1. bookVolume 25 (2021): Issue 1 (January 2021)
Journal Details
License
Format
Journal
eISSN
2083-8506
First Published
01 Jan 1997
Publication timeframe
1 time per year
Languages
English
access type Open Access

Developing tolerance to eye contact in autism: A feasibility study with adults using behavioral, interview, and psychophysiological data

Published Online: 17 Dec 2021
Page range: 240 - 263
Journal Details
License
Format
Journal
eISSN
2083-8506
First Published
01 Jan 1997
Publication timeframe
1 time per year
Languages
English
Abstract

Many individuals with autism report that eye contact makes them stressed or uncomfortable. Besides expressing their right to respect for neurodiverse ways of nonverbal communication, some autistic individuals also express the wish to improve their capacity to tolerate eye contact. In the current study, five autistic adults completed a 21- to 28-day computerized program that combines psychoeducation with graduated exposure to eye contact through photos. Interview data, questionnaires, gaze patterns, and psychophysiological measures indexing stress and arousal (pupillary and galvanic skin response levels) were collected to monitor and evaluate outcomes. At intake, discomfort resulting from eye contact in everyday life was described as overwhelming and multifaceted. Post-training data showed that observed increases in eye contact were not happening at the expense of heightened arousal. These results provide information about the (complex) nature of eye gaze discomfort in autism while pointing toward promising techniques to increase discomfort tolerance.

Keywords

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa10.1191/1478088706qp063oa Search in Google Scholar

Creswell, J. W. (2014). A concise introduction to mixed methods research. SAGE Publications. Search in Google Scholar

Creswell, J. W., & Báez, J. C. (2020). 30 essential skills for the qualitative researcher. SAGE Publications. Search in Google Scholar

Dalton, K. M., Nacewicz, B. M., Johnstone, T., Schaefer, H. S., Gernsbacher, M. A., Goldsmith, H. H., et al. (2005). Gaze fixation and the neural circuitry of face processing in autism. Nature Neuroscience, 8(4), 519–526. https://doi.org/10.1038/nn142110.1038/nn1421 Search in Google Scholar

Díaz-García, A., González-Robles, A., Mor, S., Mira, A., Quero, S., García-Palacios, A., ... & Botella, C. (2020). Positive and Negative Affect Schedule (PANAS): Psychometric properties of the online Spanish version in a clinical sample with emotional disorders. BMC Psychiatry, 20(1), 1–13. https://doi.org/10.1186/s12888-020-2472-110.1186/s12888-020-2472-1 Search in Google Scholar

Dunn, D. S., & Andrews, E. E. (2015). Person-first and identity-first language: Developing psychologists’ cultural competence using disability language. American Psychologist, 70(3), 255–265. doi: 10.1037/a003863610.1037/a0038636 Search in Google Scholar

Emerson, R. W. (1876). The prose works of Ralph Waldo Emerson (Vol. 2). James R. Osgood and Company. Search in Google Scholar

Fenn, K., & Byrne, M. (2013). The key principles of cognitive behavioural therapy. InnovAiT, 6(9), 579–585. https://doi.org/10.1177/175573801247102910.1177/1755738012471029 Search in Google Scholar

Foxx, R. M. (1977). Attention training: the use of overcorrection avoidance to increase the eye contact of autistic and retarded children. Journal of Applied Behavioral Analysis, 10(3), 489–499. https://doi.org/10.1901/jaba.1977.10-48910.1901/jaba.1977.10-489 Search in Google Scholar

Gernsbacher, M. A. (2017). Editorial perspective: The use of person-first language in scholarly writing may accentuate stigma. Journal of Child Psychology and Psychiatry, 58(7), 859–861. https://doi.org/10.1111/jcpp.1270610.1111/jcpp.12706 Search in Google Scholar

Guetterman, T. C., Fetters, M. D., & Creswell, J. W. (2015). Integrating quantitative and qualitative results in health science mixed methods research through joint displays. Annals of Family Medicine, 13(6), 554–561. https://doi.org/10.1370/afm.186510.1370/afm.1865 Search in Google Scholar

Hadjikhani, N., Åsberg Johnels, J., Zurcher, N. R., Lassalle, A., Guillon, Q., Hippolyte, L., . . . Gillberg, C. (2017). Look me in the eyes: Constraining gaze in the eye-region provokes abnormally high subcortical activation in autism. Scientific Reports, 7, 3163. https://doi.org/10.1038/s41598-017-03378-510.1038/s41598-017-03378-5 Search in Google Scholar

Joseph, R. M., Ehrman, K., McNally, R., & Keehn, B. (2008). Affective response to eye contact and face recognition ability in children with ASD. Journal of the International Neuropsychological Society, 14(6), 947–955. https://doi.org/10.1017/S135561770808134410.1017/S1355617708081344 Search in Google Scholar

Jaswal, V. K., & Akhtar, N. (2018). Being vs. appearing socially uninterested: challenging assumptions about social motivation in autism. Behavioral and Brain Sciences, 1-84. https://doi.org/10.1017/S0140525X1800182610.1017/S0140525X18001826 Search in Google Scholar

Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250. Search in Google Scholar

Kliemann, D., Dziobek, I., Hatri, A., Baudewig, J., & Heekeren, H. R. (2012). The role of the amygdala in atypical gaze on emotional faces in autism spectrum disorders. Journal of Neuroscience, 32(28), 9469–9476. https://doi.org/10.1523/JNEUROSCI.5294-11.201210.1523/JNEUROSCI.5294-11.2012 Search in Google Scholar

Kose, L. K., Fox, L., & Storch, E. A. (2018). Effectiveness of cognitive behavioral therapy for individuals with autism spectrum disorders and comorbid obsessive-compulsive disorder: a review of the research. Journal of Developmental and Physical Disability, 30(1), 69–87. https://doi.org/10.1007/s10882-017-9559-810.1007/s10882-017-9559-8 Search in Google Scholar

Kylliäinen, A., & Hietanen, J. K. (2006). Skin conductance responses to another person’s gaze in children with autism. Journal of Autism and Developmental Disorders, 36(4), 517–525. https://doi.org/10.1007/s10803-006-0091-410.1007/s10803-006-0091-4 Search in Google Scholar

Lord, C., & Risi, S. (2003). Diagnostic criteria for the Collaborative Programs of Excellence in Autism [Paper presentation]. Meeting of the NIH Collaborative Programs of Excellence in Autism, Los Angeles, CA. Search in Google Scholar

Maratos, F. A., Gilbert, P., & Gilbert, T. (2019). Improving well-being in higher education: adopting a compassionate approach. In P. Gibbs, J. Jameson, & A. Elwick (Eds.), Values of the university in a time of uncertainty (pp. 261–278): Springer. Search in Google Scholar

McGlensey, E. (2016). 16 People with autism describe why eye contact can be difficult. Retrieved from http://themighty.com/2016/02/why-eye-contact-can-be-difficult-for-people-with-autism/ Search in Google Scholar

Merz, E. L., Malcarne, V. L., Roesch, S. C., Ko, C. M., Emerson, M., Roma, V. G., . . . Sadler, G. R. (2013). Psychometric properties of Positive and Negative Affect Schedule (PANAS) original and short forms in an African American community sample. Journal of Affective Disorders, 151(3), 942–949. https://doi.org/10.1016/j.jad.2013.08.01110.1016/j.jad.2013.08.011 Search in Google Scholar

National Institute for Health and Clinical Excellence. Autism: recognition, referral, diagnosis and management of adults on the autism spectrum. (Clinical guideline 142.) 2012. Retrieved from http://guidance.nice.org.uk/CG142. Search in Google Scholar

Nyström, P., Falck-Ytter, T. & Gredebäck, G. (2016). The TimeStudio Project: An open source scientific workflow system for the behavioral and brain sciences. Behavioral Research 48, 542–552. https://doi.org/10.3758/s13428-015-0616-x10.3758/s13428-015-0616-x Search in Google Scholar

Onghena, P., Maes, B., & Heyvaert, M. (2019). Mixed methods single case research: State of the art and future directions. Journal of Mixed Methods Research, 13(4), 461–480. https://doi.org/10.1177/155868981878953010.1177/1558689818789530 Search in Google Scholar

Ortiz, L., & Sjölund, A. (2015). Motiverande samtal vid autism och ADHD. Natur Kultur Akademisk. Search in Google Scholar

Pelphrey, K. A., Sasson, N. J., Reznick, J. S., Paul, G., Goldman, B. D., & Piven, J. (2002). Visual scanning of faces in autism. Journal of Autism and Developmental Disorders, 32(4), 249–261. https://doi.org/10.1023/A:101637461736910.1023/A:1016374617369 Search in Google Scholar

Perihan, C., Burke, M., Bowman-Perrott, L., Bicer, A., Gallup, J., Thompson, J., . . . Sallese, M. (2020). Effects of cognitive behavioral therapy for reducing anxiety in children with high functioning asd: A systematic review and meta-analysis. Journal of Autism Developmental Disorders, 50(6), 1958–1972. https://doi.org/10.1007/s10803-019-03949-710.1007/s10803-019-03949-7 Search in Google Scholar

Seltzer, M. M., Krauss, M. W., Shattuck, P. T., Orsmond, G., Swe, A., & Lord, C. (2003). The symptoms of autism spectrum disorders in adolescence and adulthood. Journal of Autism Developmental Disorders, 33(6), 565–581. https://doi.org/10.1023/B:JADD.0000005995.02453.0b10.1023/B:JADD.0000005995.02453.0b Search in Google Scholar

Tottenham, N., Tanaka, J. W., Leon, A. C., McCarry, T., Nurse, M., Hare, T., . . . Nelson, C. (2009). The NimStim set of facial expressions: Judgments from untrained research participants. Psychiatry Research, 168(3), 242–249. https://doi.org/10.1016/j.psychres.2008.05.00610.1016/j.psychres.2008.05.006 Search in Google Scholar

Trevisan, D., Roberts, N., Lin, C. J., & Birmingham, E. (2017). How do individuals with Autism experience eye contact? A qualitative analysis of first-hand accounts. PLoS One, 12(11), e0188446. https://doi.org/10.1371/journal.pone.018844610.1371/journal.pone.0188446 Search in Google Scholar

Ung, D., Selles, R., Small, B. J., & Storch, E. A. (2015). A systematic review and meta-analysis of cognitive-behavioral therapy for anxiety in youth with high-functioning autism spectrum disorders. Child Psychiatry & Humand Development, 46(4), 533–547. https://doi.org/10.1007/s10578-014-0494-y10.1007/s10578-014-0494-y Search in Google Scholar

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.10.1037/0022-3514.54.6.1063 Search in Google Scholar

Wright, J. (2006). Cognitive behavior therapy: Basic principles and recent advances. FOCUS, 4(2), 173–178. https://doi.org/10.1176/foc.4.2.17310.1176/foc.4.2.173 Search in Google Scholar

Zhou, J., Sun, J., Chen, F., Wang, Y., Taib, R., Khawaji, A., . . . Li, Z. (2015). Measurable decision making with gsr and pupillary analysis for intelligent user interface. ACM Transactions on Computer- Human Interaction, 21(6), 33. https://doi.org/10.1145/268792410.1145/2687924 Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo