The Costs and Benefits of Portraying Autism on TV

A scene from "The Good Doctor".

Source: ABC

This week, ABC's The Good Doctor returns for its fifth season. The show, about an autistic surgeon, is part of a small wave of recent series, including Netflix’s Atypical and Freeform’s Everything’s Gonna Be Okay, prominently featuring autistic characters.

For the most part, I think more representation of autism on TV is a good thing. I've written before about how influential TV can be, with the potential to reduce prejudice.

But one thing I've always found mildly annoying about portrayals of autism on TV is an overwhelming focus on high-functioning (sometimes extremely high-functioning) autism. (And even within that high-functioning subgroup, portrayals of autism have historically been pretty narrowly constrained.) There's a reason autism is known clinically as a spectrum disorder: it describes a set of behaviors that vary on a spectrum from severe to mild. For many, autism is a serious disability that prevents those who have it from living ordinary, independent lives without assistance. But you wouldn't know this if your only real exposure to autism was from shows like The Good Doctor. This is essentially the point made by Alison Singer, president of the Autism Science Foundation:

"To the TV-watching public, autism has come to mean the verbal, higher-skilled, savant end of the spectrum, because individuals at that end make for interesting characters."

Can exposure to autism on TV reduce misconceptions?

So, ironically, as representation of autism on TV has increased (a good thing), public misconceptions about autism potentially have also increased (a bad thing). But what if watching shows featuring relatable and sympathetic autistic people (non-representative though they may be) could help dispel some of the more harmful misconceptions that people already have about autistic people (a good thing)?

As I've written before, there's support for this idea. Social psychologists have shown in many studies that people like things and people that are more familiar to them, an effect known as the "mere-exposure effect". It therefore stands to reason that someone who has limited experience with autism might develop a more positive attitude toward autistic people if they regularly watch a show with an autistic character.

That's effectively what Stephanie Stern and Jennifer Barnes tested in a 2019 study. Specifically, they were interested in whether watching The Good Doctor would change attitudes about autistic people. They split 144 college students into two groups: one group watched the first episode of the series, and the other watched a lecture on autism from a psychology professor. Both groups then took a test of autism knowledge and a survey of attitudes toward autistic people. The survey included pairs of positive and negative traits and the subjects circled which of the two traits in each pair better described autistic people.

The researchers found that the subjects who watched The Good Doctor had slightly better knowledge of autism behaviors (specifically, they had fewer false beliefs). The subjects who watched The Good Doctor also chose an average of about 3 (out of 20) more positive traits and about 1.5 fewer negative traits than the group that watched the lecture. Although these differences are small, they were statistically significant and notable given that they only watched one episode.

A scene from "Atypical".

Source: Netflix

The researchers themselves acknowledge some major limitations of the experiment. The biggest one is that it was highly artificial. The subjects were all college students who were accustomed to learning from lectures and videos, they were presumably on a college campus for the experiment, and they were even told that the experiment was about learning. Additionally, as I already noted, they only watched a single episode. None of these conditions come anywhere close to how people typically watch TV. For this reason alone, it's hard to predict how, say, a 40-year-old watching The Good Doctor at home on the couch for entertainment would respond.

More (biased) representation is probably better than less representation

Clearly, representation of autism on TV could be improved. But, based on the (admittedly preliminary) research, I think that the skewed representation of autism we've gotten have so far is probably a good thing on balance. Autism is estimated to affect about 1-2% of the population, which is common enough that most people without autism will likely encounter someone with autism at some point, but rare enough that many of those same people may never get the chance to spend much time with an autistic person. For those people, portrayals of characters like Shaun Murphy on The Good Doctor likely are doing more good than harm. Kerry Magro, a motivational speaker who has autism herself, seems to agree:

"Producers strive for realism in portraying these autistic characters with the danger of not clearly understanding the individuality of each person on the spectrum. It's a razor's edge. Trying to avoid producing 'inspiration porn' but also making the programming meaningful to those in the autism community. ... The Good Doctor does a fine job of navigating this razor's edge."