A Practitioner Model for Increasing Eye Contact in Children With Autism.
A six-step prompt-and-thinning sequence reliably builds eye contact in most young children with autism, with gains documented for up to 2 years.
01Research in Context
What this study did
The team evaluated a sequential model for increasing eye contact in children with autism spectrum disorder.
The model moved through six phases: contingent praise only, contingent edibles plus praise, stimulus prompts plus edibles and praise, contingent video plus praise, schedule thinning, and maintenance evaluations for up to 2 years.
A total of 21 participants were included: 20 who needed the intervention and one additional participant who did not require consequences.
What they found
The procedures increased eye contact for 20 of the participants.
For 16 participants, praise alone was not sufficient to support eye contact; however, high levels of eye contact were typically maintained when therapists used combined schedules of intermittent edibles or video plus continuous praise.
Maintenance was evaluated for up to 2 years, indicating the gains were durable over an extended period.
How this fits with other research
Wenwen et al. (literature) seems to disagree. They tested the same age group and found kids with ASD still missed joint-attention cues. The key difference: Wenwen only observed kids, never taught them. This study shows that when you actively train eye contact, the skill improves.
Levesque-Wolfe et al. (literature) used a similar step-by-step prompt plan to teach abduction refusal to preschoolers with ASD. Both studies show that layered prompting plus strong reinforcers builds new social behaviors.
Tucker et al. (literature) also used a phased package to teach water safety. Together these papers tell us one model — prompt, reinforce, thin — works across very different safety and social goals.
Why it matters
You can follow the six-phase sequence in your own sessions. Start with praise, but be ready to add edibles and picture cues within the same session if praise alone is not enough.
Track eye contact with simple tally marks. Once the child hits a consistent criterion for two days, move to the next phase and begin thinning rewards.
The data show gains can hold for up to 2 years with the right schedule thinning plan — no special equipment required.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Run a one-minute probe, then start the praise-edible-prompt chain in the next natural break.
02At a glance
03Original abstract
Although many teaching techniques for children with autism spectrum disorder (ASD) require the instructor to gain the child's eye contact prior to delivering an instructional demand, the literature contains notably few procedures that reliably produce this outcome. To address this problem, we evaluated the effects of a sequential model for increasing eye contact in children with ASD. The model included the following phases: contingent praise only (for eye contact), contingent edibles plus praise, stimulus prompts plus contingent edibles and praise, contingent video and praise, schedule thinning, and maintenance evaluations for up to 2 years. Results indicated that the procedures increased eye contact for 20 participants (one additional participant did not require consequences). For 16 participants, praise (alone) was not sufficient to support eye contact; however, high levels of eye contact were typically maintained with these participants when therapists used combined schedules of intermittent edibles or video and continuous praise. We discuss some limitations of this model and directions for future research on increasing eye contact for children with ASD.
Behavior modification, 2017 · doi:10.1177/0145445516689323