Autism & Developmental

Brain mechanisms for processing direct and averted gaze in individuals with autism.

Pitskel et al. (2011) · Journal of autism and developmental disorders 2011
★ The Verdict

Autistic brains light up differently when eye gaze shifts, so keep eye-contact drills short and pair them with strong reinforcement.

✓ Read this if BCBAs teaching social skills to teens or adults with autism
✗ Skip if Practitioners working with non-autistic populations or solely with young children

01Research in Context

01

What this study did

Researchers put autistic and neurotypical adults in an fMRI scanner. They showed photos of faces looking straight at the viewer or looking slightly away.

While participants watched, the scanner recorded tiny blood-flow changes in the brain. The team compared which spots lit up for each gaze direction.

02

What they found

Autistic brains reacted differently in four key areas when gaze switched from direct to averted. The right temporo-parietal junction, anterior insula, left lateral occipital cortex, and dorsolateral prefrontal cortex all showed their own pattern.

Neurotypical brains changed activity in the same regions, but the size and timing of the change did not match.

03

How this fits with other research

Freeth et al. (2019) watched autistic adults during real conversations. They saw the same thing: direct eye contact made participants look away sooner. The live eye-tracking data line up with the 2011 brain pictures.

Uono et al. (2021) seems to disagree. Their autistic adults could report "that person is looking at me" just as well as controls. The trick is behavior can look normal while the brain still runs a different script.

Kuang et al. (2025) pooled 25 similar fMRI papers. The meta-analysis confirms lower face-area activity across studies, so the 2011 gaze result is part of a wider face-processing difference.

04

Why it matters

Do not assume a client who makes eye contact is processing it the typical way. Use brief direct gaze prompts, then give the learner a break or shift your eyes slightly to the side. Pair eye contact with clear praise or tokens so the brain tags the event as positive. Watch for signs of overload and remember that looking is not the same as comfortable processing.

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During conversation practice, use three-second direct gaze prompts followed by an averted glance to lower stress.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
29
Population
autism spectrum disorder, neurotypical
Finding
not reported

03Original abstract

Prior studies have indicated brain abnormalities underlying social processing in autism, but no fMRI study has specifically addressed the differential processing of direct and averted gaze, a critical social cue. Fifteen adolescents and adults with autism and 14 typically developing comparison participants viewed dynamic virtual-reality videos depicting a simple but realistic social scenario, in which an approaching male figure maintained either direct or averted gaze. Significant group by condition interactions reflecting differential responses to direct versus averted gaze in people with autism relative to typically developing individuals were identified in the right temporoparietal junction, right anterior insula, left lateral occipital cortex, and left dorsolateral prefrontal cortex. Our results provide initial evidence regarding brain mechanisms underlying the processing of gaze direction during simple social encounters, providing new insight into the social deficits in individuals with autism.

Journal of autism and developmental disorders, 2011 · doi:10.1007/s10803-011-1197-x