eye contact with engagement or respect.

For many with ASD, eye contact can trigger sensory overload or extreme discomfort. A study by the University of Edinburg found that some autistic individuals describe eye contact as “burning” or “painful”, leading to increased stress and withdrawal (Robinson et al., 2020). When children are repeatedly forced to comply, it can foster negative associations with social interactions, ultimately hindering communication rather than improving it. Trauma-informed approaches emphasize that forcing eye contact can erode trust between the chid and caregiver, reinforcing fear rather than connection (Hoover, 2015). Instead of demanding eye contact, adults should focus on other indicators of attention, such as verbal responses or body language.

Furthermore, the belief that eye contact is necessary for effective communication is culturally biased. Not all neuotypical individuals maintain constant eye contact, and many cultures view direct eye contact as disrespectful (Akechi et al., 2013). For autistic individuals, alternative forms of engagement– such as listening while looking away–can be just as meaningful. Research supports that accomodating sensory needs improves participation and reduces distress (Jones et al., 2016). By shifting expectations, we validate the diverse ways people communicate, fostering self-esteem and autonomy in individuals with ASD.

The long-term effects of forcing eye contact can contribute to emotional trauma. Repeated exposure to distressing demands may lead to chronic anxiety, avoidance behaviors, or even PTSD symptoms in extreme cases (Haruvi-Lamdan et al., 2018). Trauma-sensitive teaching requires recognizing that behavioral compliance should never come at the cost of mental well-being. Autistic advocates consistently highlight the acceptance–not assimilation–should be the goal (Autistic Self Advocacy Network, 2022). Instead of enforcing rigid social norms, educators and parents should collaborate with autistic individuals to find comfortable communication methods.

It’s time to challenge the assumption that eye contact equals attentiveness or respect. Forcing this behavior can be harmful, and alternatives must be embraced. If you are an educator, therapist, or caregiver, commit to neurodiversity–affirming practices by learning from autistic voices and research. Share this knowledge with others and advocate for sensory-friendly communication in family or friend gatherings, schools and workplaces.

Call to action: Advocate for sensory-friendly practices in your community. For more resources visit Autistic Self Advocacy Network and ASAN’s resources on respectful supports to take action today. https://autisticadvocacy.org/ or check out the references below for further readings.

References:

Akechi, H., Senju, A., Uibo, H., Kikuchi, Y., Hasegawa T., & Hietanen, J. K. (2013). Attention to eye contact in the West and East: Autonomic responses and evaluate ratings. PLOS ONE, 8(3),e59312.

Autistic Advocacy Network. (2022). Forced compliance and trauma.

Hadjikhani, N., Asberg Johnels, J., Zücher, N. R., Lassalle, A., Guillon, Q., Hippolyte, L., … & Gillberg, C. (2017). Look me in the eyes: Constraining gaze in the eye-region provokes abnormally high subcortical activation in autism. Scientific Reports, 7(1), 3163.

Haruvi-Lamdan, N., Horesh, D., & Golan, O. (2018). PTSD and autism spectrum disorder: Co-morbidity, gaps in research, and potential shared mechanisms. Psychological Trauma, 10(3), 290-299.

Trevisan, D. A., Roberts, N., Lin, C., & Birmingham, E. (2017) How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts. PLOS ONE, 12(11), e0188446.