Are there methods to increase tolerance of eye contact?

I’m very curious to see what other responses you get, but I did want to share that we have seen a noticeable improvement in my son’s poor eye contact since doing Vision Therapy with him. I think that although he doesn’t have sensory integration dysfunction , his sensory system is still out of whack and he finds it hard to listen and look at the same time. VT seems to have made this easier for him.

Well as a person with AS, I have to tell you that eye contact is over rated by NTs (neurotypicals— that is “normal people”). There are good reasons that kids with SI problems, AS, etc. avoid it. First of all there is a processing thing, if a kid is looking at you s/he might not be able to understand you. Second to some, eye contact is not pleasant, somewhat painful. I don’t know if it is fixating visually or some other factor. Another is that NTs get info from eye contact whereas some of us do not. So it is like requiring something that is not beneficial to us and might even be uncomfortable, etc. I have learned a common AS trick that can be taught to kids, and that is to look at someone’s ear or mouth. People don’t know the difference! But get this, you also have to learn to look away, as staring is not NT appropriate. Gosh you know you NTs are so strange! :-)
(Hey, just to let you know how the world looks to us. :-))

I would not try to train eye contact via the typical behavioral methods some suggest like reinforcing it and so on. (I have seen such things).

OTOH, I have heard that my eye contact improved after sensory integration therapy and that was quite late in life. Visual therapy might also be helpful. I had a dx of visual motor problems and difficulty fixating visually by an optometrist. I never found out if that would help as I did not have anyone to work with me. Also as an adult it would be less useful I imagine.

BTW, I wonder if being up front isn’t so much a visual thing as an auditory one. I doubt if he is relying on visual info from the teacher. BUT he could be hearing her better and also could be seeing the blackboard and so on better.

Also one thing I know to be helpful is to handle something that doesn’t make a lot of noise (likes legos) but is sensorially calming. For example, something like silly putty, kosh balls, those squishy balls they use for computer users, bean bags, etc. I call them “stim toys” and they can also be calming— and might even help him focus.This may help with the group leader having to repeat instructions.

Good luck,

—des

My son’s eye contact improved when we played the staring game. We stare at each other and the first one to laugh or move their eyes away loses.
His SI issues were not as bad as you described so you child might not tolerate this game.

I also think that anything you can do to integrate your child will help all areas not just eye contact.

A few things to look into:
neuronet
balmetrics
Sensory Integration occupational therapy (sometimes can be done at school but you will have to ask for an ot eval.)
Vision therapy with a therapist that does body work addressing balance and timing
Interactive metronome can help with integration issues. It did wonders for my son.

I was hyperlexic as a child, and still have difficulty tolerating eye contact. (At this point I am pretty normal, all things considered, and am a practicing physician. One learns to compensate) However, I had fairly poor auditory processing, and in order to compensate, and until a few years ago, I used to automatically write anything said to me on a mental blackboard in the front of my mind, thus using my fine visual memory and reading ability to compensate for my crummy auditory memory and listening ability. (I avoided lecture courses like the plague, and relied on the note service in medical school.) I find that if I look people in the eye, I start to fixate on their eye movements, and am unable to either use my mental blackboard (old trick), or take mental notes on what they are saying (new trick.) So, if I am to understand speech, I NEED TO NOT LOOK PEOPLE IN THE EYE. What I do instead, is I look just at the bridge of their noses. This area does not move, and so does not interfere with my visual/mental assist to auditory comprehension. Incidentally, sitting next to my kid, (who at the time had CAPD), while she plugged through Fast Forward 1 & 2, did a great deal to improve my listening comprehension, so you might want to try that with your kid. However, I warn you that I still find looking people in the eyes stressful, and avoid it where possible. Furthermore, I get no information from looking people in the eye, although I have learned to do quick scans to read body language in my 46 years of life. (Not that that tells me a whole lot, most of the time.) Besides trying FF, may I suggest that you simply explain to your kid why other people with his problem do what he is doing, (he probably doesn’t know why he is doing what he is doing, himself), and suggest that he look people in the bridge of their nose until listening work gets easier for him?

Hey shirin,

I thought your comments on hyperlexia were interesting. I’m writing this OT as I am having no luck signing in (don’t know why I got signed off!). Always get error messages and you are a guest.

Anyway I read at 3 years. My comprehension was not so hot otoh.
Tutoring in reading is great, sort of like one long scrabble game. :-)

—des

You’ve got lots of great responses here! I sometimes work with autistic kids (as a sub. special ed. aide), and what I’ve usually been told is to try for as much eye contact as possible. Maybe this is something that develops over time, or some children devise good coping strategies (i.e. looking at the bridge of the nose).
I agree that SI games and vision therapy techqiues might be helpful for this…and may help with other things as well!

Yeah well a lot of people who work with autistic kids go pretty much purely behaviorally. If you want something then you deal with it strictly from a behavioral point of view. They don’t understand some of the complexities like folks working with ld kids. (I think if you think about autism is really a form of learning disability and a severely autistic kid is severely/profoundly ld). If you watch the Kanner type kids they do a lot of looking thru the corners of their eyes. This is clearly a processing thing.

BTW, when I worked with them, I had the kids look in my direction, mostly for things like showing them things, ie signs.

I’ve been around OTs as they spin kids. Just about guaranteed right after the OT spins the kid they look right at her. I don’t know so much about vision therapy with autistic kids or some other stuff that goes for processing, but I’d guess you would have better results.

Teaching eye contact behaviorally is tricky (even if I would recommend it) as eye contact is complex. If you don’t look away you are staring, and just when exactly do you look away, etc. I’ve learned that people like the eye contact, and I try to do my tricks. :-)

—des

About not staring: what I do, is I have trained myself to do quick scans for body language at LEAST every 30 seconds during face-to-face conversation. This is easiest done during my turn to speak, and avoids the staring problem. (It is a bit fatiguing, so when I am with a patient I spend a lot of time looking at the paperwork, or at the problematic body part instead, which is a LOT easier.) I usually plug through some form of checklist while doing a scan; kinda like http://www.johnmole.com/articles18a.htm. This means that (1) I’m not staring, (2) I am maintaining (pseudo) eye contact, and (3) my eye movements look natural. (It’s kind of like having Hanson’s disease. Because people with that condition don’t feel pain in large areas of their body, we train them to check all affected parts every 5 minutes so that they don’t accidentally lose toes and fingers in doors, or whatever. They get used to deliberately doing things to compensate for their absence of pain.

Shirin— I also have learned a trick to avoid staring, which is kind of timing myself the way you do. I’m not sure about body language as I don’t get that so welll either. I wonder if I’d remember the body language stuff on that website, but it’s interesting. i guess I would guess some of these.

I more or less wanted to make the point that this is complex behavior. Having the kid have eye contact isn’t enough as there is more to it than that, such as looking away, and there are times you aren’t supposed to look. Very complex. So just teaching a kid from a behavioral standpoint will not be very effective, and as you say is draining. I do this looking at paper work myself. When I go see a parent, I have papers in front of me, so I can look at these— actually have to. I don’t think it is anything like natural, and only really works if the kid cares one flip or another. It’s a bit hard with a AS teenager, say. Luke Jackson in “Freaks, Geeks and Aspergers Syndrome” (great book btw) talks about this, and he is 14, but I daresay Luke is brighter than the average AS kid even.

Things like sensory integration or visual therapy may not always work, but I would pretty much guess the eye contact out of those would be more natural. I’m pretty sure this is a processing thing and quite not easily done (might be qned?) using behavioral means.

But for an older kid or adult, learning the “tricks” would be useful. People often do not trust someone who doesn’t make eye contact, in this culture at least. Different cultures have different takes on this, for example in some American Indian cultures it is impolite to have much eye contact.
Makes me think this is even more complex!

—des

I just wanted to add that my 21 year old son has an anxiety disorder and he rarely makes eye contact even with us. I cannot believe that therapist did not work toward gradually increasing eye contact instead of insisting on it the first time, That could cause an anxiety attack in some people.

Janis

Gee, des, shirin, and now me — three of us that don’t make eye contact easily. Hmmm. I also do the bridge of the nose thing, or I focus behind the person.

I am over-sensitive to eye movement and body language and if I concentrate I catch every little movement of nervousness or anxiety or frustration, and then I start to reflect it back; not good. So I try to let most of it go by me.

In tutoring, I sit side by side with the student and we both look at the book, and that works very well. I also look at the kid’s eyes from the side and see if he is actually looking at the reading and tracking over it; have made some interesting and distressing discoveries that way.

Forcing eye contact clearly doesn’t work, but teaching these coping skills will certainly help.