Assessment & Research

Endophenotyping social cognition in the broader autism phenotype.

Pua et al. (2024) · Autism research : official journal of the International Society for Autism Research 2024
★ The Verdict

Faux-pas blindness runs in autism families and is easy to spot with a 20-question story test.

✓ Read this if BCBAs who coach teens or adults with autism and want to know if social-skills gaps also live in family members.
✗ Skip if Clinicians focused only on early-intake toddlers where basic joint attention is the main target.

01Research in Context

01

What this study did

Pua et al. (2024) gave the 20-item Faux Pas Test to three groups: adults with autism, their adult relatives, and adults with no family link to autism.

They wanted to see if trouble spotting social gaffes runs in families, a possible inherited marker.

02

What they found

Relatives scored in the middle. They did worse than controls but better than their autistic family members.

The pattern looked like a step ladder, hinting that poor faux-pas recognition is part of the broader autism phenotype.

03

How this fits with other research

Kahng et al. (1999) built the same test 25 years earlier and showed kids with Asperger syndrome missed faux pas. The new study moves the lens from kids to whole families.

Wetterneck et al. (2006) found autism parents were slow reading facial emotion. Kiat adds a second social-cog snag—faux-pas blindness—strengthening the idea that parents carry subtle social traits.

Cornew et al. (2012) saw odd social referencing in baby siblings. Together the papers trace a timeline: atypical social responses appear in infancy, linger into adulthood, and sit in relatives who never get an ASD diagnosis.

04

Why it matters

If you assess an autistic client, consider giving the quick Faux Pas Test to parents or siblings. A low score flags the broader phenotype and helps explain why social coaching at home may need extra support. It also reminds you to check your own language for hidden social rules that typical learners take for granted.

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Add the Faux Pas Test to your adult intake packet; one low score in a parent signals you should spell out hidden social rules during parent training.

02At a glance

Intervention
not applicable
Design
case study
Sample size
184
Population
autism spectrum disorder
Finding
negative

03Original abstract

Relatives of individuals with autism spectrum disorder (ASD) may display milder social traits of the broader autism phenotype (BAP) providing potential endophenotypic markers of genetic risk for ASD. We performed a case-control comparison to quantify social cognition and pragmatic language difficulties in the BAP (n = 25 cases; n = 33 controls) using the Faux Pas test (FPT) and the Goldman-Eisler Cartoon task. Using deep phenotyping we then examined patterns of inheritance of social cognition in two large multiplex families and the spectrum of performance in 32 additional families (159 members; n = 51 ASD, n = 87 BAP, n = 21 unaffected). BAP individuals showed significantly poorer FPT performance and reduced verbal fluency with the absence of a compression effect in social discourse compared to controls. In multiplex families, we observed reduced FPT performance in 89% of autistic family members, 63% of BAP relatives and 50% of unaffected relatives. Across all affected families, there was a graded spectrum of difficulties, with ASD individuals showing the most severe FPT difficulties, followed by the BAP and unaffected relatives compared to community controls. We conclude that relatives of probands show an inherited pattern of graded difficulties in social cognition with atypical faux pas detection in social discourse providing a novel candidate endophenotype for ASD.

Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3057