PONE-D-25-10256Diagnostic status influences rapport and communicative behaviours in dyadic interactions between autistic and non-autistic people

PLOS ONE

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After careful analysis, both the reviewers and I agree that your paper addresses a significant issue, presents a novel and attractive research approach, and contributes to our understanding of communication behaviors among autistic individuals in dyadic interactions. Overall, the manuscript is well-written. However, several aspects require further refinement and clarification. These include details regarding the research methodology, such as the formulation of hypotheses, the rationale behind the choice of indices, and a description of the process for matching dyad partners, as well as certain unclear sections in the introduction and discussion, as highlighted in the reviews. I believe that addressing the reviewers’ insightful comments will improve the quality of the manuscript.

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Additional Editor Comments:

After careful analysis, both the reviewers and I agree that your paper addresses a significant issue, presents a novel and attractive research approach, and contributes to our understanding of communication behaviors among autistic individuals in dyadic interactions. Overall, the manuscript is well-written. However, several aspects require further refinement and clarification. These include details regarding the research methodology, such as the formulation of hypotheses, the rationale behind the choice of indices, and a description of the process for matching dyad partners, as well as certain unclear sections in the introduction and discussion, as highlighted in the reviews. I believe that addressing the reviewers’ insightful comments will improve the quality of the manuscript.

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Reviewers' comments:

Reviewer's Responses to Questions

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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: Yes

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3. 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: No

Reviewer #2: Yes

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4. 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

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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: The manuscript in question tackles an intriguing question using a novel and appropriate approach. It was also enjoyable to read. The authors are correct that this area is currently understudied and I believe their report will present a valuable addition to the study of Autism and Social Cognition. Nonetheless, I have a few thoughts I would like to offer for consideration before I can recommend this article for publication.

The introduction is very informative and focused, but I'd like to see a brief explanation/definition of the terms rapport and backchanneling before these are used in the argument - the former is sometimes ambiguous and can be operationalised in different ways, whereas the latter may not be known to many readers. The role of kinematics and why they matter when exploring rapport and comunication could also be established more as that is another non-intuitive factor.

I would also appreciate if the authors could briefly cover the deficits-or-differences argument, as this is very relevant here. The authors already bring up the current implicit understanding of Autism in terms of social deficits (line 59) that contrasts with the cited literature showing effective communication and high rapport among matched pairs. I would just like to see this addressed explciitly.

The authors mention larger group setting (line 92) and groups larger than dyads (line 114) - briefly addressing dyadic vs group interactions may be informative and clarify the scope of the current manuscript.

For understandable reasons, the introduction and article in general treat "Autistic" and "Non-Autistic" as homogenous groups. It is okay and expected if intra-group diversity is not within scope, but this is a broad issue within the field at large so it should be explicitly stated as a limitation: Both co-occuring conditions, and different levels of Autism (certainly level 3) - would no-doubt affect the results and dyadic communication, as would other individual differences and conditions among the non-Autism group that were not recorded.

I notice that participants were recruited from different countries. Could the authors please clarify whether each country contributed the sae proportion to each dyad-arrangement? It doesn't have to be equal between countries but it should be equal across arrangements. If any country contributed, for example, a majority of Autistic dyads but a minority of Non-Autistic dyads, then cultural factors become an important consideration.

Might the results regarding the diagnostic status of the partner be influenced by social desirability? It seems logical that one dyad member would be hesitant to report low rapport if they knew their partner was Autistic, which would explain the high rapport of mixed dyads. This would be an interesting effect in itself but would present a confound that should be mentioned. To further explore this, the authors could compare the rapport ratings within mixed pairs, looking for differencxes between the Autistic and non-Autistic partner's ratings.

I may be reading this wrong (which may affect my previous point), but in the paragraph starting on line 362, the authors seem to say that informed mixed dyads report higher rapport, which is driven by the Autistic member who, when informed, reports lower rapport. This is obviously contradictory so I am guessing something may have gotten switched around here or the paragraph is not entirely clear. Upon reviewing figure 3 and table 4, I think there is a mistake in line 363, which possibly should say that uninformed mixed dyads reported higher rapport, not lower. In that case my previous point becomes moot but I would still like to see a deeper discussion of this effect.

It is already part of the data but a direct test comparing ratings of Autistic participants, depending on whether they interacted with an Autistic or non-Autistic partner, may be interesting. Currently this is somewhat hard to judge due to mixed pairs being averaged across the two participants.

Minor comments:

On line 96, the words "is a" are repeated.

Hypotheses H2b (line 152) and H3c (line 160) are phrased in a way that is very hard to parse. Please consider rewriting.

In hypothesis H3a (line 158), I believe the authors mean to say that Autistic participants will exhibit dimished or reduced multimodal indices, as the amount of indices stays the same.

Errant ")" on line 190.

Reviewer #2: Thank you for the opportunity to review this article. This is a well-written paper presenting a thoughtfully designed study that makes a valuable contribution to the field. The comprehensive analysis of verbal and non-verbal cues across same- and mixed-neurotype interactions addresses an important gap in the existing literature. I offer the following suggestions to enhance the paper's clarity.

Page 3, line 57: I find this sentence unclear. If a shift is mentioned, I would expect some contrast between views/methodologies to be present in the previous sentences, which is not the case.

Page 6, lines 132-133: This sentence is slightly misleading. When first reading it, I assumed that utterance length had been measured in number of words, since it is introduced as a verbal interaction metric. However, the supplementary material reveals that length was measured in seconds, including silent pauses—which constitutes a non-verbal component. To avoid confusion, I suggest reformulating this sentence and/or specifying upfront that utterance length refers to the temporal duration of utterances.

I would also like to see a brief explanation of 1) why utterance length was chosen as an interaction metric (utterance length is not mentioned in the Introduction, whereas other measures such as smiles, nods, movements are) and 2) why the authors chose to measure it in seconds rather than in words ?

Page 6, line 136: I also wonder if referring to the eight elements of social interaction as multimodal indices is correct since most elements are not multimodal but unimodal (e.g., nods, smiling, total upper body velocity, acceleration, and jerkiness).

Page 7, lines 144-148: I find the formulation of hypothesis 1(and its sub-hypotheses) unclear and would suggest reformulating as separate sentences or as bullet points. Furthermore, it is not clear from the introduction and literature review why the authors hypothesise that self-reported rapport will be lower for autistic participants compared to non-autistic participants.

Page 7, lines 149-164: Hypothesis 2a mentions social behaviors, are those the same as multimodal indices mentioned in Hypothesis 3? If yes, why use two different terms? If not, what does social behaviors refer to?

Likewise, Hypothesis 2a stipulates that autistic individuals will produce increased, less smooth movements but Hypothesis 3a stipulates that they will exhibit fewer multimodal indices (which includes kinematic measures as stated on page 6 (lines 134-135) in the research aims). This seems contradictory.

Finally, the authors expect autistic participants to increase social behaviours such as smiling in mixed neurotype dyads due to heightened social demands (H3c). What does heightened social demands refer to specifically?

I would suggest reformulating more clearly and consistently hypothesis 2 and 3 (and their sub-hypotheses).

Page 8, lines 185-186: The inclusion of self-diagnosed individuals in the autistic group should be mentioned upfront in the abstract. While I fully support including self-identified participants—given recruitment challenges and barriers to formal diagnosis—this information needs to be transparent from the outset. Group composition impacts result interpretation and generalizability and should also be discussed in the Discussion/Limitation section.

Related to this, I also wonder if it is appropriate to use “diagnostic status” as outcome variable name, given the mixed status of participants. Maybe a preliminary note would be useful to clarify what the authors mean by diagnostic status.

I'd also recommend reporting the distribution of clinical versus self-diagnosis across dyad types, not just by individual group membership.

Page 8, line 189: Could the authors provide more information on how dyad partners were matched. Did they try to match them by age or sex/gender ?

Page 11, line 254: What were the causes of coding disagreement for the variable “Smiling” ? Were they systematic or random ? This result should also be mentioned in the Discussion or Limitation section.

Typos

Page 5, 99-99: To address this gap, the Actor-Partner Interdependence Model (APIM) is a is a statistical model used to analyse data from dyadic relationships which allows for the simultaneous examination of how each person's behaviours and characteristics influence not only their outcomes but those of their partner.

Page 12, line 276: recording --> recoding

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Reviewer #1: No

Reviewer #2: No

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Diagnostic status influences rapport and communicative behaviours in dyadic interactions between autistic and non-autistic people

PONE-D-25-10256R1

Dear Dr. Efthimiou,

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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Ewa Pisula

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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: (No Response)

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

Reviewer #1: Yes

Reviewer #2: (No Response)

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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: (No Response)

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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: I thank the authors for thoroughly addressing all my comments and thoughts. I have no further concerns regarding this manuscript and recommend publication. It was an enjoyable, interesting read and I wish the authors good luck in the future.

Reviewer #2: (No Response)

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Reviewer #1: Yes: Tim Vestner

Reviewer #2: No

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