3 OF THE BIGGEST AUTISM MYTHS
"Autistic people have poor social skills"
Autistic people have social skills. We need to stop perpetuating the narrative that Autistic people have social deficits. When Speech and Language Therapists carry out assessments on Autistic children they need to consider that the assessments are based on neurotypical (NT) language and communication developmental norms. Pragmatics is a field built upon NT styles of communication and so we cannot and should not assume Autistic people have pragmatic language impairments.
Forcing NT social skills on Autistic people leads to:
The rationale behind teaching Social Skills is so that Autistic people learn how to socialise in the 'real world' (with NTs...) so they can make friends and live fulfilling lives. But often the result is the opposite. Telling them that in order to make friends and be successful in life they must change who they are and act differently is extremely damaging. It teaches them to mask. Having to adopt the social skills of NTs makes Autistic people feel more isolated, insecure, depressed, and anxious because they feel they have act less autistic if they want to be accepted. It doesn't result in long-lasting meaningful friendships - it results in friendships that are surface-level, one-sided, less meaningful, and ultimately leave the Autistic person feeling misunderstood and burnt out due to the exhaustion of mimicking NTs. As a marginalised group of people Autistics have been historically socially rejected, bullied, and excluded since being young children - even when they try and adopt the social skills of NTs and act like everyone else. Social Skills training teaches them they must fit in, blend in, and they learn that it's not OK to be who they are.
Alot of people reading this might be thinking "ok, this sounds interesting, I get it. But wait, Autistic kids have to be prepared for the 'real world' and live in society like we do. We have to teach them these skills. Everyone else has to do it, that's just life". My response to this is - It is OK to teach autistic people about how neurotypical people interact and communicate. In fact, it's important we do this because they're likely going to be encountering these interactions in their daily lives - for their own emotional and physical safety it's important they know what to expect in these interactions so that when misunderstandings happen, they know how to manage these, and don't place the blame on themselves.
In addition - assuming 'we' and 'everyone else' are NT, then no, it's not the same.
Autistic people are neurologically different and are living in a world that's not set up for them. This means that NT people do not experience the daily struggles and barriers that Autistic people do on a daily basis. NTs don't have to mask like Autistics do because they haven't experienced years of social trauma whereby masking is a conditioned response as a way to self-protect. NTs don't need to do this. And if they do 'mask' it is not to the same detriment or cost on their mental, emotional, sensory, physical health. They don't have sensory overload and meltdowns due to suppressing personality and physical traits that are deemed as socially undesirable. They don't have to spend hours/days/weeks attempting to re-charge from constant social interaction demands. They don't experience the damage to self-esteem. They don't have to suppress their stimming, echolalia, communication style or special interests. They don't have to force eye-contact to the point where it's physically painful or anxiety-inducing. They don't have to give up their authenticity in order to be accepted.
Autistic people have BETTER social engagement when they are with other Autistic people
THE RESEARCH / EVIDENCE
"Social interaction is relational - it relies on the communication partner's skills as much as it does on the autistic person's" - (Sasson et al., 2017)
Communication is a 2-way street. Misunderstandings that happen in a conversation are not solely down to 1 individual - The Double Empathy Problem (Dr. Damian Milton)
Autistic children show better social engagement when they are with other Autistic children, compared to when they're with NT peers - (Kasari et al., 2015)
"In conversations involving two autistic participants, flow, rapport and intersubjective attunement were significantly increased and in three instances, autistic interlocutors appeared to experience improvements in their individual communicative competence contrasted with their other conversations" - (Williams et al., 2021)
Autistic people share information just as successfully as NT people. Autistic people "have the skills to share information well with one another and experience good rapport, and that there are selective problems when autistic and non-autistic people are interacting" - (Crompton et al., 2020)
Autistic people disclosed more about themselves to other autistic people compared to non-autistic people. "Results suggest that social affiliation may increase for autistic adults when partnered with other autistic people, and support reframing social interaction difficulties in autism as a relational rather than an individual impairment" - (Morison et al., 2020)
"Neurotypical peers are less willing to interact with those with autism based on thin slice judgments" - (Sasson et al., 2017)
The take-away message...
Just as much as we teach Autistic children about what NT social skills look like, it's imperative we teach NT children what Autistic social skills look like, and to ACCEPT differences. We need to allow autistic people to communicate in the way that they prefer and let them be who they truly are.
"Autistic people lack empathy"
Whilst I'm not denying that some Autistic people lack empathy (as with any group of people), it has been theorised for decades that being Autistic = having no empathy. Autistic people actually feel things so intensely that it is overwhelming. Some of the most empathic people I know are Autistic. Being hypersensitive to stimuli in the environment means that other people's emotions can be exhausting (see 'Sensory Processing'). Social reciprocity can be too demanding when an Autistic person is trying to process so much stimuli whilst managing language processing / executive functioning difficulties. However, to NTs, this is often misinterpreted as a communication deficit or coldness.
The Double Empathy Problem proposed by Dr. Damian Milton (an Autistic researcher / academic) states that empathy is a relational, transactional process and so a conversation is a 2-way street. The misunderstandings that occur between a neurotypical and an autistic person happens to both people. The mutual incomprehension is shared by both sets of people; the non-autistic AND Autistic person. A neurotypical person will not understand how an autistic person experiences the world and does not communicate the way an Autistic person does.
Yet, it's Autistic people who are labelled as having social impairments and given treatment to force them to understand non-autistics better, instead of teaching NTs the communication styles of Autistic people. NTs communicate in very different ways. E.g. in my experiences, NT individuals have a greater tendency to drop hints and assume the other person knows what they are thinking based on little information (mind reading) and then expect them to know what response to give. I often find myself having to ask multiple follow-up questions to what a NT says, especially when I am asked a question. They often impose their ideas of what's socially acceptable and do not consider what is going on in the mind of the Autistic person in these exchanges. '.
Autistic people experience constant communication breakdowns with people in the community because of the differences in communication styles. Many NTs will claim they have superior social skills than Autistics. But this is simply not true. There are MANY NTs who lack empathy and have poor social skills. NTs don't say what they mean, leave room for different interpretations, are vague in what they say, and then when autistic people ask questions for clarification, the NT treats them like they're the one with the problem. When we say "I don't know what you mean", or "I don't understand", it's just as much the responsibility of the NT to clarify the misunderstanding and communicate clearly. NTs say Autistic people lack the ability to perspective-take, have rigid inflexible thinking. Yet it's often NTs that have inflexible thinking and don't perspective-take with Autistic people.
"Autistic people lack a Theory of Mind (ToM)"
ToM is said to be 'the ability to put yourself in another person's shoes' and it is impaired in Autistic people (or non-existent), however, it has been widely misunderstood for decades and completely de-bunked. The ToM conceptcomes from a false-belief (deception) test designed in the 1980s called The Sally-Anne test. Clinical Psychologist Simon Baron-Cohen and colleagues designed the test in order to assess a child's ToM. They found that the Autistic children failed this test whereas the neurotypical children passed it. Baron-Cohen formulated the "mindblindness" theory (an inability to know what others are thinking) and his findings led to this theory being used as the framework for decades of research and interventions regarding autism. It's taught on college courses and degree programs.
ISSUES WITH THE TEST
1) There is more to passing this test than having an 'intact' ToM.
It's not enough to demonstrate that the child can predict the outcomes of others. To follow it the child must follow the actions of 2 characters in a narrative, has to know that Sally could not have seen the switching of objects, and has to understand the exact meaning of the question. So if you are a child with language difficulties, has problems sequencing, has anxiety, attentional difficulties, they could easily fail.
2) The study's sample size was TINY.
In the study only 20 Autistic children and 27 neurotypical children were included, or, as Baron-Cohen described, "NORMAL CHILDREN". To draw such conclusions from a small number of participants is concerning especially since it sparked a generation of theories and assumptions.
3) The test is based on neurotypical developmental norms
...and it draws conclusions based on the researchers' experiences of the world. Which is a neurotypical experience and so they do not know how it feels to experience the world as an Autistic person
4) Autistic people don't tend to do well on tests that involve deception.
5) The ToM 'deficit' cannot account for the 2 sets of people failing to understand each other
6) ToM might be delayed in some Autistic children but that doesn't mean it never exists
The Sally-Anne test
What's interesting is that a slightly altered version of the test was conducted with autistic children whereby a reward was offered for the correct answer, and this drastically improved the results (74% of children passed this test, whereas only 13% passed the original test). And there has since been a newer theory: ToM can be separated into affective empathy (inferring people's emotions) and cognitive empathy (inferring people's beliefs). Whilst some Autistic people score lower on cognitive measures, it has been found that they score no differently on affective measures compared to non-Autistics.
Milton, D. E. M. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883-887.
"Speaking of autism" (2020). - The double empathy problem: Link
Sasson, N., Faso, D., Nugent, J. et al. Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Sci Rep 7, 40700 (2017). https://doi.org/10.1038/srep40700
Kasari C, Dean M, Kretzmann M, Shih W, Orlich F, Whitney R, Landa R, Lord C, King B. Children with autism spectrum disorder and social skills groups at school: a randomized trial comparing intervention approach and peer composition. J Child Psychol Psychiatry. 2016 Feb;57(2):171-9. https://pubmed.ncbi.nlm.nih.gov/26391889/
Crompton CJ, Ropar D, Evans-Williams CV, Flynn EG, Fletcher-Watson S. Autistic peer-to-peer information transfer is highly effective. Autism. 2020;24(7):1704-1712. doi:10.1177/1362361320919286
Morrison KE, DeBrabander KM, Jones DR, Faso DJ, Ackerman RA, Sasson NJ. Outcomes of real-world social interaction for autistic adults paired with autistic compared to typically developing partners. Autism. 2020 Jul;24(5):1067-1080. doi: 10.1177/1362361319892701
Peterson, C., Slaughter, V., Peterson, J., Premack, D. (2013). "Children with autism can track others' beliefs in a competitive game. Link
The Sally-Anne test. Baron-Cohen, Simon; Leslie, Alan M.; Frith, Uta (October 1985). "Does the autistic child have a "theory of mind"? - Link
Mutual (Mis)understanding: Reframing Autistic Pragmatic “Impairments” Using Relevance Theory Citation: Williams GL, Wharton T and Jagoe C (2021) Mutual (Mis)understanding: Reframing Autistic Pragmatic “Impairments” Using Relevance Theory. Front. Psychol. 12:616664. doi: 10.3389/fpsyg.2021.616664 link