Is Lack of Eye Contact an Autism Symptom? What the Research Shows

Differences in eye contact are one example of the social communication differences used to diagnose autism, but a lack of eye contact alone does not mean a child is autistic. Many autistic people avoid eye contact because it can feel uncomfortable or overwhelming. A diagnosis requires a full evaluation of communication, behavior and development.

Your toddler does not look at you when you say their name. Your teenager stares at your shoulder during a conversation. A friend tells you that autistic kids "never" make eye contact. Which of these is a sign of autism, and which is just a person being a person? This guide explains what the research says about autism eye contact: how it fits into diagnosis, why many autistic people avoid it, what happens when it is forced, and what to do instead. If you are watching for other early differences, our guide to the early signs of autism is a good starting point.

Is Lack of Eye Contact an Autism Symptom?

It can be one part of the picture, but it is never enough on its own. The DSM-5 criteria, as summarized by the CDC, list "abnormalities in eye contact and body language" as an example of differences in nonverbal communication. The CDC page notes that the examples are illustrative, not exhaustive. A diagnosis requires persistent differences in each of three areas of social communication and interaction, plus at least two of four types of restricted, repetitive behaviors.

That means a child who avoids eye contact does not meet criteria for autism for that reason alone. Shyness, anxiety and personality can all affect how much people look at each other. If eye contact is one of several things you have noticed, talk to your pediatrician, and read when autism is diagnosed to see what an evaluation involves.

Autism and Eye Contact in Babies and Toddlers

Researchers have studied eye contact in infants for years, and the results show why it is not a simple test. A 2013 study from Emory University and the Marcus Autism Center, funded by NIMH and published in Nature, followed babies from birth to age 3 using eye tracking. Babies who were later diagnosed with autism looked at a caregiver's eyes less and less over time. The decline began between 2 and 6 months, and by 24 months they looked at the eyes about half as long as other babies. Nearly all of the children diagnosed were in a group with an older sibling who was autistic, so this was not a general-population screen.

Later work is more cautious. A 2024 study in the journal Autism used live eye tracking with 169 infants at about 10, 14 and 18 months, and found that how infants responded to an adult's direct gaze did not distinguish those who were later diagnosed from those who were not. The authors concluded that attenuated responses to direct gaze in infancy are "neither strong nor specific early markers of autism."

So eye contact is one thing clinicians notice, not a test. Screening tools such as M-CHAT ask about many behaviors at once, and eye tracking is currently a research tool rather than something a pediatrician uses.

Why Do Autistic People Avoid Eye Contact?

For many autistic people, eye contact is not a lack of interest. It is uncomfortable. Two lines of research support this.

Brain imaging. In a 2017 fMRI study in Scientific Reports, Hadjikhani and colleagues scanned 23 autistic participants and 20 non-autistic participants while they watched faces. When they could look anywhere, brain activity in the amygdala was similar between groups. When a cross on the screen made them look at the eyes, the autistic group showed unusually high activity in the amygdala and other subcortical regions. The authors suggested that this overreaction may be behind eye avoidance in daily life, pointing to oversensitivity rather than indifference. The study was small, did not track where people looked during scanning, and included only participants with normal intelligence.

A later review of 11 neuroimaging studies found that eight supported this "eye avoidance" idea, in which avoiding eyes reduces uncomfortable arousal. The review notes the evidence base is small, and most participants were male and higher-functioning, so it should not be generalized to everyone.

First-hand accounts. Trevisan and colleagues analyzed 698 statements from 364 people who said they were autistic, drawn from YouTube videos and an online forum, in a 2017 study in PLOS ONE. Common themes were fear and anxiety, physical symptoms such as dizziness and nausea, a feeling of being invaded or exposed, sensory overload, and difficulty listening while making eye contact. Many who were pressured to make eye contact as children described it as traumatic. The authors note that diagnoses could not be verified and that the sample probably leans toward people with strong reactions. They also concluded that eye contact difficulties are not the same for everyone, so the reasons likely vary from person to person.

If your child covers their ears or avoids bright lights too, those differences may be connected. Our guide to sensory sensitivity in autism explains how.

Other Reasons a Person Might Avoid Eye Contact

Autism is one of several explanations. Social anxiety can cause the same behavior, and the two can occur together. Our comparison of social anxiety and autism explains how clinicians tell them apart. Attention, shyness and personal or family customs can also play a part. This is why an evaluation looks at the whole child and not at a single behavior.

Is Avoiding Eye Contact a Problem?

Not by itself. Many autistic people listen, understand and connect well without looking at someone's eyes. The Hadjikhani authors do note that avoiding the eyes can mean missing some social information, so there can be a tradeoff. That is a reason to make communication easier, not to make a child endure discomfort.

Social difficulty also runs in both directions. Autistic and non-autistic people may misread each other, which researchers call the double empathy problem. Our overview of the double empathy problem covers it.

Forcing Eye Contact Has Costs

Hadjikhani and colleagues caution that forcing autistic people to make eye contact in therapy "might be counterproductive and elicit more anxiety." They suggest that any attempt to increase eye contact be gradual and paired with incentives and ways to make it less stressful. In the Trevisan study, people described compensating by looking at the mouth or nose, softening their focus, sitting at an angle, or making eye contact only at key moments.

Doing this all day is tiring. This kind of effort overlaps with what people call masking, which we cover in our guide to autism masking.

What to Do Instead of Asking for Eye Contact

The research above does not show that increasing eye contact helps a child by itself. Here is a more useful way to think about it.

• Ask what the goal is. If the goal is "my child is understood and understands others," there are more direct ways to get there than counting seconds of eye contact.
• Teach other ways to show listening. A nod, a short reply, turning toward the speaker or repeating back what was said all show engagement. Our guide on functional communication explains how to build ways to ask for what a child needs.
• Let the person choose. Teens and adults can tell you what feels manageable. If a person wants to practice eye contact, it should be their choice, and it should stay gradual.
• Build social skills without making eye contact the test. See social skills support for ideas.
• Read our practical guide. We also have eye contact strategies for people who want to practice.

How to Talk With Someone Who Avoids Eye Contact

You do not need eye contact to have a good conversation. Sit side by side instead of face to face. Let the person look at an object, the floor or the distance. Check understanding by asking a question or noticing their reply. Our guide on how to talk with autistic people has more conversation tips.

Where ABA Therapy Fits

A good ABA program starts with what the child needs to communicate, not with how the child looks while communicating. A BCBA can help by:

• Looking at what a child's gaze is telling you, such as discomfort, fatigue or focus.
• Teaching ways to ask for a break, get attention, and show listening that do not depend on eye contact.
• Setting an eye contact goal only when the child or family wants one and it serves a purpose, and making any practice gradual and optional.
• Working with speech and occupational therapists so supports are consistent.

If a plan lists "increase eye contact" as a goal, ask your BCBA why it is there and what it is meant to help with.

Frequently Asked Questions

Q: Can autistic people make eye contact?

A: Some do, some do it only sometimes, and some find it too uncomfortable. Eye contact differences vary a lot between individuals, and many people use strategies such as looking at the whole face, the mouth, or a spot nearby.

Q: Does avoiding eye contact mean my child isn't listening or doesn't care?

A: Not necessarily. The Hadjikhani authors suggest that eye avoidance may reflect oversensitivity to social information rather than indifference. Check understanding through what your child says and does, not where they look.

Q: What can I say instead of "look at me"?

A: Try saying your child's name and waiting, using a gesture or a picture cue, or asking a question that needs an answer. These are practical suggestions and not research-tested scripts. Choose what works for your child.

Q: Is there a test for eye contact differences?

A: Not one that doctors use. Eye tracking is mainly a research tool, and the 2024 infant study found that gaze responses were not strong or specific markers. Evaluations look at communication, behavior and development together.

Ready to Talk About ABA Therapy?

If you are looking for support for your child, our team can explain how ABA therapy works and what a first assessment looks like. Visit Apex ABA to learn more, contact us or call 888-690-0663.

This article is general information and not a diagnosis or medical advice.

Sources

1. CDC, "Clinical Testing and Diagnosis for Autism Spectrum Disorder" (DSM-5 criteria summary): https://www.cdc.gov/autism/hcp/diagnosis/index.html
2. Jones, W., & Klin, A. (2013). Attention to eyes is present but in decline in 2-6-month-old infants later diagnosed with autism. Nature. NIMH summary: https://www.nimh.nih.gov/news/science-updates/2013/earliest-marker-for-autism-found-in-young-infants
3. Rudling, M., Nyström, P., Bussu, G., Bölte, S., & Falck-Ytter, T. (2024). Infant responses to direct gaze and associations to autism: A live eye-tracking study. Autism, 28(7): https://journals.sagepub.com/doi/10.1177/13623613231203037
4. Hadjikhani, N., et al. (2017). Look me in the eyes: constraining gaze in the eye-region provokes abnormally high subcortical activation in autism. Scientific Reports, 7, 3163: https://nmr.mgh.harvard.edu/nouchinelab/pdfs/Hadjikhani_et_al-2017-Scientific_Reports.pdf
5. Eye Gaze in Autism Spectrum Disorder: A Review of Neural Evidence for the Eye Avoidance Hypothesis. Journal of Autism and Developmental Disorders (2022): https://link.springer.com/article/10.1007/s10803-022-05443-z
6. Trevisan, D. A., Roberts, N., Lin, C., & Birmingham, E. (2017). How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts. PLOS ONE, 12(11), e0188446: https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0188446