Prediction in autism spectrum disorder: A systematic review of empirical evidence

“It is also in line with the predictive processing framework, which is grounded in a “free-energy principle” that frames all prediction (and all action) as serving to minimize a long-term average of “surprise,” defined as the deviation of the organism’s state from a narrow preferred distribution [Friston, 2010].”

“The past 20 years have seen a compelling attempt to unify many of the manifestations of prediction (as well as the rest of cognition) under the banner of predictive coding or predictive processing [Friston, 2005, 2018; Rao & Ballard, 1999].”

“The past 20 years have seen a compelling attempt to unify many of the manifestations of prediction (as well as the rest of cognition) under the banner of predictive coding or predictive processing [Friston, 2005, 2018; Rao & Ballard, 1999].”

“…of associative learning theories that posit that “stimulusselective learning is achieved (at least partly) through modifications of attention paid to each stimulus on the basis of the degree with which each stimulus reliably signals the (unconditioned stimulus)” [Le Pelley, 2004; Mackintosh, 1975].”

“Indeed, several formulations of the PIA hypothesis draw heavily on the framework of “predictive processing,” which grounds a prediction-based account of perception, learning, and action in a growing set of neurobiological mechanisms [Bastos et al., 2012; Friston, 2018].”

“Modulation as an immediate result of making prediction errors (reactive modulation in response to unexpected uncertainty), thought to be mediated by norepinephrine [Yu & Dayan, 2005].”

“…should be central to the discussion: within predictive processing, attention is understood as a mechanism for precision modulation, with top-down attention corresponding to prospective precision modulation based on inferred context [Feldman & Friston, 2010], likely moderated by acetylcholine.”

“In 2014, several independent groups of researchers proposed variations on a hypothesis of a broad, domain-general predictive impairment1 in autism (PIA) [Lawson, Rees, & Friston, 2014; Sinha et al., 2014; Van de Cruys et al., 2014].”

“Such a predictive learning difference could be understood in the context of learning the successor representation (SR), a construct created to explain phenomena in reinforcement learning but which has broad implications [Dayan, 1993; Gershman, 2018].”

“For example, there are many EEG studies that analyze MMN that were not captured by our search because they have not been described within the context of the prediction literature or were published prior to the emergence of the PIA hypothesis.”

“…this literature suggests a general underutilization of spontaneous predictive motor processes, a conclusion in line with earlier results suggesting reduced predictive feeding behavior in children and infants with ASD [Brisson, Warreyn, Serres, Foussier, & Adrien-Louis, 2012; Cattaneo et al., 2007].”

“The two reviewed studies that directly investigated reactive precision modulation—the capacity to modulate error signaling and learning rate based on patterns of prediction errors— dealt with this problem by describing behavior with normative computational models and fitting parameters representing aspects of learning…”

“Indeed, several formulations of the PIA hypothesis draw heavily on the framework of “predictive processing,” which grounds a prediction-based account of perception, learning, and action in a growing set of neurobiological mechanisms [Bastos et al., 2012; Friston, 2018].”

“However, one study indicated that this effect may be attentiondependent [Karaminis et al., 2020], as we discuss below.”

“…of associative learning theories that posit that “stimulusselective learning is achieved (at least partly) through modifications of attention paid to each stimulus on the basis of the degree with which each stimulus reliably signals the (unconditioned stimulus)” [Le Pelley, 2004; Mackintosh, 1975].”

“Two showed a reduced influence of accumulated stimulus statistics on perceptual report [Karaminis et al., 2016; Lieder et al., 2019].”

“Such a predictive learning difference could be understood in the context of learning the successor representation (SR), a construct created to explain phenomena in reinforcement learning but which has broad implications [Dayan, 1993; Gershman, 2018].”

“Intact mismatch-negativity responses to vowel sounds in pre-term infants [Cheour et al., 1998] suggest that at least some sensory streams have acquired such an implicit expectation of repetition at birth.”

“Differences in the number of anticipatory saccades may have been attributable to the lack of a visible target in the two experiments reporting fewer saccades [Goldberg et al., 2002].”

“…for example, “estimates of unobserved or missing information on the basis of a model… (which) can be (but are not necessarily) future-oriented” [Teufel & Fletcher, 2020].2 According to this definition, one might “predict” what is in an opaque box based on its weight and the sound it makes…”

“These authors brought together a rich history of research on perceptual differences in ASD [Mitchell & Ropar, 2004] and a growing literature describing perception as a process of Bayesian inference in which data are assimilated in the context of prior expectations.”

“It may be linked to the narrowed scope of spatial attention in ASD [Robertson et al., 2013], which itself may underlie the observation of weaker neural suppression [Schallmo et al., 2020].”

“…(Van de Cruys et al., 2018) of these studies reported that responses from the ASD group were less influenced by priors than responses from the control group [Amoruso et al., 2019; Chambon et al., 2017; Karaminis et al., 2016; Lieder et al., 2019; Palumbo et al., 2015; von der Lühe et al., 2016].”

“The two reviewed studies that directly investigated reactive precision modulation—the capacity to modulate error signaling and learning rate based on patterns of prediction errors— dealt with this problem by describing behavior with normative computational models and fitting parameters representing aspects of learning…”

“This face-specific habituation result has been replicated by other researchers [Kleinhans, Richards, Greenson, Dawson, & Aylward, 2016; Webb et al., 2010]; however, only one of these studies met the inclusion criteria for this review.”

“INSARCannon et al./Prediction in Autism Spectrum Disorder624 Two studies reviewed here looked directly at attended vs. unattended predictions, with the target of attention determined by task instructions [Gonzalez-Gadea et al., 2015; Westerfield et al., 2015].”

“Three of these studies showed reduced perceptual adaptation in the ASD group [Turi et al., 2015, 2016; van Boxtel et al., 2016].”

“The third [Chambon et al., 2017] showed ordinary learning and biasing application of stimulus statistics on perceptual report; this was contrasted against the lack of social bias in the ASD group in a social version of the task.”

“…Powers, GillespieLynch, & Lum, 2016], but EEG and brain imaging evidence suggests that participants with ASD may be using a different and perhaps more intentional learning strategy to succeed in these tasks [Scott-Van Zeeland et al., 2010; Zwart, Vissers, van der Meij, Kessels, & Maes, 2017].”

“One study used non-social learned outcome expectancies [Mosner et al., 2019], and two used social conditions [Balsters et al., 2017; Kinard et al., 2020].”

“Three of these studies showed reduced perceptual adaptation in the ASD group [Turi et al., 2015, 2016; van Boxtel et al., 2016].”

“Four studies looked at predictions based primarily on social expectations, which are presumably learned over a lifetime of social experiences but may also have an innate component [Wynn, 2008].”

“…studies of implicit and statistical learning have shown no behavioral differences in ASD [Foti, De Crescenzo, Vivanti, Menghini, & Vicari, 2015; Mayo & Eigsti, 2012; Obeid, Brooks, Powers, GillespieLynch, & Lum, 2016], but EEG and brain imaging evidence suggests that participants with ASD may…”

“…to repeated tones [Font-Alaminos et al., 2020; Kolesnik et al., 2019; Millin et al., 2018; Ruiz-Martínez et al., 2020] and faces [Ewbank et al., 2017; Tam et al., 2017] but not to other images [Millin et al., 2018; Utzerath, Schmits, Buitelaar, & de Lange, 2018] as measured by EEG and fMRI.”

“Three of these studies showed reduced perceptual adaptation in the ASD group [Turi et al., 2015, 2016; van Boxtel et al., 2016].”

“Eight of these studies measured anticipatory eye movement as an indicator of prediction [Barzy et al., 2019; Braukmann et al., 2018; Ego et al., 2016; Ganglmayer et al., 2020; Greene et al., 2019; Krogh-Jespersen et al., 2018; Schuwerk et al., 2016; Vivanti et al., 2018].”

“Of these, one reported unambiguously behaviorally impaired prediction: ASD children’s perceptual inferences indicated that they did not learn to predict an action from a statistically associated context in which that action occurred [Amoruso et al., 2019].”

“These results, combined with results not reviewed here indicating intactness of static priors (Van de Cruys et al., 2018) (perceptual biases not dependent on an antecedent context but applicable throughout life), indicate that ASD is not characterized by an impairment in employing predictions as…”

“Of these, two reported differences in anticipatory action [Fulceri et al., 2018; Landa, Haworth, & Nebel, 2016], two reported no impairment in anticipatory behavior (eye movements [Ego et al., 2016] or instructed timed response [Tewolde, Bishop, & Manning, 2018]), and one reported difference in…”

“This included decreased neural habituation to repeated tones [Font-Alaminos et al., 2020; Kolesnik et al., 2019; Millin et al., 2018; Ruiz-Martínez et al., 2020] and faces [Ewbank et al., 2017; Tam et al., 2017] but not to other images [Millin et al., 2018; Utzerath, Schmits, Buitelaar, & de Lange,…”

“[Barzy et al., 2019; Deschrijver et al., 2016; Kunchulia et al., 2017, 2020; Lawson et al., 2017; Tam et al., 2017; Thillay et al., 2016].”

“Individuals with ASD were observed to show similar ramping activity (contingent negative variation, or CNV) preceding predictable targets as well as non-targets, while TD controls showed a greater CNV amplitude preceding predictable targets only [Thillay et al., 2016].”

“These results were nuanced: individuals with ASD demonstrated impaired habituation to auditory but not visual stimuli [Millin et al., 2018], and to faces (Ewbank et al., 2017; Tam et al., 2017), but not shapes (Ewbank et al., 2017).”

“, 2013], which itself may underlie the observation of weaker neural suppression [Schallmo et al., 2020].”

“, 2016]), the remaining six found fewer predictive eye movements in ASD based on learned [Schuwerk et al., 2016] or instructed [Greene et al.”

“This face-specific habituation result has been replicated by other researchers [Kleinhans, Richards, Greenson, Dawson, & Aylward, 2016; Webb et al., 2010]; however, only one of these studies met the inclusion criteria for this review.”

“…to repeated tones [Font-Alaminos et al., 2020; Kolesnik et al., 2019; Millin et al., 2018; Ruiz-Martínez et al., 2020] and faces [Ewbank et al., 2017; Tam et al., 2017] but not to other images [Millin et al., 2018; Utzerath, Schmits, Buitelaar, & de Lange, 2018] as measured by EEG and fMRI.”

“Finally, the presence of a stronger omission response to the sight of a handclap without the sound [van Laarhoven et al., 2020] suggests that predictive processes based on strongly learned associations are present in ASD, and that signaling differences may stem from an over signaling of prediction…”

“Two studies measured spontaneous anticipatory motor behavior in infants at risk of ASD as an indicator of their predictions [Landa et al., 2016; Northrup, 2017] and found these behaviors under expressed.”

“…part associations [Braukmann et al., 2018] and comparable predictive tracking of a moving object through occlusion [Ego et al., 2016]), the remaining six found fewer predictive eye movements in ASD based on learned [Schuwerk et al., 2016] or instructed [Greene et al., 2019] statistical tendencies.”

“However, results showing prolonged but successful predictive learning in ASD [e.g., Ganglmayer et al., 2020], and unimpaired predictive behavior under conditions of explicit instruction [e.g., Ego et al., 2016], suggest that predictive behaviors and cognitive strategies may be promising targets for…”

“Two more studies looked at predictions based on kinematic/temporal extrapolation in combination with other information [Amoruso et al., 2019; Krogh-Jespersen, Kaldy, Valadez, Carter, & Woodward, 2018].”

“The other used a similar approach, but measured participant eye movement [Król & Król, 2019].”

“Two further studies had participants engage in deliberately coordinated real or virtual movement and used associated parameters (e.g., timing, position, speed) as measures of prediction [Fulceri et al., 2018; Tewolde et al., 2018].”

“However, one study indicated that this effect may be attentiondependent [Karaminis et al., 2020], as we discuss below.”

“Other INSARCannon et al./Prediction in Autism Spectrum Disorder626 intervention studies have focused on enhancing prediction skills by using simulators to teach new skills, including driving Cox et al., 2020].”

“, 2018] and comparable predictive tracking of a moving object through occlusion [Ego et al., 2016]), the remaining six found fewer predictive eye movements in ASD based on learned [Schuwerk et al.”

“One study demonstrated intact repetition suppression to shapes in the visual cortex, but a difference in response to expected compared to unexpected faces in V1 [Utzerath et al., 2018].”

“Two studies measured spontaneous anticipatory motor behavior in infants at risk of ASD as an indicator of their predictions [Landa et al., 2016; Northrup, 2017] and found these behaviors under expressed.”

“…(Van de Cruys et al., 2018) of these studies reported that responses from the ASD group were less influenced by priors than responses from the control group [Amoruso et al., 2019; Chambon et al., 2017; Karaminis et al., 2016; Lieder et al., 2019; Palumbo et al., 2015; von der Lühe et al., 2016].”

“…studies found no differences in predictive eye movements (i.e., equal amounts of predictive saccades based on common action/body part associations [Braukmann et al., 2018] and comparable predictive tracking of a moving object through occlusion [Ego et al., 2016]), the remaining six found fewer…”

“One study used non-social learned outcome expectancies [Mosner et al., 2019], and two used social conditions [Balsters et al., 2017; Kinard et al., 2020].”

“A second study had participants indicate their predictions by explicitly reporting what they thought would happen, specifically which of two cars they thought would arrive first [Sheppard et al., 2016].”

“INSARCannon et al./Prediction in Autism Spectrum Disorder624 Two studies reviewed here looked directly at attended vs. unattended predictions, with the target of attention determined by task instructions [Gonzalez-Gadea et al., 2015; Westerfield et al., 2015].”

“[Barzy et al., 2019; Deschrijver et al., 2016; Kunchulia et al., 2017, 2020; Lawson et al., 2017; Tam et al., 2017; Thillay et al., 2016].”

“[Barzy et al., 2019; Deschrijver et al., 2016; Kunchulia et al., 2017, 2020; Lawson et al., 2017; Tam et al., 2017; Thillay et al., 2016].”

“Studies looking at predictive eye movements based on kinematic information found them unaffected [Ego et al., 2016; Krogh-Jespersen et al., 2018].”

“Associative learning would be particularly dif fi cult in ASD when predictive features have low salience or consistency 20 .”

“These different theories and assumptions were presented in a recent literature review on prediction in autistic people [167].”

“We hypothesized that impairments in ToM and social prediction may make it more difficult for individuals with ASD to exert social influence 29–33 .”

“Over the years, published research has adopted electroencephalography (EEG) signals for mental health predictions, including conditions such as schizophrenia [6], epilepsy [7], dementia [8] and autism [9].”

“…precise turn-timing is highly challenging cognitively, as it can only be achieved if speakers are able to accurately predict the communicative intentions of their interlocutor [60–65], and b) predicting the behaviour of others is a skill that many autistic individuals seem to struggle with [66].”

“A consistent observation is that some autistic individuals1 do not rely on past information to flexibly adjust their behavior and adapt to changing situations (Cannon et al., 2021).”

“These context-dependent results support the generally inconsistent study findings in the field (see [27,33] for reviews) and align with our previous observations [42,43,48,77].”

“Comparisons to non-autistic youth have suggested specific differences in prediction abilities, which were reviewed in a recent review assessing the empirical evidence of prediction impairment in autism that suggested specific differences in prediction in autistic individuals (Cannon et al., 2021).”

“28,77 However, as previously discussed, predictive models remain untested and debated for the interoception (and also debated for exteroception in autism; see Sapey-Triomphe et al; 78 Cannon et al; 79 Finnemann et al; 80 Ward et al 81 ).”

“Slower target detection during learning may stem from difficulties with encoding and binding linguistic stimuli, computing probabilistic relationships, or learning the predictive parings between stimuli (Cannon et al., 2021).”

“This is consistent with a systematic review of prediction in autism (Cannon et al., 2021) that proposed that predictive impairment may be restricted to difficulty learning of subtle predictive relationships, differences in the neural signaling of low-level implicit predictions, and a relative absence of spontaneous en…”

“Neural data suggest enhanced low-level perceptual processing and reduced top-down modulation, supporting a predictive coding framework for perception in ASD [49].”

“Researchers have proposed that such a pattern could be consistent with reductions of habituation: if autistic people are less able learn regularities, or fail to apply such expectations to predict stimuli, the neural response to repeated stimuli might not diminish (Cannon et al., 2021).”

“The results advance our understanding of ASD (as seen through this animal model) in terms of the influential predictive coding theory.”

“Empirical evidence is still insufficient to decide among these alternatives [191].”

“A recent systematic review of the literature on ASD and prediction [17] found that the spontaneous predictive engagement of motor processes seems to be impaired in autism.”

“…for understanding the autistic cognitive profile, pointing to a particular style of processing sensory information and prior knowledge in ASD (Cannon et al., 2021; Lawson et al., 2014, 2017; Noel et al., 2022; Noel & Angelaki, 2023; Palmer et al., 2017; Pellicano & Burr, 2012; Sinha et al.,…”

“While this has not been shown previously using MMN specifically, evidence for intact priors in autism has been found for the visual (Croydon et al., 2017; Karvelis et al., 2018; Pell et al., 2016; Van de Cruys et al., 2018) and tactile (Cannon et al., 2021) modalities.”

“A growing body of literature has adopted the framework of a different predictive process in autism and tried to explain various aspects of the autism phenotype (see Cannon et al., 2021 for a review).”

“Evidence supporting this model of autism is summarized by Palmer et al. (2017) and Cannon et al. (2021).”

“All these perceptual characteristics point to an altered role of prior information during predictions of sensory input in autistic perception (Cannon et al. 2021).”

“Systematic reviews that evaluate PP studies in mental health disorders mostly come with mixed results (Angeletos Chrysaitis & Seriès, 2023; Cannon et al., 2021).”

“Research has demonstrated that autistic individuals are capable of learning statistical regularities and are influenced by priors (Cannon et al. 2021; Angeletos Chrysaitis and Seriès 2023), challenging the simplistic hypo-prior hypothesis (Pellicano and Burr 2012).”

“Social deficits in autistic individuals may arise due to difficulty in using past information to flexibly adjust social behavior and adapt to changing social situations [37], which can be interpreted as a failure to update internal models of one’s social world.”

“The predictive coding theory of autism provides a unifying framework to explain core symptoms [3,8,9,11,22–28].”

“Specifically, children with ASD find learning predictable cause-and-effect pairings more challenging than engaging in predictive processing of repetitive behaviors 9 .”

“Autistic individuals have also been shown to overestimate the volatility of the sensory environment (Lawson et al. 2017) and have been associated with difficulties in higher-order predictive processing across longer temporal intervals (Sinha et al. 2014a, Cannon et al. 2021).”

“1 3 that differential performance in prediction and learning associations among autistic and neurotypical individuals may be more readily observed under more implicit conditions (Cannon et al., 2021).”

“[22] suggests that social prediction differences in ASD could be the most notable expression of an underlying domain general predictive processing deviance.”

“…entrainment to rhythmic events involves alignment of the phases of slow oscillations with temporally predictable stimuli, such that these stimuli fall within an optimal phase of network excitability (Henry and Obleser, 2012; Cannon, 2021), often leading to improved perception and performance.”

“For example, autism has been claimed to be a prediction disorder (Sinha et al., 2014; Van de Cruys et al., 2014), although the evidence is mixed (Cannon, O ’ Brien, Bungert, & Sinha, 2021; Prescott et al., 2022).”

“Sinha and colleagues (Cannon et al., 2021; Sinha et al., 2014), for example, proposed that some typical phenotypes of autism, such as insistence on sameness, sensory hypersensitivities, difficulties interacting with dynamic objects, difficulties with theory of mind, and islands of proficiency…”

“Evidence suggests that ASC individuals have difficulty extracting the statistical structure, i.e., the predictability, of environments that vary in terms of action opportunities and their consequences [44–48].”

“Regardless of domain, predictive processing involves learning the regularities between antecedents and conse-quents, and detecting and applying the learned associations to a similar situation (Cannon et al., 2021; Perruchet & Pacton, 2006).”

“Predicting upcoming events is inherent to all domains of human behavior, from sensorimotor to cognitive to social (Cannon et al., 2021; Lawson et al., 2014; Pellicano & Burr, 2012; Sinha et al., 2014; Van de Cruys et al., 2014).”

“Our findings are also consistent with recent predictive coding accounts of autism that suggest a privileged processing of prediction error in autistic individuals (for a recent review, see Cannon et al., 2021).”

“…learned antecedent-consequence pairings tend to be those with antecedents that have consistent, task-relevant predictive value during learning (Cannon et al., 2021), which emphasizes two critical prerequisites for acquiring proper priors: one is that the antecedent should be consistent and…”

“Cannon et al. (2021) summarized the literature as follows: studies reporting similarities between autistic and NT groups were those in which antecedents had consistent predictive value relevant to the task and were temporally adjacent or overlapping with the consequence.”

“To this end, several computational models have been suggested: predictive impairment 26,32,33 suggests that ASD generates high prediction errors and this, in turn, hampers performance in dynamic environments and favors stability and repetition.”

“Studies from recent years show reduced adaptation to changes in the environment, and more specifically, compromised tempo-keeping and reduced synchronization to rhythmic stimuli (Lieder et al. , 2019; Cannon et al. , 2021; Vishne et al. , 2021; Kasten et al. , 2023) (but see (Cannon et al. , 2023)).”

“…predictive impairments to underlie autism spectrum disorder (ASD), many of which were based on the Bayesian Brain framework ( Brock, 2012; for a review see Cannon et al., 2021; K. J. Friston et al., 2013; Lawson et al., 2014; Pellicano & Burr, 2012; Sinha et al., 2014; van de Cruys et al., 2014).”

“It has been suggested that this precision imbalance results in more frequent prior updates in autistic individuals, as compared to their non-autistic peers. population (Pesthy et al., 2023; Rybicki et al., 2021; for reviews see Cannon et al., 2021; Chrysaitis & Seriès, 2023).”

“Indeed, reviews of prediction-related tasks in the field of autism (Cannon et al., 2021; Merchie & Gomot, 2023) show a trend of testing a single behavioral or neural measure, as opposed to multiple measures that together may better reflect the multifaceted phenomenon of prediction.”

“Atypicality in perception has been suggested to be a key feature of ASD as a consequence of a reduced integration of experience [46,47]: this makes it more difficult to use knowledge derived from the past to generate predictions about the occurrence of new events [48].”

“Similar refinements of the predictive processing account of autism appear to be necessary for the framework to account for the empirical data, and the necessary synthesis of the empirical evidence so far has recently begun (Angeletos Chrysaitis & Seriès, 2022; Cannon et al., 2021).”

“There is a large body of evidence exploring the predictive coding errors of individuals on the autism spectrum, across experimental paradigms and modalities, including spontaneous gaze [8,9], emotion prediction [10], auditory prediction [11], and social expectations [12] (for a review, see [13]).”

“In the case of ASD, there is consistent evidence that children and adolescents experience difficulties integrating sensory, motor, and social cues, which compromises their ability to form stable predictions about the environment and to update those predictions efficiently (15, 16).”

“A previous review study suggested that individuals with ASD exhibit decreased neural activity and behavioral habituation to stimulus repetition as compared to neurotypical individuals [47, 48].”

“Importantly, however, this may be contradictory to the domain-generality of prediction-based theories of ASD (see Cannon et al., 2021).”