Jaswal & Akhtar's (J&A's) critique of the reduced social motivation theory of autism is insightful and courageous in its efforts to advocate for greater understanding of autistic people by contradicting assumptions generated by a theory that has dominated autism research and treatment for at least the past decade. I appreciate their call for people to respect unconventional ways of communicating and their use of developmental and cross-cultural research to highlight that there is often no clear boundary between “autistic” and “non-autistic” behaviors, as human behaviors are shaped by interactions situated within diverse cultural contexts. Although J&A's target article is the third synthesis about the social motivation theory published this year, their approach is refreshing. (For evidence that social reward processing does not appear to be impaired relative to non-social reward processing in autism, see Bottini Reference Bottini2018; Clements et al. Reference Clements, Zoltowski, Yankowitz, Yerys, Schultz and Herrington2018.) However, their article omits reference to Asperger's work and to changes in the diagnostic criteria over time. To truly understand the origins and consequences of the reduced social motivation theory, we must examine how it has been shaped by historical contexts.

The article traces the reduced social motivation theory to Kanner's (Reference Kanner1943) article, long considered the first account of “autism.” Apparently independently, Kanner (Reference Kanner1943) and Asperger (Reference Asperger1944/1991) introduced classifications that became part of what we now call autism spectrum disorder (ASD; but for evidence that both were influenced by Frankl, a Jewish clinician who left Austria as the Nazis came into power, see Robison Reference Robison2017). Kanner's participants exhibited severe language difficulties while Asperger's were verbally skilled. Kanner (Reference Kanner1943, p. 250) described autism as the “innate inability to form the usual, biologically provided affective contact with people.” Asperger (Reference Asperger1944/1991, p. 78) described children with “autistic psychopathy” as dwelling “among people as if a stranger.” Reduced social motivation was a defining characteristic of both accounts. Indeed, both adapted a term Bleuler (Reference Bleuler1911) had used to describe social withdrawal in schizophrenia. As emphasized in the target article, many autistic people critique this framing. However, some self-advocates agree with it; Robison (Reference Robison2017, p. 8) asserted that “affective contact is the key component of autistic disability.”

Differences in perspectives about social motivation among autistic people align with the heterogeneity of the spectrum. Although Asperger has been described as the first to appreciate the diversity of the spectrum (Silberman Reference Silberman2015), recent research indicates that Asperger may have highlighted the talents of some autistic youth to emphasize their value to society while allowing others to be euthanized (Czech Reference Czech2018). Asperger's (Reference Asperger1944/1991) mix of empathy and harshness towards autistic people is evident in his writing; he noted that “one is sometimes surprised at how much is absorbed … despite the apparent lack of interest” (p. 78) but also said that autistic psychopaths’ “malice and cruelty … arise from this impoverished emotionality” (p. 81). Indeed, Sheffer (Reference Sheffer2018) interpreted her archival research as evidence that Asperger's definition of autistic psychopathy was shaped by the Nazi agenda of developing classifications to guide eugenics. According to Sheffer, Asperger and other clinicians in Nazi-governed Austria evaluated the degree to which people showed gemüt, which she interpreted as interest in and empathy for others, to determine if they would be valuable to society or not. If Sheffer's interpretation is correct, the dehumanizing potential of the social motivation theory shaped the very emergence of the diagnostic category autism.

Indeed, reduced social motivation, or “pervasive lack of responsiveness to other people” (italics added), was central to the diagnostic criteria for autism when it was first introduced into the DSM-III (American Psychiatric Association 1980). However, Wing and Gould (Reference Wing and Gould1979; mentioned briefly in a footnote in the target article) published evidence that not all autistic people exhibit reduced social motivation. Wing (Reference Wing1981) asserted that there were at least three subtypes of autism: “aloof,” “passive,” and “active-but-odd,” and introduced Asperger's paper into English to highlight the diversity of the spectrum. When Asperger's syndrome was incorporated into the DSM-IV in 1994 (American Psychiatric Association 1994), the criteria for autism shifted to include less severe social difficulties (e.g., qualitative impairment in social interaction). The criteria for ASD in the DSM-5 (American Psychiatric Association 2013) remains far less severe than the extremely reduced social responsiveness of 1980. Therefore, one might expect reduced social motivation to be more apparent among people diagnosed before 1994.

However, the reduced social motivation theory rose to prominence after 1994. Although social-emotional disconnection was highlighted in initial definitions of autism, sensory-motor and cognitive explanations then became popular (Rimland Reference Rimland1964; Schopler & Reichler Reference Schopler and Reichler1968). When the reduced social motivation theory was first introduced, it was described cognitively before the focus shifted to the possibility that autistic people specifically do not find social stimuli inherently rewarding (Dawson et al. Reference Dawson, Toth, Abbott, Osterling, Munson, Estes and Liaw2004). Not only do the aforementioned syntheses problematize this hypothesis, but also recent prospective research indicates that eye contact and social orienting are not typically reduced early in infancy in autism (Elsabbagh et al. Reference Elsabbagh, Gliga, Pickles, Hudry, Charman and Johnson2013; Jones & Klin Reference Jones and Klin2013; Young et al. Reference Young, Merin, Rogers and Ozonoff2009). Social interest can also develop with time (Rumsey et al. Reference Rumsey, Rapoport and Sceery1985). One of the testimonials in the target article is from Donald Triplett, the first case study in Kanner (Reference Kanner1943). The article from which the quote was derived highlights the difference between Triplett's increased social motivation as an adolescent and his father's early descriptions of him as “perfectly oblivious to everything about him” (Donvan & Zucker Reference Donvan and Zucker2010).

By situating the reduced social motivation theory within the historical contexts that shaped it, we can better critique it. Although it is a gross overgeneralization in relation to current diagnostic criteria and has been used in dehumanizing ways, some autistic people do report experiencing reduced social motivation; we should respect this difference as well. I am optimistic that the target article and surrounding discussion will be an antidote to a prior article in Behavioral and Brain Sciences that used the reduced social motivation theory to assert that autistic people are less than human (Tomasello et al. Reference Tomasello, Carpenter, Call, Behne and Moll2005). Autism researchers commenting on that article mostly endorsed its premise. I believe the times are changing (for evidence of this, see Fletcher-Watson et al. Reference Fletcher-Watson, Adams, Brook, Charman, Crane, Cusack, Leekam, Milton, Parr and Pellicano2018; Prizant Reference Prizant2015).