Autism on the Screen: Shaping Public Knowledge of Autism

Background:

The film Rainman (1988) was a breakthrough in depicting characters with autism spectrum disorders (ASD). In representations since that time, the character’s diagnosis may be clearly stated, as in Rainman, or diagnostic speculations may stem from the general public (as in the character of Sheldon Cooper in Big Bang Theory). Despite increases in estimated prevalence of ASD diagnosis globally, most people do not have substantial direct personal experience of the condition. Therefore, it is likely that depictions of characters with ASD on screen have substantial influence on public attitudes towards and knowledge of ASD. 

Objectives:  

To investigate how characters with ASD are portrayed on screen when assessed against diagnostic criteria. Sub-topics include: a) whether evidence suggests that those characters not explicitly labelled as having an ASD diagnosis would receive a diagnosis in real life; and b) whether specific characteristics associated with ASD (e.g. savant skills) are over-represented on screen.

Methods:

Clinical best estimate evaluations of n=10 characters from film and television were made using DSM-5 and ICD-10 diagnostic criteria. Two raters agreed an evaluation method in partnership drawing on evidence from two characters, and subsequent ratings were performed independently. Raters have at least 15 years’ expertise working with autism including work in diagnostic services.

Results:  

Characters demonstrated an almost perfect match to diagnostic criteria from both DSM-5 and ICD-10. Thus representations of ASD on screen are not misleading, but could be described as archetypal. The prevalence of savant-like skills is much higher than in the true population. Characters on screen who are not explicitly labelled with a diagnosis do display the full complement of traits employed in diagnosis, but not to an extent that these impact negatively on daily living, and thus real life diagnosis would not necessarily be sought or warranted in these cases.

Conclusions:  

Representations of ASD on screen cannot be described as inaccurate, apart from an over-representation of savant skills. In contrast, on-screen characters with ASD present with every associated trait. Narrative imperatives may drive the over-representation of savant skills on screen. This may also explain why characters in long-standing TV series seem to be immune to many of the difficult consequences of autism.

Characters with ASD in television and film play a role in shaping knowledge and awareness of ASD in society. In an ideal world screen representations would not only be diagnostically accurate but also do justice to the obstacles faced by people on the spectrum, while illustrating how people with ASD can achieve great things in a supportive environment. There are examples of both of these representations in our sample, but it is impossible to represent in an individual character the heterogeneity of the autism spectrum. This may contribute to the frequent objections raised by the autism and Autistic communities to characters with ASD on screen. Therefore a goal for the community might be to encourage larger numbers of incidental characters with ASD on screen in order to present a more nuanced picture of the multiple facets of the condition.