SLPCase-ControlAutism : the international journal of research and practice2018

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

Lydia Vella, Howard A Ring, Mike Rf Aitken and 3 others

PMID 28425298

WHAT IT FOUND

Adults with autism took longer to make decisions and gathered more information before choosing.

However, their final choices were more logical and advantageous than those of neurotypical controls. The delay reflects careful analysis, not impaired decision-making ability.

Key findings

01Participants with ASD took significantly longer to make decisions than controls.

02Participants with ASD made more advantageous choices on the Iowa Gambling Task than controls.

03There was no evidence that participants with ASD paid more attention to negative outcomes than positive ones.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study lacked ecological validity; laboratory tasks do not reflect the complex, social, and pressured nature of real-world decision-making. The age range of participants was wide (16 to 65 years), which may have reduced statistical power. Anxiety levels were higher in the ASD group and appeared to moderate some results, particularly information sampling. Nine participants with ASD and one control were taking antidepressant or anxiolytic medication, which may have influenced decision-making; results changed when these participants were excluded. The study did not include measures of general cognitive processing speed, so slower decision-making could partly reflect broader processing differences.

The easy way to misread this

Do not interpret the slower decision-making speed as a sign of cognitive impairment or inability to decide. The study found that autistic adults made more logical and advantageous choices than controls, suggesting the delay reflects a careful, analytical approach rather than a deficit.

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