Lack of Eye Contact as a Symptom of Autism

"Lack of eye contact" is a well-known symptom of autism. People with autism are less likely to look directly at another person's eyes, which suggests they're less engaged with others or less responsive to people in general.

A father playing with this daughter outside
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However, lack of eye contact isn't as simple as it seems. Not only can it occur for many different reasons, but it may also have quite a few causes.

Diagnosing Autism

According to the DSM-5, autism is characterized by "marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction."

Lack of eye contact is one of many criteria used by doctors to diagnose autism, but that symptom alone isn't enough to suggest the diagnosis. it's just one of many signs and behaviors which may suggest autism.

Since there are no blood and imaging tests for autism, doctors must rely on the spectrum of characteristic behaviors to make a diagnosis. The list can then compared to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.

Based on the evidence, the doctor can either confirm or exclude autism as the cause or, alternatively, suggest that the diagnosis is inconclusive.

Why the Lack of Eye Contact?

There are many reasons why any child might not make eye contact; by no means do all of those reasons relate to autism. For example, they may:

  • Be fearful of or dislike the person who is attempting to make eye contact
  • Have a hearing problem and be unaware that they should look at someone
  • Feel a general sense of social anxiety or shyness
  • Be from a culture that sees direct eye contact as a sign of disrespect (this includes many Asian cultures)

Children with autism, however, generally seem to avoid eye contact for different reasons. While studies are not absolutely conclusive, findings suggest that children with autism:

  • Often lack the usual social motivation that leads other children to make eye contact
  • Find it difficult to focus both on spoken language and on another person's eyes at the same time
  • May not understand that watching another person's eyes is more revealing than, for example, watching that person's mouth or hands
  • Can find eye contact to be a very intense and overwhelming sensory experience

Other Diagnostic Criteria

The DSM-5 defines autism as a persistent lack of social communication and interactions across multiple contexts as characterized by the following behaviors:

  • The lack of social-emotional reciprocity (the mutual exchange of input and responses)
  • The lack of nonverbal communication (including facial expression)
  • The inability to develop, maintain, or understand relationships, often perceived by others as being apathetic or disinterested

Clearly, the lack of eye contact can and does play a part in all of these behaviors.

A child who lacks eye contact but does interact socially, use non-verbal communication, and build close personal bonds is unlikely to be autistic—even if she lacks eye contact.

Recognizing a Problem

The lack of eye contact on its own should never be considered symptomatic of autism. This is especially true in infants who may not make eye contact but will generally turn their heads in the direction of a person's face.

However, you may want to investigate autism if your child is under three, lacks eye contact, and exhibits any of the other following traits:

You may then contact a developmental pediatrician or psychologist to conduct an evaluation.

A Word From Verywell

If your child is diagnosed with autism, therapy can start to develop or enhance his or her general communication skills. While some of the focus will be placed on developing eye contact, it is usually not the begin-and-end-all solution.

For some, eye-to-eye contact can the source of enormous anxiety and/or overstimulation. Setting realistic, incremental goals is always the best way to ensure that your child gets the most appropriate care specific to their needs.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

  2. Lauttia J, Hlminen TM, Leppanen JM, et al. Atypical Pattern of Frontal EEG Asymmetry for Direct Gaze in Young Children with Autism Spectrum Disorder. J Autism Dev Disord. 2019;49(9):3592-3601. doi:10.1007/s10803-019-04062-5

  3. Jones EJ, Gliga T, Bedford R, Charman T, Johnson MH. Developmental pathways to autism: a review of prospective studies of infants at risk. Neurosci Biobehav Rev. 2014;39:1-33. doi:10.1016/j.neubiorev.2013.12.001

Additional Reading

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.