Autistic traits and self-consciousness
I am very interested in ways to diagnose and help children with autistic traits as early as possible. Van Trigt, Colonnesi, Brummelman, Jorgenson, & Nikolic (2023) published “Autistic Traits and Self-conscious Emotions in Early Childhood” in Child Development. Here’s the highly edited article:
Self-conscious emotions arise from evaluating the self through the eyes of others. Given that children with autistic traits may experience difficulties with understanding others' minds, they might show less attuned self-conscious emotions. Two-to-five-year-old children's (N = 98, Mage = 48.54 months, 50% girls, 92% White) self-conscious emotions (guilt, embarrassment, and shame-like avoidance) were observed after children “broke” the experimenter's favorite toy. Data were collected from March 2018 till June 2019. Children with more autistic traits showed less theory of mind (ToM), and more shame-like avoidance, but associations were not mediated by ToM. This provides initial evidence that children with more autistic traits may show disturbances in some but not all self-conscious emotions, which could hinder their social functioning.
Self-conscious emotions are self-evaluative emotions that arise in relation to social rules They reflect the interpersonal self, that is, how the self relates to others. Some self-conscious emotions, such as guilt and embarrassment after misbehavior motivate prosocial behaviors and evoke forgiveness and appeasement in others. Other self-conscious emotions, such as shame, are considered less socially adaptive, as they trigger withdrawal and avoidance, thereby inhibiting prosocial behaviors. A lack or surplus of self-conscious emotions could lead to problems in forming and maintaining social relationships, since self-conscious emotions help people navigate social situations in which they misbehaved or broke social rules. Given the difficulties in navigating social relationships, children with more autistic traits might be prone to disturbances in self-conscious emotions after transgression.
Here, for the first time, we investigated the association between autistic traits and self-conscious emotions of guilt, embarrassment, and shame in young children. Although past empirical studies have shown that older children and adults with autism spectrum disorder (ASD) show disturbances in self-conscious emotions, it is currently unknown whether disturbances in self-conscious emotions after transgression are related to autistic traits in early childhood. This is important for two reasons. First, it speaks to whether early-emerging autistic traits are related to disturbances in the interpersonal self thereby advancing the theory on autism, which has not focused extensively on disturbances in the self early in child development. Second, it allows us to elucidate early risk factors for later autism.
Three core self-conscious emotions that typically occur after breaking social norms or rules are guilt, shame, and embarrassment. All three self-conscious emotions are thought to be a reaction to social valuation that serves to motivate people to behave in socially appropriate ways. They all require self-evaluation as well as the awareness of others' evaluation of the self. However, they also differ from each other in important ways. Guilt involves a negative sense of evaluation of one's own displayed behavior—a specific action, but it does not inflict a negative evaluation of the whole self. When individuals experience guilt, they regret their action and wish they behaved differently. Thus, feelings of guilt motivate individuals to show prosocial behavior and repair the negative consequences of the action that caused these feelings, such as by apologizing and repairing. Observational studies show that even 2 - and 3 year olds show such guilt-related behaviors.
Embarrassment involves evaluations of the presented self, as opposed to the core self in shame. This generates more short-term and situation-specific negative evaluations about oneself. Expressions of embarrassment may serve as appeasement, a nonverbal acknowledgment of shared social standards, and a nonverbal apology. These expressions have been described as withdrawing behavior (e.g., gaze or head aversions) accompanied by a smile, also known as embarrassed or coy smiles. Traditionally, it has been thought that embarrassment may occur only after children become self-aware at around 18 months old. However, recent research has shown that embarrassment-related reactions, in the form of coy smiles (as a result of social exposure), may appear already in infancy.
Shame involves a negative sense about the entire self. When individuals evaluate the whole self negatively, they may not be motivated to repair, as there is little they can do to repair the whole self. In fact, they may rather hide themselves. They may physically shrink as if to hide from evaluation. Shame is often considered an inhibitor of prosocial behavior and is reflected through withdrawal behaviors—such as aversion of the eyes, head, or the whole body—while having a neutral or negative facial expression. These behaviors can be observed in toddlers, suggesting children can experience shame from an early age. However, some scholars have argued that these behaviors are not rooted in shame but in fearful avoidance, perhaps because toddlers may not yet be able to experience shame as a distinct emotion. We, therefore, refer to these behaviors as shame-like avoidance.
Past studies investigating self-conscious emotions in toddlers and young children have, thus, adopted the functionalist approach to emotions, according to which self-conscious emotions serve a social function and are, therefore, shown through visible and measurable behaviors in social contexts in which they typically occur, such as after a mishap or transgression. According to this approach, guilt may be defined through behaviors aiming at repairing a social relationship, embarrassment through behaviors aiming to appease. On the contrary, shame may be defined through behaviors aiming at withdrawing and avoiding.
The experience of self-conscious emotions may be contingent on several sociocognitive abilities. First, children need self-awareness, which typically develops between 18 and 24 months. Second, children need to be able to realize they did something wrong. To do so, they need to internalize social rules and norms and be aware that their own behavior conflicted with such rules and norms. This ability emerges around the age of 3 years. Third, children need to be aware of and able to reflect on how other people think and feel about them. Self-awareness is related to ToM—the ability to accurately understand others' mental states and predict others' behaviors accordingly that starts developing in toddlerhood and develops further throughout childhood.
[S]ome scholars have argued that young children can experience and display rudimentary forms of self-conscious emotions before explicit self-awareness (typically measured through self-recognition in the mirror) and explicit ToM (typically measured through the explicit false-belief understanding) are typically acquired. This is because young children may possess implicit self-awareness and implicit ToM early in development. Supporting these ideas, several studies have demonstrated expressions of self-conscious emotions, such as guilt, embarrassment, and shame when exposed to others' attention or after a misbehavior already in toddlers and expressions of embarrassment even in infancy.
Whereas guilt and embarrassment after a transgression may help individuals repair and maintain social relationships, not experiencing any guilt or embarrassment, or experiencing more shame, may instead inhibit prosocial behavior and, consequently, disrupt the formation or maintenance of close social relationships. In the present research, we build on these findings to understand the early manifestations of autistic traits in children.
Whereas children with ASD have no difficulties in conceptual self-awareness (i.e., they recognize themselves in the mirror), they do show disturbances in interpersonal self (i.e., they have difficulty understanding their role in social interactions and how others may see them as social agents). This disturbed interpersonal self may be reflected through less attuned self-conscious emotions in social situations. For example, when children with ASD see themselves in the mirror, they recognize themselves and show interest in their mirror image; however, they do not show self-conscious emotions, such as embarrassment and coyness. Less attuned self-conscious emotions seen in children with ASD may be due to sociocognitive deficits, such as deficits in ToM.
Impairments in ToM abilities may contribute to disturbances in self-conscious emotions after transgression. If children do not understand they broke a norm or hurt somebody's feelings and do not understand another person's perspective (e.g., they broke a friend's toy and they do not understand that this event made the friend sad), they are unlikely to experience guilt and embarrassment. And if children do not understand accurately another person's feelings and thoughts and cannot predict their behaviors, they may focus on the self, feelings of failure, and experience shame and show more avoidance and withdrawal. This idea is based on past research that indicated that children with lower ToM abilities cannot accurately predict others' reactions in social situations because they do not understand others' mental states, experience these social situations as stressful and unpredictable, and, therefore, show avoidance and withdrawal in social situations. Similarly, there is experimental evidence showing that compared with people experiencing guilt, people experiencing shame before engaging in a perspective taking task, show worse perspective taking. Therefore, the experience of guilt and embarrassment may be related to advanced ToM abilities whereas the experience of shame may be related to lower levels of ToM abilities.
As children with more autistic traits have been shown to have lower ToM abilities, they may show less guilt and embarrassment and more shame-related withdrawal, partly caused by impairments in ToM (i.e., difficulties in recognizing and understanding others' emotions and beliefs). It is of note that we do not expect impairments in ToM to be the sole cause of unattuned self-conscious emotions. There may be alternative pathways of autistic traits to unattuned self-conscious emotions, such as communication deficits, lower levels of affective empathy or elevated levels of fear or anxiety.
So far, the association between autistic traits or ASD and self-conscious emotions has been investigated only in older children and adolescents. Together, empirical findings confirm that older children with ASD have disturbed self-conscious emotional expressions. A recent study showed that for children who are at risk of developing ASD, early intervention that starts before the age of 2 greatly reduces the chance of developing ASD later in life. Therefore, early recognition of autistic traits, possibly expressed by showing less attuned self-conscious emotions, may facilitate treatment and even prevention of ASD.
We investigated the association between autistic traits and self-conscious emotions after a misbehavior in young children aged 2–5 years. We hypothesized that children's levels of autistic traits would be associated with less guilt, less embarrassment, and more shame-like avoidance. We also hypothesized that these associations would be partially due to the deficits in ToM and that they would already emerge in toddlerhood.
Participants were 98 children aged 2–5 years (24–72 months, M = 48.54, SD = 13.50; 92% White; 50% girls), accompanied by one of their parents, ages 22–48 years (M = 35.76, SD = 6.14; 83% mothers). Parents mostly had a Dutch ethnicity (81.6%), were relatively highly educated (11% doctorate, 30% university degree, 35% college degree, 24% high school/vocational degree) and were, based on monthly household income, from various socioeconomic status.
We used the parent-report Social Responsiveness scale—Preschool Version (SRS) to measure children's autistic traits, a shortened version of the ToM test-Revised (ToM test-R; Steerneman & Meesters, 2009), an adapted version (Pears & Fisher, 2005) of the emotion understanding task to measure emotion recognition in young children, and the Broken Toy mishap, adapted from Drummond et al. (2017), to observe children's expressions of self-conscious emotions.
A principal component analysis using Oblimin rotation, which allows for factors to correlate, was performed to find which coding behaviors loaded onto the same factor, underlying a specific self-conscious emotion. Together, the factors explained 71% of the variance. The factor loadings indicated that the children's responses to the Broken Toy mishap were organized in four patterns that are consistent with theory, and similar to previous studies: guilt, embarrassment, and two types of shame-like avoidance: (1) Guilt consists of repairing behavior, and verbal expressions of comforting the experimenter and expressing concern. (2) Embarrassment consists of gaze and head aversion while smiling. (3) Nonverbal shame-like avoidance consists of gaze, head, and body aversion. (4) Verbal shame-like avoidance consists of a high latency to speak to the parent and to the experimenter, and fewer verbal expressions that indicate taking responsibility or adopting the experimenter's perspective. The different behaviors belonging to the same latent factor were standardized and averaged to make the composite self-conscious emotion variable.
Autistic traits were significantly and negatively related to ToM, β = −.18, p = .017, indicating that children with more autistic traits had lower levels of ToM. Autistic traits were not significantly related to guilt directly, β = −.02, p = .867. Our data most supported the idea that autistic traits are not related to guilt: Therefore, our data indicated that children with more autistic traits do not show unattuned guilt after transgression. [O]ur analyses indicated that there is no compelling support for either our hypothesis that autistic traits are related to less embarrassment or for the idea that autistic traits are not related to embarrassment.
Autistic traits were not significantly related to verbal shame-like avoidance directly. These results confirmed our path model finding that autistic traits are related to more verbal shame-like avoidance, but if this process includes intermediary variables, there is no support for the hypothesis that ToM is one of those mediators.
In post hoc exploratory analyses, results indicate that children with more autistic traits displayed more verbal shame-like avoidance, but not due to lower ToM. Verbal shame-like avoidance was significantly related to another ToM ability, that is, emotion understanding, in the way that children who had lower levels of emotion understanding showed more verbal shame-like avoidance. Age did not moderate any of the associations found in the main model. This indicated that the effects of autistic traits on ToM and self-conscious emotions remained relatively stable between ages 2 and 5 years.
Overall, we found evidence that children with more autistic traits show more verbal shame-like avoidance. There was also some evidence for more nonverbal shame-like avoidance; however, the evidence lacks statistical significance. Our findings did not support the idea that children with more autistic traits show less guilt and embarrassment after transgression. Although children with more autistic traits showed lower ToM levels, disturbances in self-conscious emotions were not due to lower ToM in children with more autistic traits. More broadly, these findings highlight that children with more autistic traits may express disturbances in some but not all self-conscious emotions and may experience deficits in ToM already in early childhood, but these deficits do not necessarily translate into less attuned self-conscious emotions at this age.
We did not find evidence that children with more autistic traits showed less guilt or embarrassment. This stands in contrast to previous studies showing significantly fewer expressions of guilt and embarrassment in children with ASD. A possible explanation is that the majority of previous studies was done with older children and/or clinical samples. It may be that disturbances in guilt and embarrassment are, thus, not early precursors of autism but rather a symptom that occurs later in child development and in more severe ASD symptoms. As shame-like avoidance inhibits a prosocial response after making a social transgression, elevated levels of shame-like avoidance may cause problems in the repairing and maintenance of social relationships.
Children with more autistic traits showed lower levels of ToM, yet this did not, in turn, relate to less guilt, less embarrassment, or more shame-like avoidance. These findings are in line with the idea that difficulties with understanding others' emotions causes uncertainty in complex social situations and, therefore, more shame-like avoidance. More advanced ToM skills such as first order and false belief seem, however, unrelated to shame-like avoidance. These findings also shed light on the likely reasons of why ToM is not a mechanism through which autistic traits are related to disturbances in self-conscious emotions. Children with higher autistic traits seem not to show any deficits in the ToM ability that may matter for the experience of self-conscious emotions—emotion understanding, but only in belief understanding, which, importantly, does not seem to play an important role in the experience of self-conscious emotion.
Regarding the elevated expressions of verbal shame-like avoidance in our study, it may be that children with more autistic traits have elevated levels of social anxiety, including elevated fear of negative evaluations, which, in turn, could explain more shame-like behaviors such as avoidance Overall, our findings imply that children with more autistic traits have more sociocognitive deficits and display less attuned verbal shame-like avoidance, but the latter is not necessarily rooted in the former. Despite experiencing more sociocognitive deficits, children with more autistic traits do not display less attuned self-conscious emotions other than shame-like avoidance. However, our findings show that impaired ToM skills are already present in early childhood in children with more autistic traits, even in a nonclinical sample. ToM deficits may not necessarily relate to problems in social behavior, such as unattuned self-conscious emotional expressions, but more so to communication deficits. In our study, communication deficits could manifest as elevated verbal shame-like avoidance, which may be a precursor for later social impairments in ASD.
Our findings have potential implications for early intervention for children with more autistic traits. Our results imply that impaired ToM skills, although related to more autistic traits, may not predict less attuned self-conscious emotions, at least not yet in early childhood. Previous intervention studies found that interventions for autism (focusing on ToM), improve ToM skills and autistic traits, but fail to result in wider improvements in social behavior, such as adhering to social rules, and social relationships. As ToM skills do not necessarily relate to disturbances in self-conscious emotions, interventions for regulating self-conscious emotions in ASD may have to focus on these emotions directly, possibly through directly targeting disturbed self-conscious emotions. For example, in the case of excessive shame experiences, enhancing (self-)compassion with mindfulness interventions may be a useful option.
Our work shows that children with more autistic traits have more deficits in ToM and show more shame-like avoidance after a transgression in early childhood. This implies that children with high levels of autistic traits may have difficulties in how they relate to other people early in development, especially when there is a threat to social status and existing relationships due to a transgression. As shame is known to hinder the repair of social relationships after wrongdoing, it may cause young children with more autistic traits to feel not socially connected. Therefore, new intervention strategies to regulate shame through enhancing (self-)compassion, such as mindfulness interventions, which have been found to be effective in preschool children and in older children with ASD, may be considered when targeting children with more autistic traits.
I know this is a long summary but I find it fascinating that, in early childhood, social anxiety and communication deficits may play critical roles in the development of autism symptoms and self-consciousness. I love the conclusion that mindfulness interventions may be especially powerful.