Autism spectrum disorder (ASD) is diagnosed through a series of different symptoms, yet few are as recognizable or common as the symptoms of ASD relating to social dysfunction. It’s noted that cases of mild as well as severe autism often exhibit some form of social dysfunction, particularly in the realm of subtle, non-verbal communication.
When other children or adults fail to say things ‘plainly’ and try to convey meaning through subtext or certain gestures, it’s likely that the patient will misunderstand or completely miss the intended meaning.
There are several theories as to why this is, but it is important to stress that this ‘problem’ takes many forms and shapes, and that while some can cope with their troubles and develop the means to recognize and even understand many cues that might previously have been missed (particularly in milder cases of autism, or in those previously diagnosed with Asperger’s), many do not intuitively learn to cope with this difference in communicative skill, and only improve with early and repeated intervention.
To help better understand why a child on the spectrum might fail to pick up on social cues, it helps to understand what they are, and why they are important.
What Count as ‘Social Cues’?
Social cues range from subtext in the tone of one’s voice, to the unwritten and ‘obvious’ social etiquette that can be most plainly seen in adolescents who develop cliques and a social hierarchy based on displays of dominance and shared interests. Just as most children would intuitively know not to pick a group of strangers to suddenly talk to, neurotypical children naturally develop the means to pick up on subtle changes in one’s voice or body language to catch a lie, understand sarcasm, or figure out that what’s being said is meant to be a secret.
Social cues can be very complicated to understand, as behavior that might be appropriate within a very specific context can be seen as wildly inappropriate in another context. For children with ASD, these very complex rules are often completely unspoken and unnatural, and at first, completely incomprehensible.
In general, social cues can be categorized as any non-verbal communication that is not previously codified or explained, as well as the implied etiquette surrounding certain situations. Take the practice of talking to strangers, for example. Within a certain context, it is perfectly normal to join a group of strangers and simply engage with them – for example, at invited parties, orientation day at school, or during certain off-duty hours at the bar. But within a different context, such behavior could be seen as ‘weird’ or ‘annoying’.
Similarly, a child or young adult on the spectrum might not pick up on subtle cues to stop talking about something, whether it’s something that was intended to only be held in confidence, or whether it’s simply a matter of speaking at length about a subject everyone else has lost interest in.
It’s Not Just Non-Verbal
When it comes to verbal communication, similar issues occur. Different cases of autism exhibit wildly different issues, but a common thread is a lack of understanding for pragmatics (how the use of language changes based on context, such as using a different tone with a teacher than with a friend, or an indoor voice versus a play voice) and prosody (the tempo and rhythm of speech, including concepts such as intonation, emphasis, and varying pitches). Just as children with autism can have a hard time knowing how to speak appropriately, they often miss on non-verbal cues by others telling them how to behave.
This is not a simple issue, and it’s not an issue entirely to blame on the diagnosis of autism. While language issues and missed cues can be frustrating to neurotypical individuals and many cues can be taught with enough practice, depending on the severity of a person’s condition, more can be done to help peers of autistic children learn to understand and accept their peer’s differences, and in turn help them better understand what is expected or wanted of them within a given situation.
Why Autism Struggles with Social Cues
There are different theories that can help explain why social cues, body language, and non-verbal communication are so complex for children on the spectrum, but these explanations do little to explain why autism often struggles with other forms of social communication and the complexities of language. In general, one theory on the nature of missing non-verbal cues involves the natural inclination among children with autism to avoid eye and facial contact.
While we teach our children that it’s polite to look at another person when they are speaking to you, for children on the spectrum, doing so is incredibly uncomfortable and feels threatening. Research indicates that deficits in the ability to recognize expressions among patients with ASD may link to a heightened response.
Although most people learn to read faces intuitively and become ‘experts’ in recognizing cues during normal conversation, people on the spectrum avoid looking at the face as an adaptive strategy, due to increased activity in the amygdala. Put plainly, they are more likely to be agitated and to experience feelings of anxiety when making eye contact. This is because making eye contact is perceived as threatening in the brain, and while this is ‘overcome’ in most people depending on the context of the situation (eye contact is still socially threatening in many situations), people with ASD have a heightened reaction to direct eye contact.
Presumably, this cascades into a long series of other problems with missing facial cues, expressions, and gestures, because our ability to naturally intuit what another person is implying non-verbally often relies on a complete picture of their face. There are also hints that it’s a cyclical issue, wherein problems with facial recognition and processing lead to poorer social interactions, which further cause one to avert from social interaction and facial processing, deepening the issue.
Can Children with Autism Learn to Recognize Social Cues?
Methods of training facial recognition in people with other disorders exist but have not been applied in autism treatment. However, teaching children on the spectrum to try and make eye contact is often a part of applied behavior analysis (ABA), as part of a greater series of interventions aimed at helping people with ASD develop the skills to better pick up on social cues. In the future, there may be a place of ‘face training’ in children and adults with ASD who have problems with social communication.
However, ABA is not a one-size-fits-all treatment. Some children respond better than others, and the rate of one’s progress is entirely subjective. Research shows that earlier intervention leads to better overall progress, and more lasting progress.