Assessment over webcam and the eye contact issue.

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Shadweller
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13 Jan 2022, 2:53 am

I've been surprised and pleased to get my assessment date back quicker than I expected.

The only thing I'm not so pleased about is that it is proposed to be held remotely via webcam. I guess this is an inevitable and unavoidable sign of the times that we are in, and everything is now being done this way. Including where it can cause issues.

From experience of this set up with my 16 weeks of CBT for social anxiety, I know that the whole eye contact thing for me does not play out anything like it does in real life. It's like the screens and lenses and everything else makes it feel far more remote and shielded and safe and comfortable, and less real in a way. Looking directly at a person and have them look directly at me is so much easier via this method I find.

My therapist commented that my eye contact was good. "In real life", I am not like this at all. I can sense from people mirroring me back that there is no eye contact and I really dislike direct eye contact, it is so uncomfortable. I cant hold someones eyes at all. I find it difficult to gaze casually without staring and overdoing it sometimes.

My fear is that this is not going to be a reliable or valid indication of what my eye contact is like in real life. I'm definitely going to mention this to them.

Anyone else had any similar experiences or concerns? I have heard of people failing to get a diagnosis because they have been told that their eye contact was too good. Even though the assessment was done over webcam. This really is concerning me.



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13 Jan 2022, 7:05 am

There is far too much emphasis on eye contact in the media. You do not have to have ( or not have) eye contact to be diagnosed with autism. ( using DSM5 in the USA at least)

You must have struggles with social issues and struggles with communication, you must have rigid and repetitive though and behaviors.

Please don't worry about eye contact, especially over webcam communications. If the diagnosing professional is up to date and experienced with assessments, the eye contact thing is just a tick in the box for a very long list of possible criteria or symptoms to look for.

Today the
eye contact" thing is not nearly as important as in years past as a sign ( or symptom if you accept the medical terminology) of autism.

PS Its OK to be anxious and to tell the assessing party/parties that you are anxious. They will understand. Keep us posted!


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Double Retired
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13 Jan 2022, 11:21 am

I think my diagnosis was based upon what I said during the interviews and exercises, or how I fared on the questionnaires.

Observation was, I'm sure, a factor but I suspect it was more just to give the Psychologist additional confidence in the diagnosis. They'd probably understand that eye-to-eye is different than eye-to-camera.


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CarlM
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13 Jan 2022, 7:48 pm

Can't you give them a report from someone else who can describe your eye contact?


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ToughDiamond
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14 Jan 2022, 1:35 am

I would think that unless the camera lens were somehow embedded in the screen between (the image of) the other person's eyes, then if you do look at (the image of) their eyes, it'll seem to them that you're looking away from them, and if you look at the camera lens, it'll seem like you're looking them in the eye. The further away the lens is from their eyes, the greater the illusion. If the assessor doesn't know that, then the assessor is likely to be mistaken about the amount of eye contact you make.

But I don't understand if you're worried about (seeming to) make eye contact too much to get a diagnosis or too little to make them happy.



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14 Jan 2022, 1:55 am

Is the assessment with a mental health professional? If so it shouldn't be a problem..i mean it is an issue you have so they shouldn't make an issue of it. Sure for like a job interview or interacting with coworkers you may want to try and get better at stuff like that.. or at least figure a way to fake it a bit. But if it's a evaluation with a mental health professional its probably better if they see you struggle with eye contact than just trying to fake it.

Cause yeah you don't want to fake it for an evaluation as that may make it harder for them to determine if you have legitimate autism issues or not.



Shadweller
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14 Jan 2022, 12:50 pm

Thanks for the replies.

My OP may have been a bit confusing. In real life I don't make good eye contact naturally. Sometimes I may try and compensate for my natural lack of eye contact by consciously forcing the issue and trying to maintain eye contact just because all the advice and 'conventional good manners' insist that you must - for example when in job interviews. But then I can tell that I am doing it wrong, and can just end up staring at people and making them feel uncomfortable.

I have recently finished 16 weeks of CBT over webcam. My therapist said that my eye contact was good. Even though she wasn't assessing me she just commented on that. I am concerned that My ASD assessor may think the same thing and conclude that my eye contact is good, because I find it far easier to look and be looked at over screens, as opposed to 'real life' (not over webcams) where this is not the case at all.

I know that difficulties with making eye contact is one of the traits of Autism. And so presenting with that difficulty would score a point in an ASD assessment. If I am apparently making good eye contact over webcam then that is an invalid minus point I would score in my Assessment of Autism traits. It makes sense to me, but it's hard to explain if it's not making sense to anyone else. This may only mean anything to anyone else with exactly the same issue.

This would only become an important issue if they were to say "you are not Autistic - because you have made good eye contact during the assessment." If that was to happen it would make the assessment and method of assessment fundamentally invalid and scientifically unsound, due to the remote method of the assessment. I have read on other forums first hand tales of people stating that this is exactly what happened to them during their assessments, and it seems to me that it can make the assessment invalid, null and void if this was to happen. It's so frustrating that the whole process is so riddled with potential flaws and faults.

Of course none of this worse case scenario has actually happened to me yet. It's just a "what if it does happen" concern to be prepared for just in case. I believe that it is sensible to be prepared for an outcome that could arise, based purely on my own and other peoples previous experiences. I'm not going to fret about it too much, because that would be pointless, I'm just going to be prepared.

Sorry for rambling on. I hope this makes some sort of sense.



Elgee
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14 Jan 2022, 1:39 pm

I'm having a similar issue. My in-person eval has been scheduled, and I've always had GOOD strong eye contact. I've been reading threads on Quora, here and autismforums about eye contact. There ARE people diagnosed with autism who claim to have always had good eye contact. Several have posted they will stare down a person to assert authority or when pissed off.

One person said her 3 year old was diagnosed with non-verbal autism and has "great eye contact." I read of another case of a non-verbal child with dx'd autism who has "good eye contact."

I'd think that a good psychologist could tell when the client is staring unnaturally vs. an NT subconscious gaze. If I'm listening to someone explaining something or telling a breathy story, I will "stare" into their left eye and hold it there. This always has come with a little distraction, including the conscious effort to "do it right." It's not uncomfortable (no burning, creepiness, fear or amygdala activation that causes a feeling of panic). BUT it has a mechanical quality to it, like sustaining a handshake while in conversation.

It's also made me wonder, every so often while in the midst of it, if that person could somehow "read" me or tell something about me.

I've always thought that all of this was a little bit of paranoia, but the more I read others' accounts, the more I realize that this is the light end of eye contact issues for some autistics.

I also have an issue when speaking to a GROUP. I am simultaneously aware of gaze distribution and making sure everyone gets equal time with my eye contact. "Okay, time to look the next person in the eyes. Hold it. Now the next one. Hold it." These mechanics don't happen with NTs, do they?

The psy won't know you have these issues unless you TELL him/her. I'm not going to assume that my psy will think my sustained eye contact is a stare or looks unnatural. If by the end of the eval, she hasn't brought it up, I will then tell her everything I just wrote here.

Descriptions of ASD on medical sites don't say, "Struggling with eye contact is essential for diagnosis." But what's alarming is that I've read several posts on autismforums of people being denied a diagnosis based on eye contact. WHY is it so difficult to believe an autistic can have a history of good (sustained) eye contact? Why not also deny a diagnosis if they don't flap their hands or have a monotone voice?

I'm hoping confirmed ASD'ers contribute to this thread that they've always had good eye contact. I'm so worried this will disqualify me. I have all the other traits.



Shadweller
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14 Jan 2022, 2:23 pm

Yes everyone is different. Including those on the Autism Spectrum. One doesn't have to tick all the boxes. Lack of eye contact definitely is one of the boxes that can be ticked for some people when Assessing for Autism.

I cant really do eye contact in real life, but apparently I can appear to over webcam. My CBT therapist told me so. So I have objective proof. It may appear to the assessor that my eye contact over web cam is good, and they therefore might conclude that I don't have Autism.

I can only pray that they are sufficiently open minded to listen to what I have to say on the subject, if this situation does arise.From the look of the CVs of my assessors they seem to be very experienced and knowledgable, so hopefully none of this will cause any issues.

I presume there will be an opportunity during the assessment for me to raise any concerns or questions. This issue is definitely going to be something that I want to discuss with them.



Elgee
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14 Jan 2022, 2:53 pm

Why not have it in person? Webcam won't give them the oppty to note body language indicative of ASD such as stimming or whatever. Webcam can also subconsciously suppress facial expressions that they might need as part of the assessment. I think the evaluators can gain much more informamtion person to person sitting only five feet across from the client. I'm hoping my assessor will have me sitting close across from her. This way she can note details of my facial expressions/eye contact without a camera lens skewering anything. I've seen those Webcams. They make faces/eyes look kind of strange.



Shadweller
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14 Jan 2022, 3:12 pm

I don't think that's an option at the moment, what with Covid and all that, everything is done online now. Even job interviews. I think the world has changed for ever.

It's a good question though. I did think of asking them if I could have it in person, but then I had the thought above about Covid. I think I may well send them an email asking about this, and see what they say.

The fact is though that I have had my assessment dates come back to within 3 months of the referral. This is on the NHS too. I have read about other people in Manchester having to wait 2-3 years! I've no idea why this has been so quick. I may have been lucky with my timing, catching some sort of lull or something I don't know. Maybe it's the online thing speeding everything up.



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14 Jan 2022, 5:13 pm

I agree eye contact is a commonly mentioned trait but not obligatory. I would expect a qualified assessor to notice it but certainly not rely on it to the exclusion of other evidence—and in a remote session, if they want to explore the issue, I would think they would have to ask you about it because I don't recall any write-ups saying we're bad at looking at cameras or pictures of eyes.

I first learned of the Autism Spectrum and its associated traits when I was 64. I don't make eye contact but until then I did not know it was expected. (If I'm not looking at their eyes how the heck would I know they're looking at mine?!) When I was young my parents told me it was polite to look at people when I was talking with them and I do that—but they didn't say anything about eyes. To my knowledge it was likely only an issue a very small number of times in my life, one being during my Autism Assessment.


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Elgee
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14 Jan 2022, 5:26 pm

Double Retired wrote:
I agree eye contact is a commonly mentioned trait but not obligatory. I would expect a qualified assessor to notice it but certainly not rely on it to the exclusion of other evidence—and in a remote session, if they want to explore the issue, I would think they would have to ask you about it because I don't recall any write-ups saying we're bad at looking at cameras or pictures of eyes.

I first learned of the Autism Spectrum and its associated traits when I was 64. I don't make eye contact but until then I did not know it was expected. (If I'm not looking at their eyes how the heck would I know they're looking at mine?!) When I was young my parents told me it was polite to look at people when I was talking with them and I do that—but they didn't say anything about eyes. To my knowledge it was likely only an issue a very small number of times in my life, one being during my Autism Assessment.


I like the way you color "Autism Spectrum." When you've historically looked at people when talking/conversing, where DID you look if not the eyes? All over or did you focus on the mouth, between the eyes, neck? What about their eyes drew you away from them? I'm still trying to figure this out. I'm drawn to the eyes when the exchange is fairly back and forth or a one-time brief exchange like when I ask someone at the gym if they're done using a piece of equipment. But if I'm in a position where I must listen to some kind of story or explanation, the sustained eye contact feels like an obligation.



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14 Jan 2022, 8:17 pm

Elgee wrote:
I'm still trying to figure this out. I'm drawn to the eyes when the exchange is fairly back and forth or a one-time brief exchange like when I ask someone at the gym if they're done using a piece of equipment. But if I'm in a position where I must listen to some kind of story or explanation, the sustained eye contact feels like an obligation.

I get by with just glancing at their faces fairly frequently (particularly when they've just said something they or I think is important or surprising), and trying to make sure my body is turned towards them, and I might close my eyes a lot which I hope comes over as concentrating on what they're telling me. And I might kind of point an ear towards them or move closer to them if there's much background noise, to reinforce the idea that I want to hear what they're saying. I just have to hope that the stereotype of feeling ignored if the "listener" isn't gazing fixedly at the speaker isn't true of most people. Because I can't do that and actually take in what they're saying. Strangely, Alan Watts (Zen Buddhist) suggested that was true of everybody, though he also said that some teachers demand it.



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14 Jan 2022, 11:17 pm

I'm glad you enjoy my games with the colors it, amuses me.

And where do I look? Well, for a start, I don't stand to close. If my head is sort of aimed towards theirs it doesn't matter what my eyes do.

"What about their eyes drew you away from them?" Well, it feels to intimate. When I was at the office of the Psychologist who diagnosed me I was sitting not too far in front of her. I looked at her eyes but immediately found it uncomfortable. It felt way too intimate. The thoughts going through my mind were something along the lines of "What am I doing?! I'm a married man!! I shouldn't be doing this!"


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Elgee
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15 Jan 2022, 10:28 am

Double Retired wrote:
I'm glad you enjoy my games with the colors it, amuses me.

And where do I look? Well, for a start, I don't stand to close. If my head is sort of aimed towards theirs it doesn't matter what my eyes do.

"What about their eyes drew you away from them?" Well, it feels to intimate. When I was at the office of the Psychologist who diagnosed me I was sitting not too far in front of her. I looked at her eyes but immediately found it uncomfortable. It felt way too intimate. The thoughts going through my mind were something along the lines of "What am I doing?! I'm a married man!! I shouldn't be doing this!"


What if you're giving eye contact to a man (who you know is straight)? Does it still feel too personal or intimate? The behavior I find "too intimate" is when a stranger holds a door open for me, which, if I pander to this, forces me into their personal space. That's why if someone's ahead of me going towards a door I'm also headed for, I'll slow down or stop and check my phone or something so that they don't think I'm close enough to hold the door open for. But surprisingly, some will STILL do it if I'm 25 feet away. They also probably want eye contact. I know their eyes are on mine as I pretend to text. I'll STILL play around with my phone until they give up holding the door. Anyways, how is man to man eye contact for you, and what about children's eyes?