Autism and Social Cues

One of the hallmark traits of autism is difficulty with social activities and behaviors. This is commonly stated as “autistic people cannot read social cues” although the true diagnostic criteria for autism don't state this outright. This struggle with social cues and social norms is well-documented among autistic people.

I was scrolling through Instagram and saw several posts from autistic adults talking about how their neurodivergence affects their relationships and social lives. One particular post brought up something interesting. She stated that she can’t understand social cues even though she experiences overwhelming empathy.

I thought that statement seemed rather contradictory. How could a person feel empathy towards someone else without understanding social cues? How could you even identify another person’s emotions without understanding body language, facial expressions, colloquialisms, and other social norms? When a person cries, I feel empathy because I can tell the person is sad. That’s reading and understanding a social cue. When a person yells, scrunches their face, and swings their arms around, I know they’re angry because I can read social cues even though I’m autistic.

This wasn’t the first time I’d encountered a weird paradox in autistic diagnostic criteria and autistic existence. I most often see paradoxes pop up when discussing autism and socializing. I’ve talked with an autistic person who thought they interpreted everything literally but could explain what they meant using a metaphor. I’ve worked with an autistic person who claimed to have zero friends because of their lack of social skills all while they led and maintained a guild on a video game consisting of over 30 people from around the world.

Nearly every time I work with an autistic client who complains of social difficulty, they are quick to report to me that they see the situation as hopeless or overwhelming because of the inherent social ineptitudes in autism. They come to me feeling worn down and hopeless about their situation. Yet, after we work through specific examples and understand what their goals are, my clients leave feeling empowered and ready to face new challenges.

Does being autistic truly necessitate social dysfunction?

The Criteria for Being Autistic

According to the latest edition of the DSM, Autism is:

A child who has persistent deficits in the three following areas of social communication and interaction plus at least two of four types of restricted, repetitive behaviors.

The three areas of social communication and interaction

1. Deficit in social-emotional reciprocity, ranging from abnormal social approach and failure of back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

2. Deficit in nonverbal communicative behaviors used for social interaction, ranging from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

3. Deficit in developing, maintaining, and understanding relationships, ranging from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

I’m not going to talk about the restrictive or repetitive behaviors right now because I want to focus on the social aspect of autism. Also, while the criteria states the person in question must be a child, in practice this means that any signs or symptoms of autism must have been present when the person was a child.

Right away, I notice that autism is literally defined by lack, deficit, inability, failure, and abnormality. Of course, autistic people would believe they can’t socialize properly and be autistic. Yet, because of my own experience growing up autistic, I know that the answer to this question can’t be that simple.

Growing Up Autistic

Like so many autistic people, my childhood was filled with moments where I failed to approach a social situation normally, had poorly integrated verbal and nonverbal communication, and failed to understand relationships. To demonstrate this, I like to tell people the story of a time in camp when I was so oblivious to a social situation that I didn’t even understand I was being bullied until years later.

Using my wide knowledge of random facts, I had just won a trivia game and was allowed to pick first from the prize bag. The camp counselor emptied her purse on the table, and I selected my wonderous reward: a Burger King pen. (It was a low-budget camp.) The other kids got to pick out their participation prizes after me and selected other neat items like half a stack of Post-it notes, a stick of gum, some paper clips strung together, and a handkerchief. (It was a really low-budget camp).

Shortly after, we were walking over to the gym and two of the boys ran up to me grinning and chuckling. One of them had selected the post-it notes and asked to borrow my pen. I handed it over and the boy quickly scribbled something on the top post-it before ripping it off and slapping it on my chest. He dropped my pen on the ground as the two of them stood there pointing and laughing at me.

Confused, I looked down at the Post-it note stuck to me and read:

S-T-U-P-I-D.

I was only more confused after reading the word, especially considering the boys seemed to think what they’d done was hilarious. I must have looked quite stunned as the camp counselor came over, ripped the post-it from my chest, and began to scold the two boys for their heinous deed. I don’t remember much of what she said because I was stuck with a single question in my mind. Why did they label me stupid when I wasn’t stupid?

I mean, I had just beaten them in a game of wits not ten minutes prior. Surely, they understood that that demonstrated my lack of stupidity. So why did they label me as stupid?

The camp counselor asked if I was okay and assured me that the boys would be punished. “Yes, I’m fine,” I told her. And I really was fine. I walked to my seat as if nothing had happened. It wasn’t until years later when I was recounting the story to a friend as an example of how kids can do dumb things that make no sense that that friend pointed out to me, “Those kids were making fun of you.”

Such misunderstandings and deficits in social-emotional understanding and approach continued into my adult life and continue to this day. You would think that this obviously demonstrates that the social deficit aspect of autism is accurate. Yet again, my experience in life tells me that the answer isn’t that simple.

The Power of Autistic Adults

A few years ago, I was on a live stream where the streamer was discussing her struggles at her job. She was a babysitter for a wealthy family who had two sons; the younger son was autistic. She was very concerned because she loved the two boys and didn’t want to be fired or removed from their lives, but she also struggled to get the younger son to do things. He wasn’t completely non-verbal, but she recognized that she couldn’t quite understand him either. She was more concerned because she couldn’t tell if his tantrums were because of him being young or because he was autistic.

On a whim, I mentioned that I was autistic and knew my parents struggled with me as a kid. I also mentioned that there were things I wish they had understood that I hadn’t been able to communicate at the time. Perhaps, she could use my experiences combined with my ability to articulate to help her take care of the young boy. She jumped at the opportunity and began a dialogue with me about the entire situation.

The babysitter’s problem came at dinner. She would fix the boys something to eat, and the autistic boy would absolutely lose his mind. He would start screaming or crying. He would run away from her if she tried to get him to sit down and eat. Most importantly, he absolutely refused to eat his food. I asked the babysitter a bunch of questions that I noticed very few neurotypical people think to ask about autistic people and especially autistic children.

I asked about the boy’s behavior outside of dinner time. I asked about the meals she made. I asked about the frequency of tantrums. I asked what the rest of his day looked like leading up to dinner. I asked about the time frame of activities and events like when he gets home from school, when he’s expected to go to bed, when he plays with toys, and when he’s supposed to eat dinner. The babysitter answered everything thoroughly. It was easy to see how much she cared for the boy even if she didn’t know what to do with him.

After I fully understood everything, I told the babysitter that deciphering if a specific tantrum was because of maturity or diagnosis was a waste of time. Tantrums are one way a person expresses that their needs aren’t being met. As we get older, we learn simpler and better ways of doing so thanks to direct instruction from other people trial and error. Her best bet was to identify the needs of the boy by communicating, understanding, and then empathizing with him. After doing so, the proper course of action would make itself clear based on the specifics of the situation.

I walked her through ways she could communicate better with the boy like offering him multiple options for dinner (“Do you want salad, chicken and rice, or soup?”) so that he didn’t feel like he was being forced to eat something he didn’t want to eat. You see, she had mentioned that the only times she asked him what he wanted to eat was when she ordered pizza, and he’d never given her trouble eating pizza. My suggestion was meant to play on this idea of letting the kid choose what he got to eat while still making sure he ate what he needed to.

I educated her about how important the sensory needs are for autistic people and how to her she might be offering the boy a sandwich, but to him she’s trying to get him to eat sandpaper. I pointed out it might be a good idea to help soothe his senses during dinner by playing music that he finds calming or by putting on one of his favorite movies while he eats. I also mentioned a food hack I still use to the current day.

Some days, autistic people just don’t want to go through the effort of eating. In those times when the thought of chewing my food aches but I know I need to consume, I just drink a protein shake. It goes down quick, it’s hydrating, and it put calories and nutrients in my body so I can function.

A few weeks later, I got back in touch with the babysitter to see how things were going. The boy hadn’t thrown a single tantrum since implementing my suggestions. The babysitter would set out a selection of food at dinner time and the boy would grab the ones he wanted. She would prepare his selection and he ate it without any problems.

Months of struggle, frustration, stress and confusion for the babysitter, the older brother (who likely felt neglected from the younger sibling getting so much extra attention), the parents, and the boy himself were resolved after an hour-long conversation with me all because nobody had thought to ask the boy what he wanted to eat.

To me, reading the boy’s social cues was easy, but all the important neurotypical people in his life failed to do so despite their best efforts.

Social is Relative

In these stories, I wanted to show that what we call social engagement has almost no objective measure. It entirely depends on the context, people, knowledge, and environment of each specific situation. A person can be deficit in one social relationship and extraordinary in another. They can be oblivious to some social cues and adept at identifying and interpreting other social cues. This helps to explain the apparent paradox of autism when it involves social engagement.

Autistic people, like any other person, will show deficits in social-emotional relationships during their lives. This is especially true during childhood when every day is filled with new people, new information, and new environments. Through this lens, it almost seems silly to identify a group of people by social deficits at any stage of life without putting highly specific measures on social behavior that are both quantitative and qualitative.

A quick illustration of neurodivergence

If you ask a group of people to explain how they perform the equation 76+28, you will receive potentially dozens of different answers. I’ve recorded a few below.

Solution A: 70+20=90, 6+8=14, 90+14=104

Solution B: 7+2=9, 6+8=14, 1+9=10, 10 and 4 means 104

Solution C: 6+8=14, drag the 4 down, carry the 1 over, 1+7+2=10, drag 10 down. 104

Solution D: 28-4=24, 76+4=80, 80+24=104

There's no debate that all solutions lead to the correct answer. Yet, it is also clear that, for some reason, the way people come to the same answers must involve different ways of thinking. It shows that we can be given the same prompt and approach it differently because of how we learn and what we are taught.

The current method of diagnosing autism through the lens of social-emotional relationships and behaviors is like saying that everyone who provides a different solution from A or D is neurodivergent.

Because we define humanity through social engagement our current diagnostic criteria for autism says that people who think differently are deficient in being human.

A Smile Doesn’t Always Mean Happy, and a Frown Doesn’t Always Mean Sad.

I think the social aspect of autistic diagnostic criteria needs an overhaul. Especially because there’s no quantitative measure of how many social cues a person needs to miss to be considered autistic and no qualitative measure of what kind of cues a person must misinterpret to be autistic.

Evaluating a person’s social difficulties and struggles can often be a key indicator of autism. One of my favorite phrases in science that is so often forgotten in society is “correlation is not causation”. Autistic people do tend to have social deficits in childhood. Without proper education and guidance, autistic people tend to carry those social difficulties into adulthood and potentially throughout their entire life. The key word is “tend” because it means that while it usually happens it is not known to be a direct cause.

Social engagement is relative and complex.

People create inside jokes within their social groups. Some social norms involve telling lies to be polite. Different gestures and facial movements mean different things depending on what country you’re in.

If a person grew up with a father who smiled when he was angry, it makes sense they might misread smiles in other people. Interestingly enough, this is a perfect example of that person being able to read and understand body language and emotion and how they can be connected. The problem was not in their ability but in their environment.

To that person on Instagram who struggles to “read social cues” despite feeling overwhelming empathy, I’d say to go easier on yourself. You’re not expected to be able to read other peoples’ minds. You’re not expected to have even 50% accuracy when reading social situations you’ve never been in before. It’s even possible that your measurement system is out of calibration because of faulty data you received to no fault of your own. Ask questions if you’re confused and know that people won’t always give the most accurate answers.

We’re all trying to figure out this social thing while pretending that we know what we’re doing.

You’re doing fine.