Are Children With ADHD Eye Contact And Social Interaction Sensitive?

Medically reviewed by Nikki Ciletti, M.Ed, LPC and Arianna Williams, LPC, CCTP
Updated November 19, 2024by BetterHelp Editorial Team

Eye contact difficulties are often linked to neurodevelopmental conditions like autism spectrum disorder (ASD). However, some individuals may wonder whether people with attention-deficit hyperactivity disorder (ADHD) can also experience discomfort or a lack of focus when making eye contact with others. Exploring the connection between ADHD, neurodiversity, and eye contact can be a way to better understand behaviors and find support with certain social challenges. If you struggle to make eye contact with others, you may find it helpful to look at other parts of a person’s face and practice in the mirror. A licensed therapist can offer further insight and guidance through online or in-person sessions.

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Understanding attention-deficit hyperactivity disorder (ADHD) symptoms 

The symptoms of ADHD can vary by subtype. Per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are three subtypes of ADHD, including primarily inattentive (ADHD-PI), hyperactive-impulsive (ADHD-HI), and combined type. 

Symptoms of ADHD-PI often include a lack of focus, difficulty remaining engaged in tasks, forgetting essential items or appointments, and experiencing memory difficulties. 

Meanwhile, people with ADHD-HI may display impulsive behavior, difficulty sitting still, a tendency to interrupt others when speaking, and quick switches in attention between activities. People with combined type ADHD may have some symptoms of both of the other subtypes.

Does ADHD make eye contact difficult? 

Difficulty making eye contact is not a criterion listed in the DSM-5 for any subtype of ADHD. However, a 2022 study found that disrupted attention when making eye contact may be linked to ADHD in children.

In this study, 82 participants from age eight to 13 were studied. Children who often shifted their gaze away from the eye contact of others typically had more significant inattention symptoms, suggesting that ADHD-PI may cause difficulty making eye contact.  

There currently aren’t any studies on ADHD and eye contact in adults. For this reason, more research may be recommended to fully understand the connection between ADHD and eye contact. Although many children live with ADHD, ADHD is usually a lifelong condition that can contribute to challenges with social cues, like making eye contact, into adulthood.

Neurodivergence and eye contact studies 

ADHD is usually considered a form of neurodivergence. Some people with ADHD may identify as neurodivergent, which generally means they have differences in cognition, sensory experiences, emotions, and social behavior that can vary from the “usual” behavior of neurotypical individuals. 

The theory of neurodiversity suggests that ADHD and conditions like autism spectrum disorder and dyslexia are not curable diseases but instead brain differences that can have positive impacts. However, these brain differences may cause functional challenges due to living in a “neurotypical world” that may not always support individuals who require accommodations.

Difficulty making eye contact is frequently correlated with autism spectrum disorder. Autistic children and adults may avoid eye contact in most situations because it can cause discomfort. Although this behavior may be seen as “rude” to some individuals, experts have found that making eye contact can reduce cognitive function and make it more difficult for Autistic and neurodivergent individuals to socialize. 

Scientific literature suggests that 50% to 70% of all Autistic individuals may also live with ADHD. For this reason, some people with ADHD who are also living with autism may experience difficulties with eye contact. However, more research is needed to understand whether this impact can be clinically observed and is not proof that eye contact difficulties are inherently common in people with ADHD. 

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Should ADHD eye contact difficulties be “corrected”? 

Debate exists over whether a lack of eye contact should be corrected or allowed. Under the neurodiversity theory, attempting to change an individual’s comfort level to make them conform to “neurotypical” norms can be harmful. People with ADHD and autism may mask their discomfort to try to “fit in” with others, which can lead to sensory burnout and overwhelm. 

Communication is key

Eye contact may indicate confidence, comfort, and honesty to some neurotypical people. However, for some neurodivergent individuals, eye contact can be incredibly uncomfortable. Not making eye contact does not usually harm anyone else and can be a way to accommodate yourself. If it makes you more comfortable to converse without making eye contact, you might communicate this to those with whom you talk to help them understand the reason behind your lack of eye contact. 

If you want to change your difficulty with eye contact, there are a few strategies you might use. 

How to make eye contact more comfortable for you

In some scenarios, people may be expected to maintain eye contact to show respect and interest, such as during job interviews. Below are several strategies people with ADHD might use to make eye contact more comfortable or to gradually improve eye contact. 

Look at other parts of the person’s face during social interaction

When focusing on the person talking, try looking at the bridge of their nose, between their eyebrows, or from one eye to the other. By not making direct contact with their eyes, you may find it easier to focus on the topic of the conversation. However, other factors of inattention may make it difficult to concentrate, so working with a therapist on this skill could be helpful. 

Mirror the other person

Mirroring another person’s behavior may help you focus on eye contact. Watch the person's body language and try to copy it as well as you can. Mirroring can show confidence and potentially create an air of “familiarity” between you and someone else. If the person doesn’t make much eye contact, it may be safe for you to also avoid eye contact around them. 

Practice in the mirror or with a friend  

Eye contact is a skill that can take time to master. Consider practicing eye contact in the mirror on your own, where you’re not pressured to socialize. When you are comfortable making eye contact with yourself and practicing conversations in the mirror, consider asking a close friend or family member if you can practice with them. When practicing, notice any discomfort in your body or moments when eye contact makes it more difficult for you to focus. You can also try practicing eye contact with characters in TV shows or movies. 

Take breaks 

People often don’t maintain eye contact without breaks, as it may appear aggressive or intense. When making eye contact, take breaks by looking at objects in your environment, looking up, or shifting your gaze. Look at how the other person is changing their eye contact and attempt to mirror their behavior. 

Have a staring contest with a friend 

In some cases, discomfort about making eye contact may be due to discomfort with the intimate sensation of looking into someone’s eyes. Making eye contact with strangers can be overwhelming when it seems like such an emotional gesture. To practice, consider having staring contests in silence with someone you trust. By learning to hold prolonged eye contact with someone in a controlled environment, it may become easier to hold eye contact in other situations. 

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Support options 

Discomfort with socialization and social norms like eye contact can be a symptom of ADHD in some cases. Neurodivergent individuals often experience discomfort when making eye contact, and doing so may reduce attention and cognitive ability. Masking your preferred behaviors to satisfy neurotypical expectations can be harmful to mental health. Talking to a professional about neurodiversity, masking, and other challenges can be a way to cope with life challenges related to ADHD. 

Online therapy for attention deficit hyperactivity disorder

If you struggle to make time for appointments because of a busy schedule or difficulty making commitments, you might find online therapy through a platform like BetterHelp more convenient. An online platform generally enables you to meet with a therapist from home via phone, video, or live chat sessions. In addition, online platforms can allow you to set appointments at times that work for you, including outside of standard business hours. 

Studies show that internet-based interventions can be effective in supporting clients with ADHD. In one meta-analysis, online interventions were usually proven effective in improving social function and attention in individuals with ADHD. 

Takeaway

ADHD may sometimes be associated with difficulty making eye contact. Difficulty making eye contact is often connected to autism, one of the highest comorbidities with ADHD. If you want to learn more about masking, eye contact, neurodivergence, or learning to change behaviors, consider reaching out to a licensed therapist online or in your area.
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