In this interview, News-Medical spoke with Dr. Stephen Stag about his latest study of autism and how children with autism struggle to read hidden emotions.
Please, can you introduce yourself, tell us about your experience in autism and what inspired your latest research?
My name is Dr. Stephen Stag. Over the last 10 years, I have been researching various aspects of the autism spectrum disorder. My previous work explored the social treatment of autism diagnosed later in life and the autistic traits of transsexual and nonbinary individuals.
I am currently researching the stress and resilience of British Indian parents with autistic children and adult experiences of breakdowns. The idea for my study of emotions came up while watching a TV show in which a happy father was crying at his daughter’s wedding. This made me think about how we process emotions in terms of context. For example, how did I know that the father was very happy and not upset?
The World Health Organization estimates that approximately 1 in 160 children worldwide have autism, but there is no single cause of autism. Why is this?
If you ask why the number of children with autism seems to be increasing, it is probably because we are getting better at recognizing autism in children. Historically, women and ethnic minorities have often neglected autism or been misdiagnosed. As knowledge about autism becomes more noticeable, parents become better at recognizing the signs of autism in their children, leading to more diagnoses.
Autism is a genetic disorder, but it is probably the result of a combination of genetic factors rather than a single gene, which makes it difficult to explain the causes of autism.
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What is meant by “hidden emotion” and how do they differ from “ordinary” emotions?
I think it’s helpful to think about actors to explain that. The actor’s job is to convey emotion and inner feelings to the audience. In real life, however, we often have to mask our feelings and hide our emotions.
For example, if a co-worker refuses a promotion and smiles weakly and says, “No problem, I didn’t think I’d get the position anyway,” we know they feel sad and unhappy. In this case, we can say that they are hiding their true feelings.
It has been proven that human emotions are extremely difficult to understand. Why is this and why would it make it even more difficult for people with autism?
This is a difficult question to answer. I’m not an expert on emotions. I would say that emotions are embedded in a social context. They serve social purposes, which makes it difficult to read one’s emotions. When emotions are simple and obvious, they are not difficult to recognize and autistic people seem to have a small problem in these cases.
However, when they are embedded in a real-world scenario, they are less obvious. Interpreting the script and many times knowing the person who shows the emotion is necessary to understand how someone really feels.
Why is the ability to detect differences between emotional expressions and emotional feelings essential to the management of social conservation?
Because it allows us to react appropriately to people and thus encourage relationships. In the above-mentioned scenario, in which the co-worker fails the promotion, we could respond by saying “don’t worry, let’s have a coffee and talk about it.”
Alternatively, we can respond by saying, “Well, you didn’t think you’d get the job anyway”; the second answer is unlikely to promote a relationship.
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Can you describe how you did your last study of children with autism and hidden emotions?
We first showed the teenage pictures of emotions. We found that they were as good as their neurotypical peers in identifying emotions. Then we showed them short videos where the actor shows his emotion (fear of seeing a spider). He then pretends to smile to hide his fear (eg the actor’s girlfriend enters the stage and he does not want her to think she is afraid). The last frame of the video freezes on the actor, pretending to be a smile.
Here, teenagers were asked to point out the actor’s emotion and the emotion the actor is experiencing. The neurotypical group identifies the emotion shown as closer to happy, and the felt emotion as closer to fear. The group with autism does not distinguish between the expressed emotion and the experienced emotion. Instead, they identified both as closer to the happy ones.
What did you find?
That adolescents with ASD were as good as their neurotypical peers in recognizing emotion from a photo. However, they found it difficult to consider the context when deciding how someone felt. As a result, their decision is based on what someone looks like, not on what their context informs them.
Were there any limitations to your study? If so, what were they?
The size of our sample was relatively small, but this is relatively common in autism research.
Do you believe that with ongoing research into the way children with autism handle emotions, we can help these children understand emotions more easily?
I think we need more research in this area. For example, we may wonder why autistic people need to be trained to recognize emotions and whether they can do so effectively.
On the other hand, suppose people understand that recognizing emotions is a difficulty and adapt to that difficulty. In this case, it will make life easier for people with autism.
What are the next steps for you and your autism research?
In terms of emotions and context, we need to study how neurotypical children develop their ability to inform their judgments about the emotions of others based on context. It would also be interesting to see when this occurs in development and what factors improve this ability.
About Dr. Stephen Stag
I am currently a Senior Lecturer at Anglia Ruskin University. I have also worked with the Westminster Parliamentary Committee on Autism.
In addition, I received scholarships to study adults diagnosed after the age of 50 and scholarships to study autism problems in minority ethnic groups in the United Kingdom.