Extending decision making competence to special populations: a pilot study of persons on the autism spectrum

Abstract

The area of decision making has much to offer in our effort to understand special populations. This pilot study is an example of just such a project, where we illustrate how traditional decision making tools and tasks can be used to uncover strengths and weaknesses within a growing population of young adults with autism. In this pilot project we extended accounts of autistic behavior such as those derived from “theory of mind” to predict key components of decision making in high-functioning young adults on the autism spectrum. A battery of tests was administered to 15 high-functioning college students with autism spectrum disorder (ASD), focusing on decision making competence (DMC) and other aspects of decision making related to known deficits associated with autism. Data from this group were compared to data from unselected college students receiving the same measures. First, as a test of a key social deficit associated with autism, the target group scored much lower on the Empathy Quotient scale. Traditional elements of decision making competency such as Numeracy and application of decision rules were comparable across groups. However, there were differences in thinking style, with the ASD group showing lesser ability and engagement in intuitive thinking, and they showed lower levels of risk taking. For comparisons within the ASD group, autobiographical reports concerning individual lifestyles and outcomes were used to derive a scale of Social Functioning. The lowest scoring individuals showed the lowest levels of intuitive thinking, the lowest perceived levels of others’ endorsement of socially undesirable behaviors, and the lowest ability to discriminate between “good” and “bad” risks. Results are discussed in terms of interventions that might aid high-functioning young adults with ASD in their everyday decision making.

Non-Clinical Autistic Traits Correlate With Social and Ethical but Not With Financial and Recreational Risk-Taking

“…Research into such uncertain or risky decision-making in ASD has so far been inconclusive. For example, some studies show that individuals with ASD make less uncertain and/or risky decisions (De Martino et al, 2008;South et al, 2014;Levin et al, 2015), whereas others fail to find such differences between individuals with and without ASD (Johnson et al, 2006;South et al, 2008South et al, , 2011.…”

“…A possible explanation of these conflicting findings is that aberrant decision-making in ASD is domain-specific. Levin et al (2015) suggest that especially social uncertainty/risk may be salient for persons with ASD, and that it would therefore be useful to examine domains separately. This premise fits with autism symptomatology: given that persons with ASD show difficulties in social interaction and communication (American Psychiatric Association, 2013), it is reasonable to expect aberrant decision-making in the social domain.…”

“…In contrast, autism symptomatology does not suggest that aberrant decision-making is likely to occur in, for instance, the financial domain. Since most studies examining uncertain and risky decisions employ financial incentives (Johnson et al, 2006;De Martino et al, 2008;South et al, 2008South et al, , 2011South et al, , 2014Levin et al, 2015), this may explain the lack of consistent findings on decision-making in individuals with ASD.…”

“…To address the premise that decision-making in ASD only differs from neurotypical decision-making in a subset of domains, Levin et al (2015) suggest using the Domain-Specific Risk-Taking (DOSPERT) scale, a self-report measure that assesses risky 1 decision-making across five domains: social, ethical, recreational, health/safety, and financial (Blais and Weber, 2006). To the knowledge of the author, so far only one study has used the DOSPERT scale in relation to ASD.…”

Familiarity modulates social approach toward stressed conspecifics in female rats

“…Schizophrenic participants exhibit impairments in theory of mind [ 26 ] and determination of trustworthiness [ 27 ]. Moreover, the inability to use social cues may correlate with the severity of social impairments in ADHD [ 28 ] and hinder one's ability to detect how others respond to a socially undesirable behavior in autism [ 29 ]. While this is not a complete account of social decision making in psychiatric disorders [ 30 ] these examples underscore the need to understand how social factors mediate social-decision making in order to develop more efficacious treatments for psychiatric conditions.…”