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Individuals with autism spectrum disorder (ASD), including those who otherwise require less support, face severe difficulties in everyday social interactions. Research in this area has primarily focused on identifying the cognitive and neurological differences that contribute to these social impairments, but social interaction by definition involves more than one person and social difficulties may arise not just from people with ASD themselves, but also from the perceptions, judgments, and social decisions made by those around them. Here, across three studies, we find that first impressions of individuals with ASD made from thin slices of real-world social behavior by typically-developing observers are not only far less favorable across a range of trait judgments compared to controls, but also are associated with reduced intentions to pursue social interaction. These patterns are remarkably robust, occur within seconds, do not change with increased exposure, and persist across both child and adult age groups. However, these biases disappear when impressions are based on conversational content lacking audio-visual cues, suggesting that style, not substance, drives negative impressions of ASD. Collectively, these findings advocate for a broader perspective of social difficulties in ASD that considers both the individual’s impairments and the biases of potential social partners.

Across three independent studies using distinct samples and a variety of methodological approaches, observers’ first impressions of individuals with ASD engaging in real-world social behavior were found to be robustly less favorable than those of matched TD controls. These negative first impressions were consistent for both adults and children with ASD, for static as well as dynamic stimuli, for both brief (2–4 s) and longer (10 s) glimpses of social behavior, and did not change with repeated exposure. Further, because these impressions were associated with reduced intentions to socially engage by observers, they may reflect a previously under-recognized contributor to the reduced quantity and quality of social interaction experienced by individuals with ASD.

Our findings show that negative first impressions of adults with ASD occurred only when audio and/or visual information was present, and not when the transcript of their speech content was evaluated (Study 1). This discrepancy suggests that social presentation style rather than the substantive content of social speech drove negative impression formation of individuals with ASD. Supporting this conclusion, a static image was sufficient for generating negative first impressions of those with ASD and including additional information, such as body movement or voice, did not worsen them further. In contrast, first impressions of TD controls improved with the addition of a visual information, suggesting that unlike the ASD group, visual cues helped rather than hurt the impressions they made on observers. We also determined that negative impressions extended beyond perceived social competence to judgments of likeability (reduced), attractiveness (reduced), and submissiveness (increased) (Study 1). However, negative impressions did not occur for all evaluated traits, with the two groups not differing on ratings of perceived intelligence or trustworthiness. The lack of group differences on these traits suggest that the social presentation differences in the ASD group may lead to more negative evaluations of traits associated with social appeal and approach behaviors (e.g., awkwardness, attractiveness, likability), than those associated with competence (intelligence) and character (trustworthiness).

We also demonstrate that negative impressions remain stable across multiple thin-slice judgments. A series of randomly selected static images of college-aged individuals with ASD collected from a first-person perspective during social interaction were consistently rated as less approachable and more awkward than matched controls, with observers indicating a lower likelihood of being friends with members of the ASD group (Study 2). These ratings were stable across ten exposures of different randomly-selected images of each individual, suggesting that the negative impressions of the ASD group were not driven by poorer or non-representative image capture or by sequence effects, but rather by reliable differences in social presentation in ASD leading to consistent negative evaluation. This finding of negative evaluations of individuals with ASD is also emphasized by the consistency of results across all three studies, which include static and dynamic stimuli, as well as representations of different age groups.

Adult and school-aged observers also report negative perceptions of adolescents with ASD (Study 3), indicating that negative first impressions persist even when observers are similar in age to those being evaluated. The extension to school-aged children is important given that individuals with ASD generally receive the greatest amount of social skills intervention during this developmental period, which decreases precipitously after high school. Thus, despite being at an age when intense attention is often paid to social skills training, the ASD children in Study 3 are nonetheless rated poorly by both adults and same-age observers. Negative first impressions by adults may affect how children with ASD are perceived and treated by educators, and similar impressions by same-age observers may limit the formation of social networks and friendships. The establishment of a peer social network during early adolescence facilitates identity formation, access to resources, stress and coping support, and general well-being, and the findings here may reflect another obstacle impeding the establishment of such social connections for youth with ASD above and beyond their already existing difficulties with social skills and social understanding.

Findings across the three independent studies were remarkably consistent despite using distinct samples and methods. Taken together, they offer strong evidence that the social presentations of individuals with ASD, particularly their non-verbal cues, including prosody, facial expressions, and body posture, are perceived less favorably and are associated with reluctance on the part of observers to pursue social engagement. This is particularly important given that individuals with ASD self-reported much greater feelings of loneliness than controls (Study 2). This is consistent with prior research indicating that individuals with ASD do not differ from their TD peers in their desire for relationships, and suggests an unmet need for social experiences in ASD. Negative first impressions may serve as a barrier to fulfilling this desire for social interaction, as approach and withdrawal behavior towards novel social partners is based on subjective perceptions regardless of their accuracy. In turn, this may limit opportunities in ASD for developing social connections and friendships, as well as the intergroup contact necessary for mitigating negative biases when present. We explored the effect of repeated exposure to images of the same individual and found no changes in perceptual ratings (Study 2). However, repeated exposure to images is not equivalent to increased familiarity, and thus the current study cannot assess whether increased personal contact with individuals with ASD reduces negative impressions over time. Future studies are encouraged to explore this possibility, as such evidence would be consistent with a large literature in social psychology indicating that increasing intergroup contact reduces bias and prejudice. In order to determine the effect of increased familiarity on these types of ratings, future studies would need to pursue a longitudinal approach, collecting interpersonal ratings at several time points over the course of weeks or months.

It is also important to explore specific components of visual and/or auditory presentation that may lead to negative impressions of young adults with ASD (e.g., body posture, prosody, grooming, and fashion). Several of the stimuli used across the three studies were videos and there is some evidence in the literature that the movement patterns of individuals with ASD are atypical and may represent a salient cue of awkwardness or difference to TD observers. Kinematic analyses of facial expressions in this population point to subtle dynamic differences related to the complexity of dynamic transitions as well as symmetry of movement patterns between face regions, which could represent at least some of the cues potential conversation partners use to form their first impressions of individuals with ASD. However, negative judgments of people with ASD in our studies were not limited to video stimuli, but remained equally robust for static images, indicating that the rougher movement patterns of individuals with ASD are not solely to blame for this phenomenon. It remains an open question whether videos would lead to more negative first impressions than static images within more socially demanding contexts such as the dynamic interaction in Study 2 that required spontaneous responses to questioning, rather than the one-sided social presentations elicited in studies 1 and 3.

Recent studies also suggest the presence of autism-specific dysmorphology, specifically related to distances between facial features that could lead to perception of atypicality even when looking only at static images. However, significant dysmorphic features most commonly characterize individuals with more significant autism symptoms and severity. This does not describe the individuals with preserved language and cognitive skills who appeared in the stimuli for the studies presented here and therefore cannot explain the rapid and robust negative evaluations reported here. Additionally, individuals with ASD are rated less favorably than their TD peers even in audio-only conditions (Study 1), indicating a significant contribution of prosodic features to the negative first impressions we report. Based on evidence in the literature and the data presented here, we propose that negative first impressions of ASD are not founded on any one feature of expression, but rather represent an effect of subtle physical, dynamic, and auditory cues of presentation that can also include additional features, such as clothing choices, grooming habits, gaze patterns, or body posture.

The consistency of findings across these studies using different methodologies and stimulus types indicates that the foundation of these negative perceptions is complex and difficult to isolate. If our goal is to improve social interactions for individuals with ASD, it may therefore be equally important to educate others to be more aware and accepting of social presentation differences, rather than trying to change the many interwoven factors of self-presentation that mark the expressions of individuals with ASD as atypical. Given the social cognitive difficulties in perspective taking associated with autism6, some individuals with ASD may lack insight about how their social presentation is viewed by potential social partners. Others, however, may be more cognizant of these perceptions but are comfortable in their self-expression. For them, intervention strategies targeting awareness and acceptance among TD peers in their social environments may be a more sensitive and accommodating approach than encouraging impression management strategies.

The studies reported here should be viewed in the context of several limitations. Although the real-world social presentations used in each study provided a more naturalistic portrayal of actual social behavior in ASD compared to previous work using actors or vignettes, they may not fully reflect how impression formation occurs during live social interaction. We only included explicit judgments made of those with and without ASD. In addition to what participants indicate explicitly, their biases may also play out in more implicit ways. Future studies may seek to address whether implicit biases towards those with ASD parallel the more explicit findings reported here. Further, all participants with ASD in this study were intellectually-capable, and findings may not generalize to cognitively impaired populations. Additionally, while ratings did not differ for male and female stimulus participants in studies 1 and 2, sample sizes of females were small and future studies should examine whether patterns differ by gender. Finally, these studies present only group-wise comparisons and do not address individual differences among those with ASD, nor whether individual characteristics of the raters (e.g., gender, personality, etc.) affect the results reported here.

These limitations notwithstanding, the current project provides convergent evidence across three independent studies that first impressions of individuals with ASD are significantly less favorable than those of matched TD controls, and are associated with greater reluctance on the part of observers to pursue social engagement. The data demonstrate that negative impressions are formed across age groups and based on a range of features, including visual, auditory, dynamic, and static cues, indicating that these impressions are not context- or stimulus-dependent and are likely to persist across a range of real-world social situations. Taken together, these findings suggest that social interaction difficulties in ASD are not solely an individual impairment but also a relational one, and consideration of both of these factors is necessary for a full understanding of social impairment in ASD. The reluctance of TD individuals to engage in social interactions with their ASD peers further limits the opportunities for individuals with ASD to practice their already fragile social skills. This can have a significant negative impact on the ability of socially aware and socially interested individuals with ASD to improve their social communication abilities and work toward more successful social integration. Therefore, intervention and education approaches that target both those with ASD as well as their TD peers may offer a more comprehensive approach for improving social and functional outcomes in autism.

Read more at: https://www.nature.com/articles/srep40700

TAG WORDS: “SCHOOL FOR AUTISM HONG KONG” “EARLY INTERVENTION HONG KONG” “AUTISM RESOURCE CENTRE” “ABA AUTISM” “SPECIAL NEEDS HONG KONG” “AUTISM HELP”

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