High-Functioning Autism and Eye Contact Explained

Explore high-functioning autism eye contact, its challenges, research insights, and strategies for improvement.

judah schiller
Judah Schiller
May 24, 2024
Published On
May 24, 2024

Understanding High-Functioning Autism

High-functioning autism is a term often used within the realm of autism spectrum disorder (ASD) to describe individuals who can read, write, speak, and manage life skills without much assistance. This term, though not an official medical diagnosis, provides a means to discuss those with lower support needs within ASD.

Characteristics of High-Functioning Autism

Individuals with high-functioning autism display a range of characteristics, similar to others on the autism spectrum, but are generally able to navigate life with less support. The term "high-functioning" can be misleading, as it does not necessarily mean that these individuals do not face significant challenges. They might still struggle with social interactions, sensory issues, and other aspects tied to ASD, but they can generally perform most life skills independently.

The term "high-functioning autism" was sometimes used interchangeably with Asperger's syndrome, a condition characterized by difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behavior and interests. However, it's important to note that Asperger's syndrome was eliminated from the DSM-5 and is no longer an official diagnosis.

Diagnosis and Levels of Support

The levels of ASD are divided into three: Level 1, Level 2, and Level 3, with individuals at Level 1 requiring less support and those at Level 2 or Level 3 needing more intensive, long-term support [1].

When diagnosing ASD, trained psychologists use tools such as the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), along with a thorough developmental history. Diagnosis can occur as early as 18 months, although some individuals may be diagnosed much later [1].

The support needed for ASD varies significantly and depends on each individual's unique symptoms. Those at Level 2 or Level 3 require more intensive and long-term support than those at Level 1.

In summary, understanding high-functioning autism and its associated characteristics can provide a foundation for exploring specific challenges often faced by these individuals, such as difficulties with eye contact. Acknowledging and understanding these challenges is a critical step towards finding effective strategies to support individuals with high-functioning autism.

Challenges with Eye Contact

A key aspect of the high-functioning autism spectrum is the challenge individuals may face with eye contact. These difficulties often have an impact on social interactions, making it important to understand the underlying issues.

Eye Contact Difficulties in Autism

In social interactions, eye contact plays a significant role. However, for those with high-functioning autism, eye contact can be a challenging task. According to a study published on PubMed, individuals with autism spectrum disorder (ASD) showed comparable ability to perceive a self-directed gaze as typically developing individuals. However, the frequency of perceiving a self-directed gaze decreased as gaze aversion increased in both groups.

Additionally, the research highlighted the absence of an ingroup bias in individuals with ASD for the perception of a self-directed gaze, which is commonly observed in typically developing individuals. Further, variations in oculomotor and visual sensing were observed in ASD, including increased positional variation in eye fixations and increased pupillary reactions to live faces.

Impact on Social Interactions

The difficulties with eye contact prevalent in high-functioning autism can significantly impact social interactions. The ability to maintain eye contact is often associated with attentiveness and engagement in social conversations. When individuals with ASD struggle with eye contact, it may be wrongly perceived as disinterest or lack of engagement.

Moreover, the absence of ingroup bias in ASD can also contribute to atypical emotional experiences during social interactions. This absence suggests that individuals with ASD may not have the same emotional reactions to familiar and unfamiliar faces as typically developing individuals do. This can influence their social interactions and the way they perceive and process social cues.

Understanding these challenges is crucial for those interacting with individuals with high-functioning autism. Recognizing the difficulties they face with eye contact can foster greater empathy and facilitate more inclusive and supportive communication strategies.

Research Insights on Eye Contact

The matter of eye contact in individuals with high-functioning autism is a subject of extensive research. This section will delve into the neurological responses to eye contact and the differences in brain activity in autistic individuals.

Neurological Responses to Eye Contact

Eye contact triggers particular neural systems in individuals with Autism Spectrum Disorder (ASD). Studies indicate that during live eye-to-eye contact, ventral occipital-temporal regions within the brain are engaged in individuals with ASD. In contrast, typically developing (TD) individuals show activity in dorsal parietal and lateral prefrontal regions.

Furthermore, variations in oculomotor and visual sensing have been observed in individuals with ASD. These include increased positional variation in eye fixations and increased pupillary reactions to live faces. Such responses underline the unique ways in which individuals with ASD process eye-to-eye contact.

Neurological Responses to Eye Contact ASD TD
Engaged Brain Regions Ventral Occipital-Temporal Regions Dorsal Parietal and Lateral Prefrontal Regions
Variations in Oculomotor and Visual Sensing Increased Positional Variation in Eye Fixations, Increased Pupillary Reactions -

Brain Activity Differences in Autistic Individuals

Research shows that there are correlations between the neural responses during live eye-to-eye contact and the severity of social symptoms in individuals with ASD. Specifically, neural responses in the right dorsal parietal regions were negatively correlated with social symptom severity as measured by the Autism Diagnostic Observation Schedule (ADOS-2) scores [2].

The same correlation was observed when measuring social symptom severity using the Social Responsiveness Scale (SRS-2) scores. This negative correlation was present in both ASD and TD participants.

Furthermore, the level of cross-brain synchrony during live eye-to-eye contact was found to be reduced in individuals with ASD compared to TD participants.

Brain Activity Differences ASD TD
Neural Responses in Right Dorsal Parietal Regions Negative Correlation with ADOS-2 and SRS-2 Scores Negative Correlation with SRS-2 Scores
Cross-Brain Synchrony During Live Eye-to-Eye Contact Reduced Normal

These insights pave the way for better understanding and addressing the challenges associated with high-functioning autism eye contact. It opens avenues for the development of more targeted therapeutic strategies that can ultimately improve the quality of life for individuals with ASD.

Strategies to Improve Eye Contact

Eye contact is a significant aspect of non-verbal communication. However, for individuals with high-functioning autism, maintaining eye contact can be challenging. Fortunately, there are several strategies and therapies that can help improve eye contact and overall communication skills.

Behavioral Therapies for Eye Contact

Behavioral therapies, such as Applied Behavior Analysis (ABA), have shown to be effective in improving eye contact skills in individuals with high-functioning autism. ABA therapy focuses on developing coping strategies, improving communication skills, and reducing anxiety around eye contact [4].

Sensory integration therapy, which aims to help autistic individuals process overwhelming stimuli, has also been suggested to assist with adapting to sustained eye contact.

Various strategies can be used during these therapies to encourage eye contact, such as reinforcing natural incidents of eye contact, having conversations about favorite subjects, modeling eye contact, shaping the behavior gradually, and using visual supports. These approaches should be tailored to the individual's needs and experiences.

Alternative Communication Methods

While improving eye contact can help individuals with high-functioning autism to better connect with others, it's important to respect the individual's comfort levels and personal experiences. For some, making eye contact can be distressing or uncomfortable, and they may prefer to interact in ways that don't require direct eye contact.

Alternatives to direct eye contact can be applied to help these individuals participate in social interactions. For instance, they can focus on an activity or object during a conversation. This strategy allows them to engage in the interaction without the discomfort of making direct eye contact [6].

It's essential to remember that communication involves more than just eye contact. Recognizing and respecting individual communication styles can go a long way in supporting individuals with high-functioning autism. Whether through behavioral therapies or alternative communication methods, there are various effective strategies for improving eye contact and overall communication skills in individuals with high-functioning autism.

Supporting Individuals with High-Functioning Autism

Supporting individuals with high-functioning autism, particularly in relation to eye contact, involves understanding their unique communication styles and learning how to interpret nonverbal cues.

Recognizing Individual Communication Styles

Individuals with high-functioning autism may experience varied communication abilities. For example, some children with autism achieve their preschool speech and language milestones, only to be identified as having autism when they start school where the social-communication demands increase. They may talk fluently but have significant difficulty with the social aspects of language, such as knowing how to initiate and maintain a conversation, and understanding meaning from other people's body language.

On the other hand, older children and teenagers with autism may exhibit very limited use of language or excessive use of it. They may have a 'flat' tone to their voice and repeat certain phrases over and over. They might talk 'at' others rather than having a 'back and forth' conversation, or talk mostly about their topics of interest. They may not understand facial expressions and non-verbal cues, have difficulty with small talk, and have a limited range of responses in social situations.

Another characteristic is the use of echolalia, which means repeating words or phrases over and over, often using them without meaning or in an unusual context. Echolalia can be immediate (repeating words or phrases straight after hearing them) or delayed (repeating words and phrases at a later time).

Recognizing these unique communication styles is crucial in understanding and supporting individuals with high-functioning autism.

Importance of Understanding Nonverbal Cues

People on the autism spectrum may have difficulty with eye contact and non-verbal communication, which can make social interactions challenging. They may not hold eye contact or use body language in expected ways, misunderstand or misuse gestures, and have a lack of, or different, facial expressions [7].

However, making eye contact can be very difficult for many individuals with high-functioning autism. Some may find it distressing or uncomfortable, while others may prefer to interact in ways that do not require eye contact. It is important to consider the individual child's feelings and experiences when deciding whether to work on improving eye contact.

Understanding these nonverbal cues and considering the individual's comfort with eye contact is key in supporting individuals with high-functioning autism. This understanding can help to tailor communication strategies and interactions to meet their needs, promoting a more inclusive and accommodating environment.


[1]: https://www.healthline.com/health/high-functioning-autism

[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9645655/

[3]: https://pubmed.ncbi.nlm.nih.gov/32847375/

[4]: https://www.discoveryaba.com/aba-therapy/high-functioning-autism-eye-contact/

[5]: https://www.healthline.com/health/autism/autistic-eye-contact

[6]: https://behavioral-innovations.com/blog/children-with-asd-improve-eye-contact/

[7]: https://thespectrum.org.au/autism-strategy/autism-strategy-communication/