- I am a lecturer in the Psychology Department at the University of Sheffield. My main area of interest is visual atten... moreI am a lecturer in the Psychology Department at the University of Sheffield. My main area of interest is visual attention in Autism Spectrum Disorders. I am currently exploring the cognitive profile of the broader autism phenotype with a view to improving understanding the diagnostic boundaries of ASD. My main collaborator at the University of Sheffield is Dr Elizabeth Milne (director of the Sheffield Autism Research Lab). I am working on a number of projects in this area using the techniques of EEG and eye-tracking.
I am also interested in studying social attention in the real-world. I am working on projects relating to this with Dr Tom Foulsham (University of Essex) and Prof Alan Kingstone (University of British Columbia).
My third area of interest is investigating cultural differences in the expression of autistic traits. This work is being conducted with Dr Rajani Ramachandran (India) and Dr Elizabeth Sheppard (Malaysia).edit
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Environments that require social interaction are complex, challenging and sometimes experienced as overwhelming by autistic people. However, all too often theories relating to social interaction processes are created, and interventions... more
Environments that require social interaction are complex, challenging and sometimes experienced as overwhelming by autistic people. However, all too often theories relating to social interaction processes are created, and interventions are proposed, on the basis of data collected from studies that do not involve genuine social encounters nor do they consider the perception of social presence to be a potentially influential factor. In this review, we begin by considering why face-to-face interaction research is important in this field. We then discuss how the perception of social agency and social presence can influence conclusions about social interaction processes. We then outline some insights gained from face-to-face interaction research conducted with both autistic and non-autistic people. We finish by considering the impact of social presence on cognitive processes more broadly, including theory of mind. Overall, we demonstrate that choice of stimuli in studies assessing social...
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Background: Individuals with Autism Spectrum Disorders attend to the natural world in a different manner to typically developing individuals. There is evidence that they displaying diminished interest in social stimuli (Jones & Klin,... more
Background: Individuals with Autism Spectrum Disorders attend to the natural world in a different manner to typically developing individuals. There is evidence that they displaying diminished interest in social stimuli (Jones & Klin, 2008; Klin et al. 2002) especially in the first few fixations when viewing complex scenes (Freeth et al., in press). Could the impact of visual saliency (low-level properties such as colour, intensity and orientation) account for any of these differences? Actions are often performed in a routinised, repetitive way by individuals with ASD. Is this style evident in their patterns of eye movements when natural scenes are viewed? Objectives: * To discover whether individuals with ASD are influenced by visual saliency in a similar or different manner to matched controls when viewing naturalistic scenes. * To discover whether eye movement scanpaths are predictable over time and whether individuals with ASD are drawn to similar or disparate aspects of natural ...
Deletions and duplications at the chromosomal region of 16p11.2 have a broad range of phenotypic effects including increased likelihood of intellectual disability, autism, attention deficit hyperactivity disorder (ADHD), epilepsy, and... more
Deletions and duplications at the chromosomal region of 16p11.2 have a broad range of phenotypic effects including increased likelihood of intellectual disability, autism, attention deficit hyperactivity disorder (ADHD), epilepsy, and language and motor delays. However, whether and how sensory processing is affected has not yet been considered in detail. Parents/caregivers of 38 children with a 16p11.2 deletion and 31 children with a 16p11.2 duplication completed the Sensory Behaviour Questionnaire (SBQ) and the Child Sensory Profile 2 (CSP-2) along with other standardised questionnaires assessing autistic traits (SRS-2), ADHD traits (Conners 3), anxiety (SCAS-P) and adaptive behaviour (VABS-3). SBQ and CSP-2 responses found that sensory processing differences were clearly evident in both 16p11.2 deletion and 16p11.2 duplication, though there was significant variation in both cohorts. SBQ data indicated the frequency and impact of sensory behaviour were more severe when compared to ...
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Provision of post-diagnostic support for autistic adults in the UK is both inequitable and inadequate, resulting in autistic adults facing unnecessary challenges and wide-ranging poor outcomes. A modified Delphi sought to establish... more
Provision of post-diagnostic support for autistic adults in the UK is both inequitable and inadequate, resulting in autistic adults facing unnecessary challenges and wide-ranging poor outcomes. A modified Delphi sought to establish autistic adults’ priorities for optimal provision of post-diagnostic support. The study was co-designed with ten autistic adults across a series of three onlineworkshops. Forty-three autistic adults, who had received their diagnosis in adulthood, completed a series of three online questionnaires. Over three rounds, 153 support priorities were identified. Of these, 30 priorities reached or exceeded a consensus threshold of 80% of respondents being in agreement that the item described an important element of post-diagnostic support. Priorities were grouped into four topics: (1) delivery of support; (2) emotional and psychological support; (3) person-centred support; (4) practical support. The highest consensus priorities were that post-diagnostic support sh...
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Knowledge of autistic individuals’ experiences of self-compassion is very limited. This study investigated autistic women’s experiences of self-compassion after receiving their diagnosis in adulthood. Eleven autistic women completed... more
Knowledge of autistic individuals’ experiences of self-compassion is very limited. This study investigated autistic women’s experiences of self-compassion after receiving their diagnosis in adulthood. Eleven autistic women completed semi-structured interviews analysed using interpretative phenomenological analysis. Three super-ordinate themes were identified: ‘Disconnect between the autistic self and experience of societal expectations’ (the burden of conformity; autism is misunderstood; social challenges; mental health impact); ‘Unmasking: the process of self-understanding’ (autonomy and self-compassion; validation and grief) and ‘Impact on relationships’ (diagnosis disclosure dilemmas; connection and understanding). Frustration with society’s misconceptions of autism and unhelpful thinking styles were presented as barriers to self-compassion. Most participants reported that their diagnosis had led to the development of a greater sense of self-understanding, which facilitated self-...
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There have been numerous attempts to identify what makes the ground floor interfaces of street edges engaging for pedestrians. Their subdivision has often been highlighted as important, predominantly, in line with functions along their... more
There have been numerous attempts to identify what makes the ground floor interfaces of street edges engaging for pedestrians. Their subdivision has often been highlighted as important, predominantly, in line with functions along their length. However, the effect of subdivision on street edge engagement is yet to be empirically tested. We use mobile eye-tracking to systematically examine where and for how long pedestrians visually engage ground floors in relation to their subdivision. We consider three scales of subdivision: morphologically defined plinths (different building ground floors), territorially defined segments (different areas of territorial ownership) and spatially defined micro-segments (different spaces separated by pillars and partitions). Results show that segments dominate ground floor visual engagement, with micro-segments also having a significant influence. Plinths were shown to have no direct effect upon such engagement. We subsequently use these findings to sh...
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PURPOSE This study aimed to undertake a multidisciplinary characterization of the phenotype associated with SOX11 variants. METHODS Individuals with protein altering variants in SOX11 were identified through exome and genome sequencing... more
PURPOSE This study aimed to undertake a multidisciplinary characterization of the phenotype associated with SOX11 variants. METHODS Individuals with protein altering variants in SOX11 were identified through exome and genome sequencing and international data sharing. Deep clinical phenotyping was undertaken by referring clinicians. Blood DNA methylation was assessed using Infinium MethylationEPIC array. The expression pattern of SOX11 in developing human brain was defined using RNAscope. RESULTS We reported 38 new patients with SOX11 variants. Idiopathic hypogonadotropic hypogonadism was confirmed as a feature of SOX11 syndrome. A distinctive pattern of blood DNA methylation was identified in SOX11 syndrome, separating SOX11 syndrome from other BAFopathies. CONCLUSION SOX11 syndrome is a distinct clinical entity with characteristic clinical features and episignature differentiating it from BAFopathies.
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Weaver syndrome and Tatton-Brown Rahman syndrome are rare genetic overgrowth conditions associated with intellectual disability. Recent evidence suggests increased prevalence of autism in these conditions, though current understanding of... more
Weaver syndrome and Tatton-Brown Rahman syndrome are rare genetic overgrowth conditions associated with intellectual disability. Recent evidence suggests increased prevalence of autism in these conditions, though current understanding of cognition and behaviour is poor. This research will provide a comprehensive overview of the cognitive strengths and difficulties, and behavioural profile of these conditions. Results will be made available to clinical geneticists and families so they know what outcomes to expect and to educators so appropriate educational strategies can be adopted.
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Being able to follow the direction of another person’s line-of-sight facilitates social communication. To date, much research on the processes involved in social communication has been conducted using computer-based tasks that lack... more
Being able to follow the direction of another person’s line-of-sight facilitates social communication. To date, much research on the processes involved in social communication has been conducted using computer-based tasks that lack ecological validity. The current paradigm assesses how accurately participants can follow a social partner’s line-of-sight in a face-to-face scenario. In Study 1, autistic and neurotypical adults were asked to identify which location, on a grid of 36 potential locations, the experimenter was looking at on a series of discrete trials. All participants (both autistic and neurotypical) were able to effectively make line-of-sight judgements, scoring significantly above chance. Participants were also just as effective at making these judgements from either a brief, 1s, glance or from a prolonged, 5s, stare. However, at the group level, autistic participants were significantly less accurate than neurotypical participants overall. In Study 2, potential variation...
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BACKGROUND Despite increased understandings that the whole family system is influenced by a family member being diagnosed with an Autism Spectrum Condition (ASC), the experiences of siblings can be overlooked. However, recently... more
BACKGROUND Despite increased understandings that the whole family system is influenced by a family member being diagnosed with an Autism Spectrum Condition (ASC), the experiences of siblings can be overlooked. However, recently understanding of siblings' experiences has begun to develop via qualitative studies. AIMS This review aimed to systematically identify, appraise and review the qualitative literature investigating the lived experience of siblings of autistic people. METHODS AND PROCEDURES Six databases were systematically searched for studies reporting empirical qualitative data on the lived experience of neurotypical siblings of autistic people. Eighteen studies met inclusion criteria and were analysed using Thematic Synthesis. OUTCOMES AND RESULTS Data synthesis revealed four superordinate themes; Roles and responsibilities, different to what may be expected typically; Impact of behaviours, particularly aggressive behaviours; Process of adjustment, including learning and developing empathy and acceptance; Interpersonal experiences with others and between siblings. CONCLUSIONS AND IMPLICATIONS A narrative of love and empathy was present throughout. However, several participants also experienced significant difficulties affecting their mental health. Findings suggest a sense of agency, understanding ASC, time spent alone with parents, supportive environments and the chance to relate to other siblings as protective factors in facilitating positive psychological wellbeing for siblings of autistic people.
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Social attention is atypical in autism. However, the majority of evidence for this claim comes from studies where the social partner is not physically present and the participants are children. Consequently, to ensure acquisition of a... more
Social attention is atypical in autism. However, the majority of evidence for this claim comes from studies where the social partner is not physically present and the participants are children. Consequently, to ensure acquisition of a comprehensive overview of social attention in autism, systematic analysis of factors known to influence face-to-face social attention in neurotypicals is necessary and evidence from adulthood is required. This study assessed the influence of experimenter gaze direction (direct or averted) and conversational phase (speaking or listening) on social attention during a face-to-face conversation. Eye-tracking analyses indicated that when the experimenter looked directly at the participant, autistic adults looked at the experimenter’s face less than did neurotypical adults. However, this between-group difference was significantly reduced when the experimenter’s gaze was averted. Therefore, opportunities for reciprocal social gaze are missed by autistic adult...
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Sotos syndrome (Sotos) and Tatton-Brown Rahman Syndrome (TBRS) are two of the most common overgrowth disorders associated with intellectual disability. Individuals with these syndromes tend to have similar cognitive profiles and high... more
Sotos syndrome (Sotos) and Tatton-Brown Rahman Syndrome (TBRS) are two of the most common overgrowth disorders associated with intellectual disability. Individuals with these syndromes tend to have similar cognitive profiles and high likelihood of autism symptomatology. However, whether and how sensory processing is affected is currently unknown. Parents/caregivers of 36 children with Sotos and 20 children with TBRS completed the Child Sensory Profile 2 (CSP-2) and the Sensory Behaviour Questionnaire (SBQ) along with other standardised questionnaires assessing autistic traits (SRS-2), ADHD traits (Conners 3), anxiety (SCAS-P) and adaptive behaviour (VABS-3). Sensory processing differences were clearly evident in both syndromes, though there was significant variation in both cohorts. SBQ data indicated that both the frequency and impact of sensory behaviour were more severe when compared to neurotypicals, with levels of sensory behaviour impact and frequency being similar to autistic...
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Supplemental material, AUT853442_Lay_Abstract for 'I was exhausted trying to figure it out': The experiences of females receiving an autism diagnosis in middle to late adulthood by Alexandra Leedham, Andrew Thompson, Richard Smith... more
Supplemental material, AUT853442_Lay_Abstract for 'I was exhausted trying to figure it out': The experiences of females receiving an autism diagnosis in middle to late adulthood by Alexandra Leedham, Andrew Thompson, Richard Smith and Megan Freeth in Autism
Supplemental material, AUT756786_Lay_Abstract for Social partner gaze direction and conversational phase; factors affecting social attention during face-to-face conversations in autistic adults? by Megan Freeth and Patricia Bugembe in... more
Supplemental material, AUT756786_Lay_Abstract for Social partner gaze direction and conversational phase; factors affecting social attention during face-to-face conversations in autistic adults? by Megan Freeth and Patricia Bugembe in Autism
Supplemental material, AUT778286_Lay_Abstract for Autistic people's perspectives on stereotypes: An <b>interpretative phenomenological analysis</b> by Caroline Treweek, Chantelle Wood, Jilly Martin and Megan Freeth in Autism
The ability to interpret and follow the gaze of our social partners is an integral skill in human communication. Recent research has demonstrated that gaze following behaviour is influenced by theory of mind (ToM) processes. However, it... more
The ability to interpret and follow the gaze of our social partners is an integral skill in human communication. Recent research has demonstrated that gaze following behaviour is influenced by theory of mind (ToM) processes. However, it has yet to be determined whether the modulation of gaze cueing by ToM is affected by individual differences, such as autistic traits. The aim of this experiment was to establish whether autistic traits in neurotypical populations affect the mediation of gaze cueing by ToM processes. This study used a gaze cueing paradigm within a change detection task. Participants’ perception of a gaze cue was manipulated such that they only believed the cue to be able to ‘see’ in one condition. The results revealed that participants in the Low Autistic Traits group were significantly influenced by the mental state of the gaze cue and were more accurate on valid trials when they believed the cue could ‘see’. By contrast, participants in the High Autistic Traits grou...
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Knowledge of how parenthood is experienced by autistic women is currently poor. Nine autistic mothers to children aged 5–15 years completed semi-structured interviews, analysed using Interpretative Phenomenological Analysis. All mothers... more
Knowledge of how parenthood is experienced by autistic women is currently poor. Nine autistic mothers to children aged 5–15 years completed semi-structured interviews, analysed using Interpretative Phenomenological Analysis. All mothers considered at least one of their children to also be autistic. Four superordinate themes emerged: 1. Autism fundamentally impacts parenting; 2. Battle for the right support; 3. Development and acceptance; and 4. The ups and downs of parenting. The themes demonstrate that while motherhood is largely a joyful experience for autistic mothers (Themes 1 and 4), it is associated with specific issues unlikely to be found in neurotypical motherhood (Theme 1), including negotiating misunderstandings from others (Theme 2). The need for self-care and self-acceptance was expressed (Theme 3) with parenting resulting in personal growth and adaptation (Theme 3). Feelings of intense connection and closeness were experienced (Theme 4), though managing children’s need...
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The presence of other people, whether real or implied, can have a profound impact on our behaviour. However, it is argued that autistic individuals show decreased interest in social phenomena, which leads to an absence of these effects.... more
The presence of other people, whether real or implied, can have a profound impact on our behaviour. However, it is argued that autistic individuals show decreased interest in social phenomena, which leads to an absence of these effects. In this study, the agency of a cue was manipulated such that the cue was either described as representing a computer program or the eye movements of another participant. Both neurotypical and autistic participants demonstrated a social facilitation effect and were significantly more accurate on a prediction task when they believed the cue represented another participant. This demonstrates that whilst autistic adults may show difficulties in interpreting social behaviour this does not necessarily arise from a lack of sensitivity to social agency.
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Existing knowledge of street edge experience has often been constructed using methods that offer a limited opportunity to gain empirical insight from the first-hand perspective of pedestrians. In order to address this, mobile eye-tracking... more
Existing knowledge of street edge experience has often been constructed using methods that offer a limited opportunity to gain empirical insight from the first-hand perspective of pedestrians. In order to address this, mobile eye-tracking glasses were used during the current investigation to provide a detailed understanding of pedestrian visual engagement with street edges along both non-pedestrianised and pedestrianised urban streets. Through this, the current study advances empirical knowledge of street edge experience from a perspective that has previously been challenging to capture and quantify. The findings demonstrate that people visually engage with street edge ground floors more than their upper floors, that visual engagement is distributed more towards the street edge on the walked side of non-pedestrianised streets than the opposite side, and that visual engagement with street edges of pedestrianised streets is balanced across both sides. The study findings also highlight...
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Females often receive autism spectrum condition diagnoses later than males, leaving needs misunderstood. This study aimed to explore the lived experiences of female adults diagnosed with an autism spectrum condition in middle to late... more
Females often receive autism spectrum condition diagnoses later than males, leaving needs misunderstood. This study aimed to explore the lived experiences of female adults diagnosed with an autism spectrum condition in middle to late adulthood. Eleven autistic females diagnosed over the age of 40 years completed semi-structured interviews, analysed using Interpretative Phenomenological Analysis. Four superordinate themes emerged: A hidden condition (pretending to be normal and fitting in; mental health and mislabelling), The process of acceptance (initial reactions and search for understanding; re-living life through a new lens), The impact of others post-diagnosis (initial reactions; stereotyped assumptions), and A new identity on the autism spectrum (negotiating relationships, connections and community; changing well-being and views of the self; the meaning of diagnosis). Findings highlight several factors not previously identified that affect late diagnosis in females, including ...
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Autism stereotypes can often portray autistic people in a negative way. However, few studies have looked at how autistic people think they are perceived by others, and none have specifically asked autistic people what they think the... more
Autism stereotypes can often portray autistic people in a negative way. However, few studies have looked at how autistic people think they are perceived by others, and none have specifically asked autistic people what they think the autistic stereotypes are. Semi-structured interviews with 12 autistic adults (aged between 20 and 63 years) were conducted. Using interpretative phenomenological analysis, three main themes emerged from the data. These were as follows: (1) the primary stereotype is that autistic people are ‘weird’; (2) autistic stereotypes have negative effects and consequences; and (3) autistic people are heterogeneous. This study makes an important and novel contribution to understanding the experience of being autistic by exploring how autistic people feel they are perceived by others and identifying some of the ways in which negative stereotypes are believed to have negative consequences for autistic people.
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Sotos syndrome is a congenital overgrowth disorder, associated with intellectual disability. Previous research suggests that Sotos syndrome may be associated with relative strength in verbal ability and relative weakness in non-verbal... more
Sotos syndrome is a congenital overgrowth disorder, associated with intellectual disability. Previous research suggests that Sotos syndrome may be associated with relative strength in verbal ability and relative weakness in non-verbal reasoning ability but this has not been explicitly assessed. To date, the cognitive profile of Sotos syndrome is unknown. Cognitive abilities of a large and representative sample of individuals with Sotos syndrome (N = 52) were assessed using the British Ability Scales (BAS3). The majority of participants had intellectual disability or borderline intellectual functioning. The cluster score profile analysis revealed a consistent verbal ability > non-verbal reasoning ability profile. Four specific criteria were proposed as the Sotos syndrome cognitive profile (SSCP): verbal ability > non-verbal reasoning ability; quantitative reasoning T-score or matrices T-score <20th percentile; quantitative reasoning T-score < mean T-score; recognition of ...
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This research aimed to ascertain the contents (Study 1) and valence (Study 2) of the stereotype associated with Autism Spectrum Conditions (ASC) in university students. Study 1 used a free-response methodology where participants listed... more
This research aimed to ascertain the contents (Study 1) and valence (Study 2) of the stereotype associated with Autism Spectrum Conditions (ASC) in university students. Study 1 used a free-response methodology where participants listed the characteristics that they thought society associates with individuals with ASC. This study revealed that the stereotypic traits most frequently reported by students without personal experience of ASC were poor social skills, being introverted and withdrawn, poor communication and difficult personality or behaviour. Study 2 had participants rate the valence of the 10 most frequently mentioned stereotypic traits identified in Study 1, along with additional traits frequently used to describe disabled and non-disabled people. This study found that eight of the ten most frequently listed stereotypic traits from Study 1 were seen as negative, and were rated significantly more negatively than traits used to describe non-disabled people. The knowledge of ...
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Selective attention is atypical in individuals with autism spectrum conditions. Evidence suggests this is also the case for those with high levels of autistic traits. Here we investigated the neural basis of spatial attention in those... more
Selective attention is atypical in individuals with autism spectrum conditions. Evidence suggests this is also the case for those with high levels of autistic traits. Here we investigated the neural basis of spatial attention in those with high and low levels of self-reported autistic traits via analysis of ERP deflections associated with covert attention, target selection and distractor suppression (the N2pc, NT and PD). Larger N2pc and smaller PD amplitude was observed in those with high levels of autistic traits. These data provide neural evidence for differences in spatial attention, specifically, reduced distractor suppression in those with high levels of autistic traits, and may provide insight into the experience of perceptual overload often reported by individuals on the autism spectrum.
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Individuals with autism spectrum disorder (ASD) often display enhanced attention to detail and exhibit restricted behavior. However, due to a lack of comprehensive eye-movement modeling techniques, it is currently unknown whether these... more
Individuals with autism spectrum disorder (ASD) often display enhanced attention to detail and exhibit restricted behavior. However, due to a lack of comprehensive eye-movement modeling techniques, it is currently unknown whether these behavioral effects are also evident during scene viewing (i.e., detailed visual inspection and restricted visual exploration). Free-viewing eye-tracking data from observation of everyday photographic scenes were recorded during 2 experiments involving high-functioning adolescents with ASD and matched typically developing (TD) controls (Experiment 1, ASD n = 14; TD n = 22; Experiment 2, ASD n = 16; TD n = 23). Data from both experiments were combined and analyzed using 5 novel methods of eye-tracking, time-course analysis, enabling detailed characterization of viewing strategies. Participants' verbal descriptions of scenes were also assessed. Scenes either contained a centrally positioned person whose face was in full view or contained no centrally...
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Background: The ability to perceive and accurately interpret social cues is imperative to our understanding of the social world. Social impairment is a major characteristic of autism spectrum disorders (ASD). Conflicting findings have... more
Background: The ability to perceive and accurately interpret social cues is imperative to our understanding of the social world. Social impairment is a major characteristic of autism spectrum disorders (ASD). Conflicting findings have been reported in visual fixation patterns when participants are presented with stimuli containing another person’s eyes (Klin et al. 2002; Dalton et al. 2005; Van der Geest, 2002). Objectives: 1. To investigate whether visual fixation patterns for participants with ASD when free-viewing scenes containing a person are similar or different from the visual fixation patterns of typically developing control participants. 2. To investigate whether the eye-gaze direction of another person influences visual fixation patterns in typically developing participants and those with ASD. Methods: 24 high-functioning adolescents with ASD and 24 control participants completed a free-viewing eye-tracking study. A series of static scenes depicting a person looking straig...