Monday, July 19, 2010

Please Don't Tell Your Child to Look me in the Eye

I remember when Jacob was diagnosed, one of the first services I implemented was speech therapy. Jacob was verbal, but he needed help in learning how to use his speech. Beginning at age 3 1/2, he was taught concepts like rhymes, antonyms, synonyms, and the basic usage of speech that he wasn't able to master on his own.  One of the areas his therapist targeted was Jacob's lack of eye contact, something common for children on the autistic spectrum. I was taught early on to constantly remind Jacob to make eye contact with anyone who conversed with him.

I witnessed a mom doing the same thing on Saturday with her young son.

Each month, the Autism Society and AMC theatres nationwide have a monthly Sensory Friendly Screening of a newly-released major motion picture. The lights are slightly up, the sound is slightly down, no previews or commercials are played prior to the showing, kids can walk around and parents are free to let their child bring food and toys into the theatre. It's a wonderful site to see a roomful of parents and children with autism enjoying a the latest kid-friendly blockbuster release at the theatre. Many times, parents express their thanks with words like "keep up the good work", and "I'd never be able to see an entire movie with my child without these screenings". I always love seeing parents totally at ease because their child can make noise or walk in the aisles without having to worry if anyone is annoyed. Remember, we're just miles from Hollywood - family outings to see the just-released big-budget kid-themed film seems like an essential element of the cultural landscape for every LA parent. For me, not being able to go to the movies with Jacob was one of the unfriendly reminders that Jacob had challenges. Most of my friends never think had to twice about going to the movies as a family, so I can only imagine how much fun this would have been for Jacob had these screenings existed 10 years ago.

Last Saturday, I was the representative from the Los Angeles Autism Society chapter for one of these monthly AMC/ASA screenings, and I spoke to a mom who was with her 3 year old son with autism. I saw them together a few minutes later, and I greeted the boy and asked him his name. "Miles", he said, though it was a little tough to understand. Mom gently repeated his name, and I said "Hi Miles, nice to meet you". We shook hands, I gave him a high five, and Mom and child turned to enter the theater. I said "Bye Miles, see you later". His mom stopped him, and said "Look at Susan, and say good bye".

I know Mom's intentions were good.  This was me with Jacob not too long ago. Not making eye contact is not socially acceptable, so I was told that Jacob needed  to learn how. I knew that when Jacob was cute and little, people wouldn't be so judgmental. But as he aged, this would become a problem - a teenager or adult who does not make eye contact is viewed as being disrespectful. Just as I often did with Jacob, Miles's Mom prompted her son to make eye contact. When Jacob was the same age, my fear was probably similar to hers. Neither of us wants our child grow up to be perceived as someone who is rude or inconsiderate.

Being a wiser person about the world of ASDs, if I speak with an adult and he has difficutly making eye contact, I would probably think he is on the autism spectrum. I'd be compassionate rather than judgmental. But most people don't think like me. So, take a moment to really think about the reasons for prompting someone to make eye contact. Put yourself in the mind of Miles during our interaction.

If Miles does not want to make eye contact with me, why is it beneficial to tell Miles to make eye contact if he has no desire to do so? If he doesn't feel the need to look at me, if there is no natural curiosity to read the cues from my non-verbal communication, if he has no desire to find out if I'm really showing that I'm listening or yawning because I'm bored, if he has no desire to share the experience of being congurent in our feelings and our thoughts, why would telling him to make eye contact further his interest? This would be similar to giving someone a tool without instructions on how to use it. Like telling someone to make scrambled eggs when they'd never used a stove. With instruction, the importance of the stove would be understood and making scrambled eggs becomes an easy thing to do. Once he's understood why the stove is important, the person's interest could be further sparked and could lead to the desire to make new and interesting discoveries beyond just cooking eggs.

So the question is why don't children with autism make eye contact? Because they don't know how to the handle constant changes that are required while interacting with someone. In order to have a reciprocal conversation, our brains use many dynamic skills all at the same time: we listen to the other person, we interpret their non-verbal cues and vocal intonations, and we reference our own past expereinces to formulate responses to new information. For us neureotypicals, the skills we've leaned in order to have reciprocal conversations are something that we developed naturally. For us,  most interactions throughout our day are positive and are conducted without much difficulty.

The wiring of the brain of a child with autism makes this type of neurological multi-tasking very difficult, and this makes having a reciprocal conversation an overwhelming and confusing experience.  It's like having the TV and the radio playing at the same time.  Turn off the radio and it's easier to focus on what the TV is communicating.  For a child with autism, take away having to interrupt the non-verbal cue of facial expressions, and it's easier to focus on the words being said.  This can help to make the experience of having a conversation less stressful.  Unfortunately, without non-verbal communication, you miss most of the context of what is being said by the other person which makes having a successful reciprocal conversation extremely difficult.  This is a big reason why people with autism like to dominate conversations on their topics of interest.  It's easier to talk about something you know a lot about than having to react in the moment about things you may know nothing about.

Prompting a child to do something for the sake of compliance does not facilitate a child's inner longing for self-discovery of their world. It doesn't foster a desire to connect to people outside himself. In order to encourage a child to expand their desire for curiosity, a parent needs to help thier child feel safe. A parent needs to help their child expereience new discoveries in an environment that is comfortable and not scary or overwhelming.  There also has to be a context for eye contact.  A child needs to understand that you look at someone's face to gather information, like knowing if they bored so you know it's time to stop talking or change the subject.  A skill taught without context is meaningless, so telling a child to look at someone's eyes when the child doesn't understand the reason does nothing to help him develop appropriate communication skills.

To all those parents who want to prompt their child to make eye contact, think about what your child will be thinking when he hears your request. Remember, he doesn't want to make eye contact; this is a tough thing for him to do. Your goal is help him feel secure enough so he won't feel so overwhelmed.  You want him to reference your non-verbal communication so he will include you in the conversation.  As I've mentioned before, the only program I know that directly addresses this issue is Relationship Development Intervention. Once the trust is established and the child doesn't fear the unknown changes in his environment, making eye contact during a conversation won't be such a scary thing for him to do anymore.

So, the next time you want your child to look you in the eye, make sure he knows the reason why.  Remember, eye contact without context is meaningless.  Your goal is not to have your child look at you for the sake of looking.  Your goal is to have your child look at you so he can get more information about your conversation.  And once your child has that desire to look you in the eye, he'll do that for others as well.


2 comments:

  1. Thank you Susan! I have an 11 yr old w/ HFA & eye contact remains one of the most poorly understood aspects of ASD. If anything, I hear people say that children "can't handle input" but now why - in an RDI sense, as you describe. RDI was key to our early intervention & still part of our lifestyle. I have a small list for SF bay area folks interested in RDI if you're interested - it's at http://health.groups.yahoo.com/group/rdibayarea/ - S.Cal isn't too far away to join - we have parents & professionals on the list but not a lot of traffic. Thanks again for sharing your blog!

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  2. I don't know where to start. I have just found out that my oldest 9 yrs old maybe on the spectrum. I just thought being a girl she was just emotional, but boy was I wrong! She's emotional because of how her brain works. Never in a million yrs did I think this would happen. I'm so glad to know now, and my husband and I can go forward to get her tested to make sure this is really is what is going on. She has sensory overload and is socially awkward which now makes more sense than ever. She also has trouble looking at people when talking to or when people are talking to her. My biggest regret right now is telling her to look at me when I talk to you. As her mom I feel completely emotional for not realizing this sooner. I'm just glad that it has brought to my attention and get her help so we can help her grow into her own and help her succeed at life!

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