PONE-D-23-39903The Relationship Between Interpersonal Distance Preference and Estimation Accuracy in AutismPLOS ONE

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the opportunity to review the article titled "The Relationship Between Interpersonal Distance Preference and Estimation Accuracy in Autism" submitted to PLOS One. The study examined an important topic, and addresses a gap in the interpersonal distance literature, by investigating the correlation between distance estimation biases and preferences in autism. I believe interpersonal distance and its regulation is indeed part of the complexities of social communication, it suggests that there is a possibility for autistic individuals to make errors or experience difficulties in this aspect.

The methodology employed in this study is thorough, and the results are presented with clarity.

The manuscript could be considered for publication once the following aspects are addressed, which would significantly enhance the quality of the paper.

1. Introduction:

The literature of interpersonal distance in autism is not sufficiently broad, the literature review may not have been extensive. Although, it is possible that during the lengthy process of writing and review, the authors had not yet been aware of the most recent publications at the time of drafting the introduction, it would have been advisable to conduct a search prior to submission. There are a few new articles from the last year, and it would be interesting to discuss the results in light of the latest theories and results.

- Farkas K, Pesthy O, Guttengéber A, Weigl AS, Veres A, Szekely A, Komoróczy E, Szuromi B, Janacsek K, Réthelyi JM, Németh D. Altered interpersonal distance regulation in autism spectrum disorder. PLoS One. 2023 Mar 31;18(3):e0283761. doi: 10.1371/journal.pone.0283761

- Fusaro M, Fanti V, Chakrabarti B. Greater interpersonal distance in adults with autism. Autism Res. 2023 Oct;16(10):2002-2007. doi: 10.1002/aur.3013

- Farkas K, Pesthy O, Janacsek K, Németh D. Interpersonal Distance Theory of Autism and Its Implication for Cognitive Assessment, Therapy, and Daily Life. Perspect Psychol Sci. 2024 Jan;19(1):126-136. doi: 10.1177/17456916231180593

It might be also interesting to compare the results of interpersonal distance estimation with estimation bias about the self in autism.

- Asada K, Tojo Y, Hakarino K, Saito A, Hasegawa T, Kumagaya S. Brief Report: Body Image in Autism: Evidence from Body Size Estimation. J Autism Dev Disord. 2018 Feb;48(2):611-618. doi: 10.1007/s10803-017-3323-x

2. Methods and study design

a. Participants characteristics: authors described that participants were high functioning and autistics were matched by IQ to neurotypical controls, however education level, estimated IQ, comorbidities were not reported. Comorbidities and medication are especially important.

3. The above aspects are minor issues due to the matching (nonverbal IQ testing), but it is not clear why did the authors decide not to include participants if they did not score positively on the ADOS? ADOS is neither eligible in itself to confirm the diagnosis of autism in adulthood, nor specific. Many of the adult autistics have been in therapy for a long time at the age of 25, and score lower in ADOS, than the threshold, and psychiatric diagnoses (such as psychotic conditions, severe mood disorders, social anxiety etc.) might result in false positives.

The history of early atypical development and clinically confirmed diagnosis could be valid indicators of proper ASD diagnosis. It is especially problematic, as AQ scores are relatively low (which is also possible in itself among autists in care). The authors addressed this issue in section 3.1.1. How can the low AQ score be reconciled with the high ADOS scores that confirm the diagnosis?

4. Data analysis and results: the concept and the statistical analysis is clear and simple

5. Discussion: The cautious interpretation of the results is mostly valid; however, there are two points where I disagree with the authors.

a. In 5.1 pont authors argued that “autists may choose an interpersonal distance based on perceived expectations of others rather than their own personal comfort.“ Most often the exact opposite is the case: autists might not at all consider others’ preference, only choose social interactions (including distance) based on their own personal notion or perspective, ignoring the fact that the other person is already feeling uncomfortable or doesn't even notice the attempt at closeness (being off the radar).

b. The next sentence “when autistic individuals overestimate interpersonal distance, they may anticipate their social partner approaching and, therefore, choose to increase their distance” does not really seem logical to me; in fact, I would assume the opposite correlation. If you overestimate a distance, you would continue to approach until you reach the appropriate and comfortable distance. Overestimating the distance means that you perceive the other person or object to be farther away than they actually are, so you would adjust your movement accordingly to close the gap and reach the desired distance.

6. Limitations: It might be a more pronounced limitation, that the study used a virtual social situation, as the actual presence of the other person has implications on other sensory modalities (olfactory, proprioceptive, acoustic), beyond the challenging situation of meeting a stranger face to face.

7. Finally: There are a few typos in the manuscript; it would be worthwhile to carefully review the text for accuracy (e.g. 4.1. chapter title: Results Summery).

Reviewer #2: The manuscript addresses a highly exciting and important issue: the regulation of interpersonal distance and distance estimation in autism. Due to the limited number of studies in this area, all the collected data are crucial and should be published.

However, there are several points for major revision:

1. Some significant recent results and theories in this area have been omitted from the literature. For example, Farkas et al. (2023) examined interpersonal distance regulation in autism, and their study's ecological validity is much higher than many others, as they investigated distance regulation in real circumstances, not just virtually or using VR. This should be mentioned and interpreted in the introduction and discussion.

2. In 2024, a significant theoretical work was published on distance regulation in autism, which fundamentally defines this area (Farkas et al., 2024). This theory should be integrated into both the introduction and the discussion. I can give a broader perspective to the manuscript.

3. In addition to classical frequentist statistics, the results section should also include the results of Bayesian statistics.

4. It is advisable to rewrite the first paragraph of the discussion to only summarize the results. The interpretation should be proposed in the subsequent paragraphs.

5. One limitation of the study is that the distance regulation was not conducted in real circumstances; instead, the participants looked at a monitor, where a figure approached or moved away, etc. This significantly reduces the ecological validity of the study. The authors mention this in the limitations section, but it should be further elaborated. Sensory hypersensitivity is a very important factor in autism. This is completely overlooked in this type of study design. In the design used by the authors, the autistic participant does not see a real person with all their characteristics, such as random movements, smells, sounds, footsteps, etc. In a more realistic situation, as in Farkas et al. (2023), these are present. It would be worth making a detailed comparison of the different study designs in terms of hypersensitivity and ecological validity.

References:

1. Farkas et al. (2023). Altered interpersonal distance regulation in autism spectrum disorder. Plos one, 18(3), e0283761.

2. Farkas et al. (2024). Interpersonal distance theory of autism and its implication for cognitive assessment, therapy, and daily life. Perspectives on Psychological Science, 19(1), 126-136.

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Reviewer #1: No

Reviewer #2: No

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The Relationship Between Interpersonal Distance Preference and Estimation Accuracy in Autism

PONE-D-23-39903R1

Dear Dr. Nur Givon-Benjio,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Claudia Brogna

Academic Editor

PLOS ONE

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors have addressed the reviewers' comments, the quality of the revised article has improved and now suitable for publication.

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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