“The same, but entirely different”: reframing autistic social communicative (dys)function through mixed methods research

Abstract

Autistic social communication has often been framed as ‘deficient’, in comparison to the implied ideal social communication style of nonautistic people. Research has likewise focused on nonautistic people’s experiences of and perspectives on autistic social communication, and the ways in which the autistic social communication style is difficult for nonautistic people to understand. However, increasing involvement of the autistic community in research, alongside the work of autistic academics, has begun to challenge this perspective. Concepts such as the neurodiversity paradigm and the double empathy problem have emerged from this context, both of which emphasise a) the natural diversity of human dispositions, including social and communicative dispositions, and b) the role that context and environment plays in enabling or disabling people, including the role of the social environment in enabling or disabling social communication.

Despite this, there remains a dearth of research exploring the autistic perspective on social communication, and exploring what an autistic social communicative style (absent deficit-focused comparisons to a nonautistic one) might look like. The research in this thesis provides rich qualitative descriptions of autistic sociality and communicative experiences, as well as examining how social environments can render autistic people’s social communication (dys)functional, through four studies.

In an effort to understand and characterise the autistic social communicative style, Study 1 explores the social communication behaviours of nine autistic adults (4 women, 1 non-binary, 4 men, aged 23-70) via a two-week-long online focus group, focusing on their experiences and perspectives. The topics covered how participants signal (dis)interest and (un)enjoyment in conversations, their natural social communication behaviours, and the differences in their experiences of interacting with autistic compared to nonautistic people. The critical realist thematic analysis reveals five key themes: different social communication experiences, different social communication expectations, conflicts with neurotypical-normative social expectations, compensation and masking, and finding shared understandings. From these themes, drawing on the social model of disability, a conceptual model is developed to illustrate how (often-neuronormative) social environments interact with an autistic communicative style to produce either miscommunication and masking or fulfilling social encounters.

Study 2 draws on the findings from Study 1 to further explore the autistic social communicative style, at a less featural and more abstract level, with a focus on how autistic and nonautistic communication styles differ. Another online focus group was run over two weeks, with eight autistic adults (7 women, 1 non-binary). Participants discussed their social values, experiences interacting with nonautistic people, and positive social interactions. They also provided feedback on each other's contributions, and on the themes from the previous focus group. Through reflexive thematic analysis, five themes were identified: “Always be truthful”; “Invisible demands and their impacts”; “I don’t think neurotypical people do the same for us”; “Autistic strengths, autistic positives”; and “The role of autistic community”. The findings highlight how differing social communication expectations and experiences can lead to misunderstandings and conflicts between autistic and nonautistic individuals. It emphasises the role that honesty, authenticity, sensory differences, accommodation of others, and non-normative sources of joy play in defining the autistic social communicative style.

To investigate how social contexts impact (non)autistic social interactions from an outside perspective, Study 3 investigates how observers’ ability to identify autistic individuals is impacted by their conversational partner’s neurotype. Autistic and nonautistic raters were shown videos (n=78; 39 autistic) and photos (n=54; 27 autistic) of interactions between autistic and nonautistic people, in same- and mixed-neurotype dyads. Raters were asked to determine whether each participant in the interactions was autistic. Analysis (primarily via a generalised linear model) reveals that raters identify autistic individuals at rates better than chance. However, identification accuracy varies significantly based on contextual factors such as dyad type, stimulus type, and rater neurotype. Most notably, autistic-autistic dyads make identifying autism very difficult. This is perhaps because observers are using social awkwardness as a proxy for autism identification, despite autistic-autistic interactions having good rapport. Autistic and nonautistic raters also have different patterns of accuracy, with nonautistic raters more likely to assume participants were nonautistic. These findings emphasise the role that social context, observer neurotype, and social biases play in the perception of autistic social communication by observers, and also the role they play in defining the outcomes of autistic social communication.

Study 4 takes the findings from Studies 1-3, and applies them to a real-world setting, in a novel context for explorations of cross-neurotype communication from an autistic perspective: a social care setting for autistic adults with high support needs. This ethnographic study took place at two day-support services, over the course of a year, and involved participant observations and interviews, alongside reflexive and autoethnographic process by the (autistic) researcher. Analysis of the data via grounded theory produced four core concepts: “Part of a larger whole”; “Fear and control”; “Friends, favourites, and coexistence”; and “Who are we? Who are they?”. These concepts emphasise the role of contextual factors in governing the relationship between staff and the autistic people they support; the complex playing-out of different kinds of power within staff-supported people relations; the depth and nuance of cross-neurotype friendships and interactions in an institutional setting; and open questions around authority, knowledge production, and the provision of care in a high-support-needs context.

Collectively, the findings from these studies inform the synthesis of a novel theory of autistic social communication, Theory of (Un)Known Mind (ToUKM). Drawing on also extant sociological, psychological, and neurological literature, ToUKM seeks to reconcile recent findings centred around the double empathy problem (including those from this thesis) with the body of literature on autistic theory of mind difficulties. ToUKM posits that nonautistic people achieve 'mind-reading' by socially and mentally aligning with one another (i.e. by making their behaviours and beliefs more like those of the people they are interacting with), making them more predictable and understandable; whereas autistic individuals do not engage in this social alignment. This divergence leads to different theories about the knowability and significance of others’ mental states, creating a fundamental conflict that contributes to social dysfunction between autistic and nonautistic individuals.

The findings presented in this thesis offer a comprehensive examination of autistic social communication, through challenging deficit-based models and emphasising autistic social communication as a social communication ‘style’ that requires study in its own right. It highlights that differences in social communication between autistic and nonautistic individuals reflect distinct communicative styles, shaped by varying social expectations and contexts (Studies 1 & 2). It reveals that misunderstandings and communication difficulties often arise from these differences, rather than per se from inherent impairments (Studies 1-3). It proposes a context-sensitive and non-pathologizing theory for the mechanisms behind these cross-neurotype misunderstandings (Theory of (Un)Known Mind). And, by exploring the interplay between autistic and nonautistic communication styles (Study 4), this thesis underscores the importance of including autistic perspectives in the production of knowledge about autistic social communication. This thesis therefore advocates for a shift – in autism research, and in autism researchers’ perspectives – towards an approach that values and accommodates autistic communication as a valid and complex style of social interaction, with implications for improving social understanding between autistic and nonautistic people.