Social Motivation in Autism Spectrum Disorder: A Mixed-Methods Exploration Using Eye-Tracking, Behavioral Tasks, Self- and Parent-Reports, and Qualitative Insights.

<p id=p00005>Autism spectrum disorder (ASD) is a neurodevelopmental disorder that originated from childhood, social deficits are core symptoms of ASD. Previous studies, from a information processing perspective, proposed that a deficit in social cognitive is the cause of social impairment. However, research showed that the lack of cognitive ability was not the only reason for the social deficits of individuals with ASD, but also closely related to the social motivation deficits. Social motivation theory suggests that social motivation deficits exist in the early life of individuals with ASD and affect their subsequent development. Studying the social motivation of individuals with ASD is of great value to explain the causes of their social deficits and find the direction of intervention in the future. Therefore, this study summarizes the specific behaviors and internal and external influencing factors of social motivation deficits in individuals with ASD. In the future, it is important to comprehensively consider these factors, to strengthen the integrated research on the social motivation theory of individuals with ASD, so as to accurately understand the social motivation deficits of individuals with ASD. <br/>Social motivation theory suggests that social motivation is a powerful driving force to guide individual’s social behavior. The theory also highlights that social behavior is mainly manifested in social orientation, social reward and social maintenance, so this paper firstly summarizes the related researches on the behavioral level of social motivation deficits in individuals with ASD, which are mainly reflected in the following three aspects: (1) The results of social orientation research show that individuals with ASD often show impaired attention to social stimuli, reduced direct gaze on the face, reduced gaze on the eyes, etc. On the one hand, this deficit is related to their abnormal face processing strategies; on the other hand, they may have difficulties in representing the intrinsic reward value of social stimuli; (2) The results of social reward research show that social reward stimulation has no significant incentive effect on individuals with ASD. They lack the ability to experience the happiness of social interaction, cant get happiness from interaction and lack the desire to help others, which is related to the abnormality of reward processing system (amygdala, ventral striatum, prefrontal cortex and other brain regions). (3) The results of social maintenance research show that individuals with ASD have few social maintenance strategies, they are not good at maintaining social relationships with others, do not actively show their own advantages, do not actively imitate others, and lack the desire and motivation to establish and maintain good relationships with others. <br/>Finally, because the research conclusions of social motivation deficits in individual with ASD are not completely consistent, this paper comprehensively and systematically analyzes the influencing factors of social motivation deficits, and finds that it includes internal factors and external factors. The internal factors are mainly reflected in individuals age, gender and physiological mechanism, while the external factors are mainly reflected in social communication environment, experimental stimulus materials, difficulty and nature of experimental tasks. In order to improve the credibility and effectiveness of the research on the social motivation of individuals with ASD, and fully and accurately grasp the characteristics of social motivation in individuals with ASD, in the future, it is important to study the social motivation deficits of individuals with ASD of different ages and genders, to optimize the experimental tasks, broaden the types of materials, further improve the experimental design, and to strengthen the integrated research on the social motivation theory of individuals with ASD, deeply explore the relationship among the behavioral, biological and evolutionary levels under this theory, and further analyze the relationship among the three behaviors of social motivation(social orientation, social reward and social maintenance).

The Social Motivation Theory proposes that social reward processing differences underlie autism. However, low social motivation has also been linked to higher anxiety. Given the co-occurrence between autism and anxiety, it is possible that anxiety drives the association between social motivation and autistic characteristics. This study tests the mechanisms underlying the association between social motivation and autistic traits. Participants were 165 adolescents (71 male), aged 10-16 years, from the Mapping profiles of cognition, motivation and attention in childhood (C-MAPS) study, enriched for autistic traits (70 participants with an autism diagnosis, 37 male). Participants completed a battery of online experimental tasks, including a Choose-a-Movie social motivation task and social cognition measures (theory of mind; emotion recognition), alongside parent-reported child anxiety and autistic traits. Higher social motivation was significantly associated with lower autistic traits (β = -.26, p < .001). Controlling for social cognition did not change the association between social motivation and autistic traits. Controlling for anxiety did significantly reduce the strength of the association (unstandardized coefficient change: p = .003), although social motivation remained associated with autistic traits (β = -.16, p = .004). Post hoc analyses demonstrated differential sex-effects: The association between social motivation and autistic traits was significant only in the females (β = -.38, p < .001), as was the attenuation by anxiety (unstandardized coefficient change: p < .001). The association between social motivation and autistic traits could be partially attributed to co-occurring anxiety. Sex-specific effects found in females may be due to environmental factors such as increased social demands in adolescent female relationships. Results are consistent with self-report by autistic individuals who do not identify as having reduced social motivation.

Difficulties in making and maintaining social relationships is common among autistic people. These difficulties are thought to be due to differences in autistic social interaction and social communication that have been theorized to be the result of reduced social motivation. We argue that this theory does not account for camouflaging, a combination of strategies that are employed frequently by many autistic individuals in pursuit of obtaining social relationships; however, its utility in achieving satisfactory friendship and intimate relationships for the individual is not clear. This review synthesizes empirical evidence of camouflaging as a strategy for achieving friendships and/or intimate relationships among autistic adolescents and adults. A systematic search yielded 1421 records. Forty-nine full texts were screened, and eight qualitative studies were retained. Results reveal that camouflaging was a main strategy in pursuit of friendship, with little evidence for intimate relationships, in this sample of autistic adolescents and adults. For most, camouflaging is exhausting, often ineffective and inefficient, and ultimately a challenge to one's social authenticity. Research suggests that many autistic individuals rely on camouflaging in pursuit of friendship and intimate relationships, although this is often a nonpreferred strategy. Some autistic individuals seek to replace camouflage with alternative strategies to obtain social relationships, yet outcomes typically remain dissatisfying. This demonstrates that we need to reconsider the social motivation theory, and to better understand alternative strategies that can help autistic individuals to obtain authentic, satisfactory social relationships, and to support opportunities to achieve these desired outcomes. Why is this topic important?: Many autistic individuals feel dissatisfied with the quality and quantity of their social relationships and are, therefore, more vulnerable to loneliness and reduced well-being. This may be because autistic people communicate and interact differently to non-autistic individuals. These differences can, at times, be misinterpreted as a lack of motivation to socialize and connect with other people. But many autistic individuals are motivated to build meaningful friendships and intimate relationships and often rely on camouflaging to achieve these outcomes. Regardless of their efforts, many autistic people continue to struggle to make the social connections they desire. Therefore, the effectiveness of camouflaging on building friendships and intimate relationships needs to be better understood.What was the purpose of this review?: We set out to understand the impact that camouflaging has the friendships and intimate relationships of autistic individuals by examining the existing research.What are the results of this review?: We found that camouflaging is a common strategy used by many autistic individuals to connect with others in aim to build and maintain friendships, especially with non-autistic people. Pressure to camouflage began early in life, for many autistic participants, and continued to increase in both complexity and use across the lifespan. However, many autistic individuals remained dissatisfied with the friendships and intimate relationships gained through its use. For many, camouflaging prevented genuine social interactions, and the friendships that resulted from its use were often lacking in closeness and authenticity for the autistic individual. To reduce the reliance on camouflaging, some autistic individuals socially withdrew, or attempted to find friendship within the autistic community or in social contexts where camouflaging felt less necessary. Yet, many autistic participants remained feeling lonely, frustrated, and dissatisfied with their social relationships.What were the weaknesses of this review?: Only half of the eight studies involved an autistic researcher and author, while most studies incorporated community participation in the design of the study. We found that participants were mostly female, from countries such as the United Kingdom and United States of America, and most participants were above18 years of age. Results may be impacted by a lack of researcher and sample diversity, and minimal autistic input in study design and interpretation; thus, generalization of these findings may be limited. Camouflaging is an evolving area of research, and we recognize that there may be terminology or perspectives that were not captured by our review.What do the authors recommend and how will this help autistic adults in the future?: More research is needed to better understand autistic social interactions and to support alternative strategies to camouflaging, including environmental modifications and changes in the way non-autistic people understand and interact with autistic people. We recommend that autistic individuals' strengths and needs drive this area of research, and that supports address ways that all people can help to enhance autistic social outcomes. We anticipate that these strategies will promote more authentic social relationships, reduce reliance on camouflage, help to decrease loneliness, and improve well-being among autistic individuals.

Photo ID 117847165© Mohamad Faizal Ramli|Dreamstime.com INTRODUCTION In our cosmic narrative, for centuries we believed the Earth held the universe's center, a belief that shifted with evidence and transformed our understanding of our cosmic place. Correspondingly, paradigms surrounding autism have been shaped by medical assumptions that label it a condition, a disorder, or even a tragedy. Just as our understanding of celestial perceptions evolved, that Earth was not at the center of the universe, it is time for a seismic shift in how we perceive and address autism. ANALYSIS Venturing into autism research, we see the prevailing medical paradigm that defines Autism Spectrum Disorder (ASD) as a developmental disability caused by neurological differences.[1] Social communication, repetitive behaviors, language, movement skills, cognitive abilities, and emotional reactions—all cast as deficits.1 This narrative, embraced by researchers, medical professionals, and society, serves as the foundation of our current understanding. Yet, delving deeper unveils a counter-narrative—one not etched by researchers but articulated by those living with autism. This narrative introduces us to the neurodiversity paradigm, a revolutionary lens that sees autism as a part of the rich tapestry of human neurological development, fostering a stable cognitive landscape.[2] It posits that there is no singular "healthy" brain; and no definitive way of neurocognitive functioning.2 Shockingly, although this perspective is more inclusive, portraying autistic people as crucial contributors to humanity, it remains the more controversial model in society. Contrasting with the classical medical view that treats autism as a disease to be eradicated, the neurodiversity paradigm challenges the notion of normalizing society and underscores the importance of recognizing autism as an advancement. Without it, we would lose invaluable perspectives, strengths in attention to detail, visual perception, creative and artistic talents, mathematical and technical abilities, and expertise in ‘niche’ areas.[3] Asserting that every form of neurological development holds equal validity, deserving of respect and human rights, the neurodiversity paradigm counters the deficit mindset perpetuated by the traditional medical view. The repercussions of our medical-centric assumptions extend beyond perception; they infiltrate the very fabric of societal structures. Autism is labeled a disability. But is it autism that disables individuals, or is it the societal environment that excludes and alienates cognitive diversity? The traditional medical model points fingers at individuals, placing the onus on the differently abled person, not the disabling environments. For example, our societal perspective on disability is largely framed by the medical model, which views disability as an individual problem. According to this model, the disability is located within the person experiencing it—within individuals like me.[4] For instance, I often find myself becoming excessively overstimulated in places like department stores. The bustling environment—loud, brightly lit, unpredictable, and crowded—is a sensory challenge. Following the medical model attributes my struggle in department stores to a perceived problem with the way my brain processes sensory inputs, attributing it to my autism. The consequences of the medical model are far-reaching and profound, particularly in shaping our understanding of autism. This perspective places undue blame on those with autism and directs the focus of research toward "curing" autism rather than addressing societal structures that contribute to exclusion and alienation. One glaring example of this misguided approach is the predominant focus of autism research on finding a cure, as seen in 2020 with a major research theme centered around gene therapies aimed at altering the genetic factors associated with autism-related conditions.[5] Even influential organizations like Autism Speaks, until 2016, subscribed to the notion of seeking a cure.[6] Their evolution, acknowledging the need to listen to the lived experiences of autistic individuals, led to a shift in their mission—from searching for a cure to promoting advocacy, support, understanding, and acceptance.6 This shift highlights the importance of moving away from the medical model. Instead, we should adopt more inclusive models like the neurodiversity or social model of disability, which are rooted in the idea that neurological differences, including autism, are natural variations of the human brain. Listening to the voices of those with autism and embracing the social model of disability allows us to recognize that disabling factors often reside in societal structures, not within the individuals themselves. This paradigm shift is crucial for fostering an inclusive society that values and accommodates cognitive diversity. For instance, when we enter the social model of disability—an alternative lens that shifts the blame from the individual to the environment, it views disability not as a characteristic but as an action done to individuals by society4. In this model, going to a department store is not a struggle for me because there is something inherently wrong with me, but it is a struggle because the environment around me does not cater to my diverse needs. Imagine if our world, including department stores, were designed with neurodiversity in mind—quiet, dimly lit, predictable, and spacious. Neurodivergent individuals would still be cognitively different, but their surroundings would not disable them. Adopting the social model of disability would catalyze shifts in research and attitudes toward autism, reflecting the transformative changes observed in the department store examples. Rather than focusing on changing autistic individuals to fit societal norms, the emphasis would shift to enhancing the lives of neurodivergent people by advocating for structural changes in society. This shift aims to foster inclusivity while preserving individuals' authenticity and embracing their unique differences. Autistic individuals are not seeking a cure for autism because our neurodivergent way of thinking is integral to our identity. Yet, the considerable funding directed toward researching autism's causes for prevention or a "cure" underscores a lack of consideration for our voices in deciding how research funds are utilized. The emphasis on normalization, a cornerstone of the medical model's view of autism, prioritizes societal desires over the well-being of autistic individuals already part of our society. It is imperative to recognize this flaw in research that aims to cure autism, as it risks genetic research for eugenic purposes, necessitating regulation by the autistic community.[7] Redirecting resources from the pursuit of an unwanted cure to research supporting and empowering autistic people to lead fulfilling lives is essential. This redirection involves investing in communication research, offering tools such as communication boards, picture exchange communication systems, speech-generating devices, or sign language for nonverbal or speech-challenged autistic individuals, giving them a voice in our society.[8] Community living research, centered on community inclusion programs, not only provides services but also educates and reinforces accommodations for daily activities such as in schools, workplaces, or even in department stores as stated in the example.[9] Attention to support services for autistic individuals and their families, including residential and day support programs, respite, recreation, and transportation, is crucial.[10] A commitment to promoting lifelong support for autistic individuals necessitates advocating for caregiver support, home and community-based services, financial planning resources, and more.10 Additionally, research aiming to identify qualitative results of adaptation and modification strategies to support inclusive education for autistic students is paramount at school and classroom levels.[11] Research to improve healthcare quality and the healthcare system for autistic individuals is also essential, as they face shorter lifespans and worse health than non-autistics.[12] All these research initiatives align with the principles of the social model of disability. However, as a society that does not follow the social model; the bulk of our understanding of autism is rooted in research driven by medical assumptions and paradigms. In 2022, the United States allocated $306 million to autism research[13]. However, a considerable portion of this research approaches autism as a problem to be solved. An examination of a comprehensive study focused on the allocation of NIH autism research funding from 2008 to 2018 reveals a striking trend. In this distribution, 49.7% of the total funds were allocated to treatment development and evaluation, which represented 53.6% of all projects.[14] This statistic underscores a predominant emphasis on genetic and biological research. However, the goal of such research is not only to understand the underlying reasons for autism so we can cure it. But this research also explores ways of prevention or management of autism through pharmacological treatment or behavioral therapies like intervention or Applied Behavioral Analysis, both of which are intervention models focused on changing the external behaviors of autistic individuals, with the goal of making an autistic person look and act non-autistic.14,[15] Contrastingly, only a minimal fraction of NIH funding—9.1%, approximately $225 million out of nearly $2.5 billion dedicated to ASD research—was channeled towards services-related research.14 This includes critical areas such as improving accessibility and quality of services in the community, characterizing understudied groups, policy development, dissemination, and implementation.14 This glaring discrepancy highlights a dimin

Autistic individuals are underrepresented in employment and postsecondary education. Research is hampered by a lack of psychometrically valid instruments that can be used to assess the vocational activities of autistic people. This study examined the psychometric properties of an Australian modified version of the Vocational Index for Adults with Autism (M-VIAA), an assessment of vocational independence. Participants were 105 autistic and 106 nonautistic young adults aged 17-26 years recruited from the longitudinal Study of Australian School Leavers with Autism. We examined psychometric properties of the M-VIAA by (1) comparing scores between autistic and nonautistic participants, (2) examining convergent validity with daily living skills, and (3) divergent validity with autistic traits. We explored change over time by comparing baseline and 24-month follow-up scores in autistic participants. We found vocational independence to be significantly higher in nonautistic participants compared with autistic participants. We did not find a significant relationship between daily living skills and the M-VIAA. There was a small but significant relationship between the M-VIAA and autistic traits. Scores on the M-VIAA remained stable over time for a subsample of autistic participants. The present study provides preliminary support for the M-VIAA with some limitations. Support for construct validity was mixed with support for concurrent and discriminant, but not convergent validity. We suggest that the M-VIAA may not capture the full complexity of vocational challenges faced by autistic people. Future research should build on the structure of the VIAA while ensuring applicability across cultures and contexts, as well as ensuring the richness of vocational activities of autistic people is captured. Why was this study done?: Despite the urgent need to improve employment and other vocational outcomes of autistic people, there are few instruments that measure the range of vocational independence demonstrated by these individuals. The Vocational Index for Adults with Autism (VIAA) is an instrument that identifies the common vocational activities that autistic people engage in following high school. There is a need, however, for researchers to examine the usefulness of the instrument and its applicability in countries outside the United States.What was the purpose of this study?: The goal of this study was to evaluate a modified version of the VIAA (M-VIAA) in a group of autistic people from Australia.What did the researchers do?: We examined responses to the M-VIAA in 211 autistic and nonautistic young adults. We compared the M-VIAA with participant's daily living skills and level of autistic traits, as well as any change in scores over time.What were the results of the study?: Vocational independence was higher in nonautistic participants than in autistic participants. Vocational independence was not related to daily living skills; however, it was related to autistic traits. Over 2 years, scores on the M-VIAA did not change a lot for the autistic participants.What do these findings add to what was already known?: Our study provides some initial support for the M-VIAA in a non-US-based population. However, we also identified that the instrument may not represent the full range of challenges nor the richness of vocational activities experienced by autistic individuals in postsecondary vocational settings.What are potential weaknesses in the study?: The M-VIAA provides limited information about the richness of postsecondary vocational and education activities that autistic individuals may be engaged in. Because few individuals reported having an intellectual disability, we are unable to say how our results might apply to these individuals. Because we modified the instrument for use in Australia, our results may not apply to different countries or to the original version of the instrument.How will these findings help autistic adults now or in the future?: Our study provides preliminary support for the Australian version of the VIAA but suggests that it could be improved to better reflect the richness and range of vocational challenges experienced by autistic people. Our findings therefore identify areas for improvement for assessing the vocational activities and independence of autistic people.

The goal of the present study was to examine the link between poor attention to social information and mindreading abilities in children with autism spectrum disorder (ASD). Results demonstrated that children with ASD tended to perform worse than neurotypical children on both social orienting and theory of mind tasks. Preference for human faces and motion tended to be related but only for the neurotypical children. These findings provide partial support for the social motivation theory.

Research about strengths in autistic individuals has often been based on informant perspectives. These may not align with the subjective experiences and perspectives of autistic people themselves. This study therefore aimed to center the perspectives of autistic people through a qualitative synthesis investigating the lived experiences of strengths in autistic individuals. A systematic search identified 26 qualitative articles that met the inclusion criteria, out of articles that used qualitative methods to understand autistic participants' perspectives on strengths in autism. A thematic synthesis approach generated four themes as follows: wired differently, focused interests enrich life, embracing an autism identity, and context-dependent strengths. The review findings showed that autistic individuals value abilities and attributes that they can use to help them thrive in their daily lives, for example, by enhancing their performance at work, enjoyment during an activity, or helping others. Participants had differing views about whether their strengths were attributable to their autism. Autistic strengths extended beyond abilities to pride in having an autism identity and self-knowledge. Participants recognized that their ability to express themselves or their strengths often depended on the context. Recommendations include supporting autistic individuals to openly explore their interests and experiences and to recognize for themselves the characteristics and skills they value, for example, how to draw upon focused interests to develop relaxation strategies. Why is this an important issue?: Autism research has often focused on the difficulties faced by autistic people rather than on their strengths. Also, research has often asked parents or professionals their opinions rather than asking autistic people themselves.What was the purpose of this study?: We wanted to understand how autistic people experience and talk about their own strengths. Strengths are the things we are good at.What did the researchers do?: This type of research is called a systematic review and meta-synthesis. We searched online databases to find all the published research articles in this area. We looked for studies that asked autistic people how they experience their own strengths. We collected the findings from the studies and identified themes across them. The themes tell us what autistic people think about their strengths.What were the results of the study?: We found 26 published articles that could be included in our review. We generated four themes. Autistic people described different thinking abilities and traits that they linked to autism: some brought enjoyment while others were useful life skills. Focused interests were described as enriching life through bringing well-being, knowledge and skills, and opportunities for social connection. Autistic participants described that having an autistic identity could be a strength, for example, through reflecting on their past or taking pride in their differences. Strengths changed over time and depended on the context of the time or situation.What do these findings add to what was already known?: This adds to our knowledge by providing an integrated and robust summary of all the published literature in the area. Our findings show that autistic people experience some of their autistic traits as strengths, including thinking skills and focused interests.What are potential weaknesses in the study?: Not many of the included articles set out to explore strengths, so we did not always have a large amount of data to analyze from each study. We are just focusing on one aspect of the autistic experience: some people may not experience autistic strengths, either through not associating their experiences with autism or because they experience mostly challenges associated with autism.How will these findings help autistic adults now or in the future?: The findings show that autistic people identify strengths and benefits to being autistic. It could help to share these findings with newly diagnosed autistic people or those who are struggling with understanding autism and what it means for them personally. It might help autistic people who have mostly identified challenges associated with being autistic to identify some of their strengths.

Autistic individuals often experience difficulties in social settings. Although autistic individuals may not intuitively know the "typical" way to behave in social settings, many autistic individuals have a desire to fit in so they develop techniques to "camouflage" their autistic traits. Although camouflaging may help individuals to navigate social environments, camouflaging has also been shown to produce negative psychological outcomes. This study aims to explore whether this "camouflaging" strategy is associated with poor social competence, an aspect of the autism diagnosis. In this study, 247 nonautistic adults completed the Multidimensional Social Competence Scale (MSCS) to assess their social competence, and the Camouflaging Autistic Traits Questionnaire (CAT-Q) to assess the extent to which they used strategies to compensate or mask behaviors characteristic of autism in social settings. We found that over and above IQ, gender, and executive functioning scores, social competence (MSCS) scores reliably predicted the extent to which nonautistic individuals camouflaged, accounting for 25% of the variance in CAT-Q scores. Importantly, even when autistic traits were controlled for, social competence was still able to account for additional variance in CAT-Q scores. These results suggest that low social competency in nonautistic adults predicts camouflaging as a strategy in social situations. Given these camouflaging behaviors are being performed in an attempt to comply with an environmental demand to behave in a particular manner, these results also highlight the importance of conceptualizing the social challenges that autistic and nonautistic individuals face in a bidirectional manner, where the onus is not solely on the individual to comply with social conventions but also on society to accommodate diverse behavioral traits. Why was this study done?: Some autistic individuals try to hide their autistic traits to "fit in" with others, referred to as "camouflaging." Nonautistic adults also report camouflaging, but it is unclear whether this camouflaging is related to social difficulties that are not specific to autism. No research has been conducted to examine the relationship between social competence and camouflaging in nonautistic adults.What was the purpose of this study?: To further understand the factors that are related to camouflaging behaviors. More specifically, whether social abilities, and/or autism characteristics, are related to whether nonautistic adults camouflage.What did the researchers do?: We had 257 nonautistic adults complete various questionnaires, including ones that asked them about their camouflaging behaviors and social abilities. We examined the relationships between the scores from these questionnaires and the influence of other factors such as gender, intelligence, and executive functioning.What were the results of the study?: We found that both social abilities and autistic traits were related to camouflaging behaviors. Indeed, nonautistic adults who had poor social skills, and more autistic traits, engaged in more camouflaging. Social skills were associated with camouflaging even after we considered factors such as gender, intelligence, and executive functioning.What do these findings add to what was already known?: These findings help us understand camouflaging by demonstrating that it may be a common response to social difficulties in nonautistic, as well as autistic, adults. These results also indicate that camouflaging is related to low social competency, not just autism characteristics.What are the potential weaknesses in the study?: The participants in our study completed questionnaires through which they were required to pick from set answers, rather than describe their experiences. We may be missing important qualitative differences in the way nonautistic adults camouflage compared with autistic adults.How will these findings help autistic adults now or in the future?: By comparing what is shared and what is unique with nonautistic people who share traits with autistic people, a more precise definition and study of camouflaging behavior are possible. Rather than see camouflaging as a phenomenon that occurs exclusively in autistic people because of their disability, it may be that both autistic and nonautistic people use camouflaging when they perceive themselves to lack the necessary social competencies that are expected within their social contexts. Because both autistic traits and social competency are related to camouflaging behavior, we can begin to think about how to tease apart which characteristics are more likely to evoke camouflaging in autistic individuals and how this may be similar or different in nonautistic individuals. This knowledge will ultimately contribute to the development of more tailored approaches to prevent and/or reduce the negative impact of camouflaging behaviors for autistic adults.

ABSTRACTThe social motivation theory hypothesizes that autistic individuals' experience diminished social motivation due to reduced social reward, social orienting, and social maintaining. Low social motivation has been linked to increased vulnerability to internalizing difficulties within this population. This systematic review and meta‐analysis examined the relationship between social motivation and internalizing symptoms across the lifespan in autistic individuals. Relevant research papers until February 2025 were identified by searching EMBASE, PsycINFO, PubMed, and Web of Science databases (PROSPERO protocol: CRD42024547863). The systematic review included 14 studies (n = 4590). A total of three meta‐analyses were run using Pearson's correlation coefficients between social motivation and (1) anxiety, (2) depression, and (3) social anxiety, and the moderating effect of age, sex, and study quality were assessed using meta‐regressions. Sensitivity analyses were run to assess whether one study was influencing the results of the meta‐analysis. Greater difficulties with social motivation are associated with increased anxiety, depression, and social anxiety, with a moderate pooled effect size across all domains. Sensitivity analyses did not significantly alter any of the results. Age, sex, and quality of study were nonsignificant moderators. Reduced social motivation may be associated with an increased vulnerability to internalizing difficulties in autistic individuals. The stability across age, sex, and study quality highlights social motivation as a potential transdiagnostic target for intervention in autistic individuals.

Background: There is a general belief in the scientific community that autistic people have emotion recognition (ER) difficulties. Despite this, the research is inconclusive, with roughly half of the studies showing that autistic people have similar ER ability to non-autistic people. The alexithymia hypothesis posits that ER differences found in some autistic individuals might be due to concurrent alexithymia, with some incipient research backing this claim. One limitation of past literature is the focus on facial expressions, with ER from body language remaining understudied, especially in relation to autism and alexithymia. Methods: Adults ( N = 364) completed a face and body ER task containing video expressions of all basic emotions, during which we measured their accuracy, confidence, and intensity ratings. Participants also completed Alexithymia (PAQ) and autism traits (AQ-10) questionnaires. After data cleaning, we split participants into an autistic group ( n = 71) and non-autistic group ( n = 279). We used alexithymia scores to further split the two autism groups into high and low alexithymia categories. We investigated the effects of autism and alexithymia on body and face ER accuracy (unbiased hit rates), confidence ratings, and intensity ratings. Results: Autistic individuals had slightly lower accuracy and confidence than non-autistic individuals. When alexithymia was modeled with autism, autistic people were no different than non-autistic people on accuracy and confidence. Alexithymia was a better predictor of confidence than autism and interacted with modality. Bodies were harder to recognize than faces, but we found no interaction between modality and autism or alexithymia. Our results did not find differences in intensity ratings. Conclusion: Alexithymia may account for differences in ER accuracy and confidence between autistic and non-autistic people. Our findings support the alexithymia hypothesis of autism. This is the first study comparing facial and bodily ER in autistic and non-autistic people and in low- and high-alexithymia-score individuals.

Autistic people often receive unfavorable first impressions from non-autistic people, likely because of stigma related to divergent social presentations and expressive behaviors. Although facial expressivity influences first impressions in the general population, no research has examined whether expressivity differences in autism relate to the formation of first impressions by non-autistic people. It is also unclear whether facial expressivity in autism varies depending upon contextual demands and whether this affects first impressions. We video-recorded 21 autistic and 21 non-autistic adults in two contexts, interviewing for their ideal job and discussing a personal interest, and quantified the percentage of video frames displaying positive, neutral, and negative facial affect using iMotions software. We also compared facial affect between the autistic and non-autistic groups within and between contexts. Later, 335 non-autistic undergraduates rated participants using the First Impression Scale to assess whether impressions were modulated by context and showed associations with facial expressivity. Findings demonstrated that autistic and non-autistic adults differed in overall emotional expressivity, with non-autistic participants displaying more positive affect at a trend-level than autistic participants. Autistic adults also received less favorable first impressions, and these showed some correspondence with their emotional expressivity. For example, their displays of negative affect were moderately to strongly related to worse impressions in the job interview context, a pattern not found to the same degree for non-autistic participants. Impressions of autistic participants also improved more than for non-autistic ones when talking about a personal interest compared with the job interview context, and when their diagnosis was disclosed to observers. Collectively, these findings indicate that autistic people demonstrate divergent facial emotional expressivity that relates to the less favorable impressions they receive from non-autistic observers. Context and diagnostic disclosure also affect how autistic people are perceived. Why is this an important issue?: Autistic people are often stigmatized in professional and personal settings. It is important to understand the factors that relate to stigma in everyday contexts to create more inclusive environments for autistic people.What was the purpose of this study?: To understand whether autistic differences in how emotions are expressed in the face relate to how autistic people are perceived in personal and professional contexts.What did the researchers do?: We asked autistic and non-autistic adults to describe a personal interest and sit for a mock job interview. Later, non-autistic people provided their first impressions of adults and reported on how successful they believed participants were in communicating a personal interest, and in getting hired from their interview. We also examined the facial expressions of participants to see if expressions related to the first impressions autistic and non-autistic people received.What were the results of the study?: We found that autistic and non-autistic adults differ in how they display emotions in their faces, and these differences related to how autistic adults were perceived by non-autistic observers. Autistic expressions were less often categorized as displaying positive emotion, and their displays of negative emotion were related to poorer first impressions in job interviews. Context also affected these judgments. Autistic participants received poorer first impressions in a professional context relative to a personal context, and they were rated as more successful when observers were informed that the person they rated was autistic.What do these findings add to what was already known?: These findings indicate that autistic people express emotion differently in their faces and this is associated with non-autistic people viewing them less favorably than non-autistic people. Furthermore, autistic people were evaluated more positively when talking about personal interests than when interviewing for a job, which did not happen to the same degree for non-autistic people. These findings suggest that biases toward divergent displays of facial expressions may contribute to the disparities autistic people face in personal and professional contexts.What are potential weaknesses in the study?: The software used to analyze facial expressions was developed on non-autistic people and may not accurately measure autistic facial emotion. The autistic sample included in the study was also limited in size and lacked diversity. Future research should include other groups of autistic people, such as those with higher support needs.How will these findings help autistic adults now or in the future?: The results may be used to inform non-autistic people of their biases toward the expressive differences of autistic adults in personal and professional contexts to help minimize discrimination and exclusion.

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Autistic adults often report lower subjective quality of life (QoL) than non-autistic adults. Despite older age also often being associated with lower QoL, little is known about the first-hand experiences of, and influences on, QoL for middle-aged and older autistic adults compared with their non-autistic peers. Thirty-three participants (autistic n = 15, non-autistic n = 18) aged 50–89 years completed semi-structured interviewed that explored their QoL. Responses were thematically analysed, and themes were compared to identify similarities and differences between groups. Both autistic and non-autistic groups reported similar QoL experiences, but with subtle differences. Social support from family and friends was important for both groups. Both noted shrinking social networks with age, but the non-autistic group was often less satisfied with their social lives. Concerns about health and sleep changes were common, but autistic participants often mentioned persistent mental health issues affecting their wellbeing. Autistic individuals also highlighted sensory sensitivities and difficulties with change. Receiving their autism diagnosis was significant for autistic participants, aiding self-acceptance. Acceptance of age-related changes was common in both groups, but the autistic group was more willing to seek support, while the non-autistic group often saw asking for help as losing their independence. These findings highlight similarities and differences in aspects relevant to QoL for middle-aged and older autistic and non-autistic adults. While many similarities were found, the autistic group reported subtle differences in their experiences. Experiences such as social connectedness and coping with change could be targeted to improve the QoL of ageing autistic adults. • We used interviews to ask autistic (n = 15) and non-autistic adults (n = 18) about what influences their QoL in older age. • The autistic and non-autistic groups reported many similarities in their QoL experiences; however, subtle differences were found. • These differences could be targeted for interventions, to improve QoL for older autistic people. • For example, supporting preferred socialisation, addressing mental health difficulties, and supporting transitions to ease change.

Although autistic adults may establish better dyadic rapport with autistic relative to non-autistic partners, it is unclear whether this extends to group settings. The current study examined whether rapport differs between autistic groups, non-autistic groups, and mixed groups of autistic and non-autistic adults, and whether differing diagnostically from the rest of the group results in lower rapport. One hundred and forty-three adults were assigned to one of four group types of four participants each: all-autistic, all-non-autistic, non-autistic majority (three non-autistic, one autistic), and autistic majority (three autistic, one non-autistic). Groups participated in a 5-minute building activity and afterwards completed a 5-item rapport measure assessing their experience. The all-autistic groups did not differ on overall rapport from the all-non-autistic groups and had significantly higher rapport on two items (enjoying the interaction and friendliness of the group) than both types of mixed groups. At the individual level, autistic participants expressed more ease and enjoyment when interacting with other autistic adults relative to non-autistic adults, and their rapport declined as more non-autistic participants were included in the group. In contrast, rapport for non-autistic participants remained relatively consistent regardless of group composition. We discuss potential reasons why autistic participants were more affected by group composition than non-autistic participants.Lay abstractAutistic adults sometimes get along better with other autistic people compared to non-autistic people, but so far this has only been studied in two-person interactions. This study examined how well autistic and non-autistic people develop rapport in a group setting and whether rapport differs when group members share or do not share a diagnosis. We assigned 143 adults to 36 groups of four adults each. Some groups only had autistic members, some only had non-autistic members, and some were “mixed” groups of autistic and non-autistic members. Groups participated in a tower-building task for 5 minutes and afterwards completed a survey about rapport with the group. The groups of all-autistic participants expressed that their interactions were more enjoyable and friendly than the mixed groups. Autistic participants reported lower rapport when interacting with non-autistic adults, while non-autistic participants reported similar rapport whether interacting with autistic or non-autistic group members. Overall, findings are not consistent with a social deficit model of autism, as autistic adults often established rapport with partners in a group setting. Their level of rapport, however, depended strongly on the social context, particularly whether other autistic people were also in the group.

Social motivation is a foundational construct with regard to the etiology, neurobiology, and phenotype of autism spectrum disorder (ASD). Multiple theories suggest that early emerging alterations to social motivation underlie a developmental cascade of social and communication deficits across the lifespan. Despite this significance, methods to measure social motivation vary widely, with little data to date as to how different measures might compare. In this study, we explore three existing caregiver-report measures that have been proposed to quantify social motivation among school-age children with ASD (n = 18; all male) and without ASD (n = 36; 50% female), with the broad goal of characterizing social motivation across measures and specific aims of investigating (a) diagnostic and sex differences in social motivation, (b) correspondence between measures, and (c) relationships between social motivation and broader social outcomes. Across all three measures, individuals with ASD had lower social motivation by caregiver-report. However, they did display individual differences in the degree of social motivation reported. There were no differences in social motivation between males and females without ASD on any of the three measures. For the full sample, measures of social motivation correlated with one another as anticipated, and stronger social motivation was associated with stronger social skills and fewer social difficulties. Our data suggest that social motivation among children with ASD may be best conceptualized as an individual difference that is diminished on average relative to peers but which varies among children and adolescents with ASD, rather than as an absolute absence or uniform deficit. LAY SUMMARY: Several theories suggest that children with autism spectrum disorder (ASD) experience less social motivation than their peers without ASD, contributing to difficulties in social skills. Based on multiple caregiver-report questionnaires, social motivation was reduced on average for school-age children with ASD but also varied among children with ASD. Stronger social motivation was related to stronger social skills and fewer social problems. Future work should include more girls with ASD, consider social motivation across age groups, and include first-hand perspectives from people with ASD.