Social Issues

Date Last Revised: October 30, 2008
Date Published: April 2, 2007

One of the hallmarks of autism is a lack of interest in or connection with other people. ¹ Although other senses, like hearing or touch, may also be impacted by autism (see Sensory Issues), it is the “social sense” ² – our intuitive understanding of how to read, reach out to, and successfully interact with other human beings -- that is most intensely affected.

An infant seems uninterested in making eye contact, never smiles, or can’t bear to be held. A toddler rocks in a corner, watching his own fingers flick before his face in seeming fascination, oblivious to a parent’s attempts to engage him. A child wanders the playground in circles before stopping to stare at the pattern of veins in a fallen leaf, uninterested in the other kids and unable to engage in the recess activities going on around him.

Gaze, Joint Attention, and Neurodevelopment

This is not the way it’s supposed to be. Human infants are hardwired to seek out faces, as opposed to other objects in the environment,³ and to prefer the sound of a human voice over any other sound,⁴ paying special attention when that voice is loaded with strong emotion.⁵ Even before they can talk, very young children begin to initiate social connection with a parent by pointing to an object and then alternating their gaze from parent to object and back again, one of a series of behaviors that involve joint attention.⁶ The communication is clear: “Check out that pretty toy! Isn’t that the coolest thing you’ve ever seen? Isn’t it great we can enjoy it together?” A parent understands intuitively, delighting in the shared experience, smiling, making eye contact, gushing over the toy. The child revels in this supportive feedback, encouraged to find more things to share. Sharing feels good.

The sharing isn’t just warm and wonderful, either. It’s essential, and not just to emotional well-being. The brain, especially in the first years of life, does not only record what happens to us, but builds itself in response to external and internal experiences, particularly social and emotional ones. What this means is that the line between the purely physical (brain structures and chemistry), and the social-emotional or psychological (feelings and shared meaning) has been blurred. Brain structure and experience are interconnected.^7,8

Infants on the autism spectrum lack the overriding interest typical infants display for human faces and voices.⁹ They tend not to seek out their parent’s gaze, and so cannot initiate or respond to attempts at shared enjoyment,¹⁰ even if they are very much attached to their parent. If the brain is indeed developing in part based on interaction and experiences typical infants help create, it’s a double whammy for the child with an ASD. Not only do they suffer from that initial social deficit, but its lack contributes “to a disturbance in social experience that is so robust as to compromise subsequent neurological and behavioral development.”¹¹ This explains why experts are so adamant about early intervention. Whatever was wrong to begin with may be getting even more wrong with time.

Wherever a person falls on the autism spectrum, they are affected by this tendency to not pay attention to the social world.¹² They may focus on objects instead of people…or look over a conversational partner’s shoulder instead of into their eyes. One study showed this by tracking the gaze of people watching a video. Typical people watching a dramatic scene tended to focus right on an actor’s eyes. People with ASDs, in contrast, tended to look at mouths or, if they were on the more disabled end of the spectrum, inanimate objects like light switches on the wall.¹³ Lacking whatever programming drives most of us to focus in on human faces, voices, and gestures means individuals with ASDs – from those who have an intellectual disability to those with high IQs¹⁴ -- are missing masses of social information.¹⁵

Theory of Mind

People with ASDs not only have a hard time noticing the social world; they have a hard time interpreting it. Early problems with gaze and joint attention, it is believed, come to impact their theory of mind.¹⁶ Theory of mind simply refers to the understanding that other people have their own thoughts, perceptions, and intentions separate from one’s own. It is part of seeing others as separate beings with their own agendas. To accommodate others, to predict their future behavior, to manipulate or please them, you must have this inbuilt capacity to guess something about who they are and what they might do or desire. Individuals with ASDs lack this ability to a staggering degree.

Because they cannot read social cues, including facial expressions,¹⁷ body language, or tone of voice, ¹⁸ people all across the autism spectrum are at a disadvantage. Another person may look at his watch (“You’re boring me” or “I’ve gotta go, I’m late!”), use a sarcastic tone, grimace to show increasing annoyance, quirk their eyebrows in disbelief – all of it lost on the person with an ASD. They cannot “see” the social signals that bombard us every day. Neither can they respond appropriately. How could they? They never received the message that was sent: I’m bored. I’m late. You’re making me mad.

As a result of all this, individuals with ASDs look “odd” to the outside world. They may stop in the middle of the sidewalk to stare at a fan revolving in a storefront window, oblivious to the crowds of people trying to get by. They may pick their nose in public with no consciousness that this is not OK; walk away in the middle of a conversation; or talk on and on about a topic of no interest to the listener. They may bump into other people, as if they did not see them, or as if they had misjudged how much space was available.

Even higher functioning individuals who are trying to pay attention, who want to connect, constantly commit social mistakes, alienating their peers.¹⁹ In fact, if you are trying to evaluate a child’s ability to read the social world, relationships with peers are key. Adults will often adapt to a child’s unique way of interacting. Peers will seldom do so. It is in relationships with peers that social issues become most glaring.²⁰

Conclusion

In summary, those with ASDs may seem aloof, or run right up to strangers and start conversations on obscure topics. They may be lost in their own thoughts, or trying unsuccessfully to connect. Either way, people all across the autism spectrum suffer from an inability to understand the complex dance that characterizes the social world.

References: 

1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author.
2. Gray, C. (2002). The sixth sense II. Arlington, Texas: Future Horizons.
3. Valenza, E., Simion, F., Cassia, V.M., & Umilta, C. (1996). Face preference at birth. Journal of Experimental Psychology: Human Perception and Performance, 22(4), 892-903.  Abstract
4. Fifer, W.P., & Moon, C.M. (1994). The role of the mother’s voice in the organization of brain function in the newborn. Acta Paediatrica Supplement, 397, 86-93.
5. Grossmann, T., Striano, T., & Friederici, A.D. (2005). Infants’ electric brain responses to emotional prosody. NeuroReport, 16(7), 1825-1828.  Abstract
6. Mundy, P., & Burnette, C. (2005). Joint attention and neurodevelopmental models of autism. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.650-681). Hoboken, NJ: John Wiley & Sons.
7. Sullivan, R., Wilson, D.A., Feldon, J., Yee, B.K., Meyer, U., Richter-Levin, G., Avi, A., Michael, T. Gruss, M., Bock, J., Helmeke, C., & Braun, K. (2006). The international society for developmental psychobiology annual meeting symposium: Impact of early life experiences on brain and behavioral development. Developmental Psychobiology, 48(7), 583-602.  Abstract
8. Quartz, S.R., & Sejnowski, T.J. (1997). The neural basis of cognitive development: A constructivist manifesto. Behavioral and Brain Sciences, 20, 537-596.  Abstract
9. Osterling, J.A., Dawson, G., & Munson, J.A. (2002). Early recognition of 1-year-old infants with autism spectrum disorder versus mental retardation. Developmental Psychopathology, 14(2), 239-51. Abstract
10. Mundy, P. (1995). Joint attention and social-emotional approach behavior in children with autism. Development and Psychopathology, 7, 63-82.
11. Mundy, P., & Burnette, C. (2005). Joint attention and neurodevelopmental models of autism. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.650-681). Hoboken, NJ: John Wiley & Sons. Page 673.
12. Carter, A.S., Davis, N.O., Klin, A., & Volkmar, F. (2005). Social development in autism. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.312-334). Hoboken, NJ: John Wiley & Sons.
13. Klin, A., Jones, W., Schultz, R., Volkmar, F., & Cohen, D. (2002). Visual fixation patterns during viewing of naturalisitic social situations as predictors of social competence in individuals with autism. Archives of General Psychiatry, 59, 809-816.  Abstract
14. Klin, A. (2000). Attributing social meaning to ambiguous visual stimuli in higher-functioning autism and asperger syndrome: The social attribution task. Journal of Child Psychology and Psychiatry, 41(7), 831-846.  Abstract
15. Dawson, G., Meltzoff, A.N., Osterling, J., Rinaldi, J., & Brown, E. (1998). Children with autism fail to orient to naturally occurring social stimuli. Journal of Autism and Developmental Disorders, 28(6), 479-485.  Abstract
16. Baron-Cohen, S. (1995). Mindblindness: An essay on autism and theory of mind. Cambridge, MA: MIT Press.
17. Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The "Reading the Mind in the Eyes" test revised version: A study with normal adults, and adults with Asperger Syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2), 241-251.  Abstract
18. Rutherford, M.D., Baron-Cohen, S., & Wheelwright, S. (2002). Reading the mind in the voice: A study with normal adults and adults with Asperger Syndrome and high functioning autism. Journal of Autism and Developmental Disorders, 32(3), 189-194.  Abstract
19. Shea, V., & Mesibov, G.B. (2005). Adolescents and adults with autism. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.288-311). Hoboken, NJ: John Wiley & Sons.
20. Carter, A.S., Davis, N.O., Klin, A., & Volkmar, F.R. (2005). Social development in autism. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.312-334). Hoboken, NJ: John Wiley & Sons