Why Autism Is Not a Social Communication Disability

Distinguishing the internal from the external

Imagine how it might feel for reading faces to feel like computing exact distances between all of the wheels in this picture to millimeter precision once per second. Photo by Markus Spiske on Unsplash

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Taxonomizing disabilities

Here are some examples of how autism is classified in no particular order:

• ICD-11: 6A02, with 6A00–6A0Z under “Neurodevelopmental disorders”, within 06 under “Mental, behavioural or neurodevelopmental disorders”
• ICD-10 (still in use by many countries, updating is very slow): F84, under “Pervasive developmental disorders”, and more broadly F80-F89 “Disorders of psychological development”
• DSM-5: Within “Neurodevelopmental Disorders”
• Rutgers University Department of Kinesiology and Health: “Sensory Disabilities”
• Social Security Administration (US): 12.10, under “Mental Disorders”

I will now get into why the Rutgers categorization makes the most sense out of all of these, from my first-hand perspective, and based on what many autistic people have described. Yes, it makes the most sense to class autism with blindness, and deafness.

Social differences and unusual developmental trajectories as byproducts of reduced sensory gating

Let’s use my experience as an anecdotal example.

Here are some verbatim quotes from multiple clinical evaluation reports:

• “There were minimal inflections noted in speech….”
• “…used few gestures to emphasize and elaborate on their thoughts…”
• “It was noted that occasionally, they used overly sophisticated language to describe simple concepts/ideas…”
• “…didn’t make frequent eye contact.”
• “…gets so fixated on a topic that it annoys others…”
• “…was noted to display repetitive motor mannerisms…”
• “…did not share enjoyment with the examiner”
• “…used to line up her belongings…”
• “…used to reverse pronouns as a child and referred to herself in the third person…”
• “…would be more likely to do well in jobs that are one-task focused, valued accuracy and quality over speed, have a clear routine, have limited social interaction, and that are structured with clear expectations…”
• “They come across as brash and insensitive, and may be viewed as insulting and critical even when unprovoked…”
• “Demonstrated below average knowledge of desirable and undesirable attitudes/behaviors of sales people in various fields…”
• “…sometimes smiles appropriately…”

Each and every one of these observations can be tied back to fundamental differences in how all of my senses operate, rather than some abstract notion of lacking some discrete brain center specialized to socialization that leads to “incorrect” social behavior.

Furthermore, behaviorism, especially in isolation from other approaches, doesn’t make a whole lot of sense as an approach with respect to subsequent relevant clinical interventions.

I’m often perplexed that clinicians, with all of their fancy training, decided that pure behaviorism was what worked best for us, but thankfully, we’re slowly starting to get away from that.

This may be very counterintuitive amid conventional wisdom. Allow me to explain.

Eye contact and body language

For me, looking someone in the eye feels not much unlike staring straight into the sun. In some ways, it may even be more intense, and is in fact, such a distractingly jarring experience that it actually makes conversations hard to follow.

Naturally, it follows that there’s not much I can do with this physically uncomfortable avalanche of unstructured information that comes from other people’s eyes, so most of the time, I fail to read into it and respond as expected.

Ditto for facial expressions, tone, word choice, and body language. Perceptually, they are a big collection of largely unfiltered disjoint details that I have to piece together into the communicative meaning that is pragmatic language.

It’s also pretty unsurprising that my differences in reading faces also leads to what I think might be an attenuated form of prosopagnosia, where I have to have spent a lot of time around someone before I can reliably recognize them, especially if their hair or sense of style changes too much between in-person encounters.

I’ve been told by many people that I “talk too loudly” and this is because I cannot naturally effectively filter out the vibrations my voice produces over background noise and the responses of my conversation partner(s).

And one of the few things my linguistics professors agreed upon is that language acquisition in early childhood (and beyond) does not arise out of operant conditioning.

It inherently has little, if anything to do with whether one cares about other people or their perspectives, and has social motivation. Externally, without curiosity regarding our inner worlds, this looks like “lack” of perspective taking, shared enjoyment, brashness, and many other uncharitable things.

None of that is a behavior that can be eliminated with the right carrot and stick, or a set of scripts, at least not without making social communication a much more taxing activity than it already is.

Social camouflage, sometimes to the point of making others believe there are no social differences present in a person at all, is very expensive and highly unsustainable.

Being “high support needs” and/or intellectually disabled doesn’t change this either. If anything, this segment of the autistic population is even more vulnerable to the negative ways in which many people act upon the disconnect between their inner worlds and observable social behavior, and has fewer avenues for fighting back.

Would you ask a blind person, even one who does not have speech abilities, whose other senses have developed to compensate, to see something in exchange for a piece of candy?

Repetitive behaviors (AKA stims and special interests)

Because of the bottom-up sensory “processing” (we aren’t much like computers) and monotropic cognitive style described, a rather idiosyncratic collection of coping and compensatory mechanisms occur.

Stims, such as the lining up of stuffed animals I did as a toddler, the “repetitive motor mannerisms” observed by a neuropsychologist, and intense interest in avant garde music that consumed my life as a tween and teen, provide nonnegotiable anchor points and means of self-expression within this sea of low-level unfiltered, unparsed data.

Reducing these merely to social deviance and miscommunication invites repression not any less catastrophic and disorienting than a vet deciding that dogs don’t need whiskers because humans don’t have them and wouldn’t find much use for them.

Funding realities pertaining to and ease of manualization of therapies like traditional ABA and other strictly behavioral social training methodologies like Think Social! and PEERS do not change any of the above described realities.

Alexithymia

If you’re autistic and reading this and thinking “But I don’t have any sensory issues, I’m literally just bad at social stuff.”, know that that’s also what I once thought as well, and sadly, it was reinforced by people who should have had the clinical training, curiosity, and experience to know better, and at the very least, inform their clients when they needed to use certain language to convince gatekeepers to provide support.

I find it easier to at least somewhat excuse laypeople who are just responding to me from their implicit cultural biases mapping actions to communicative intent, though it certainly would be nice if more people didn’t just run with whatever they made up their mind about regarding me in under a minute and exercised at least a little bit of critical thinking in this area.

Through a combination of struggling to filter my own internal noise (interoception is a sense too!) and masking efforts that I learned at a very early age that involved downplaying my own discomfort, I became extremely out of touch with the cause and effect of my innate perceptual differences and their social byproducts.

Research

While there are many severely flawed published manuscripts out there attempting to understand autistic people solely through the behaviors without asking us, or at least acknowledging the limitations of this sort of empirical methodology at the end of the paper, and fruitless attempts at mapping some idea of social behavior onto other mammalian species that we value far less than humans, we have finally begun to see scientific evidence that validates what many autistic people have been screaming from the rooftops about for years.

The newest major version of the DSM even validated sensory differences as a legitimate part of the diagnostic criteria in 2013.

If you’re curious, look into sensory gating research as it pertains to autism, as well as the neuroimaging studies that have identified neurological hyperconnectivity, as well as sensory phenotype research.

Final disclaimer

Know that while the above resonates for myself and many other autistic people, it is still an extremely heterogeneous condition, with a vast biological ecosystem (that we’ve still barely begun to scratch the surface of).

If you personally find that monotropism and sensory perceptual differences do not primarily explain your autistic traits, what is it that you think does instead?

Let us know in the comments.