Using Qualitative Methods to Explore the Subjective Experience of Eye Contact in Autistic Teens and Adults
Several theories attempt to explain why individuals with Autism Spectrum Disorder (ASD) are reluctant to engage in eye contact during social interaction. Social motivation accounts suggest that social information is less intrinsically rewarding to individuals with ASD (Chevallier et al., 2012). Aversion theories suggest that mutual gaze elicits a hyperarousal response in ASD, possibly mediated by amygdala dysfunction, leading to an aversion to eye contact (e.g., Dalton et al., 2005). Finally, Sensory processing accounts suggest individuals with ASD have difficulties coordinating multiple sensory systems (Crane et al., 2009) and therefore avoid eye contact during conversation to avoid sensory overload. Remarkably, no published research to date has utilized qualitative methods to explore the subjective experience of eye contact in individuals with ASD, which could have significant theoretical implications. Objectives:
The purpose of this study was to understand how high-functioning adults and teenagers with ASD experience eye contact in their daily lives. Our research question was “How do people with ASD experience eye contact?”
Using keywords “Eye Contact” and “Autism,” we searched the Internet for high quality autobiographical accounts of teenagers and adults with ASD describing their lived experiences with eye contact. We accepted videos for analysis when the person in the video spoke in English, reported a diagnosis of ASD, and discussed their ownexperience with eye contact (as opposed to discussing the ASD population generally). Although data collection is still in progress, nine YouTube videos have met the inclusion criteria thus far. Videos were transcribed and entered into NVivo. Using a phenomenological approach (Groenewald, 2004), we coded the transcripts, identified trends and generated themes.
Results: (Preliminary Themes)
1) Sensory overload. Two participants described a need to concentrate on the mouth during conversation to aid comprehension. Four described maintaining eye contact as being exhausting, in part due to the overwhelming amount of information provided by the eyes and face. Similarly, three described an inability to simultaneously make eye contact and comprehend words of their conversation partner.
2) Aversion. Seven participants described one or more negative feelings including embarrassment, discomfort or anxiety while making eye contact. Three said eye contact feels “unnatural,” and four expressed feelings of invasion or violation from being looked at in the eye.
3) Cultural norms. Three participants described a failure to understand the importance of eye contact and why it is an expected social convention. Two participants expressed a desire for society to accept their differences, and to not assume they are being disrespectful for neglecting eye contact. Two recognized the importance of eye contact for the purpose of “fitting in” or appearing “normal.”
In general, data support theories that suggest sensory processing abnormalities and aversion contribute to lack of eye contact in the ASD population, but little evidence for social motivation accounts were observed. Interventions should evaluate the individual with ASD’s views on cultural norms surrounding eye contact in designing appropriate solutions for eye contact difficulties. Results of this study should be interpreted with caution due to sampling bias.