The role of alexithymia in reduced eye-fixation in Autism Spectrum Conditions.

Bird et al. (2011) tracked eye movements of adults with autism while they looked at faces. The team also gave each person two quick surveys: one for autism traits and one for alexithymia.

Alexithymia means trouble naming and feeling emotions. The goal was to see which score—autism or alexithymia—better predicted how long each adult looked at the eyes.

Adults who scored high on alexithymia looked at the eyes less. Autism trait scores did not predict eye looking time.

In plain words, emotional processing problems, not autism itself, drove the well-known eye-avoidance pattern.

Ma et al. (2021) pooled 164 eye-tracking papers and confirmed less eye gaze in autism worldwide. Their meta-result includes the 2011 data, showing the alexithymia link is part of a universal gaze difference.

McLennan et al. (2008) seemed to disagree: they found no overall eye-gaze gap in adults with autism. The key difference is emotion type. D et al. used simple happy or angry faces; Geoffrey et al. used neutral faces. Neutral faces may expose the alexithymia effect that simple emotions hide.

Fleury et al. (2019) extended the idea to kids. They showed that children's alexithymia, not ASD diagnosis, predicted how much parents interacted with them. The same pattern—alexithymia over autism—now spans eye gaze, parent talk, and emotion regulation (Nour et al. 2023).

If a client avoids eye contact, screen for alexithymia before assuming pure social deficit. Target emotion labeling and interoception skills; they may boost both feelings vocabulary and natural gaze. When you pick stimuli for social skills training, know that neutral faces can trigger more gaze avoidance than clear happy or angry ones—adjust difficulty accordingly.