Differentiated, rather than shared, strategies for time-coordinated action in social and non-social domains in autistic individuals

"What does 'often' even mean?" Revising and validating the Comprehensive Autistic Trait Inventory in partnership with autistic people

BACKGROUND

In this study, we revised the comprehensive autistic trait inventory (CATI)-a self-report inventory of autistic traits, in collaboration with autistic people and provided preliminary evidence for its validity as a self-report measure of autistic traits in the general population. An established strength of the CATI is its ability to capture female autistic traits. Our project aimed to extend this further, to increase the inventory's accessibility, and to minimise stigma induced by deficit-based representations of autistic experience.

METHODS

Together with 22 individuals from the autism and autistic communities, we created the Revised Comprehensive Autistic Trait Inventory (CATI-R). Revisions included rewording items to increase clarity or reduce stigma and expanding items to capture diverse autistic experiences. We also present a series of guidelines for developing self-report inventories of subclinical neurodivergent traits. We validated the CATI-R within a large sample (n = 1439), comprising people with a self-reported autism diagnosis (n = 331), people who self-identified as autistic (n = 44), and non-autistic participants (n = 1046).

RESULTS

We successfully validated a revision of the CATI. A confirmatory factor analysis supported the six-subscale structure (two-factor bifactors model: Chi-squared = 2705.73, p < .001, RMSEA = .04, SRMR = .03, CFI = .95, TLI = .94). Spearman's rank correlations showed positive relationships between all subscales (all rs >  .56, ps < .001). Convergent validity was demonstrated by significant correlations between the CATI-R and two contemporary inventories of autistic traits: the AQ (rho = .86, p < .01) and BAPQ (rho = .82, p < .01). Finally, a measurement invariance analysis indicated that total-scale scores can be compared across genders.

LIMITATIONS

Our study presents only initial evidence for the validity of the CATI-R that should be enriched with further analyses and types of data, including a larger number of participants who do not identify as male or female.

CONCLUSIONS

This project provides a revised trait inventory that resonates with actual autistic experience, along with guidelines for creating self-report measures that are sensitive, accessible, and non-stigmatising.

Neural Mechanisms of Social Interaction Perception: Observing Interpersonal Synchrony Modulates Action Observation Network Activation and Is Spared in Autism

How the temporal dynamics of social interactions are perceived arguably plays an important role in how one engages in social interactions and how difficulties in establishing smooth social interactions may occur. One aspect of temporal dynamics in social interactions is the mutual coordination of individuals' behaviors during social interaction, otherwise known as behavioral interpersonal synchrony (IPS). Behavioral IPS has been studied increasingly in various contexts, such as a feature of the social interaction difficulties inherent to autism. To fully understand the temporal dynamics of social interactions, or reductions thereof in autism, the neural basis of IPS perception needs to be established. Thus, the current study's aim was twofold: to establish the basic neuro-perceptual processing of IPS in social interactions for typical observers and to test whether it might differ for autistic individuals. In a task-based fMRI paradigm, participants viewed short, silent video vignettes of humans during social interactions featuring a variation of behavioral IPS. The results show that observing behavioral IPS modulates the Action Observation Network (AON). Interestingly, autistic participants showed similar neural activation patterns as non-autistic participants which were modulated by the behavioral IPS they observed in the videos, suggesting that the perception of temporal dynamics of social interactions is spared and may not underly reduced behavioral IPS often observed in autism. Nevertheless, a general difference in processing social interactions was found in autistic observers, characterized by decreased neural activation in the right middle frontal gyrus, angular gyrus, and superior temporal areas. These findings demonstrate that although the autistic and non-autistic groups indeed differed in the neural processing of social interaction perception, the temporal dynamics of these social interactions were not the reason for these differences in social interaction perception in autism. Hence, spared recruitment of the AON for processing temporal dynamics of social interactions in autism does not account for the widely reported attenuation of IPS in autism and for the widely reported and presently observed differences in social interaction perception in autism.

Interacting with autistic virtual characters: intrapersonal synchrony of nonverbal behavior affects participants' perception

Temporal coordination of communicative behavior is not only located between but also within interaction partners (e.g., gaze and gestures). This intrapersonal synchrony (IaPS) is assumed to constitute interpersonal alignment. Studies show systematic variations in IaPS in individuals with autism, which may affect the degree of interpersonal temporal coordination. In the current study, we reversed the approach and mapped the measured nonverbal behavior of interactants with and without ASD from a previous study onto virtual characters to study the effects of the differential IaPS on observers (N = 68), both with and without ASD (crossed design). During a communication task with both characters, who indicated targets with gaze and delayed pointing gestures, we measured response times, gaze behavior, and post hoc impression formation. Results show that character behavior indicative of ASD resulted in overall enlarged decoding times in observers and this effect was even pronounced in observers with ASD. A classification of observer's gaze types indicated differentiated decoding strategies. Whereas non-autistic observers presented with a rather consistent eyes-focused strategy associated with efficient and fast responses, observers with ASD presented with highly variable decoding strategies. In contrast to communication efficiency, impression formation was not influenced by IaPS. The results underline the importance of timing differences in both production and perception processes during multimodal nonverbal communication in interactants with and without ASD. In essence, the current findings locate the manifestation of reduced reciprocity in autism not merely in the person, but in the interactional dynamics of dyads.

Diversity, epistemic injustice and medicalization

This Viewpoint explores challenges within the neurodiversity framework, with a particular focus on autism, and discusses three critical aspects: the risk of epistemic injustice, the balance between over and undermedicalization, and the terminological complexities associated with the "neuro-" prefix. It underscores the importance of a balanced approach that avoids overmedicalization while providing essential support, addresses concerns about the indiscriminate use of "neurodiverse", questions the terminology on neurodiversity, and suggests considering a broader term like "biopsychosocial diversity". Ultimately, this Viewpoint advocates for a measured approach to neurodiversity, emphasizing historical context and a diverse perspective to foster collaboration between cognitive science and behavior research.