Wednesday, June 27, 2012

look into my eyes

One of the things most people with autism have trouble with is eye contact. It is one of the classic signs of autism. Tate has limited eye contact. There are theories out there about why. Some people think that eye contact is painful to a person with autism. I don’t think that is it. I don’t think Tate feels pain when he looks into my eyes but it does seem to make him uncomfortable. He looks away long before another child would. 

When Tate was a toddler and had lost much of the language he had developed, he then retreated into himself. He, like many children with autism, had the ability to shut out the world around him. He didn’t answer when we called. He stopped looking up when someone walked into the room, and he seemed deaf at times. When I was first educating myself about autism I kept reading about the avoidance of eye contact. When I had Tiny K (an early intervention team provided by the state) come to our home to have Tate evaluated, I had one foot in denial and one foot in the world of autism. I argued, “look, he looks at my face and he doesn’t avoid eye contact.” One of the teachers pointed out to me, very gently, that Tate did use eye contact, but on his own terms. If he initiated the interaction then he used brief eye contact but if someone else tried to engage him then he had almost no eye contact. I saw they were right. This is still true today. When Tate is excited enough to talk to someone about something HE is interested in (usually a movie) then he becomes animated and will make and maintain a little eye contact. However, if someone attempts to start a conversation with Tate, we often have to remind him to look at their face. We even have to ask him to turn toward the person who is speaking to him. He doesn’t use appropriate body language to show he is listening at all. Sometimes he isn’t. I have told him that people do not know you are interested in them if you are not looking at them. I imagine him thinking, “But I am NOT interested in them.” I have said, “Tate, you have to show you are interested in someone if you want them to like you.” I can imagine him thinking, “I don’t care if they like me or not.” I have told him he needs to be friendly. I can imagine him wondering why it matters if he is friendly or not. It makes no difference to him. If I had to describe autism in one word, and only one word, the best word would be “aloof.” The definition for aloof is: “uninvolved or unwilling to become involved with other people or events; remote in manner.” That sums autism up in a nutshell.

One of the things we work on a lot with Tate is reciprocity. Reciprocity is the back-and-forth exchange people have with each other, in conversation or any interaction. Tate just doesn’t know how to “keep the ball rolling” in conversation but also with body language, including eye contact. None of it comes naturally and what we are able to teach seems stiff and insincere. 

We attend a very tiny congregation of the Church of Christ. When services are dismissed, I often stop Tate from leaving the building to sit in the car. I tell him he needs to greet three people. He almost always chooses to speak to the same three people, and all he says is “hello.” He will usually answer any questions they ask him. If I give him the stipulation that he has to say more than “hello,” then he will tell them something about the next movie coming out that he wants to see. Then he wanders off, sometimes while they are in mid-sentence. The people we see at worship services are adults who he has known all his life. He knows the names of about six people we worship with. If I tell him to greet someone specifically, he often has to have me point to the person I named. He has been attending worship with these people since he was born but he cannot name most of them. They are friendly to him and always glad to see him but he has probably never looked at them really. 

I went to a workshop recently given by a speech pathologist. She talked about how to teach social skills to people with autism. She uses a term: “thinking with your eyes.” A person with poor social skills needs to be taught to look at other people and see what they are looking at. She says we have to teach kids with autism that others “think with their eyes.”  This is true. Tate doesn’t follow my eye gaze to see what I am looking at. Joint attention is not something that people with autism learn naturally. It must be taught. Typically developing children learn early on, if someone says, “look!” you should look at their eyes to see WHAT they are looking at, and then follow their gaze. I have been thinking a lot about this since that workshop and working on this with Tate. It is a hard concept to teach. 

As I was working in the kitchen this morning, I noticed one of our kittens watching me through the window. He wanted fed and he was watching me to see which direction I was moving. When I left the window and went toward the door he was there, greeting me. The kitten was better able to anticipate my motives and movements than Tate is much of the time. When I went outside, our miniature goats began bleating, calling for attention and our rabbit hopped over to the side of her hutch, hoping I would be reaching in to pet her. I am not saying these animals are smarter than Tate, by any means. Tate is a smart boy, with emotions and he loves and is loved. It was just interesting to me as I fed, watered, and petted animals this morning, how much attention they sought from me compared to Tate. I offered Tate breakfast and he accepted. If I would have tried to hug him he would have allowed it but not really wanted it. I talked to him and he did respond, but not with any enthusiasm. Yes, I know many ten year old boys would not want to be hugged by their mom and many boys would not love to have a conversation with their mother, first thing in the morning, but Tate has never really wanted much interaction, at any age. He does allow me to touch him, hug him and show him affection though, and many with autism would not. So, for this I am grateful. 

In contrast to Tate and autism, there is Sydney and ADHD.  She got up this morning, clinging to my leg as I walked around trying to get things done. She started talking before she was even out of bed and did not stop, even while chewing her food. She has “never met a stranger.” She stares at people, even their faces, and never gets tired of conversing with anyone that will listen. She might have a little trouble with reciprocity but it would be only because she hardly pauses to let someone else get a word in. When we go to worship, she makes it around to many of the adults, telling them all about her pets, toys and activities and asking them questions about themselves. She loves people. There are many days I wish I could give a small part of what Sydney has to Tate and a little of Tate would rub off on Sydney. He would become more interested in his surroundings and she would calm down a little. In some ways, I suppose that has happened. Without Sydney, Tate definitely wouldn’t be able to do some of the things he can.  Sydney is a great therapist for sure. 



If you enjoyed this post, you might also like this one about Tate's aversion to touch:  Don't Touch My Skin

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