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

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.