Background: Eye contact in autism is said to be different than in all other populations worldwide. But despite decades of research on the nature of eye contact in autism, no definitive conclusions can be made. This while more understanding of this phenomenon could help overcome social problems that arise from atypical eye contact. One reason for this lack of understanding could be that the it's still unclear what the similarities and differences in eye contact are between people with and without autism. Furthermore, insufficient insight has been gained into how people with and without autism reflect on their own eye contact.

Aim: To compare objective measures of eye contact in adults with and without autism along with an exploration in how adults with and without autism reflect on their own eye contact. 

Method: An exploratory mixed methods design, developed in co-design with adults with lived experience. The design consisted of two parts. In the first part, a videotaped individual conversation was conducted with adults with autism (N=27) and without autism (N=27) about a mild and a complex topic. Duration, frequency of eye contact, and level of arousal were registrated, as well as notable eye behavior. In the second part, the participant and researcher reflected on the videotaped conversation, and notable eye behavior was also registrated. Quantitative analysis of the data from the first part was conducted using software programs SPSS and Matlab. Qualitative thematic analysis of the reflections in the second part was conducted using software programs Atlas.ti and Microsoft Excel.

Results and conclusions: At this moment, data analysis is conducted and will most likely be completed by the middle of 2026. It is estimated that the article will be published in the period the World Congress on Autism Research & Innovation will take place. Hypotheses are that adults with autism have a higher or lower duration and frequency of eye contact during interactions compared to adults without autism, that there is a difference in the eye behavior of adults with and without autism during mild topics compared to complex topics, that the level of arousal during eye contact is higher in adults with autism compared to adults without autism, that eye contact during an interaction is experienced as more intense by adults with autism compared to adults without autism and that adults with autism reflect on their eye behavior with a more neutral posture than adults without autism.

Implications for practice: This research could contribute to a better understanding of eye contact in adults with autism in comparison with adults without autism. Insight into the nature of eye contact in autism provides more guidance for both the adult with autism and the interaction partner. This in turn may help reduce interaction problems arising from eye contact in autism.

Jos Boer studied Nursing Specialism in Psychiatry (Honor Program) and graduated cum laude in 2022. After that, he started working as a primary practitioner at the Specialistic Center for Developmental Disorders, a top clinical center for adults with neurodevelopmental disorders and all comorbidity. Jos Boer is also PhD candidate at University Medical Center (UMC) Utrecht, where he focuses on the nature of eye contact in autism. Besides that, he is project manager of the Platform Nursing Research at the Dimence Groep, facilitating more than 900 nursing professionals. Jos Boer participates in many projects, for example in national guideline development and in the department for Nursing Specialists of V&VN; the national nursing association in the Netherlands. And he is a guest lecturer in neurodevelopmental disorders at the University of Applied Sciences in Amsterdam.