The influences of face inversion and facial expression on sensitivity to eye contact in high-functioning adults with autism spectrum disorders.

Researchers showed upright and upside-down faces to adults with autism and neurotypical adults. They used eye-tracking to measure how wide the 'gaze cone' was for each group.

The gaze cone is the area around the eyes where a person still feels like someone is looking at them. A narrow cone means you pick up tiny eye-direction changes. A wide cone means you need bigger shifts to notice.

Neurotypical adults had a narrow gaze cone for upright faces and a wide cone for inverted faces. That is the normal pattern.

Adults with autism kept the same wide cone for both upright and inverted faces. Flipping the picture did not change their sensitivity to eye contact.

Hedley et al. (2015) also found no inversion effect in adults with autism, but they tested face recognition instead of gaze. The two studies together suggest upside-down faces throw off autistic adults less than expected.

Falck-Ytter (2008) looked at preschoolers with autism and saw bigger pupil dilation and more feature-locked looking when faces were inverted. That seems opposite to the adult findings, but the kids were much younger and the task was free viewing, not gaze detection. The contradiction fades when you account for age and method.

Faja et al. (2009) showed adults with autism are less accurate at spotting configural face changes, especially around the eyes. The new result adds that they also miss subtle gaze-direction cues, giving you two reasons to keep eye-contact instructions clear and explicit.

Do not assume your client will notice small shifts in your eye gaze during social skills drills. Use clear verbal cues like 'Look at my eyes' and larger head turns. If you rely on subtle eye signals, autistic adults may miss them, even when the face is right-side up.