Non-autistic observers both detect and demonstrate the double empathy problem when evaluating interactions between autistic and non-autistic adults.

LAY ABSTRACT: The "double empathy problem" refers to breakdowns in communication and understanding that frequently occur between autistic and non-autistic people. Previous studies have shown that autistic people often establish better rapport and connection when interacting with other autistic people compared to when interacting with non-autistic people, but it is unclear whether this is noticeable to non-autistic observers. In this study, 102 non-autistic undergraduate students viewed and rated video recordings of "get to know you" conversations between pairs of autistic and non-autistic adults. Sometimes the pairs were two autistic people, sometimes they were two non-autistic people, and sometimes they were "mixed" interactions of one autistic and one non-autistic person. Observers tended to rate non-autistic participants and their interactions the most favorably, but-consistent with the "double empathy problem"-they rated mixed interactions between autistic and non-autistic people as the least successful. They also perceived that only non-autistic people disclosed more when interacting with a non-autistic conversation partner. Autistic participants' partners in the conversations tended to evaluate them more favorably than did outside observers, suggesting that personal contact may facilitate more positive evaluations of autistic people. Furthermore, observers expressed less social interest in participants than did the autistic and non-autistic participants in the interactions. Together, these findings suggest that non-autistic observers both detect and demonstrate some aspects of the double empathy problem.

A mixed method comparison of stigma toward autism and schizophrenia and effects of person-first versus identity-first language.

Introduction: While stigma toward autistic individuals has been well documented, less is known about how autism is perceived relative to other stigmatized disabilities. As a highly stigmatized condition with similar social cognitive features to autism, schizophrenia may offer a useful comparison for stigma. Previous studies have found that autistic people may be perceived more favorably than those with schizophrenia, but little is known about the underlying volitional thoughts that contribute to differences in how these conditions are perceived. Methods: The present study utilizes a mixed-methods approach, allowing for a detailed understanding of how young adults perceive different diagnostic labels. 533 college undergraduates completed questionnaires reflecting their perceptions of one of eight diagnostic labels: four related to autism (autism, autistic, autism spectrum disorder, or Asperger's), two related to schizophrenia (schizophrenia or schizophrenic), and two related to an unspecified clinical condition (clinical diagnosis or clinical disorder). Participants also completed an open-ended question regarding their thoughts about, and exposure to, these labels. Responses were compared across broader diagnostic categories (autism, schizophrenia, general clinical condition), with thematic analysis used to assess the broader themes occurring within the open-ended text. Results: While perceptions did not differ significantly for person-first and identity-first language within labels, several differences were apparent across labels. Specifically, quantitative results indicated greater prejudice towards autism and schizophrenia than the generic clinical condition, with schizophrenia associated with more perceived fear and danger, as well as an increased preference for social distance, compared to autism. Patterns in initial codes differed across diagnostic labels, with greater variation in responses about autism than responses about schizophrenia or the general clinical condition. While participants described a range of attitudes toward autism (patronizing, exclusionary, and accepting) and schizophrenia (fear, prejudice, and empathy), they refrained from describing their attitudes toward the general clinical label, highlighting the centrality of a cohesive group identity for the development of stigma. Finally, participants reported a number of misconceptions about autism and schizophrenia, with many believing features such as savant syndrome to be core characteristics of the conditions. Conclusion: These findings offer a more detailed account of how non-autistic individuals view autism and may therefore aid in the development of targeted programs to improve attitudes toward autism.

A Cross-sectional Conceptual Replication and Longitudinal Evaluation of the PANSS-Autism-Severity-Score Measure Suggests it Does Not Capture Autistic Traits in Individuals With Psychosis.

BACKGROUND: Autism and psychosis co-occur at elevated rates, with implications for clinical outcomes, functioning, and suicidality. The PANSS-Autism-Severity-Score (PAUSS) is a measure of autism trait severity which has not yet been validated externally or longitudinally. STUDY DESIGN: Participants were derived from the GROUP and SCOPE datasets. Participants included 1448 adults with schizophrenia spectrum disorder (SSD), 800 SSD-siblings, 103 adults diagnosed with an autistic spectrum condition (ASC), and 409 typically-developing controls (TC). Analyses from the original validation study were conducted with SSD participants, and extended into ASC, SSD-sibling, and TC participants. Test-retest reliability of the PAUSS at 2-weeks and long-term stability 3 and 6-years was also examined. STUDY RESULTS: Results differed in important ways from the original validation. SSD participants reported higher PAUSS scores than other groups, with only a fraction of ASC participants scoring as "PAUSS-Autistic." Cronbach's alpha was acceptable for the SSD cohort only. Two-week stability of the PAUSS was fair to good for all PAUSS scores. Long-term stability was poor for most PAUSS items but fair for total PAUSS score. CONCLUSIONS: Results suggest that the PAUSS does not appear appropriate for assessing autism, with the low rate of PAUSS-Autistic in the ASC population suggesting the PAUSS may not accurately reflect characteristics of autism. The relative lack of long-term stability is cause for concern and suggestive that the PAUSS is capturing features of psychosis rather than autism traits.

Assessing the diametrical model of schizotypal and autistic traits in emotion recognition and social functioning in a community sample.

BACKGROUND: Some research suggests that schizotypal and autistic traits can produce opposing effects on the mentalizing domain of social cognition. Although such findings support a diametrical model proposing that psychotic and autistic traits represent opposite extremes of the social brain continuum, results from recent studies have been more inconsistent, and the applicability of this model to other social cognition domains remains unclear. To test the diametrical model more broadly, this study examined the interactions between schizotypal and autistic traits on emotion recognition and social functioning. METHOD: A total of 791 participants recruited from the general population self-reported schizotypal traits using the Schizotypal Personality Questionnaire-Brief Revised (SPQ-BR) and autistic traits using the Broad Autism Phenotype Questionnaire (BAPQ). Participants also completed the Emotion Recognition 40 task and the Specific Levels of Functioning (SLOF) scale. RESULTS: The SPQ subscales of interpersonal relationships and disorganized symptoms interacted significantly with social BAP on overall emotion recognition performance and the accuracy of identifying neutral faces. Supporting the diametrical model, elevated levels of both schizotypal and autistic traits contributed to higher emotion recognition accuracy compared to elevations on only one trait. For social functioning, however, the diametrical model was not supported. A main effect was found such that higher interpersonal relationship difficulties on SPQ predicted lower work skills on SLOF, and higher levels of both schizotypal and autistic traits combined to produce even lower social functioning. CONCLUSIONS: These findings suggest that the diametrical model may be more relevant to social cognition than to social functioning.

Heterogeneity of social cognitive performance in autism and schizophrenia.

Autistic adults and those with schizophrenia (SCZ) demonstrate similar levels of reduced social cognitive performance at the group level, but it is unclear whether these patterns are relatively consistent or highly variable within and between the two conditions. Seventy-two adults with SCZ (52 male, Mage  = 28.2 years) and 94 with diagnoses on the autism spectrum (83 male, Mage  = 24.2 years) without intellectual disability completed a comprehensive social cognitive battery. Latent profile analysis identified four homogeneous subgroups that were compared on their diagnosis, independent living skills, neurocognition, and symptomatology. Two groups showed normative performance across most social cognitive tasks but were differentiated by one having significantly higher hostility and blaming biases. Autistic participants were more likely to demonstrate fully normative performance (46.8%) than participants with SCZ, whereas normative performance in SCZ was more likely to co-occur with increased hostility and blaming biases (36.1%). Approximately 43% of participants in the full sample were classified into the remaining two groups showing low or very low performance. These participants tended to perform worse on neurocognitive tests and have lower IQ and fewer independent living skills. The prevalence of low performance on social cognitive tasks was comparable across clinical groups. However, nearly half of autistic participants demonstrated normative social cognitive performance, challenging assumptions that reduced social cognitive performance is inherent to the condition. Subgrouping also revealed a meaningful distinction between the clinical groups: participants with SCZ were more likely to demonstrate hostility biases than autistic participants, even when social cognitive performance was otherwise in the typical range. LAY SUMMARY: Social cognition refers to the perception and interpretation of social information. Previous research has shown that both autistic people and those with schizophrenia demonstrate reduced performance on traditional social cognitive tasks, which we replicate here at the group level. However, we also found that almost half of autistic participants performed in the normal range. Over a third of participants with schizophrenia did as well, but for them this performance was accompanied by a hostility bias not commonly found in the autistic sample. Taken together, findings challenge assumptions that difficulties in social cognition are a uniform characteristic of these clinical conditions in those without intellectual disability.

Effects of an Educational Presentation About Autism on High School Students' Perceptions of Autistic Adults.

Background: Social communication difficulties are a clinical characteristic of autism, but social interactions are reciprocal in nature and autistic individuals' social abilities may not be the only factor influencing their social success. Nonautistic individuals' social perceptions and behavior also contribute to autistic individuals' social difficulties. Previous research has identified that nonautistic individuals' perception of autistic individuals is influenced by autism knowledge and the quantity and quality of exposure to autistic people. The current research aimed to examine how autistic adults are perceived by high school students, assess whether quality and quantity of autism contact predicts these perceptions, and explore whether these perceptions are malleable. Methods: One hundred fifty-one senior high school students (15-19 years old) completed the First Impression Scale after viewing video recordings of 20 autistic and 20 nonautistic adults in social situations, either before or after viewing a 50-minute educational presentation detailing the everyday experiences of autistic people and participating in a question-and-answer session. We assessed students' prior experiences with autistic people using the Quantity and Quality of Contact Scale and their own self-perceived social competence using the Multidimensional Social Competence Scale. Results: Consistent with previous studies, students rated autistic adults less favorably than nonautistic adults. However, the educational presentation produced modest but significant improvements on these ratings, with students who viewed the presentation rating autistic adults as more attractive and likable and reporting greater social interest in them compared to those who had not yet viewed the presentation. Furthermore, consistent with a double empathy framework, exploratory analyses indicated that self-reports of greater social competence among students was associated with greater bias against autistic adults, whereas reports of higher quality interactions with autistic people were associated with less bias. Conclusion: Previous research has demonstrated that nonautistic adults evaluate autistic people less favorably and report lower social interest in them relative to nonautistic controls. In this study, we extend these findings to adolescents but find these biases are somewhat malleable, with education about autism exerting some modest benefits. Changing nonautistic attitudes about autistic differences may provide an avenue for improving interactions for autistic individuals without putting the onus on autistic individuals to change or mask their behavior and identity.

Why is this an important issue?: Nonautistic people often have negative views or biases about autistic differences. These biases contribute to the "Double Empathy Problem," where the attitudes, misunderstandings, and behaviors of nonautistic people can add to the social challenges faced by autistic people. However, we do not know how and why these negative biases develop, and more research is needed to understand when they appear, what factors contribute to them, and whether they can be changed. What was the purpose of this study?: We wanted to look at whether nonautistic teenagers at high school share the same biases toward autistic people that have previously been shown in adults. We then wanted to see if we could improve nonautistic teenagers' views of autistic people by teaching them about what being autistic means. We were also curious whether high school students who have spent more time with autistic people would view autistic people more positively. Finally, we were interested in whether nonautistic people's views of autistic people depend on how they viewed their own social skills. What did the researchers do?: High school students (15­19 years old) viewed an educational presentation describing the everyday experiences of autistic people and took part in a question-and-answer session about autism. They also made judgments about 20 autistic and 20 nonautistic adults in videos, such as whether they thought the person in the video was likable or awkward, and if they would hang out with them or not. Half of the students made these judgments before viewing the presentation and the other half did this after viewing the presentation. This allowed us to see whether the educational presentation could change high school students' attitudes about autistic people. The high school students also filled out questionnaires about their experiences with autistic people and their own social skills, so we could assess whether these things were associated with attitudes about autistic people. What were the results of this study?: Students viewing the educational presentation first rated autistic adults as more attractive, likable, and said they would be more interested in hanging out with them compared with the students who had not yet viewed the presentation. Students who reported higher quality experiences with autistic people in the past judged autistic people in the videos more positively, but those who thought they personally had strong social skills judged the autistic adults more negatively. What do these findings add to what was already known?: We previously knew that nonautistic adults have negative attitudes toward autistic people. In this study, we show that nonautistic high school students also show negative attitudes toward autistic people. More importantly, we also find that these views can be improved somewhat by a presentation about autism. We also show that nonautistic adolescents who say they are the most socially skilled rate autistic people the most negatively. This may be because they are the most likely to value "typical" or "normative" social skills and be more judgmental about those who socialize in a different way. What are the potential weaknesses in the study?: Students only rated autistic people from videos. We are not sure if the results would have been the same if the students were judging autistic people in real life or directly interacting with them. We also do not know if the judgments would be different if we had used different autistic adults or a more diverse sample. For instance, none of the autistic adults in the videos had an intellectual disability. How will these findings help autistic adults now or in the future?: These findings suggest that educating about autistic lives and high-quality contact with autistic people may be tools for improving the attitudes of nonautistic adolescents. This stage in life may be particularly important for improving the acceptance and inclusion of autistic people, as late adolescence is when many autistic people are beginning the transition to adulthood and their well-being may be increasingly affected by their experiences with nonautistic people.

Studies of autistic traits in the general population are not studies of autism.

Studies of autistic traits in the general population are becoming increasingly prevalent. In this letter to the editor, we caution researchers against framing and interpreting studies of autistic traits in the general population as extending to autism and implore them to be clear about when their study sample does and does not include autistic participants.

Greater Social Interest Between Autistic and Non-autistic Conversation Partners Following Autism Acceptance Training for Non-autistic People.

Bi-directional differences in social communication and behavior can contribute to poor interactions between autistic and non-autistic (NA) people, which in turn may reduce social opportunities for autistic adults and contribute to poor outcomes. Historically, interventions to improve social interaction in autism have focused on altering the behaviors of autistic people and have ignored the role of NA people. Recent efforts to improve autism understanding among NA adults via training have resulted in more favorable views toward autistic people, yet it remains unknown whether these benefits extend to real-world interactions between autistic and NA people. The current study explores whether a brief autism acceptance training (AAT) program can improve social interactions between autistic and NA adults. Thirty-nine NA males were randomly assigned to complete AAT or a no-training control condition, then participated in a 5-min unstructured conversation with an unfamiliar autistic male (n = 39). Following the conversation, participants rated their perceptions of interaction quality, first impressions of their partner, and their interest in future interactions with their partner. In dyads where the NA individual completed AAT, both the autistic and NA person endorsed greater future interest in hanging out with their partner relative to dyads in which the NA adult did not complete AAT. However, other social interaction outcomes, including ratings of interaction quality and first impressions of autistic partners, largely did not differ between training and no-training conditions, and assessments of the interaction were largely unrelated for autistic and NA partners within dyads. Results also indicated that NA participants, but not autistic participants, demonstrated substantial correspondence between evaluations of their partner and the interaction, suggesting that autistic adults may place less weight on trait judgments when assessing the quality of an interaction. These findings suggest that the brief AAT for NA adults used in this study may increase mutual social interest in real-world interactions between NA and autistic adults, but more systematic changes are likely needed to bridge divides between these individuals. Future work with larger, more diverse samples is recommended to further explore whether interventions targeting NA adults are beneficial for improving autistic experiences within NA social environments.

Situational context influences the degree of hostile attributions made by individuals with schizophrenia or autism spectrum disorder.

OBJECTIVES: Previous work has demonstrated that the tendency to make hostile attributions is not a stable trait but varies across different social situations. Therefore, we sought to investigate whether hostile attributions within clinical samples are better understood as a persistent characteristic or one that varies across contexts. METHODS: The current analyses investigated patterns of attributions among people diagnosed with schizophrenia (SCZ, n = 271) or autism spectrum disorder (ASD, n = 100) and non-clinical control participants (NCC, n = 233) in an existing data set. RESULTS: Results showed that specific relational features in vignettes portraying different social encounters influence the way people make attributions and that variability across contexts is present in both non-clinical and clinical populations. Like non-clinical participants, participants diagnosed with ASD ascribed the greatest hostility to a scene involving an authority figure. In contrast, SCZ participants reported the greatest hostility in response to a scene involving a friend. CONCLUSIONS: These findings suggest that salient environmental factors should be considered when assessing social cognitive skills and biases. PRACTITIONER POINTS: Hostile attributions should be perceived as situational constructs rather than stable and persistent characteristics. Hostile attributions were most prevalent among persons diagnosed with schizophrenia; however, on average, all participants showed greater hostility for situations involving an authority figure, an acquaintance, or a friend relative to those involving a co-worker or stranger. Psychotherapists and clinicians working with people diagnosed with schizophrenia or autism spectrum disorder could work on identifying situation triggers, which may prompt hostile attributions. Psycho-educational and psychotherapeutic interventions can be altered based on individual triggers of hostile attributions, and attempts can be made to lessen these attributions. Paranoia appears to be linked to hostile attributions regardless of the specific clinical diagnosis and should be considered in the therapeutic process.

Effects of autism acceptance training on explicit and implicit biases toward autism.

LAY ABSTRACT: Autistic adults face prejudice from non-autistic people. They are often judged unfairly and left out of social activities because of their differences. This can make it difficult for autistic people to make friends and find jobs. Some training programs have tried to teach autistic people to act more like non-autistic people to help them gain acceptance. Fewer have focused on teaching non-autistic people how to be more autism friendly. In this study, we used a short training video that teaches people about autism. The video was created with the help of autistic adults and included clips of real autistic people. We found that non-autistic people who watched this video had better knowledge about autism and showed more autism-friendly attitudes than those who watched a video about mental health or those who did not watch any video. They were more open to having a relationship with an autistic person and had more positive beliefs about autism. However, our video did not affect people's unconscious attitudes about autism. People in our study connected autism with unpleasant traits, even if they had watched the autism training video. This suggests that teaching non-autistic people about autism may promote more autism-friendly attitudes, but some beliefs may be harder to change.

Cognitive and Social Cognitive Self-assessment in Autistic Adults.

An aspect of metacognition associated with broader functional abilities in several clinical conditions, but previously unexamined in autism, is self-assessment (i.e., the ability to accurately self-evaluate one's own performance). We compared self-assessment between 37 autistic adults without intellectual disability to 39 non-autistic (NA) controls on a series of three general cognitive and three social cognitive tasks. Whereas autistic adults and NA adults did not differ in their self-assessment accuracy on general cognitive tasks, they did on social cognitive tasks, with autistic adults demonstrating lower accuracy. The direction of their inaccuracy was variable (i.e., both over and underestimation), and self-assessment was largely unrelated to their level of social functioning. Over versus underestimation may have different functional implications, and warrants future investigation.

Avoiding Ableist Language: Suggestions for Autism Researchers.

In this commentary, we describe how language used to communicate about autism within much of autism research can reflect and perpetuate ableist ideologies (i.e., beliefs and practices that discriminate against people with disabilities), whether or not researchers intend to have such effects. Drawing largely from autistic scholarship on this subject, along with research and theory from disability studies and discourse analysis, we define ableism and its realization in linguistic practices, provide a historical overview of ableist language used to describe autism, and review calls from autistic researchers and laypeople to adopt alternative ways of speaking and writing. Finally, we provide several specific avenues to aid autism researchers in reflecting on and adjusting their language choices. Lay summary: Why is this topic important?: In the past, autism research has mostly been conducted by nonautistic people, and researchers have described autism as something bad that should be fixed. Describing autism in this way has negative effects on how society views and treats autistic people and may even negatively affect how autistic people view themselves. Despite recent positive changes in how researchers write and speak about autism, "ableist" language is still used. Ableist language refers to language that assumes disabled people are inferior to nondisabled people.What is the purpose of this article?: We wrote this article to describe how ableism influences the way autism is often described in research. We also give autism researchers strategies for avoiding ableist language in their future work.What is the perspective of the authors?: We believe that ableism is a "system of discrimination," which means that it influences how people talk about and perceive autism whether or not they are aware of it, and regardless of whether or not they actually believe that autistic people are inferior to nonautistic people. We also believe that language choices are part of what perpetuates this system. Because of this, researchers need to take special care to determine whether their language choices reflect ableism and take steps to use language that is not ableist.What is already known about this topic?: Autistic adults (including researchers and nonresearchers) have been writing and speaking about ableist language for several decades, but nonautistic autism researchers may not be aware of this work. We have compiled this material and summarized it for autism researchers.What do the authors recommend?: We recommend that researchers understand what ableism is, reflect on the language they use in their written and spoken work, and use nonableist language alternatives to describe autism and autistic people. For example, many autistic people find terms such as "special interests" and "special needs" patronizing; these terms could be replaced with "focused interests" and descriptions of autistic people's specific needs. Medicalized/deficit language such as "at risk for autism" should be replaced by more neutral terms such as "increased likelihood of autism." Finally, ways of speaking about autism that are not restricted to particular terms but still contribute to marginalization, such as discussion about the "economic burden of autism," should be replaced with discourses that center the impacts of social arrangements on autistic people.How will these recommendations help autistic people now or in the future?: Language is a powerful means for shaping how people view autism. If researchers take steps to avoid ableist language, researchers, service providers, and society at large may become more accepting and accommodating of autistic people.

Social Cognition, Social Skill, and Social Motivation Minimally Predict Social Interaction Outcomes for Autistic and Non-Autistic Adults.

Social cognition, social skill, and social motivation have been extensively researched and characterized as atypical in autistic people, with the assumption that each mechanistically contributes to the broader social interaction difficulties that diagnostically define the condition. Despite this assumption, research has not directly assessed whether or how these three social domains contribute to actual real-world social interaction outcomes for autistic people. The current study administered standardized measures of social cognition, social skill, and social motivation to 67 autistic and 58 non-autistic (NA) adults and assessed whether performance on these measures, both individually and relationally between dyadic partners, predicted outcomes for autistic and NA adults interacting with unfamiliar autistic and NA partners in a 5 minute unstructured "get to know you" conversation. Consistent with previous research, autistic adults scored lower than NA adults on the three social domains and were evaluated less favorably by their conversation partners. However, links between autistic adults' performance on the three social domains and their social interaction outcomes were minimal and, contrary to prediction, only the social abilities of NA adults predicted some interaction outcomes within mixed diagnostic dyads. Collectively, results suggest that reduced performance by autistic adults on standardized measures of social cognition, social skill, and social motivation do not correspond in clear and predictable ways with their real-world social interaction outcomes. They also highlight the need for the development and validation of more ecological assessments of autistic social abilities and the consideration of relational dynamics, not just individual characteristics, when assessing social disability in autism.

Social cognition as a predictor of functional and social skills in autistic adults without intellectual disability.

Autistic adults, including those without intellectual disability, commonly experience poor social and functional outcomes. Although reduced social cognitive ability in autism is often theorized as a mechanism of these poor outcomes, there has been surprisingly little empirical work testing this assumption. Here, 103 autistic adults without intellectual disability completed a comprehensive battery that included eight social cognitive tasks psychometrically validated for use with this population (e.g., emotion recognition and theory of mind), five tasks assessing neurocognitive abilities (e.g., processing speed and working memory), performance-based measures of their functional skills, and a standardized assessment of their social skills. Collectively, the combination of demographic variables, IQ, neurocognitive performance, and social cognitive performance accounted for 49% of the variance in functional skills and 33% of the variance in social skills. For functional skills, demographic variables, and general and neurocognition independently accounted for a significant portion of the variance, but social cognition did not. Social cognition did, however, significantly mediate the effect of neurocognition on functional skills. Social cognition also accounted for significant proportion in the variance in social skills above and beyond the relatively large contribution of neurocognition. Taken together, findings indicate that social cognitive ability contributes to functional and social skills in autistic adults without intellectual disability, but this contribution may be more limited and indirect than commonly assumed. Autism Res 2020, 13:259-270. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Many social programs for autistic adults presume that improving social cognition will translate to better life outcomes. In this study of 103 autistic adults without intellectual disability, we found that social cognitive abilities do contribute to real-world social and daily living skills, but this contribution is small and indirect once general-cognitive abilities are taken into account. Although results substantiate social cognition as an independent cognitive capacity in autism spectrum disorder, its unique contribution to functional and social outcomes may be more limited than previously assumed.

Outcomes of real-world social interaction for autistic adults paired with autistic compared to typically developing partners.

Differences in social communication and interaction styles between autistic and typically developing have been studied in isolation and not in the context of real-world social interaction. The current study addresses this "blind spot" by examining whether real-world social interaction quality for autistic adults differs when interacting with typically developing relative to autistic partners. Participants (67 autism spectrum disorder, 58 typically developing) were assigned to one of three dyadic partnerships (autism-autism: n = 22; typically developing-typically developing: n = 23; autism-typically developing: n = 25; 55 complete dyads, 15 partial dyads) in which they completed a 5-min unstructured conversation with an unfamiliar person and then assessed the quality of the interaction and their impressions of their partner. Although autistic adults were rated as more awkward, less attractive, and less socially warm than typically developing adults by both typically developing and autistic partners, only typically developing adults expressed greater interest in future interactions with typically developing relative to autistic partners. In contrast, autistic participants trended toward an interaction preference for other autistic adults and reported disclosing more about themselves to autistic compared to typically developing partners. These results suggest that social affiliation may increase for autistic adults when partnered with other autistic people, and support reframing social interaction difficulties in autism as a relational rather than an individual impairment.

Comprehensive comparison of social cognitive performance in autism spectrum disorder and schizophrenia.

BACKGROUND: Autism spectrum disorder (ASD) and schizophrenia (SCZ) are separate neurodevelopmental disorders that are both characterized by difficulties in social cognition and social functioning. Due to methodological confounds, the degree of similarity in social cognitive impairments across these two disorders is currently unknown. This study therefore conducted a comprehensive comparison of social cognitive ability in ASD and SCZ to aid efforts to develop optimized treatment programs. METHODS: In total, 101 individuals with ASD, 92 individuals with SCZ or schizoaffective disorder, and 101 typically developing (TD) controls, all with measured intelligence in the normal range and a mean age of 25.47 years, completed a large battery of psychometrically validated social cognitive assessments spanning the domains of emotion recognition, social perception, mental state attribution, and attributional style. RESULTS: Both ASD and SCZ performed worse than TD controls, and very few differences were evident between the two clinical groups, with effect sizes (Cohen's d) ranging from 0.01 to 0.34. For those effects that did reach statistical significance, such as greater hostility in the SCZ group, controlling for symptom severity rendered them non-significant, suggesting that clinical distinctions may underlie these social cognitive differences. Additionally, the strength of the relationship between neurocognitive and social cognitive performance was of similar, moderate size for ASD and SCZ. CONCLUSIONS: Findings largely suggest comparable levels of social cognitive impairment in ASD and SCZ, which may support the use of existing social cognitive interventions across disorders. However, future work is needed to determine whether the mechanisms underlying these shared impairments are also similar or if these common behavioral profiles may emerge via different pathways.

Social and Object Attention Is Influenced by Biological Sex and Toy Gender-Congruence in Children With and Without Autism.

Emerging research suggests social attention in autism spectrum disorder (ASD) girls is enhanced relative to ASD boys but may also be affected by the type of social and nonsocial content presented. This study examined how biological sex and gender norms interact to influence visual attention in 79 school-aged children observing scenes that included gender-associated toys and actors of both sexes. Attention to social (faces) and object activity (hands with toys) stimuli was measured. Previously described distinctions between social attention in ASD boys and girls were replicated, with ASD girls looking more at faces than ASD boys. Irrespective of diagnosis, males and females attended more to actors that shared their same sex, and attended more to toys with gender-associations that were consistent with their own sex, suggesting that social and object salience increases for children under sex-consistent conditions. Importantly, ASD and typically developing (TD) children increased their gaze to faces when male actors were shown playing with female-associated toys, suggesting that both groups of children are sensitive to societal messages about the acceptability of males playing with female-associated toys. Our findings provide further evidence of heightened attention to faces in ASD girls relative to ASD boys, and indicate that social attention in ASD and TD children is influenced by who (male or female actor) and what (male- or female-associated toy) is being observed. Collectively, these results present a nuanced profile of attention in ASD that adds to a growing body of research indicating subtle phenotypic differences in ASD girls that may impact identification, assessment, and intervention. Autism Res 2020, 13: 763-776.. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Sex differences observed in typical development may also be present in individuals with autism. In this study, we developed an eye-tracking paradigm featuring videos of boys and girls playing with toys that varied in their gender associations. Attention to faces differed between autistic and non-autistic children but was also influenced by the sex of the actor and gender-association of toys. Autistic females demonstrated subtle attention differences that distinguished them from autistic males and may influence referral, diagnosis, and intervention.

Variability in first impressions of autistic adults made by neurotypical raters is driven more by characteristics of the rater than by characteristics of autistic adults.

Previous work indicates that first impressions of autistic adults are more favorable when neurotypical raters know their clinical diagnosis and have high understanding about autism, suggesting that social experiences of autistic adults are affected by the knowledge and beliefs of the neurotypical individuals they encounter. Here, we examine these patterns in more detail by assessing variability in first impression ratings of autistic adults (N = 20) by neurotypical raters (N = 505). Variability in ratings was driven more by characteristics of raters than those of autistic adults, particularly for items related to "intentions to interact." Specifically, variability in rater stigma toward autism and autism knowledge contributed to first impression ratings. Only ratings of "awkwardness" were driven more by characteristics of the autistic adults than characteristics of the raters. Furthermore, although first impressions of autistic adults generally improved when raters were informed of their autism status, providing a diagnosis worsened impressions made by neurotypical raters with high stigma toward autism. Variations in how the diagnosis was labeled (e.g. "autistic" vs "has autism") did not affect results. These findings indicate a large role of neurotypical perceptions and biases in shaping the social experiences for autistic adults that may be improved by reducing stigma and increasing acceptance.