Reward processing differences in autism: Current understandings and future directions.

Abstract

Differences in reward processing repeatedly have been implicated in autism. Still, the contexts in which these differences occur (e.g., social and non-social) and the extent to which they relate to autistic traits remain poorly understood. Notably, current frameworks for reward processing have yet to describe the impacts of reward processing differences on broader cognitive domains in autism. Evidence from studies of neurotypical individuals and non-human primates shows that reward has significant impacts on multiple cognitive domains, including executive control processes that have been linked to core social communication and repetitive behavior traits in autism. These findings suggest that examining reward processes in relation to cognitive functions in autism may provide important insights into neural systems that contribute to multiple developmental abilities and psychiatric features common to autism. In this review, we present a new, testable model that describes how interactions between reward and cognitive domains may have additive or synergistic contributions to key clinical traits in autism. This model is framed in context of existing evidence for reward processing differences in autism and their relationship to clinical features, as well as broader implications for expanding existing reward-based frameworks in this population.