Understanding self-reported difficulties in decision-making by people with autism spectrum disorder

• Published in: Autism : the international journal of research and practice Vol. 22; no. 5; pp. 549 - 559
• Main Authors: Vella, Lydia, Ring, Howard, Aitken, Mike, Watson, Peter, Presland, Alexander, Clare, Isabel CH
• Format: Journal Article
• Language: English
• Published: 20.04.2017
• ISSN: 1362-3613; 1461-7005
• DOI: 10.1177/1362361316687988

Autobiographical accounts and a limited research literature suggest that adults with autism spectrum disorder (ASD) can experience difficulties with decision-making. We examined whether some of the difficulties they describe correspond to quantifiable differences in decision-making when compared to adults in the general population. The participants (38 intellectually able adults with ASD and 40 neurotypical controls) were assessed on three tasks of decision-making (Iowa Gambling Task, Cambridge Gamble Task, and Information Sampling Task), which quantified, respectively: decision-making performance, relative attention to negative and positive outcomes, speed, flexibility, and information sampling. . As a caution, all analyses were repeated with a subset of participants (n ASD =29 and n Control =39) who were not taking antidepressant or anxiolytic medication. Compared to controls, the participants with ASD demonstrated slower decision-making and superior performance on the Iowa Gambling Task. When those taking the medications were excluded, participants with ASD also sampled more information. There were no other differences between the groups. These processing tendencies may contribute to the difficulties self-reported in some contexts;; however, the results also highlight strengths in ASD, such as a more logical approach to, and care in decision-making. These findingslead to recommendations for how adults with ASD may be better supported with decision-making.