First impressions of adults with autism improve with diagnostic disclosure and increased autism knowledge of peers.
The decision to disclose a diagnostic status is heavy, and for those with autism, this is accompanied with the fear of judgement and discrimination. In general, there is a gap on both ends: individuals with ASD face difficulty understanding intentions of typically developing (TD) individuals, and the difference and variability in expression of ASD can make it difficult for a TD individual to understand the mental state of an individual with ASD. As such, this study aims to find out if there is a benefit for individuals to disclose their ASD diagnosis. Findings will help individuals make a choice in disclosing their diagnosis or not. A way to do this is to see if intellectually able individuals with ASD are evaluated more or less favorably by observers if their diagnosis is disclosed. So to do this, researchers Sasson and Morrison had unfamiliar TD observers assess and report their first impressions of intellectually able adults with autism labeled with different diagnosis, including: no label, accurate label, mislabeled, schizophrenia label. The schizophrenia label allowed them to assess the stigma of ASD compared to schizophrenia, which is socially exhibited in similar ways as ASD, but is highly stigmatized due to the increased misconceptions that exist in society.
They presented TD observers with videos of participants pretending to audition for a reality/game show. The videos were labeled with either no label, an accurate label such as, “This person has an autism diagnosis” or “This person has no diagnosis,” or mislabeled, a participant with confirmed diagnosis labeled as having no diagnosis or a TD participant labeled as having autism, and lastly a “schizophrenia label.” As Sasson and Morrison predicted, participants with ASD would have favorable first impressions if their diagnosis was accurately labeled. As figure 2 below shows, ASD participants were rated more favorably when their video was matched with the accurate diagnosis
Figure 2: ASD participants with accurate labels (green), were rated more favorably than any other group.
Looking at the interaction between the participant group, their label, and the rating item, the results were varied for ASD and TD participants. Looking at figure 3, the rating item is on the x-axis and the ratings are on the y-axis.
Figure 3: In general, participants with ASD who were accurately labeled had improved ratings on all of the items compared to participants with no label. Mislabeling TD participants with an ASD label resulted in higher ratings for likeability and trustworthiness. Lastly, the schizophrenia label for ASD participants resulting is lower ratings on trustworthiness, likeability, intelligence, likelihood of hanging out with, and comfortable sitting next to.
Part of these results are affected by the pre-existing knowledge and notions the observer has about ASD and schizophrenia. A limitation discussed in the paper is the lack of data on this pre-existing knowledge, as this would have helped in understanding findings and interpretations. Another limitation is that since this is examining first impressions, it is unclear whether revealing diagnosis will be beneficial in other settings or relationships beyond the first impression. It is also important to note that the observers were given videos that essentially showed a performance, which may not be an accurate depiction of the individual during an actual, physical social interaction. This study is also only assessing intellectually able individuals with ASD so the results cannot be generalized as ASD is highly variable with different manifestations across individuals.
Overall, this study has shown that when adults with ASD disclose their diagnosis, their first impressions are rated as more likeable and trustworthy. Additionally, observers were also more inclined to start a conversation with them compared to when no diagnosis was presented. This tells us that diagnosis disclosure for adults with ASD results in more favorable judgement and better social outcomes than with no disclosure. All of this adds to the bigger picture of increasing social awareness, understanding, and acceptance of ASD and gives TD individuals a better understanding of the mental state of an individual with ASD.