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Abstract
Autistic people often have an atypical profile of abilities: while excelling in some structured paradigms, many report difficulties with making real-life decisions. To test whether decision-making in autism is different from in typically developing controls, we reviewed 104 studies that compared decision-making performance between autistic and comparison participants ( N = 2712 autistic and N = 3189 comparison participants) between 1998 and 2022. Our searches revealed four main decision-making paradigms that are widely used in the field of decision neuroscience: perceptual discrimination, reward learning, metacognition and value-based decision-making paradigm. Our synthesis highlights that perceptual processing and reward learning were similar between autistic and comparison participants, whereas value-based decision-making and metacognitive accuracy were often different between groups. Furthermore, decision-making differences were most pronounced when the autistic participant was explicitly probed to report on an internal belief, while implicit markers of the same decision (e.g. error-related response times) were usually not different. Our findings provide evidence in favour of a metacognitive explanation of decision-making atypicalities in autism.
Lay summary
Many autistic people report difficulties with real-life decision-making. However, when doing decision-making tests in laboratory experiments, autistic people often perform as well or better than non-autistic people. We review previously published studies on autistic people’s decision-making, across different types of tests, to understand what type of decision-making is more challenging. To do this, we searched four databases of research papers. We found 104 studies that tested, in total, 2712 autistic and 3189 comparison participants on different decision-making tasks. We found that there were four categories of decision-making tests that were used in these experiments: perceptual (e.g. deciding which image has the most dots); reward learning (e.g. learning which deck of cards gives the best reward); metacognition (e.g. knowing how well you perform or what you want); and value-based (e.g. making a decision based on a choice between two outcomes that differ in value to you). Overall, these studies suggest that autistic and comparison participants tend to perform similarly well at perceptual and reward-learning decisions. However, autistic participants tended to decide differently from comparison participants on metacognition and value-based paradigms. This suggests that autistic people might differ from typically developing controls in how they evaluate their own performance and in how they make decisions based on weighing up the subjective value of two different options. We suggest these reflect more general differences in metacognition, thinking about thinking, in autism.
... We live in a world of uncertainty, where the outcomes of our actions are often predictable only in probabilistic terms. To navigate the uncertainty inherent in decision-making, it is essential to adjust significant attention from researchers over the past decade (for review see (van der Plas et al., 2023). Two influential hypotheses based on predictive coding theory aim to explain the heightened sensitivity to uncertainty in adults with ASD. ...
The ability to adjust brain resources to manage expected uncertainty is hypothesized to be impaired in autism spectrum disorder (ASD), though the evidence remains limited. To investigate this, we studied 23 neurotypical (NT) and 23 high-functioning adults with ASD performing a probabilistic two-alternative value-based task while undergoing magnetoencephalography (MEG) and pupillometry. The task comprised five sequential blocks with stable reward probabilities (70%:30%), but varying stimulus pairs and reward values, enabling the assessment of behavioral and neural adaptation to expected uncertainty. We analyzed the hit rate of advantageous choices, response times, and computational measures of prior belief strength and precision. To examine cortical activation during decision-making, we used magnetoencephalographic (MEG) source reconstruction to quantify α-β oscillation suppression in decision-relevant cortical regions within the pre-decision time window. Linear mixed models were applied to assess trial-by-trial effects.
Behaviorally, ASD participants exhibited lower overall belief precision but intact probabilistic rule generalization, showing gradual performance improvement and strengthening of prior beliefs across blocks. However, unlike NT individuals, they did not show a progressive downscaling of neural activation during decision-making or a reduction in neural response to feedback signals as performance improved. Furthermore, on a trial-by-trial basis, increased belief precision in ASD was not associated with reduced cortical activation, a pattern observed in NT individuals.
These findings suggest an atypically rigid and enhanced allocation of neural resources to advantageous decisions that individuals with ASD rationally judge as optimal. This pattern may reflect an aversive response to the irreducible uncertainty inherent in probabilistic decision-making.
... Such risk preferences in AUT individuals have also been investigated in experimental studies. Recently, van der Plas et al. [12] conducted a narrative review of 104 decision-making studies on AUT people and found that their performance in reward-learning paradigms (e.g., learning which deck of cards provides the best reward) was similar to that of NTP individuals, but their performance in value-based paradigms (e.g., making a decision based on a choice between two outcomes that differ in subjective value) was different from that of NTP individuals. For example, in several studies that adopted valuebased paradigms, financial risk-taking tasks focused on choices between alternatives of equivalent objective value but different risk for rewards (i.e., a choice between a sure option to win $1 versus a risky option to have a 50% chance to win $2) have shown that AUT adults are more risk-averse than NTP adults [13][14][15]. ...
Background
Risk preference changes nonlinearly across development. Although extensive developmental research on the neurotypical (NTP) population has shown that risk preference is highest during adolescence, developmental changes in risk preference in autistic (AUT) people, who tend to prefer predictable behaviors, have not been investigated. Here, we aimed to investigate these changes and underlying computational mechanisms.
Method
We ran a game-like risk-sensitive reinforcement learning task on 75 participants aged 6–30 years (AUT group, n = 31; NTP group, n = 44). Focusing on choices between alternatives with the same objective value but different risks, we calculated the risk preference and stay probability of a risky choice after a rewarding or non-rewarding outcome. Analyses using t-tests and multiple regression analyses were conducted. Using the choice-related data of each participant, we fit four reinforcement learning models and compared the fit of each model to the data. Furthermore, we validated the results of model fitting with multiple methods, model recovery, parameter recovery, and posterior predictive check.
Results
We found a significant difference in nonlinear developmental changes in risk preference between the AUT and NTP groups. The computational modeling approach with reinforcement learning models revealed that individual preferences for surprise modulated such preferences.
Conclusions
These findings indicate that for NTP people, adolescence is a developmental period involving risk preference, possibly due to lower surprise aversion. Conversely, for AUT people, who show opposite developmental change of risk preference, adolescence could be a developmental period involving risk avoidance because of low surprise preference.
... Both behavioral and neurological visual processing differences have been detected in autism (Farashi et al., 2023;Samson et al., 2011); however, on this level, there seems to be more evidence of greater efficiency among autistic individuals, at least for simple stimuli. Other studies show meta-cognitive differences in autism (van der Plas et al., 2023), which could translate into a different time course of decision making (i.e., reaching the confidence threshold necessary to give a response). ...
Prior research has established differences between autistic and non-autistic individuals across the domains of executive function (EF). While some early theories portrayed these differences as universal to the autism spectrum, recent findings have been quite mixed. Factors like small samples, the components of EF being measured, age and intelligence quotient (IQ), and co-occurring conditions like Attention Deficit Hyperactive Disorder (ADHD) may contribute to this diversity in results. Moreover, performance over time might be expected to fluctuate in different patterns for autistic and non-autistic individuals, leading to differences in outcomes according to the length of experiments. To determine the extent of EF differences and whether these factors influence them, we recruited a sample of over 900 autistic and non-autistic participants (with generally average/above average IQ levels) from 18-77 years of age. They completed a battery of tasks measuring inhibition, cognitive flexibility, working memory, and attentional orienting to social and non-social cues. We found that performance was similar between groups in our primary measures of EF, although autistic participants were consistently slower, more susceptible to the effects of spatial cueing, and more prone to certain errors in the working memory task. Differences between groups were generally not influenced by participants’ age, gender, or IQ, and autistic participants with/without co-occurring ADHD performed similarly. Performance over time varied only in the working memory task. While autistic adults may still face related challenges in real life, these findings suggest that being autistic does not necessarily imply executive dysfunction on a basic cognitive level.
... A narrative review of decision-making in autism evaluated different types of decision-making in AP and NAP. The authors suggest that AP and NAP perform similarly well at perceptual and reward-learning decisions, while they decide differently on metacognition and value-based paradigms (van der Plas et al., 2023). We think that this might explain highly variable study results in decision-making performance of AP. ...
Decision-making under unpredictable conditions can cause discomfort in autistic persons due to their preference for predictability. Decision-making impairments might furthermore be associated with a dysregulation of sex and stress hormones. This prospective, cross-sectional study investigated decision-making in 32 autistic participants (AP, 14 female) and 31 non-autistic participants (NAP, 20 female) aged 18–64 years. The Iowa Gambling Task (IGT) and the Cambridge Risk Task (CRT) were used to assess decision-making under ambiguity and under risk with known outcome probabilities, respectively. Cortisol, estradiol, and testosterone serum levels were related to decision-making performance. Groups did not differ in overall IGT and CRT performance, but compared with NAP, AP preferred less profitable card decks with predictable outcomes while avoiding those with unpredictable outcomes. AP required more time to reach decisions compared to NAP. Additionally, AP without comorbid depression performed significantly worse than NAP in the IGT. Estradiol and cortisol concentrations were significant predictors of CRT scores in NAP, but not in AP. The study results imply that AP are ‘risk-averse’ in decision-making under ambiguity as they avoided choice options with unpredictable losses in comparison to NAP. Our findings highlight the intolerance for uncertainty, particularly in ambiguous situations. Thus, we recommend being as transparent and precise as possible when interacting with autistic individuals. Future research should explore decision-making in social situations among individuals with ASD, factoring in person-dependent variables such as depression.
... For example, social naivety, intense preoccupations and a narrow range of interests, theory of mind (or mentalising) differences (understanding other's thoughts and beliefs), sensory sensitivities, emotional regulation difficulties, poor impulse control, a tendency to focus on small details and difficulty seeing 'the bigger picture' and the co-occurrence of other psychiatric conditions [20,[26][27][28][29][30]. Autistic individuals may have more difficulty making decisions by weighing up the subjective value of two different options, particularly if there is not a clear right or wrong answer [31]. This may have direct implications as to how autistic individuals navigate challenging social situations. ...
Background
Autism spectrum disorder (hereafter referred to as autism) is characterised by difficulties with (i) social communication, social interaction, and (ii) restricted and repetitive interests and behaviours. Estimates of autism prevalence within the criminal justice system (CJS) vary considerably, but there is evidence to suggest that the condition can be missed or misidentified within this population. Autism has implications for an individual’s journey through the CJS, from police questioning and engagement in court proceedings through to risk assessment, formulation, therapeutic approaches, engagement with support services, and long-term social and legal outcomes.
Methods
This consensus based on professional opinion with input from lived experience aims to provide general principles for consideration by United Kingdom (UK) CJS personnel when working with autistic individuals, focusing on autistic offenders and those suspected of offences. Principles may be transferable to countries beyond the UK. Multidisciplinary professionals and two service users were approached for their input to address the effective identification and support strategies for autistic individuals within the CJS.
Results
The authors provide a consensus statement including recommendations on the general principles of effective identification, and support strategies for autistic individuals across different levels of the CJS.
Conclusion
Greater attention needs to be given to this population as they navigate the CJS.
... Here, we do not provide specific presentations of the latter processes. In case of interest by readers, they can be found in various forms of the literature such as [94,95]. ...
Autism spectrum disorder (ASD), affecting over 2% of the pre-school children population, includes an important fraction of the conditions accounting for the heterogeneity of autism. The disease was discovered 75 years ago, and the present review, based on critical evaluations of the recognized ASD studies from the beginning of 1990, has been further developed by the comparative analyses of the research and clinical reports, which have grown progressively in recent years up to late 2023. The tools necessary for the identification of the ASD disease and its related clinical pathologies are genetic and epigenetic mutations affected by the specific interaction with transcription factors and chromatin remodeling processes occurring within specific complexes of brain neurons. Most often, the ensuing effects induce the inhibition/excitation of synaptic structures sustained primarily, at dendritic fibers, by alterations of flat and spine response sites. These effects are relevant because synapses, established by specific interactions of neurons with glial cells, operate as early and key targets of ASD. The pathology of children is often suspected by parents and communities and then confirmed by ensuing experiences. The final diagnoses of children and mature patients are then completed by the combination of neuropsychological (cognitive) tests and electro-/magneto-encephalography studies developed in specialized centers. ASD comorbidities, induced by processes such as anxieties, depressions, hyperactivities, and sleep defects, interact with and reinforce other brain diseases, especially schizophrenia. Advanced therapies, prescribed to children and adult patients for the control of ASD symptoms and disease, are based on the combination of well-known brain drugs with classical tools of neurologic and psychiatric practice. Overall, this review reports and discusses the advanced knowledge about the biological and medical properties of ASD.
While the autism diagnosis emphasizes “deficits” in social communication, the article advances that sensory–movement differences underpin autism through a review of the following sources of evidence. This account critically challenges “autistic regression”, with evidence that sensory–movement features appear by birth as the earliest signs of autism and underlie the behavioral differences used for diagnosis, which may reflect adaptations to inherent differences and misunderstandings from others. Sensory and motor differences are salient to autistic people, but they often go underrecognized by others. They cause cascading effects in infancy on behavior and communication through differences in sensorimotor learning, automatic imitation, eye contact, sensory perception, and interests. The article then explains how sensory processing differences may influence reduced perceptual narrowing, which involves a bottom-up information processing style grounded in the surrounding environment. Furthermore, this bottom-up processing may grow from reduced sensory integration in feedback loops potentially involving the cerebellum of the brain. The article then moves into implications for the widespread consequences of these inherent differences on quality of life. The article closes with implications for autism as a construct (including underestimated empathy and pain), testing the theory, providing sensory-sensitive support and acceptance of autistic people, and applications to diverse autistic people. The theory may apply particularly well to autistic women and girls, autistic people with speech divergence, autistic people with ADHD, and autistic people with co-occurring sensory and motor-related neurodivergences. Throughout the article, the theory also provides clinical, neurological, and experiential evidence for sensory and motor differences as lifelong, challenging the notion of “losing” (an) autism (diagnosis) as instead reflecting (risky and not necessarily “successful”) camouflaging.
Despite extensive research efforts, it is unclear how autistic and non-autistic individuals compare in their ability to recognize emotions. Differences in demographic and task factors have been proposed as explanations for divergent findings, but limitations in samples and designs have obscured insight into this possibility. This study investigated the extent of emotion recognition differences among autistic adults and the influence of these factors upon them. We recruited a large sample of autistic and non-autistic adults (N = 1,239) spanning across adulthood (18–76 years). In three online experiments, we compared their performance in recognizing emotions from basic facial expressions, complex expressions conveyed by the eyes alone, and prosodic elements of speech. Autistic individuals performed as well as non-autistic ones in terms of recognition accuracy/sensitivity across measures and emotional categories but took longer to do so. We also detected comparable influences of age, estimated intelligence quotient, and gender (as well as task demands) on both groups. While autistic adults may differ in how they process emotional stimuli, they can do so effectively when given sufficient time. Accordingly, efforts to help autistic individuals improve their ability to recognize emotions may be more fruitful if they focus on efficiency over accuracy. Additionally, reaction time data may offer greater insight than accuracy into differences between autistic and non-autistic individuals on emotion recognition tasks. The similar effects of the demographic and task factors we analyzed on both groups suggest that explanations of the discrepancies in prior literature lie elsewhere.
Prior research has shown conflicting findings on decision-making differences between autistic and non-autistic individuals. To address this issue, we applied the Ultimatum and Dictator Games to examine explicit measures (probability of endorsing monetary offers) and implicit measures (response times) associated with decision-making behaviors. By analyzing response times, we aimed to determine whether decisions were intuitive (rapid) or deliberative (slower) reasoning processes. In addition, we administered an executive functions questionnaire to explore how cognitive skills correlate with implicit and explicit decision-making behaviors. The study included 24 autistic and 24 non-autistic children and adolescents aged 8–18 years. Results showed that autistic participants were less likely to propose selfish offers in the Dictator Game than their non-autistic peers. Among autistic participants, this lower tendency to propose selfish offers correlated with better executive function skills. Regarding response times, autistic participants exhibited slower responses than non-autistic participants when accepting and proposing selfish offers in both games. These findings reveal differences in selfish offer tendencies and deliberative reasoning among participants, suggesting that slower decision-making in autistic participants reflects a focus on fairness and sociomoral reasoning. Future research can explore how this reasoning style influences social interactions in various scenarios.
Lay Abstract
Autistic kids and teens often have unique ways of communicating and socializing with others. Making decisions is important in how we behave daily and how we socialize. To study if autistic participants tend to make more cooperative or selfish choices, we used two games where participants had to share money between themselves and another player. Previous results were not consistent and that is why general assumptions could not be established. Also, previous results focused on the final decisions and did not consider the process that leads to making decisions. To fill the gap in what we know, this study dug deeper by evaluating how quickly or slowly participants made decisions and explored executive functions needed for daily decisions. The study found that autistic participants, with better executive functions, made less selfish offers (where they could keep more money than their peers) than non-autistic participants. Also, autistic participants took more time to decide than non-autistic participants, only when they could earn more money than the other player. Interestingly, these results are consistent with studies indicating that autistic children distribute resources without a primary focus on personal gains. These findings reshape how we view social exchanges and recognize that slow, deliberate thinking can lead to less selfish decisions in autistic children and adolescents. Future research could explore how this reasoning style influences social interactions in varied contexts.
Prior research has established differences between autistic and non‐autistic individuals across the domains of executive function (EF). While some early theories portrayed these differences as universal to the autism spectrum, recent findings have been quite mixed. Factors like small samples, the components of EF being measured, and the age and intelligence quotient (IQ) of those being compared may contribute to this diversity in results. Moreover, research suggests performance over time might fluctuate in different patterns for autistic and non‐autistic individuals. To test EF differences and the possible influence of these factors upon them, we recruited a sample of over 900 autistic and non‐autistic participants (with generally average/above average IQ levels) from 18 to 77 years of age. They completed a battery of tasks measuring inhibition, cognitive flexibility, working memory, and attentional orienting to social and nonsocial cues. We found that performance was similar between groups in our primary measures of EF, although autistic participants were consistently slower, more susceptible to the effects of spatial cueing, and more prone to certain errors in the working memory task. Differences between groups were generally not influenced by participants' age, gender, or IQ. Performance over time varied only in the working memory task. While autistic adults may still face related challenges in real life, these findings suggest that being autistic does not necessarily imply executive dysfunction on a basic cognitive level, contradicting theories assuming universal impairments therein. Moreover, the lack of influence of included demographic factors suggests that explanations for discrepancies in the literature lie elsewhere.
Adults with autism spectrum disorder (ASD) experience stress when operating in a probabilistic environment, even if it is familiar, but the underlying mechanisms remain unclear. Their decision-making may be affected by the uncertainty aversion implicated in ASD and associated with increased autonomic arousal. Previous studies have shown that in neurotypical (NT) people, decisions with predictably better outcomes are less stressful and elicit smaller pupil-linked arousal than those involving exploration. Here, in a sample of 46 high-functioning ASD and NT participants, using mixed-effects model analysis, we explored pupil-linked arousal and behavioral performance in a probabilistic reward learning task with a stable advantage of one choice option over the other. We found that subjects with ASD learned and preferred advantageous probabilistic choices at the same rate and to the same extent as NT participants, both in terms of choice ratio and response time. Although both groups exhibited similar predictive behaviors, learning to favor advantageous choices led to increased pupillary arousal for these choices in the ASD group, while it caused a decrease in pupillary arousal in the NT group. Moreover, greater pupil-linked arousal during decisions with higher expected value correlated with greater degree of self-reported intolerance of uncertainty in everyday life. Our results suggest that in a nonvolatile probabilistic environment, objectively good predictive abilities in people with ASD are coupled with elevated physiological stress and subjective uncertainty regarding the decisions with the best possible but still uncertain outcome that contributes to their intolerance of uncertainty.
Enhanced rationality has been linked to higher levels of autistic traits, characterised by increased deliberation and decreased intuition, alongside reduced susceptibility to common reasoning biases. However, it is unclear whether this is domain-specific or domain-general. We aimed to explore whether reasoning tendencies differ across social and non-social domains in relation to autistic traits. We conducted two experiments ( N ¹ = 72, N ² = 217) using a reasoning task with social and non-social scenario comparisons to evaluate the specific information participants used when making judgments about children, in the social domain, and objects, in the non-social domain. We consistently found a greater reliance on behaviour-based information in the non-social domain, compared to the social domain, indicating a more deliberative approach. In Experiment 1, we found a correlation between autistic traits and the proportion of behaviour-based information, suggesting a more deliberative approach, when making judgments about children, and not about objects. In Experiment 2, with a larger sample, shortened version of the reasoning task, and requests for written justification, we did not identify a significant correlation between these variables. With this study, we introduce a novel scenario-based reasoning task that systematically compares the social and non-social domains. Our findings highlight the complex nature of the relationship between reasoning style and autistic traits.
Autism has been linked to difficulties within the social domain and quick decision-making. The Dual Process Theory of Autism proposes that autistic people, compared to non-autistic people, tend to prefer and perform in a more deliberative and less intuitive reasoning style, suggesting enhanced rationality in autism. However, this theory has not been systematically explored across social and non-social domains. In total, 24 autistic adults and 24 age-, gender- and non-verbal cognitive ability–matched non-autistic counterparts completed subjective and objective measures of reasoning. A scenario-based comparison task was employed, covering both social and non-social domains, to assess whether participants consistently used the same strategy across domains or alternated between strategies for their forced-choice judgements. On a subjective measure of reasoning, compared to their counterparts, autistic participants self-reported lower intuition. However, there was an opposite pattern on an objective measure, in that autistic participants responded more intuitively. No significant group differences were identified between autistic and non-autistic participants on self-reported deliberation, objectively measured reflectiveness or forced-choice moral judgements across social and non-social domains. There might be a discrepancy among autistic people for their subjective preferences and objective performances in reasoning, decision-making and judgements.
Lay Abstract
Autistic people often experience challenges in social contexts, and when decisions need to be made quickly. There is evidence showing that autistic people have a tendency for greater deliberation and lower intuition, compared to non-autistic people. This has led to the researchers’ proposal that autism is associated with an enhanced level of rationality. However, these theories have been mostly explored through the lens of either only non-social domain or only social domain. To address this gap, we recruited autistic adults and carefully matched them with non-autistic adults for comparison. We used a task representing both social and non-social interactions in a comparison structure and asked participants’ moral judgements on scenarios’ main characters. This was complemented by subjective and objective measures of reasoning. Our findings did not reveal meaningful differences between groups in terms of deliberation. However, we did observe that autistic participants self-reported lower levels of intuition, compared to non-autistic participants. Autistic people consistently rate themselves as less intuitive than their counterparts. Nevertheless, objective evidence supporting this across tasks and studies is inconsistent.
Risk preference changes nonlinearly across development. Although extensive developmental research on the neurotypical population has shown that risk preference is highest during adolescence, developmental changes in risk preference in autistic people, who tend to prefer predictable behaviors, have not been investigated. Here, we aimed to investigate these changes and underlying computational mechanisms. Using a game-like risk-sensitive reinforcement learning task, we found a significant difference in nonlinear developmental changes in risk preference between the autistic and neurotypical groups (N = 75; age range, 6-30 years). The computational modeling approach with reinforcement learning models revealed that individual preferences for surprise modulated such preferences. These findings indicate that for neurotypical people, adolescence is a developmental period involving risk preference, possibly due to lower surprise aversion. Conversely, for autistic people, who show opposite developmental trajectories of risk preference, adolescence could be a developmental period involving risk avoidance because of low surprise preference.
Adults with autism spectrum disorder (ASD) report stress when acting in a familiar probabilistic environment, but the underlying mechanisms are unclear. Their decision-making may be affected by the uncertainty aversion implicated in ASD, and associated with increased autonomic arousal. Previous studies have shown that in neurotypical (NT) people, decisions with predictably better outcomes are less stressful and elicit smaller pupil-linked arousal than those involving random 'trial-and-error' searches or self-imposed risk of exploration. Here, in a sample of 46 high-functioning ASD and NT participants, we explored pupil-linked arousal and behavioral performance in a probabilistic reward learning task with a stable advantage of one choice option over the other. Using mixed-effects model analysis, we contrasted pupil dilation response (PDR) between a preferred frequently rewarded exploitative decision and its explorative alternatives. We observed that subjects with ASD learned the advantageous probabilistic choices at the same rate over time and preferred them to the same degree as NT participants both in terms of choice ratio and decision speed. Despite similar reward prediction abilities, outcome predictability modulated decision-related PDR in ASD in the opposite direction than in NT individuals. Moreover, relatively enhanced PDR elicited by exploitative low-risk decisions predicted a greater degree of self-reported intolerance of uncertainty in everyday life. Our results suggest that in a non-volatile probabilistic environment, objectively good predictive abilities in people with ASD are coupled with elevated physiological stress and subjective uncertainty regarding the decisions with the best possible but still uncertain outcome that contributes to their intolerance of uncertainty.
Emotion recognition difficulties are considered to contribute to social‐communicative problems for autistic individuals and awareness of such difficulties may be critical for the identification and pursuit of strategies that will mitigate their adverse effects. We examined metacognitive awareness of face emotion recognition responses in autistic ( N = 63) and non‐autistic ( N = 67) adults across (a) static, dynamic and social face emotion stimuli, (b) free‐ and forced‐report response formats, and (c) four different sets of the six “basic” and six “complex” emotions. Within‐individual relationships between recognition accuracy and post‐recognition confidence provided no indication that autistic individuals were poorer at discriminating correct from incorrect recognition responses than non‐autistic individuals, although both groups exhibited marked inter‐individual variability. Although the autistic group was less accurate and slower to recognize emotions, confidence‐accuracy calibration analyses provided no evidence of reduced sensitivity on their part to fluctuations in their emotion recognition performance. Across variations in stimulus type, response format and emotion, increases in accuracy were associated with progressively higher confidence, with similar calibration curves for both groups. Calibration curves for both groups were, however, characterized by overconfidence at the higher confidence levels (i.e., overall accuracy less than the average confidence level), with the non‐autistic group contributing more decisions with 90%–100% confidence. Comparisons of slow and fast responders provided no evidence of a “hard‐easy” effect—the tendency to exhibit overconfidence during hard tasks and underconfidence during easy tasks—suggesting that autistic individuals' slower recognition responding may reflect a strategic difference rather than a processing speed limitation.
Lay Summary
It is generally considered that autistic individuals may have difficulty recognizing other people's facial emotions. However, little is known about their awareness of any emotion recognition difficulties they may experience. This study indicates that, although there is considerable individual variability, autistic adults were as sensitive to variations in the accuracy of their recognition of others' emotions as their non‐autistic peers.
Background
Several theories in autism posit that common aspects of the autism phenotype may be manifestations of an underlying differentiation in predictive abilities. The present study investigates this hypothesis in the context of strategic decision making in autistic participants compared to a control group.
Method
Autistic individuals (43 adults, 35 male) and a comparison group (42 adults, 35 male) of age and gender matched individuals, played a modified version of the prisoner’s dilemma (PD) task where they were asked, if capable, to predict their opponents’ move. The predictive performance of the two groups was assessed.
Results
Overall, participants in the autism group had a significantly lower number of correct predictions. Moreover, autistic participants stated, significantly more frequently than the comparison group, that they were unable to make a prediction. When attempting a prediction however, the success ratio did not differ between the two groups.
Conclusions
These findings indicate that there is a difference in prediction performance between the two groups. Although our task design does not allow us to identify whether this difference is due to difficulty to form a prediction or a reluctance in registering one, these findings could justify a role for prediction in strategic decision making during the PD task.
Many studies report atypical responses to sensory information in autistic individuals, yet it is not clear which stages of processing are affected, with little consideration given to decision-making processes. We combined diffusion modelling with high-density EEG to identify which processing stages differ between 50 autistic and 50 typically developing children aged 6–14 years during two visual motion tasks. Our pre-registered hypotheses were that autistic children would show task-dependent differences in sensory evidence accumulation, alongside a more cautious decision-making style and longer non-decision time across tasks. We tested these hypotheses using hierarchical Bayesian diffusion models with a rigorous blind modelling approach, finding no conclusive evidence for our hypotheses. Using a data-driven method, we identified a response-locked centro-parietal component previously linked to the decision-making process. The build-up in this component did not consistently relate to evidence accumulation in autistic children. This suggests that the relationship between the EEG measure and diffusion-modelling is not straightforward in autistic children. Compared to a related study of children with dyslexia, motion processing differences appear less pronounced in autistic children. Exploratory analyses also suggest weak evidence that ADHD symptoms moderate perceptual decision-making in autistic children.
Modulation in sensory-perceptual processing is a known characteristic of autism, although the underlying mechanism is debated. A prevailing account is formulated in Bayesian terms, where either a reduced prior or reduced noise in the measurement (sensory input) may account for the modulated perception as expressed by the posterior distribution. However, research has shown that individuals with autism use priors in some conditions, and to the same extent as neurotypicals, while other studies fail to show enhanced sensory sensitivity in these individuals. We asked whether the modulated prior effects on perception may arise from non-adaptive relative weighting of priors to sensory reliability. We employed a Two-alternative forced choice (2AFC) width discrimination task, using the width–height illusion, which is based on a long-term acquired bias, where a taller rectangle is typically perceived as thinner than a shorter one. The measurement was manipulated by adding Gaussian blur on the vertical edges of the rectangles. Typically developed individuals displayed the expected increase in bias as a function of noise in the measurement. High-functioning individuals with autism exhibited typical perceptual resolutions and similar susceptibility to the illusion. However, the relative weighting of the perceptual bias and the sensory input differed in their effect on the two groups. Individuals with autism showed a non-adaptive, consistent bias across the different degrees of sensory noise, while typically developed individuals displayed monotonically increasing biases. Cluster analyses showed that this difference in the relative weighting between the groups was preserved regardless of the overall illusion magnitude displayed by individuals in each cluster.
Lay abstract
Unique perceptual skills and abnormalities in perception have been extensively demonstrated in those with autism for many perceptual domains, accounting, at least in part, for some of the main symptoms. Several new hypotheses suggest that perceptual representations in autism are unrefined, appear less constrained by exposure and regularities of the environment, and rely more on actual concrete input. Consistent with these emerging views, a bottom-up, data-driven fashion of processing has been suggested to account for the atypical perception in autism. It is yet unclear, however, whether reduced effects of prior knowledge and top-down information, or rather reduced noise in the sensory input, account for the often-reported bottom-up mode of processing in autism. We show that neither is sufficiently supported. Instead, we demonstrate clear differences between autistics and neurotypicals in how incoming input is weighted against prior knowledge and experience in determining the final percept. Importantly, the findings tap central differences in perception between those with and without autism that are consistent across identified sub-clusters within each group.
Since its initial description, the concept of autism has been firmly rooted within the conventional medical paradigm of child psychiatry. Increasingly, there have been calls from the autistic community and, more recently, nonautistic researchers, to rethink the way in which autism science is framed and conducted. Neurodiversity, where autism is seen as one form of variation within a diversity of minds, has been proposed as a potential alternative paradigm. In this review, we concentrate on three major challenges to the conventional medical paradigm – an overfocus on deficits, an emphasis on the individual as opposed to their broader context and a narrowness of perspective – each of which necessarily constrains what we can know about autism and how we are able to know it. We then outline the ways in which fundamental elements of the neurodiversity paradigm can potentially help researchers respond to the medical model’s limitations. We conclude by considering the implications of a shift towards the neurodiversity paradigm for autism science.
Background
According to Bayesian hypotheses, individuals with Autism Spectrum Disorder (ASD) have difficulties making accurate predictions about their environment. In particular, the mechanisms by which they assign precision to predictions or sensory inputs would be suboptimal in ASD. These mechanisms are thought to be mostly mediated by glutamate and GABA. Here, we aimed to shed light on prediction learning in ASD and on its neurobiological correlates.
Methods
Twenty-six neurotypical and 26 autistic adults participated in an associative learning task where they had to learn a probabilistic association between a tone and the rotation direction of two dots, in a volatile context. They also took part in magnetic resonance spectroscopy (MRS) measurements to quantify Glx (glutamate and glutamine), GABA + and glutathione in a low-level perceptual region (occipital cortex) and in a higher-level region involved in prediction learning (inferior frontal gyrus).
Results
Neurotypical and autistic adults had their percepts biased by their expectations, and this bias was smaller for individuals with a more atypical sensory sensitivity. Both groups were able to learn the association and to update their beliefs after a change in contingency. Interestingly, the percentage of correct predictions was correlated with the Glx/GABA + ratio in the occipital cortex (positive correlation) and in the right inferior frontal gyrus (negative correlation). In this region, MRS results also showed an increased concentration of Glx in the ASD group compared to the neurotypical group.
Limitations
We used a quite restrictive approach to select the MR spectra showing a good fit, which led to the exclusion of some MRS datasets and therefore to the reduction of the sample size for certain metabolites/regions.
Conclusions
Autistic adults appeared to have intact abilities to make predictions in this task, in contrast with the Bayesian hypotheses of ASD. Yet, higher ratios of Glx/GABA + in a frontal region were associated with decreased predictive abilities, and ASD individuals tended to have more Glx in this region. This neurobiological difference might contribute to suboptimal predictive mechanisms in ASD in certain contexts.
Autism spectrum disorders have been proposed to arise from impairments in the probabilistic integration of prior knowledge with sensory inputs. Circular inference is one such possible impairment, in which excitation-to-inhibition imbalances in the cerebral cortex cause the reverberation and amplification of prior beliefs and sensory information. Recent empirical work has associated circular inference with the clinical dimensions of schizophrenia. Inhibition impairments have also been observed in autism, suggesting that signal reverberation might be present in that condition as well. In this study, we collected data from 21 participants with self-reported diagnoses of autism spectrum disorders and 155 participants with a broad range of autistic traits in an online probabilistic decision-making task (the fisher task). We used previously established Bayesian models to investigate possible associations between autistic traits or autism and circular inference. There was no correlation between prior or likelihood reverberation and autistic traits across the whole sample. Similarly, no differences in any of the circular inference model parameters were found between autistic participants and those with no diagnosis. Furthermore, participants incorporated information from both priors and likelihoods in their decisions, with no relationship between their weights and psychiatric traits, contrary to what common theories for both autism and schizophrenia would suggest. These findings suggest that there is no increased signal reverberation in autism, despite the known presence of excitation-to-inhibition imbalances. They can be used to further contrast and refine the Bayesian theories of schizophrenia and autism, revealing a divergence in the computational mechanisms underlying the two conditions.
Predictive coding theories of autism suggest that symptoms could result from an atypical learning of expectations. We assessed whether adults with autism could learn expectations in an uncertain context. Twenty-nine neurotypicals and 25 autistic adults participated in an associative learning task. After hearing a tone, participants had to predict the rotation direction of a dot pair, and to report what they perceived. There was a probabilistic association between the tone and the rotation direction. This association could reverse within a block. Both groups were biased by their expectations, as they reported perceiving a rotation consistent with the contingency in a subset of ambiguous trials where the dots did not rotate. Participants made predictions above chance level, but contrary to neurotypicals, autistic participants updated their prior expectation less after a change in contingency. Computational modeling revealed a smaller influence of associative learning on perceptual expectations in the autism group. In an additional task, participants reported how confident they were about their percepts. Both groups expressed confidence in relation to the stimuli, but certainty ratings reflected response times in neurotypical participants only. These findings, showing a more inflexible adjustment of priors in autism, should help refining the predictive coding hypotheses of autism.
Lay abstract
We have an internal representation of the world that guides our behavior, helps us predicting what comes next and therefore, reducing uncertainty. For instance, after hearing the noise of a door opening, we usually expect to see a person appearing, whose features differ depending on the context. In this example of associative learning, predictions need to be adjusted if there is a change in the environment (e.g. different person depending on the location). Recent theories suggest that the symptoms encountered in autism could be due to an atypical learning of predictions or to a decreased influence of these expectations on perception. Here, we conducted an experiment assessing whether adults with autism could learn and adjust their predictions in a changing environment. Throughout a behavioral task, participants learned to associate a sound with a visual outcome, but this association could sometimes reverse. Results showed that autistic adults could learn to make predictions that fitted the main sound–vision association, but were slower to adapt their expectations when there was an unannounced change in the environment. We also observed that both adults with and without autism tended to be biased by their expectations, as they reported seeing what they expected to see rather than what was actually shown. Altogether, our results indicate that autistic adults can learn predictions but are more inflexible to adjust these predictions in a changing environment. These results help refining recent theories of autism (called “predictive coding” theories), which intend to identify the core mechanisms underlying the autistic symptomatology.
Autism is diagnosed according to atypical social-communication and repetitive behaviors. However, autistic individuals are also distinctive in the high variability of specific abilities such as learning. Having been characterized as experiencing great difficulty with learning, autistics have also been reported to learn spontaneously in exceptional ways. These contrasting accounts suggest that some situations may be better than others for learning in autism. We tested this possibility using a probabilistic category learning task with four learning situations differing either in feedback intensity or information presentation. Two learning situations compared high- versus low-intensity feedback, while two other learning situations without external feedback compared isolated sequentially presented information versus arrays of simultaneously presented information. We assessed the categorization and generalization performance of 54 autistic and 52 age-matched typical school-age children after they learned in different situations. We found that children in both groups were able to learn and generalize novel probabilistic categories in all four learning situations. However, across and within groups, autistic children were advantaged by simultaneously presented information while typical children were advantaged by high-intensity feedback when learning. These findings question some common aspects of autism interventions (e.g., frequent intense feedback, minimized simplified information), and underline the importance of improving our current understanding of how and when autistics learn optimally. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Predictive Processing accounts of autism claim that autistic individuals assign higher precision to their prediction errors than non-autistic individuals, that is, autistic individuals update their predictions more readily when faced with unexpected sensory input. Since setting the level of precision is a fundamental part of perception and learning, we propose that such differences should be detectable in various domains at a very early age, before clinical symptoms have fully emerged. We therefore tested 3-year-old younger siblings of autistic children, with a high likelihood of later receiving an autism diagnosis themselves, and low-likelihood children with an older sibling without autism. We used a novel implicit learning paradigm to examine the effect of sensory noise on the predictions participants built. In order to learn a sequence, our participants had to select which visual information to attend to and disregard low-level prediction errors caused by the sensory noise, which the theory claims is more difficult for autistic individuals. Contrary to the proposed higher precision-weighting of prediction errors in autism, the high-likelihood children did not show signs of updating their predictions more readily when we added sensory noise compared to the low-likelihood children, either in their reaction times or in the recurrence and determinism of their response locations. These results raise challenges for Predictive Processing theories of autism, specifically for the notion that prediction errors are inflexibly highly weighted by individuals with autism.
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Autistic people report difficulties with the demands of a neurotypical world, but little research has assessed the impact of the environment on such difficulties. We investigated the effect of ambient sounds on decision-making and heart rate variability. Adults without intellectual disability were allocated to autistic (n = 38) or neurotypical (n = 37) groups matched on age, intellectual functioning and self-reported gender. Participants completed a shopping decision-making task in three randomly ordered sound conditions: no sound, non-social shopping sound (e.g. fridges humming) and social shopping sound (e.g. people talking). Decision-making latency, decision-making consistency, and heart rate variability were measured. Participants also provided qualitative reports of their experiences. Qualitative analyses indicated that autistic participants experienced (1) the non-social and social sound conditions more negatively than the no sound condition and (2) the social sound condition more negatively than neurotypical participants. However, there were no statistically significant differences in decision-making latency, decision-making consistency, or heart rate variability across sound conditions and participant groups. Further research should consider alternative quantitative measures to explore subjective experience to help understand further which aspects of the environment autistic people are sensitive to, in turn, enabling more evidence-based autism-friendly changes to be made.
Lay abstract
Many autistic people report difficulties making decisions during everyday tasks, such as shopping. To examine the effect of sounds on decision-making, we developed a supermarket task where people watched a film shown from the shopper’s perspective and were asked to make decisions between different products. The task was divided into three sections and participants completed each section in a different auditory environment: (1) no sounds, (2) non-social sounds (e.g. fridges humming) and (3) social sounds (e.g. people talking). Thirty-eight autistic and 37 neurotypical adults took part. We measured decision-making by examining how long it took to make a decision and how consistent people were with their decisions. We also measured heart rate variability because this biological response provides a measure of anxiety. After the supermarket shopping task, participants told us in their own words about their experiences. Autistic participants said that they found the non-social and social sound conditions more difficult than the no sound condition, and autistic participants found the social sound condition more negative than neurotypical participants. However, decision-making and heart rate variability were similar for autistic and neurotypical participants across the sound conditions, suggesting that these measures may not have been sensitive enough to reflect the experiences the autistic participants reported. Further research should consider alternative measures to explore the experiences reported by autistic people to help us understand which specific aspects of the environment autistic people are sensitive to. This, in turn, may enable more specific and evidence-based autism-friendly changes to be made.
Cognitive flexibility (CF) is the ability to shift between concepts or rules. Difficulty with CF is associated with autism (i.e., ASD) as it contributes to repetitive behaviours. However, little is known about CF skills of autistic adolescents with low intelligence. This study uses the Wisconsin Card Sorting Task (WCST) to assess the CF of 36 adolescents, all with a Weschler full-scale IQ between 50 and 85, 14 of whom had an ASD diagnosis. The results indicated no statistically significant differences in WCST performance between those with and without ASD. It was also found that performance IQ significantly contributed to the WCST performance in the ASD group only, suggesting an autism-specific role of non-verbal cognitive functioning in CF.
The present study evaluated the hypothesis that the strength of the relationship between executive function (EF) and repetitive behaviors and restricted interests (RBRI) symptomatology is moderated by the degree to which concurrent demands are placed on multiple aspects of EF. An eye movement task was used to evaluate inhibition and task switching ability (both together and in isolation) in a sample of 22 children with autism spectrum disorder (ASD). The Repetitive Behavior Scale-Revised (RBS-R) was used to assess the severity of RBRI symptoms. Results provide preliminary support for the aforementioned hypothesis. RBS-R scores were significantly correlated with task performance when simultaneous demands were placed on switching and inhibition; however, no such relationship was found for inhibition-only or switching-only task conditions.
Interpreting the world around us requires integrating incoming sensory signals with prior information. Autistic individuals have been proposed to rely less on prior information and make more cautious responses than non-autistic individuals. Here we investigated whether these purported features of autistic perception vary as a function of autistic-like traits in the general population. We used a diffusion model framework, whereby decisions are modelled as noisy evidence accumulation processes towards one of two bounds. Within this framework, prior information can bias the starting point of the evidence accumulation process. Our pre-registered hypotheses were that higher autistic-like traits would relate to reduced starting point bias caused by prior information and increased response caution (wider boundary separation). 222 participants discriminated the direction of coherent motion stimuli as quickly and accurately as possible. Stimuli were preceded with a neutral cue (square) or a directional cue (arrow). 80% of the directional cues validly predicted the upcoming motion direction. We modelled accuracy and response time data using a hierarchical Bayesian model in which starting point varied with cue condition. We found no evidence for our hypotheses, with starting point bias and response caution seemingly unrelated to AQ scores. Alongside future research applying this paradigm to autistic individuals, our findings will help refine theories regarding the role of prior information and altered decision-making strategies in autistic perception. Our study also has implications for models of bias in perceptual decision-making, as the most plausible model was one that incorporated bias in both decision-making and sensory processing.
We hypothesized that autistic adults may be erroneously judged as deceptive or lacking credibility due to demonstrating unexpected and atypical behaviors. Thirty autistic and 29 neurotypical individuals participated in video-recorded interviews, and we measured their demonstration of gaze aversion, repetitive body movements, literal interpretation of figurative language, poor reciprocity, and flat affect. Participants ( N = 1410) viewed one of these videos and rated their perception of the individual’s truthfulness or credibility. The hypothesis was partially supported, with autistic individuals perceived as more deceptive and less credible than neurotypical individuals when telling the truth. However, this relationship was not influenced by the presence of any of the target behaviors, but instead, by the individual’s overall presentation.
Perseveration is a well-replicated finding in autism. The aim of this study was to examine how the context of the task influences performance with respect to this phenomenon. We randomly assigned 137 children aged 6–12 with and without autism to complete a modified card-sorting task under one of two conditions: Children were either told the sorting rules on each trial (Explicit), or were given feedback to formulate the rules themselves (Implicit). While performance was enhanced on the Explicit condition for participants without autism, the participants with autism were disadvantaged by this manipulation. In contrast, there were few differences in performance between groups on the Implicit condition. Exploratory analyses were used to examine this unexpected result; increased autism symptomology was associated with poorer performance.
Background and objectives
A plethora of studies has investigated and compared social cognition in autism and schizophrenia ever since both conditions were first described in conjunction more than a century ago. Recent computational theories have proposed similar mechanistic explanations for various symptoms beyond social cognition. They are grounded in the idea of a general misestimation of uncertainty but so far, almost no studies have directly compared both conditions regarding uncertainty processing. The current study aimed to do so with a particular focus on estimation of volatility, i.e. the probability for the environment to change.
Methods
A probabilistic decision-making task and a visual working (meta-)memory task were administered to a sample of 86 participants (19 with a diagnosis of high-functioning autism, 21 with a diagnosis of schizophrenia, and 46 neurotypically developing individuals).
Results
While persons with schizophrenia showed lower visual working memory accuracy than neurotypical individuals, no significant group differences were found for metamemory or any of the probabilistic decision-making task variables. Nevertheless, exploratory analyses suggest that there may be an overestimation of volatility in subgroups of participants with autism and schizophrenia. Correlations revealed relationships between different variables reflecting (mis)estimation of uncertainty, visual working memory accuracy and metamemory.
Limitations
Limitations include the comparably small sample sizes of the autism and the schizophrenia group as well as the lack of cognitive ability and clinical symptom measures.
Conclusions
The results of the current study provide partial support for the notion of a general uncertainty misestimation account of autism and schizophrenia.
Individuals with Autism Spectrum Disorder (ASD) are thought to under-rely on prior knowledge in perceptual decision-making. This study examined whether this applies to decisions of attention allocation, of relevance for ‘predictive-coding’ accounts of ASD. In a visual search task, a salient but task-irrelevant distractor appeared with higher probability in one display half. Individuals with ASD learned to avoid ‘attentional capture’ by distractors in the probable region as effectively as control participants—indicating typical priors for deploying attention. However, capture by a ‘surprising’ distractor at an unlikely location led to greatly slowed identification of a subsequent target at that location—indicating that individuals with ASD attempt to control surprise (unexpected attentional capture) by over-regulating parameters in post-selective decision-making.
According to the predictive coding framework, percepts emerge from combinations of sensory input and prior knowledge, whose relative contributions depend on their reliability. Recent predictive coding theories suggest that Autism Spectrum Disorder (ASD) could be characterized by an atypical weighting of priors. Here, we assessed whether individuals with ASD can flexibly adjust the weight (precision) of the prior to the context. Thirty‐one neurotypical adults (NT) and 26 adults with ASD participated in a visual discrimination task designed to elicit a time‐order effect (TOE). The TOE reflects the integration of priors with sensory estimates. We used two experimental contexts: a narrow stimulus range (Narrow condition) and a broader range (Broad condition) in order to induce a prior with a higher and lower precision, respectively. Both groups learned a prior that biased their perception, as shown with the TOE. As expected, the NT group had a larger TOE in the Narrow condition than in the Broad condition, revealing a contextual adjustment of the prior precision. In contrast, ASD participants were more inflexible: the extent of the TOE was not modulated by the context. In addition, the accuracy increased when the stimulus range decreased in both group, which may be interpreted as a contextual adjustment of the sensory precision. To conclude, adults with and without ASD implicitly learned a prior mean, but ASD participants failed to flexibly adjust the prior precision to the context. This increased inflexibility in ASD could account for many symptoms, such as their intolerance of uncertainty.
Lay Summary
Based on our experience, we have expectations about our environment. Theories suggest that the symptoms encountered in autism could be due to atypical expectations, leading to an impression of an unpredictable world. Using a visual discrimination task, we showed that adults with and without autism were biased by their expectations. Yet, the extent to which expectations biased perception did not depend on the context in autism. This higher inflexibility found in autism may explain symptoms such as resistance to change.
Recent theories propose that autism is characterized by an impairment in determining when to learn and when not. We investigated this by estimating learning rate in environments varying in volatility and uncertainty. Specifically, we correlated autistic traits (in 163 neurotypical participants) with modelled learning behaviour during probabilistic reward learning under the following three conditions: a Stationary Low Noise condition with stable reward contingencies, a Volatile condition with changing reward contingencies and a Stationary High Noise condition where reward probabilities for all options were 60%, resulting in an uncertain, noisy environment. Consistent with earlier findings, we found less optimal decision-making in the Volatile condition for participants with more autistic traits. However, we observed no correlations between underlying adjustments in learning rates and autistic traits, suggesting no impairment in updating learning rates in response to volatile versus noisy environments. Exploratory analyses indicated that impaired performance in the Volatile condition in participants with more autistic traits, was specific to trials with reward contingencies opposite to those initially learned, suggesting a primacy bias. We conclude that performance in volatile environments is lower in participants with more autistic traits, but this cannot be unambiguously attributed to difficulties with adjusting learning rates.
Lay abstract
Recent theories propose that autism is characterized by an impairment in determining when to learn and when not. Here, we investigated this hypothesis by estimating learning rates (i.e. the speed with which one learns) in three different environments that differed in rule stability and uncertainty. We found that neurotypical participants with more autistic traits performed worse in a volatile environment (with unstable rules), as they chose less often for the most rewarding option. Exploratory analyses indicated that performance was specifically worse when reward rules were opposite to those initially learned for participants with more autistic traits. However, there were no differences in the adjustment of learning rates between participants with more versus less autistic traits. Together, these results suggest that performance in volatile environments is lower in participants with more autistic traits, but that this performance difference cannot be unambiguously explained by an impairment in adjusting learning rates.
Questions of how we know our own and other minds, and whether metacognition and mindreading rely on the same processes, are longstanding in psychology and philosophy. In Experiment 1, children/adolescents with autism (who tend to show attenuated mindreading) showed significantly lower accuracy on an explicit metacognition task than neurotypical children/adolescents, but not on an allegedly metacognitive implicit one. In Experiment 2, neurotypical adults completed these tasks in a single-task condition or a dual-task condition that required concurrent completion of a secondary task that tapped mindreading. Metacognitive accuracy was significantly diminished by the dual-mindreading-task on the explicit task but not the implicit task. In Experiment 3, we included additional dual-tasks to rule out the possibility that any secondary task (regardless of whether it required mindreading) would diminish metacognitive accuracy. Finally, in both Experiments 1 and 2, metacognitive accuracy on the explicit task, but not the implicit task, was associated significantly with performance on a measure of mindreading ability. These results suggest that explicit metacognitive tasks (used frequently to measure metacognition in humans) share metarepresentational processing resources with mindreading, whereas implicit tasks (which are claimed by some comparative psychologists to measure metacognition in nonhuman animals) do not. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Stimulus over-selectivity describes a phenomenon in which an individual responds only to a subset of the stimuli present in the environment and, thus, may restrict learning. This study aimed to develop understanding of the nature and role of over-selectivity in autism spectrum disorder (ASD) by analyzing the relationship of over-selectivity to core deficits of ASD: stereotyped responding and inflexibility. Over-selectivity was investigated in a visual discrimination task in 24 children, 12 diagnosed with ASD and 12 mental-age-matched typically developing children. In addition, the participants’ levels of intellectual functioning, stereotypy, and cognitive flexibility were assessed using established tools. Results showed that over-selectivity was associated with IQ and stereotyped behavior but was not related to levels of cognitive flexibility nor did cognitive flexibility significantly correlate with stereotyped behavior in individuals with ASD. The current findings require consideration when designing behavioral interventions for individuals with ASD.
As executive functioning (EF) is especially sensitive to age-related cognitive decline, EF was evaluated by using a multi-method assessment. Fifty males (60–85 years) with a late adulthood autism spectrum condition (ASC) diagnosis and 51 non-ASC males (60–83 years) were compared on cognitive tests across EF domains (cognitive flexibility, planning, processing speed, and working memory) and a self- and proxy report of the Behavior Rating Inventory of Executive Function-Adult Version. While no objective performance differences emerged, autistic males and their proxies did report more EF challenges than non-ASC males on the subjective measure. In order to know how to support the older autistic men who received their ASC diagnosis in late adulthood with their daily life EF challenges, it is important to understand what underlies these subjective EF problems.
A person's capacity to process advice is an important aspect of decision making in the real world. For example, in decisions about treatment, the way patients respond to the advice of family, friends and medical professionals may be used (intentionally or otherwise) as a marker of the "use or weigh" requirement of decision-making capacity. Here we explore neuroscientific research on decision-making to identify features of advice-taking that help conceptualize this requirement. We focus on studies of the neural and computational basis of decision-making in laboratory settings. These studies originally investigated simple perceptual decisions about ambiguous stimuli, but have more recently been extended to more complex "value-based" decisions involving the comparison of subjective preferences. Value-based decisions are a useful model system for capacity-related decision-making as they do not have an objectively 'correct' answer and are instead based on subjective preferences. In this context, advice-taking can be seen as a process in which new evidence for one or other option is integrated, leading to altered behaviour or choices. We use this framework to distinguish between different types of advice-taking: private compliance consists of updating one's privately held beliefs based on new evidence, whereas in the case of public compliance, people change their behaviour at a surface level without shifting their privately-held beliefs. Importantly, both types of advice-taking may lead to similar outcomes but rely on different decision processes. We suggest that understanding how multiple mechanisms drive advice-taking holds promise for targeting decision-making support and improving our understanding of the use and weigh requirement in cases of contested capacity.
People are often influenced by past costs in their current decision-making, thus succumbing to a well-known bias recognized as the sunk cost effect. A recent study showed that the sunk cost effect is attenuated in individuals with autism spectrum disorder (ASD). However, the study only addressed one situation of utilization decision by focusing on the choice between similar attractive alternatives with different levels of sunk costs. Thus, it remains unclear how individuals with ASD behave under sunk costs in different types of decision situations, particularly progress decisions, in which the decision-maker allocates additional resources to an initially chosen alternative. The sunk cost effect in progress decisions was estimated using an economic task designed to assess the effect of the past investments on current decision-making. Twenty-four individuals with ASD and 21 age-, sex-, smoking status-, education-, and intelligence quotient-level-matched typical development (TD) subjects were evaluated. The TD participants were more willing to make the second incremental investment if a previous investment was made, indicating that their decisions were influenced by sunk costs. However, unlike the TD group, the rates of investments were not significantly increased after prior investments in the ASD group. The results agree with the previous evidence of a reduced sensitivity to context stimuli in individuals with ASD and help us obtain a broader picture of the impact of sunk costs on their decision-making. Our findings will contribute to a better understanding of ASD and may be useful in addressing practical implications of their socioeconomic behavior.
Individuals with Autism spectrum condition (ASC) present cognitive biases and a difficulty to integrate emotional responses in decision-making, which is necessary for adequate social functioning. Thus, understanding the underlying mechanisms of the altered decision-making in individuals with ASC may eventually have a positive impact on their social functioning. The Picture decision task was employed to observe the effect of new information (fragments of an incomplete picture), interpretative context (verbal cues), and the level of confidence on decision-making processes. Our study administered the task to 49 children with ASC and 37 children with Typical Development (TD). Children with TD showed a higher probability of success when an interpretative context was given. Conversely, children with ASC had an equal probability of success regardless of whether an interpretative context was provided or not. In addition, unlike children with TD, the level of confidence did not allow predicting the probability of successful decisions in children with ASC. Finally, children with ASC had more probability of jumping to conclusions, a decision made quickly with only one fragment of the picture while being completely sure of it. These results are discussed in light of current cognitive and emotional theories on ASC.
Objectives: The aim of the study is to distinguish between perceptuomotor and cognitive inflexibility as the source of set-switching difficulties in children with autism spectrum disorder (ASD).
Methods: Seventeen adolescents with ASD and 17 neurotypical controls were presented with a computerized sequencing game using colored shapes. The sequence required a shift in perceptuomotor responding that could also be represented at a conceptual level. Measures of perceptuomotor inflexibility were based on errors and response times specifically on the critical switch item in the sequence. The task included three transfer phases in which the same rule was to be applied to new shapes and colors. Higher-order rule conceptualization was operationalized as the ability to abstract the switching rule and apply it across these phases.
Results: Participants with ASD showed predicted difficulties on the perceptuomotor shift, but no deficit on the transfer phases.
Conclusions: The study indicates a problem with perceptuomotor inflexibility in ASD that can explain why ‘extra-dimensional’ shifting is sometimes reported as problematic in this group. Implications for difficulties in more real-world contexts are discussed.
It has been argued that metacognition and mindreading rely on the same cognitive processes (Carruthers in The opacity of mind: an integrative theory of self-knowledge, Oxford University Press, Oxford, 2011). It is widely accepted that mindreading is diminished among individuals diagnosed with autism (Brunsdon and Happé in Autism 18(1):17–30, 2014), however, little is known about metacognition. This study examined metacognition in relation to mindreading and autism using post-decision wagering. Results from a student sample showed negative associations between autism traits and metacognitive accuracy, and metacognitive reaction times and mindreading. These findings were replicated in a general population sample, providing evidence of a reliable association between metacognition, mindreading and autism traits. However, adults diagnosed with autism showed equivalent levels of metacognitive accuracy to age- and IQ-matched comparison participants, albeit only with an overall increase in meta-level processing time.
Autistic people are more likely to: be diagnosed with a range of physical health conditions (i.e. cardio-vascular disease); experience premature mortality (for most disease categories); and experience barriers to effectively accessing healthcare. This systematic review sought to identify studies that report on barriers and facilitators to physical healthcare access for autistic people. A total of 3111 records were screened and six studies were included: two quantitative, two qualitative, and two mixed-methodology studies. Patient-provider communication, sensory sensitivities, and executive functioning/planning issues emerged as important barriers to healthcare. Recommendations for clinicians and those planning services are discussed.
Social decision making is often challenging for autistic individuals. Twenty autistic adolescents made decisions in the socially interactive context of a one-shot ultimatum game, and performance was compared to a large matched typical reference sample. Theory of mind, executive functioning and emotion regulation were measured via direct assessments, self- and parent report. Relative to the reference sample, autistic adolescents proposed fewer fair offers, and this was associated with poorer theory of mind. Autistic adolescents responded similarly to the reference sample when making decisions about offers proposed to them, however they did not appear to down regulate their negative emotion in response to unfair treatment in the same way. Atypical processes may underpin even apparently typical decisions made by autistic adolescents.
We examined performance on implicit (non-verbal) and explicit (verbal) uncertainty-monitoring tasks among neurotypical participants and participants with autism, while also testing mind-reading abilities in both groups. We found that: (i) performance of autistic participants was unimpaired on the implicit uncertainty-monitoring task, while being significantly impaired on the explicit task; (ii) performance on the explicit task was correlated with performance on mindreading tasks in both groups, whereas performance on the implicit uncertainty-monitoring task was not; and (iii) performance on implicit and explicit uncertainty-monitoring tasks was not correlated. The results support the view that (a) explicit uncertainty-monitoring draws on the same cognitive faculty as mindreading whereas (b) implicit uncertainty-monitoring only test first-order decision making. These findings support the theory that metacognition and mind-reading are underpinned by the same meta-representational faculty/resources, and that the implicit uncertainty-monitoring tasks that are frequently used with non-human animals fail to demonstrate the presence of metacognitive abilities.
Significance
Social influence biases even simple perceptual decisions across a range of contexts. The development and mechanism of such biases remain unclear. We systematically examined the developmental course of social influence bias exerted by another person on perceptual decisions in children between 6 and 14 years old. To probe underlying mechanisms, we applied the computational model drift diffusion to behavioral response data. Our results show that although young neurotypical children seem to be unaffected by social influence, adolescents develop a systematic bias of their responses in the direction of social influence and appear to do so by integrating social information into visual perceptual processing. The same pattern of results did not emerge in age-matched autistic children, suggesting a different developmental trajectory.
Individuals with autism and individuals with dyslexia both show reduced use of previous sensory information (stimuli statistics) in perceptual tasks, even though these are very different neurodevelopmental disorders. To better understand how past sensory information influences the perceptual experience in these disorders, we first investigated the trial-by-trial performance of neurotypical participants in a serial discrimination task. Neurotypical participants overweighted recent stimuli, revealing fast updating of internal sensory models, which is adaptive in changing environments. They also weighted the detailed stimuli distribution inferred by longer-term accumulation of stimuli statistics, which is adaptive in stable environments. Compared to neurotypical participants, individuals with dyslexia weighted earlier stimuli less heavily, whereas individuals with autism spectrum disorder weighted recent stimuli less heavily. Investigating the dynamics of perceptual inference reveals that individuals with dyslexia rely more on information about the immediate past, whereas perception in individuals with autism is dominated by longer-term statistics.
Individuals with autism spectrum disorder (ASD) have difficulties in social interactions. The cognitive domains that support these interactions include perceptual decision‐making, timing, and error‐monitoring, which enable one to appropriately understand and react to the other individual in communicative settings. This study constitutes a comprehensive exploration of decision‐making and interval timing in ASD as well as the first investigation of error‐monitoring abilities of individuals with ASD regarding their performance in the corresponding domains. We found that children with ASD fared similar to typically developing (TD) children in their first‐order task performance in two‐alternative forced choice perceptual decision‐making and temporal reproduction tasks as well as the secondary tasks (signal detection and free finger tapping tasks). Yet, they had a deficit in error‐monitoring in both tasks where their accuracy did not predict their confidence ratings, which was the case for the TD group. The difference between ASD and TD groups was limited to error‐monitoring performance. This study attests to a circumscribed impairment in error‐monitoring in individuals with ASD, which may partially underlie their social interaction problems. This difficulty in cognitively evaluating one's own performance may also relate to theory of mind deficits reported for individuals with ASD, where they struggle in understanding the mental states and intentions of others. This novel finding holds the potential to inform effective interventions for individuals with ASD that can target this error‐monitoring ability to have broad‐ranging effects in multiple domains involved in communication and social interaction. Autism Res 2018. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.
Lay Summary
Decision‐making, timing, and error‐monitoring are three of many abilities that underlie smooth social interactions. To date, these domains have been only investigated separately, but given their interactive role in social interactions that are impaired in ASD, we conducted the first study to investigate them together. Children with ASD were as successful as typically developing children in their task performances, but unlike them, were unaware of their errors in both decision‐making and timing tasks. This deficit that is limited to error‐monitoring can contribute to unraveling the unique cognitive signature of ASD and to formulating interventions with positive implications in multiple domains.
Facial impressions of trustworthiness guide social decisions in the general population, as shown by financial lending in economic Trust Games. As an exception, autistic boys fail to use facial impressions to guide trust decisions, despite forming typical facial trustworthiness impressions (Autism, 19, 2015a, 1002). Here, we tested whether this dissociation between forming and using facial impressions of trustworthiness extends to neurotypical men with high levels of autistic traits. Forty‐six Caucasian men completed a multi‐turn Trust Game, a facial trustworthiness impressions task, the Autism‐Spectrum Quotient, and two Theory of Mind tasks. As hypothesized, participants’ levels of autistic traits had no observed effect on the impressions formed, but negatively predicted the use of those impressions in trust decisions. Thus, the dissociation between forming and using facial impressions of trustworthiness extends to the broader autism phenotype. More broadly, our results identify autistic traits as an important source of individual variation in the use of facial impressions to guide behaviour. Interestingly, failure to use these impressions could potentially represent rational behaviour, given their limited validity.
Background: The phenomenon whereby behavior becomes controlled by one aspect of the environment at the expense of other equally-salient aspects of the environment (stimulus over-selectivity) is extremely common in many with Autism Spectrum Disorder (ASD). However, the theoretical mechanisms underpinning over-selectivity and its remediation are not well understood. Four experiments explored whether principles derived from associability accounts of learning, notably the concept of uncertainty, might allow better theoretical understanding of the phenomenon.
Method: Participants with ASD who had language impairments received simultaneous discrimination training (AB+/CD−), and were tested in extinction regarding the degree to which the separate elements (A and B) of the previously reinforced compound (AB+) controlled behavior.
Results: All experiments established the presence of over-selectivity; choosing one stimulus element to a greater-extent than the other. In Experiments 1 and 2, relative to a 100% feedback schedule, over-selectivity reduced when a 50%, but not a 25%, schedule of feedback was used. In Experiment 3, prolonged schedule exposure reduced over-selectivity. In Experiment 4, change from a 100% to a 33% schedule did not reduce over-selectivity.
Conclusions: These results suggest that unpredictability, rather than variability per se, or reinforcement reduction and change, reduces over-selectivity. This suggests that attentional mechanisms, especially uncertainty, may play a role in this phenomenon during its acquisition and remediation.
The sunk cost effect, an interesting and well-known decision bias, is pervasive in real life and has been studied in various disciplines. In this study, we modified a task exemplifying the sunk cost effect and used it to evaluate this behavior in individuals with autism spectrum disorder (ASD). The control group exhibited a typical sunk cost effect in our task. We found that the sunk cost effect was lower in the ASD group than in the control group. The results agree with previous evidence of reduced sensitivity to context stimuli in individuals with ASD and extend this finding to the context of the sunk cost effect. Our findings are useful in addressing the practical implications on their socioeconomic behavior.
Inclusion of stakeholder voices in the allocation of research funding can increase the relevance of results and improve community engagement in research. We describe the results of an online survey that gathered input from community stakeholders regarding autism research priorities. A demographically diverse sample of respondents (N = 6004; 79.1% female; 72.5% ages 30–59; 86.4% USA) completed the survey. Results indicated a preference for applied relative to basic science topics, though both basic and applied science areas were rated as important. Respondents gave their highest ratings to research focused on co-occurring conditions, health and well-being, adult transition, and lifespan issues. These results can guide decision-making by public and private funders when developing science funding priorities and engaging in science dissemination activities.
For autistic individuals, sensory stimulation can be experienced as overwhelming. Models of predictive coding postulate that cortical mechanisms disamplify predictable information and amplify prediction errors that surpass a defined precision level. In autism, the neuronal processing is putting an inflexibly high precision on prediction errors according to the HIPPEA theory (High, Inflexible Precision of Prediction Errors in Autism). We used an apparent motion paradigm to test this prediction. In apparent motion paradigms, the illusory motion of an object creates a prediction about where and when an internally generated token would be moving along the apparent motion trace. This illusion facilitates the perception of a flashing stimulus (target) appearing in-time with the apparent motion token and is perceived as a predictable event (predictable target). In contrast, a flashing stimulus appearing out-of-time with the apparent motion illusion is an unpredictable target that is less often detected even though it produces a prediction error signal. If a prediction error does not surpass a given precision threshold the stimulation event is discounted and therefore less often detected than predictable tokens. In autism, the precision threshold is lower and the same prediction errors (unpredictable target) triggers a detection similar to that of a predictable flash stimulus. To test this hypothesis, we recruited 11 autistic males and 9 neurotypical matched controls. The participants were tasked to detect flashing stimuli placed on an apparent motion trace either in-time or out of time with the apparent motion illusion. Descriptively, 66% (6/9) neurotypical and (64%) 7/11 autistic participants were better at detecting predictable targets. The prediction established by illusory motion appears to assist autistic and neurotypical individuals equally in the detection of predictable over unpredictable targets. Importantly, 55% (6/11) of autistic participants had faster responses for unpredictable targets, whereas only 22% (2/9) neurotypicals had faster responses to unpredictable compared to predictable targets. Hence, these tentative results suggest that for autistic participants, unpredictable targets produce an above threshold prediction error, which leads to faster response. This difference in unpredictable target detection can be encapsulated under the HIPPEA theory, suggesting that precision setting could be aberrant in autistic individuals with respect to prediction errors. These tentative results should be considered in light of the small sample. For this reason, we provide the full set of materials necessary to replicate and extend the results.
Background
The transition from primary to secondary school is particularly difficult for autistic children, a transition underpinned by an increase in prospective memory (PM) demands.
Aims
To better understand PM in autistic children of the relevant age range and its underlying processes, the current study investigated the impact of cue salience (distinctiveness) on PM in autistic and non-autistic children and adolescents. The study was unique in manipulating the visual and auditory salience of PM cues. Salient cues are assumed to put lower demands on executive control resources as compared to cues that blend in with the ongoing activity.
Methods and procedures
The children completed a computer-based categorisation task in which an event-based PM task was embedded. The salience of PM cues was manipulated (low, high visual and high auditory salience).
Outcomes and results
Results revealed that both groups benefitted from an increase in visual and auditory salience, but only autistic participants were faster to respond to auditory cues.
Conclusions and implications
Increased cue salience improved PM performance for all children. Positive effects of auditory cues were especially evident in autistic children.
Atypical processing of stimulus inputs across a range of sensory modalities in autism spectrum disorder (ASD) are widely reported. Sensory processing is known to be influenced by bodily internal states such as physiological arousal and anxiety. Since a sizeable proportion of ASD reportedly have co‐morbid anxiety disorder that are linked with dysregulated arousal, we investigated if face‐emotion arousal cues, influenced visual sensory sensitivity (indexed by temporal resolution) in ASD (n=20) compared to a matched group of typically‐developed individuals (TD, n=21). We asked further if emotion‐cued changes in visual sensitivity associated with individual differences in state‐ and trait‐anxiety. Participants reported the laterality of the second of two consecutive Gaussian‐blob flashes in a visual temporal order judgment task (v‐TOJ), demanding higher‐level visual processing. The key manipulation was presenting a task‐irrelevant face emotion cue briefly at unexpected time points preceding the task‐relevant flashes. Disgust vs Neutral emotion signals significantly enhanced the visual temporal resolution in ASD. Individual state‐anxiety scores showed a fair correlative trend of with the emotion‐cued changes of temporal resolution (Disgust vs Neutral) in ASD but missed statistical significance. Both these effects were absent in TD. The results show that individual state‐anxiety levels likely modulate the effect of emotions on visual temporal sensitivity in ASD. The findings support a nuanced approach to understand the disparate sensory features in ASD, by factoring in the interplay of the individual reactivity to environmental affective information and the severity of anxiety.
Value-based decision making plays an important role in social interaction. Previous studies have reported that individuals with autism spectrum disorder (ASD) exhibit deficits in terms of decision making. However, it is still unknown clearly whether individuals with high autistic traits within nonclinical populations employ abnormal neural substrates in value-based decision-making. To explore this issue, we investigated value-based decision making and its neural substrates in individuals with high and low autistic traits within a typically developing population who completed the revised Iowa gambling task (IGT) based on measurements of event-related potentials (ERPs). The IGT net scores were significantly lower in the group with high autistic traits than the group with low autistic traits in the fifth and sixth blocks. The ERP results showed that the feedback-related negativity (FRN) amplitude in individuals with high autistic traits allowed slight discrimination between positive and negative feedback in the low-risk option. The event-related spectral perturbations (ERSPs) and inter-trial coherence (ITC) of the theta-band frequency were also lower in the group with high autistic traits than the group with low autistic traits in the loss low-risk option. The results obtained in this study indicate that individuals with high autistic traits exhibit an unusual negative feedback process and relevant neural substrate. The FRN amplitude and theta-band oscillation may comprise a neural index of abnormal decision-making processes in individuals with high autistic traits. This study of a small sample may be considered an important step toward a more comprehensive understanding of the autism “spectrum” within a nonclinical population based on cognitive neuroscience.
Impaired executive function (EF), verbal comprehension, and theory of mind (ToM) may contribute to social difficulties in children with autism spectrum disorder (ASD). The linkage between cool (cognitive) EF and ToM has been widely investigated, but the relations between hot (affective) EF and ToM remain largely unknown. The roles of cool EF and verbal comprehension have not been previously explored together to address hot EF–ToM relations. This study applied mediation analysis to investigate the mediating effects of cool EF and verbal comprehension to further elaborate the link between hot EF and ToM in children with ASD and average intellectual abilities. A total of 97 children with ASD aged from 6 to 12 years participated in this study. Children's cool EF, hot EF, and verbal comprehension were, respectively, measured with the computerized Dimensional Change Card Sort task, Children's Gambling Task, and the verbal comprehension index of the Wechsler Intelligence Scale for Children‐fourth edition. Children's ToM was assessed with the Theory of Mind Task Battery. Partial correlation coefficients indicated that hot EF was significantly related with ToM with age controlled for. The results of the mediation analysis showed that cool EF and verbal comprehension mediated the linkage between hot EF and ToM. These findings highlight not only the connections between hot EF and ToM but also the importance of cool EF and verbal comprehension on hot EF–ToM relations in clinical assessments and interventions for school‐aged children with ASD and average intellectual abilities.
Lay Summary
Relatively few studies have investigated the hot (affective) executive function (EF)–theory of mind (ToM) relations in children with autism spectrum disorder (ASD). This study discovered that hot EF was significantly related to ToM, while cool (cognitive) EF and verbal comprehension mediated the relationship between hot EF and ToM. Therefore, the influence of cool EF and verbal comprehension on hot EF–ToM relations should be considered in studies involving children with ASD.
Camouflaging refers to strategies used by autistic people to mask or hide characteristics of autism. The current study draws on Social Identity Theory to examine the relationship between camouflaging and autism-related stigma, testing the hypothesis that camouflaging represents an individualistic strategy in response to stigma. 223 autistic adults completed an online survey measuring perceived autism-related stigma, individualistic and collective strategies, camouflaging and mental wellbeing. Results indicated that higher camouflaging was positively associated with autism-related stigma and both individualistic and collective strategy use. Autism-related stigma was associated with lower wellbeing however this relationship was not mediated by camouflaging. These findings provide partial support for our hypothesis and highlight the complex navigation of a positive autistic identity while still camouflaging.
Individuals with Autism Spectrum Disorder (ASD) report difficulties in making routine decisions. Yet there is a controversy about whether their decision performance is impaired or enhanced compared to typically developing individuals. We focused on studies of the Iowa Gambling Task (IGT) where contrary arguments have been made in this regard. In a meta-analysis, we examined differences between high functioning individuals with ASD and controls in decision performance (choice of long-term advantageous options) and choice switching on the IGT. The analysis encompassed 14 studies involving 433 participants with ASD and 500 controls. The results showed virtually no difference in IGT performance between groups (d = 0.04), except for a slight disadvantage in the first block of trials for the ASD group (d = -0.16). We also found a non-significant trend towards increased choice switching in the ASD group (d = -0.37) that may be examined in future research. In sum, decision performance on the IGT is similar in individuals with ASD and controls, though their strategy may differ.
Employment rates for autistic individuals are poor, even compared to those from other disability groups. Internationally, there remains limited understanding of the factors influencing employment across the stages of preparing for, gaining, and maintaining employment. This is the third in a series of studies conducted as part of an International Society for Autism Research (INSAR) policy brief intended to improve employment outcomes for autistic individuals. A multi‐informant international survey with five key stakeholder groups, including autistic individuals, their families, employers, service providers, and researchers, was undertaken in Australia, Sweden, and the United States to understand the facilitators and barriers to employment for autistic adults. A total of 687 individuals participated, including autistic individuals (n = 246), family members (n = 233), employers (n = 35), clinicians/service providers (n = 123), and researchers (n = 50). Perceptions of the facilitators and barriers to employment differed significantly across both key stakeholder groups and countries, however, ensuring a good job match and focusing on strengths were identified by all groups as important for success. Key barriers to employment included stigma, a lack of understanding of autism spectrum disorder (ASD) and communication difficulties. Results suggest that a holistic approach to employment for autistic individuals is required, aimed at facilitating communication between key stakeholders, addressing attitudes and understanding of ASD in the workplace, using strength‐based approaches and providing early work experience.
Lay Summary
Autistic individuals experience significant difficulty getting and keeping a job. This article presents a survey study involving autistic individuals, their families, employers, service providers and researchers in Australia, Sweden, and the United States to understand their perspectives on the factors that support or act as barriers to employment. While perspectives varied across key stakeholders, strategies such as using a holistic approach, targeting workplace attitudes and understanding, focusing on strengths, and providing early work experience are important for success. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
Although ASD (Autism Spectrum Disorder) diagnosis requires the co-occurrence of socio-emotional deficits and inflexible behaviors, the interaction between these two domains remains unexplored. We used an emotional Wisconsin Card Sorting Test adapted to fMRI to explore this question. ASD and control participants matched a central card (a face) with one of four surrounding cards according to one of three rules: frame color, facial identity or expression. Feedback informed participants on whether to change or maintain the current sorting rule. For each rule, we modeled feedback onsets to change, switch (confirming the newly found rule) and maintenance events. "Bias error", which measures participants' willingness to switch, was larger in ASD participants for the emotional sorting rule. Brain activity to change events showed no group differences. In response to switch events significantly larger activity was observed for ASD participants in bilateral Inferior Parietal Sulci. Inflexibility in ASD appears characterized by the unwillingness to switch toward processing socio-emotional information, rather than a major disruption in cognitive flexibility. However, a larger activity to switch events in ASD highlights the need for a higher level of certainty before setting into a stable processing stage, which may be particularly detrimental in the highly changeable socio-emotional environment.
Impaired predictive coding has been proposed as a framework to explain discrepancies between expectations and outcomes in autism spectrum disorder (ASD) that may contribute to core symptoms of the disorder. However, no eye tracking study has directly addressed this framework in the context of visual predictions of social and nonsocial stimuli. The current study used eye tracking to examine violations of learned visual associations of both social and nonsocial stimuli. Twenty‐six adolescents with ASD and 18 typically developing control (TDC) adolescents completed an outcome expectation eye tracking task in which predictive cues correctly (80% of trials) or incorrectly (20% of trials) indicated the location (left or right) of forthcoming social or nonsocial stimuli. During violation trials, individuals with ASD focused their gaze relatively more often on stimuli presented on locations that violated the learned association and less often on locations that corresponded with the learned association. This finding was not moderated by stimulus type (i.e., social vs. nonsocial). Additionally, participants who looked at incorrectly predicted locations more often had significantly greater ASD symptom severity. These results are consistent with theories that characterize ASD as a disorder of prediction and have potential implications for understanding symptoms related to prediction errors in individuals with ASD. Autism Res 2019, 12: 878–883 . © 2019 International Society for Autism Research, Wiley Periodicals, Inc.
Lay Summary
Individuals with autism spectrum disorder (ASD) exhibit impairments making predictions that may impact learning. In this study, we used eye tracking methodology and found that individuals with ASD were less likely to look at the predicted location when a visual routine was violated. This pattern was evident for both social and nonsocial images and was associated with greater ASD symptom severity. These findings provide additional support for predictive challenges in ASD.
Reduced social motivation is a hallmark of individuals with autism spectrum disorders (ASDs). Although the exact neural mechanisms are unclear, oxytocin has been shown to enhance motivation and attention to social stimuli, suggesting a potential to augment social reinforcement learning as the central mechanism of behavioral interventions in ASD. We tested how reinforcement learning in social contexts and associated reward prediction error (RPE) signals in the nucleus accumbens (NAcc) were modulated by intranasal oxytocin. Male adults with a childhood diagnosis of ASD (n = 15) and healthy controls (n = 24; aged 18–26 years) performed a probabilistic reinforcement learning task during functional magnetic resonance imaging in a single-center (research center in Germany), randomized double-blind, placebo-controlled cross-over trial. The interventions were intranasal oxytocin (Syntocinon®, Novartis; 10 puffs = 20 international units (IUs) per treatment) and placebo spray. Using computational modeling of behavioral data, trial-by-trial RPE signals were assessed and related to brain activation in NAcc during reinforcing feedback in social and non-social contexts. The order of oxytocin/placebo was randomized for 60 participants. Twenty-one participants were excluded from analyses, leaving 39 for the final analysis. Behaviorally, individuals with ASD showed enhanced learning under oxytocin when the learning target as well as feedback was social as compared to non-social (social vs. non-social target: 87.09% vs. 71.29%, 95% confidence interval (CI): 7.28–24.33, p =.003; social vs. non-social feedback: 81.00% vs. 71.29%, 95% CI: 2.81–16.61, p =.027). Correspondingly, oxytocin enhanced the correlation of the RPE signal with NAcc activation during social (vs. non-social) feedback in ASD (3.48 vs. −1.12, respectively, 95% CI: 2.98–6.22, p =.000), whereas in controls, this effect was found in the placebo condition (2.90 vs. −1.14, respectively, 95% CI: 1.07–7.01, p =.010). In ASD, a similar pattern emerged when the learning target was social (3.00 vs. −0.64, respectively, 95% CI: −0.13 to 7.41, p =.057), whereas controls showed a reduced correlation for social learning targets under oxytocin (−0.70 vs. 2.72, respectively, 95% CI: −5.86 to 0.98, p =.008). The current data suggest that intranasal oxytocin has the potential to enhance social reinforcement learning in ASD. Future studies are warranted that investigate whether oxytocin can potentiate social learning when combined with behavioral therapies, resulting in greater treatment benefits than traditional behavior-only approaches.
Progress in psychological science can be limited by a number of factors, not least of which are the starting assumptions of scientists themselves. We believe that some influential accounts of autism rest on a questionable assumption that many of its behavioral characteristics indicate a lack of social interest—an assumption that is flatly contradicted by the testimony of many autistic people themselves. In this paper, we challenge this assumption by describing alternative explanations for four such behaviors: (a) low levels of eye contact, (b) infrequent pointing, (c) motor stereotypies, and (d) echolalia. The assumption that autistic people's unusual behaviors indicate diminished social motivation has had profound and often negative effects on the ways they are studied and treated. We argue that understanding and supporting autistic individuals will require interrogating this assumption, taking autistic testimony seriously, considering alternative explanations for unusual behaviors, and investigating unconventional—even idiosyncratic—ways that autistic individuals may express their social interest. These steps are crucial, we believe, for creating a more accurate, humane, and useful science of autism.