Thinking Beyond Eye Contact: Part 1

The following article was first published in Autism Spectrum Quarterly’s Winter 2012 issue and was written by RDI Consultant, Linda Murphy

Eye Contact is considered to be an important skill in teaching social communication to children with ASD. Eye contact matters in communication because looking at someone usually shows that we care and are invested in the interaction. It demonstrates that we are listening to what that person is saying, and that we are thinking about the same thing. For most children, the development of meaningful eye gaze comes naturally; however, it is no secret that for many children with ASD, the development of eye contact is not automatic. As a result, we work hard to facilitate it so that children with ASD can become more socially connected.

Thinking about How Eye Contact Develops

While training to become an RDI consultant, I learned to think critically about eye contact as a treatment goal. In fact, I learned to stop talking about eye contact and instead to talk about the idea of visual referencing. This is a much more accurate description of what we want children with ASD to develop in the long term. It describes the very dynamic skill of using the sense of sight to gather, or reference, information. Typically, visual referencing develops in the first year of life. For example, babies and toddlers look to see who is approaching, to notice a new toy, and importantly, to check in with their caregivers to share affect or when uncertain about something or someone. They also use sustained eye gaze early-on to share affect in simple, back and forth interactions where they notice and respond to caregivers’ actions with vocalizations, laughing, touch, or smiles. It is in these early interactions that the caregiver mindfully delivers information at a slow pace and with appropriate affect, be it with big smiles, animated but slowly presented gestures, or softly spoken words in order to visually engage the child, while taking care not to overwhelm him or her with too much stimulation.

The sensitive communication partner also learns to wait, giving the youngster time to notice a new face or toy; focus on and think about it; and then shift his or her gaze elsewhere when ready to take in new information or engage a different communication partner. Hence, from early on the act of looking is a nuanced but complex process of taking in new information, integrating it with what is already known, and responding in an adaptive way. If at any point a baby is overwhelmed or unable to take in additional information, he or she is “wired” to gaze avert, or look away. Caregivers, for their part, are wired to wait for the baby to shift his or her gaze back, thus communicating a readiness to interact again.

Making Eye Contact versus Visually Referencing

With these developmental foundations in mind, let’s revisit the phrase make eye contact. We can see that this phrase does not capture the act of looking as a fluid, dynamic skill. Rather, it suggests a rote, mechanical, or static act—an end in and of itself for the purpose of attention. Indeed, if eye contact is

sustained for too long a period of time, it may actually be inappropriate. In contrast, the term visual referencing describes the process of using one’s vision to learn something new, and from that place of knowledge, to take the next step. It sets the stage for a dynamic communicative exchange. If we stop to think about this, we will realize how often in daily life we use visual referencing, both for communication and for other reasons. For example, we may look around at our surroundings with the intention of gathering information such as: Where is that noise coming from? orWhere is the bathroom? We may look to understand more about our communication partners. For example we may want to figure out: How is that person feeling? Did he or she understand what I just said? Are they interested in what I’m saying? What is that person thinking about right now? What is that person doing? We look to learn about changes being made to our environment. For example, we may want to find things out: Where is everyone going? or to determine the reason for the occurrence of something: Why did it just get so cold in here? There is also the important issue of our own safety—for example—we look to determine: Is it safe to cross the street? or Who is that person coming close to me? Importantly, when we view looking as a highly dynamic process, rather than as a mechanical and static end product, it will likely influence the types of strategies we use to elicit it.

Applying This Information to Children with ASD

In teaching children with ASD to visually reference, it is important to understand and respect why they may look away (e.g., perhaps there is too much stimulation) and also to give them opportunities and whatever assistance they need, to take in visual information at a pace that allows them to derive meaning from what they are seeing. When visual regard results in the taking in of meaningful information there is a natural reason to engage in it. Hence, when we help children to use their vision to take in information and, when needed, assist them in figuring things out, we motivate and empower them to become seekers of information. Ultimately, we want children with ASD to learn what we already know: If you don’t look, you will probably miss something important. If, however, we notice a child with ASD avert his or her gaze, it often means that he or she is feeling overwhelmed and unable to process anything more at the moment. Pausing, and then—when the child has shifted his or her gaze back to you—mindfully presenting information at a slower pace, with additional input as needed, can help him or her to stay visually connected for longer. Here are some ways to encourage visual referencing while providing your child with “space” to process and derive meaning from what he or she is seeing:

• Answer questions or requests that your child initiates using nonverbal communication. For example, if your child asks if she can have a glass of water, use a head nod for yes. If she wants to know where her favorite toy is, deliberately point to it across the room.

• Use language that emphasizes observational words to cue your child to visually scan his environment for information. For example, “I notice everyone is leaving!” or “I can see that Grandpa is happy that you are here!” are statements that invite visual referencing.

• In general, slow down and give your child more time to shift and adjust her gaze toward you. Approach her and lower your body so that you are at eye level with her. Call her name and then quietly wait, or

begin your communicative bid with a statement that emphasizes the importance of looking, for example, “Lucy,

I have something cool to show you!”

• Be mindful of the type and amount of information you present to your child at any given time. When working to hone visual referencing skills, use nonverbal communication dynamically and enjoyably within an interaction while consciously talking less (or not at all). By, initially, exaggerating your gestures, facial expressions, and actions while embedding them in meaningful contexts, you provide a scaffold within which children can learn to interpret nonverbal information. Here are a few examples: When it is time to go out, hold up your keys, jingle them, and gesture or look toward the door instead of saying, “Time to go.” As you eat ice cream together, exaggerate your facial expressions to communicate how much you are enjoying yours! Introduce a surprise hidden in a paper bag using wide eyes and a smile to invite shared anticipation of what you’ve discovered.

Some Final Thoughts

Once we embrace the idea of promoting the dynamic process of visual referencing over that of merely establishing eye contact, our teaching, too, becomes more dynamic. We no longer focus on simply telling kids what to do and where to look, but rather on helping them to use visual referencing to derive meaning. By providing mindful opportunities for children to visually reference people and things in their environments; adjusting our pace to theirs; and assisting them in establishing meaning, we can help to empower them to become visually connected to others in meaningful and enjoyable ways. In my next article, I will offer several games and activities to further develop the understanding and use of nonverbal communication within dynamic, reciprocal exchanges.

Linda K. Murphy M.S., CCC-SLP has been working with people with ASD for almost 20 years. She first obtained her Bachelor’s Degree in Mathematics from Boston College but after working for two years with adults with ASD in supported work and residential settings, she found her true passion and pursued a Master’s Degree in Speech Language Pathology from Emerson College. She added Relationship Development Intervention (RDI)® to her practice in 2007 in order to serve families of individuals with ASD in more effective and meaningful ways. Linda has a private practice in Beverly, MA that offers services including speech language therapy, communication assessments, school consultations, professional trainings, social pragmatics groups and RDI®. Her website is www.peerprojectstherapyfromtheheart.com and she can be reached here.