Expert: Jene Aviram - 7/10/2009

Question
Hello,

I have a 18 month old that is developing normally in every way except he doesn't make eye contact. He is talking and is starting to use two and three words at a time. He's happy and smiles and giggles a lot. He follows direction well. But for the past 6 months I've noticed he stares right at my mouth when I am speaking to him and rarely looks up at my eyes. I get a chill when he does look me in the eye, that's how rare he does it. So I searched on the Internet about it and I found this study that says two year old toddlers who look at your mouth over the eyes are probably autistic. But I don't believe he has any other signs of autism besides the lack of eye contact. I was wondering what would be other reasons for his lack of eye contact? What should I do to help him make eye contact?

Answer
Hi,

Lack of eye contact is most often associated with autism, hearing problems or speech & language delays.  Since you have researched autism and your child is on track with language, it doesn't appear as if these issues are the case for your child at all.

In my book, when a parent has a concern it's always worth seeking a professional opinion and an evaluation.  This way you can put your mind at rest.  Call your pediatrician and let him know your concerns.  Tell him exactly what you told me - that eye contact is so rare you get a chill.  Ask you who can see for an evaluation.  A Developmental Pediatrician is often the person of choice and your states Early Intervention program is another option.

Eye contact helps us determine emotions and regulate social interaction.  Your son is very young and this is the perfect time to encourage this milestone.  Some suggestions which you're probably already dong are to give your child lots of opportunities for social interaction with adults as well as his peers.  Every time he makes eye contact with you, lavish attention on him so he knows that making eye contact is fun and worthwhile.  Insist on eye contact whenever you can, but without words.  The perfect time to do this is when your son wants something.  For example, lets say he wants a cookie and you're holding it.  Go down on the floor and get close to his face while you hold the cookie close to your face.  Say his name if you need to grab his attention.  The minute he looks into your eyes, give him a huge smile and hand him the cookie.

I would also suggest playing some games with him to increase eye contact.  Does he like peek-a-boo?  This is a great game to get some eye contact.  I would also try and play some simple interactive games together that involve looking at each other before the next step takes place.  You can be creative and make these games up.  Do you have stairs in your house?  One example would be for you to sit on the top of the stairs together with a big bag of lightweight balls.  You have control of the balls.  The object of the game is to let him throw the balls down the stairs when he sees you nod your head that it's OK.  If you shake your head no, then it's not time to do that yet.  Make your expressions as dramatic as possible, particularly with your eyes.  When you are shaking your head no, scrunch up your eyes and your brows.  When you are nodding yes, look absolutely delighted.  Use NO LANGUAGE in this game.  You want him to rely on non-verbal cues.  

Hold one ball in your hand as if you're giving it to him.  When he reaches for it, shake your head no.  If he doesn't look at you, keep a firm grip on it.  Shake your head no again.  If he still doesn't look up at you, literally swing your head from side to side to try and attract his attention.  If all else fails, grunt to get his attention.  The minute he looks up at you, nod in a delighted "Yes" and let him throw it down the stairs.  Don't get despondent.  Rome wasn't built in a day.  Play this repeatedly and you will see that he'll start responding and probably love it.  Use this philosophy with other games.  Get a mailing tube and sit together at a child's table.  Angle the tube to the floor.  With the same philosophy, let him put the cars down the tube so he can see them fly out the other side.  Do you have bean bags or lots of pillows?  Kneel down and hold his hands.  Shake your head from side to side.  When you nod your head, fall down on the pillows together while you shout "We're Falling!"  Once again, try and use no directive language in these games so that your son must seek out your expressions.  You're catching him at a perfect age and consistency is key.  You will find these games will help a lot as he learns that she must look up at you for direction and information.

I wish you great success and I hope this has been of some help.

Jene Aviram
http://www.nlconcepts.com