Eye Contact With Babies: What, When, Why, and How

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When I look at the statistics Blogspot gives me, I see that day after day, large numbers of people end up at this blog when they Google questions about babies and eye contact. Parents are obviously worried about this issue, and that fact is confirmed by the existence of quite a few websites that give instructions about how to get your child to make eye contact more often. But what are the facts about all this? Can you get your child to increase eye contact? Do you need to? Why are we concerned about this matter at all?

What is eye contact? The term “eye contact” might be better replaced by “mutual gaze”, because of course there is no real “contact” about this common human action. In mutual gaze, two people’s faces and eyes are aligned so that each set of eyes is gazing at the other set. This is often very brief, although it can also be maintained for seconds at a time. Mutual gaze may also be performed in a sequence of episodes, for example as two friends approach each other, joining and breaking gaze along the way, stop and briefly engage in mutual gaze, and finally avert their gazes slightly while talking. Prolonged mutual gaze may indicate deep emotional involvement-- but it can be either a loving look or a hostile or frightened stare, depending on the context and the rest of the facial expression. Mutual gaze has a terrific communicative power for human beings, but it can have more than one meaning.

When does eye contact happen? From birth, babies are interested in looking at faces and especially eyes, and do this so carefully that they can and do accurately imitate facial expressions in the early days of life. Nevertheless, most new parents find that it is quite difficult to get a sense of mutual gaze until some weeks have passed. At about 4 to 6 weeks, as babies begin to do what used to be called “taking notice”, they start to look more responsively at people who are looking at them-- especially if the adult does something attention-getting like opening eyes and mouth wide and “looming” closer to the baby’s face. Soon, the baby smiles in response to a smile, and maintains a mutual gaze with a friendly adult (familiar or unfamiliar). If the adult looks blank or “stares through” the baby, though, the latter will avert the gaze, appear uncomfortable, and begin to cry. The baby expects the adult to “manage” his or her gaze in a way that coordinates with the baby’s gaze.

By about 6 months, babies begin to look toward an adult’s face and eyes for “social referencing” purposes, not for eye contact in and of itself, but to get information from the facial expression and the direction of the adult’s gaze. This information guides the baby in understanding the environment and knowing whether unfamiliar things are worrisome, neutral, or pleasant. The baby continues to pay attention to the direction of people’s gazes and between 9 and 12 months begins to show “joint attention”-- using the gaze as a “pointer” to show someone else where to look, and following another person’s gaze to see an interesting sight. These are not examples of mutual gaze, but they are other forms of communication that may emerge from mutual gaze.

It can be hard for an inexperienced parent to know whether a baby makes eye contact soon enough, long enough, or often enough. Anyone who expects prolonged mutual gaze many times a day from the time of birth is bound to be disappointed and frightened. The earliest eye contact events are fleeting, and even at 2 months the baby may not pay much attention without a good deal of adult effort. Mutual gaze during breastfeeding is not likely until the child is old enough to pause in sucking and look around, or let go the nipple temporarily and move the head-- perhaps 5 or 6 months of age.

Why is eye contact important? Mutual gaze is an important form of communication that conveys information both to the baby (“hey, people are quite interesting and pleasing”) and to the adult caregiver (“oh, my baby’s looking at me-- this feels so good-- he thinks I’m important and interesting”). It may be the foundation of other uses of gaze and other gestures for communication.

Looking at whether young children engage in mutual gaze can be a helpful way of understanding whether their development is typical or whether they have certain special needs. One of the best-known aspects of autism is the infrequency of eye contact. Individuals with Asperger’s syndrome, a disorder related to autism, may say that they dislike being looked at and find mutual gaze very uncomfortable. Persons with Fragile X syndrome are also known for their poor use of the gaze in social communication.

When people avoid looking at other’s eyes, or when they are simply inattentive to gaze information, they can miss much other information too. If an adult uses a word a child does not know, for instance, the child can often make a good guess by watching the adult’s gaze, to see what he or she is looking at. When a child also has poor language development, as is common in autism, the combination of underdeveloped language and of lack of gaze communication can make for serious difficulties, the appearance of deliberate noncompliance, and frustration for both child and adult. These facts all suggest that if a child is really not using mutual gaze or other gaze information, helping him or her gain those skills would be a valuable achievement.

However, it’s important to realize that increasing mutual gaze is not a way of increasing the child’s emotional attachment. Toddlers are more likely to engage in mutual gaze with people they are attached to, but increasing gaze episodes does not make them attached. Blind children become strongly attached to their familiar caregivers just as sighted children do; attachment is a very robust developmental phenomenon that involves hearing and touch as much as, or instead of, sight. Mutual gaze may have its strongest effect on adults, who are much influenced by the child’s gaze and feel a sense of emotional contact when exchanging gazes, so it’s possible that increasing mutual gaze can have an indirect effect on children through its influence on their caregivers. However, of course, blind parents also have strong emotional involvements with their children; they too can use other sources of communication to develop these intense relationships.

How to increase mutual gaze? I notice on several websites a variety of instructions for improving eye contact with children. These include wearing funny glasses (something like this was suggested by Nikolaas Tinbergen 40 years ago), playing games based on prolonging eye contact, and giving the child sweets while maintaining mutual gaze.

Whether these methods are a good idea depends in part on whether the child really does show too little eye contact for his age and situation. This is a point on which most parents need professional guidance. If the parent’s motivation comes from the belief that more eye contact would cause better attachment, and especially if the parent believes the child is poorly attached because he or she is disobedient, there is certainly little point in doing any of these things.

However, if the child is being treated for a developmental problem that is characterized by poor mutual gaze, the parent may already have received some training in rewarding eye contact or may at least be aware of how the behavior therapist works with this. An article that describes one method is to be found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2649838/ (Hall, S.S., Maynes, N.P., & Reiss, A.L. [2009]. Using percentile schedules to increase eye contact in children with Fragile X syndrome. Journal of Applied Behavior Analysis, 42, 171-176). Similar work can be done at home, but it needs to be carefully thought out beforehand.

**** Readers, if you accessed this post in a search for current work on eye contact and autism, please look at my post for Nov. 7, 2013, which discusses the Nature article by Warren Jones and Ami Klin.****


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More About Infants and Eye Contact: Gaze, Words, Gestures

How and why people make “eye contact” is a source of never-ending interest, especially to parents and caregivers of infants and toddlers. Experiencing a mutual gaze (which is probably a better term for eye contact) can be very gratifying to adults; it seems to tell us that some other person thinks we are really worth paying attention to. We don’t care for a stare-- when another person keeps his or her gaze ready to “catch” ours even though we pointedly look away-- but when we gaze at another, we are happy to find that that person gazes back at us. Because we find mutual gaze pleasing, parents are delighted when their infants return their gaze and carry on a prolonged shared look. When infants don’t do this after a few months of development after birth, their parents may also worry that there is something wrong. Perhaps the child’s vision is not normal, or perhaps there’s some burgeoning problem of early mental health. Autism is commonly feared by modern parents who have heard that lack of eye contact is characteristic of children with serious developmental problems of this type.

It’s true that in typical development, there is a growing use of the gaze in communication. It’s not just relevant to love and attachment, but to thinking about and understanding what other people want and do. Watching another person’s gaze gives more than emotional gratification—in combination with facial expression, it can tell you what he knows about, what he’s afraid of, what he wants you to do, and so on. All these are important things for a baby to figure out. Let’s not forget, though, that visually-impaired babies, children, and adults usually manage to learn these things about other people even though they do not have the capacity for mutual gaze or for monitoring the direction of another person’s gaze. The typical pattern of development for the normally-sighted baby is probably the easiest to manage, but it is not the only way human beings can learn to communicate with others and we should not give it so much importance that we think of it as a magical factor.

A recent study by Eugenio Parise et al. (“Influence of eye gaze on spoken word processing: An ERP study with infants”, Child Development , 2011,Vol. 82, pp. 842-853) examined whether a person’s gaze, seen before speaking began, made a difference to the way 5-month-old babies’ brains processed the speech they heard. The babies sometimes saw a face gazing directly at them and sometimes saw one with averted eyes; they sometimes hear a voice speaking normally (“forward”) and sometimes heard a voice speaking backward. They seemed to be especially interested in the direct gaze-- perhaps signaling “Hey, I’m talking to you, kiddo”-- combined with the unfamiliar backward-spoken words. The point about their responding differently is that the babies did not act as if what they saw and what they heard were unrelated. Instead, their listening was partly guided by what they saw, and especially by whether there was mutual gaze or not. What they saw seemed to have a role to play in their attention to and learning of the spoken language-- an exceedingly important step in child development.

One thing this tells us is that caregivers who look at infants infrequently are not giving them as many opportunities to learn as they may need. Caregivers who use their gaze, either in direct looking at the baby’s face, to “point” to an interesting object, or to avert when occasionally avoiding social contact, are providing much more information about language than dozens of flashcards pinned around the room. Caregivers who rarely use the gaze in ways babies can learn from may be depressed, sick, tired, or overwhelmed with work --- an example might be day care providers who have too many babies to care for.

Now, here’s what I want to know, and to the best of my knowledge no one has asked or answered this question: what about gesture language? It’s presently quite fashionable to use gesture language with infants and toddlers, to teach it and to encourage the children to use it, either at home or in group child care settings. Where does the adult’s gaze come into this? Can a direct gaze guide the child to be especially attentive to a gesture? If the child has to look at the hands to see the gesture, rather than listening while following the adult’s gaze to see an object referred to, how is language learning influenced? The great advantage of spoken language is that we can look at the thing talked about while listening to speech at one moment, and look at the speaker’s gaze while still listening to speech at the next moment. This seems to be a pattern that comes easily to sighted babies by about 5 months of age, but what if they don’t often get to do it, or do it only while simultaneously trying to look at a gesture?

I don’t want to suggest that gesture language in some way interferes with the typical process of learning. Babies with both visual and hearing impairments learn to communicate, but they follow their own patterns of growth and development. Is the same true for babies who are taught to use and understand gestures? It might be. There’s much still to learn, but it’s clear that eye contact can play a complicated role in both social and cognitive development.