MythBusters: Autism is social aversion

Myth: Autism is characterized by social aversion or social avoidance

As seen in: popular culture, some websites describing autism symptomatology

Evidence for this: It’s been widely reported that individuals with autism look less at the eyes of others than neurotypical individuals and early work interpreted reduced attention to the eyes of others as evidence for gaze aversion (Richer & Coss, 1976). That is, individuals with autism avoid eye contact because they regard it as aversive. The authors go so far as to recommend not engaging children with autism in eye contact because it may be uncomfortable for them.

More recent studies using neuroimaging methods seem to provide some support for this hypothesis. These studies (e.g., Kliemann et al., 2012; Tottenham et al., 2013) focused on examining activity in the amygdala while adolescents and adults with autism viewed faces.  The amygdala is believed to be involved in affective processing and emotional reactivity, and is typically active for aversive stimuli or during states of high arousal. Both these studies found increased activity in the amygdala among subjects with autism while viewing faces (and in particular the eyes) relative to neurotypical controls. Heightened amygdala response to faces has been interpreted as a potential neurobiological mechanism that may contribute to reduced attention to people, and in particular the eyes. In other words, looking at faces and making eye contact may be especially arousing for individuals with autism and these individuals avoid social contact to minimize high states of arousal or discomfort.

 Evidence against this: In 1943, Leo Kanner wrote the initial descriptions of children with what he called “autistic disturbances”. Many of these children heeded little attention to people. One child was described to “mostly ignore other people. When [the family] had guests, he just wouldn’t pay any attention. He looked curiously at small children and then would go off all alone. He acted as if people weren’t there at all”. This behavior points more to a general indifference for social interaction rather than an explicit aversion or avoidance of people.

More recent eye-tracking studies further suggest that young children with autism may be indifferent to, and not avoidant of socially relevant stimuli. When visually cued to look at a person’s eyes, toddlers with autism did not divert their gaze and in fact were more likely to sustain visual attention around the eye region (Moriuchi, Klin, & Jones, 2016). Related research examining face recognition found that toddlers with autism did not differ from their typically developing peers in the amount of time they looked at the eyes versus the mouth of still photographs of faces, but toddlers with autism were less accurate in recognizing photographs of faces they had previously seen (Chawarska & Shic, 2009). This further suggests that young children with autism are not actively looking away from faces, but perhaps are looking less to faces because they aren’t picking up the relevant social information that would support aspects of social learning.

Other studies looking at peer relations in school-aged children with autism suggest a desire to form friendships but a dearth of skillset to do so (e.g., Bauminger and Kasari, 2000). High-functioning school-aged children with autism report greater level of loneliness and poorer quality of friendship than their typically developing peers (Locke et al., 2010), which suggests that there is a desire and an understanding of what constitutes a good friendship. This is inconsistent with the social aversion/avoidance hypothesis.

Final verdict: Autism is diagnosed on the basis of social communicative difficulties, and the presence of repetitive and restrictive behaviors. This can manifest in countless ways. Autism is a developmental disorder, and with that there needs to be special consideration of age when describing symptom profiles. A toddler with autism may initially show indifference to social stimuli, including people and faces, and lose out on a lot of relevant social learning opportunities. This could then lead to lower social motivation for interactions down the line, and as an adolescent or adult this same individual may then choose to avoid eye contact because they do not feel a need to do so.

But altogether, the data suggest that individuals with autism are not actively avoiding social interactions nor do they find it explicitly aversive. The literature on peer interactions in school-aged children with autism strongly point to a desire to engage in meaningful friendships but a struggle in developing the adequate skills to do so. This points to a need for better intervention and social skills training for older individuals on the spectrum to navigate the tricky social landscape of adolescence.