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The social competence of the autistic character, Dr. Shaun Murphy, in the television series The Good Doctor. The study examines Dr. Murphy's social motivation, social inferencing, demonstrating empathic concern, social knowledge, verbal conversation skills, nonverbal sending skills, and emotion regulation. The document also compares Dr. Murphy's social competence to typical individuals with Autism Spectrum Disorder (ASD) and discusses the potential impact of the inaccurate portrayal of ASD in media.
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Running Head: SOCIAL COMPETENCE IN THE GOOD DOCTOR Major research paper: An analysis of social competence portrayed by the autistic character in the television series The Good Doctor Shauna Kluke, 8147034 Department of Communication, University of Ottawa December 1, 2020
Chapter 1: Introduction The role that the media plays within our lives and the media’s effects, including how we see people, have been vastly studied by many scholars (e.g. Katz 2001; Lasswell, 1970; Scheufele, 1999; Valkenburg et al., 2016). Not only is it important to study the effects of the media, but it is increasingly important to study the ethics of media and their effects on the general population. One area that has been explored by researchers is the stigmatization of individuals with autism spectrum disorder (ASD) (e.g. Kiggins, 2020; Nordahl-Hansen et al., 2018; Orta, 2016; Pinchevski & Peters, 2016; Poe & Moseley, 2016). At the same time, there has been an increase in autistic characters appearing in television series. Many of these depictions focus on the individual with ASD either as an outcast, meaning someone who has been rejected by society or a particular social group or as a “savant,” meaning one who has certain abilities that are beyond those of a typical person, like mathematical skills, photographic memory, and rapid calculation ability (Prochnow, 2014; Stern & Barnes, 2019). Neither of these labels are necessarily accurate and, in fact, may stigmatize ASD by reinforcing the perception that individuals with ASD are either an outcast or a savant which could skew people’s understanding and knowledge of ASD (Stern & Barnes, 2019). It is important that autistic characters in television series be depicted with accuracy as they neither deserve to be depicted as an outcast nor as a savant as that is not the entire reality of ASD (Prochnow, 2014). Autism Spectrum Disorder (ASD) Autism is now defined as a spectrum disorder in the DSM-5, meaning that there is a range of severity of the symptoms and behaviours associated with an ASD diagnosis (Poe & Moseley, 2016; Trevisan et al., 2018). At one end of the spectrum, individuals diagnosed with ASD can lead nearly typical lives with few challenges whereas at the other end of the spectrum there are
individuals who are severely impacted and have many challenges throughout their everyday lives (e.g. nonverbal, disruptive repetitive behaviours, social communication issues, self-injury, etc.) (Poe & Moseley, 2016; Prochnow, 2014). There are a vast number of indicators of ASD when being diagnosed through the DSM-5. The DSM-5 outlines several different areas of difficulty which then are broken down into the ranges of severity ( American Psychiatric Association , 2013 ). It is essential to understand that there is a range of severity and the symptoms and behaviours associated with ASD may not be exhibited by every individual diagnosed with ASD. One of the major issues that an individual with ASD may encounter in their everyday lives is the difficulty of interacting and responding appropriately in social situations. The American Psychiatric Association ’s (APA) Diagnostic and Statistical Manual of Mental Disorder (DSM-5;
social competence for assessing particular populations (i.e. individuals with ASD). The behavioural categories are as follows: Social motivation includes the behaviours associated with an individual’s motivation to interact with other people. This behavioural category measures an individual’s ability to initiate interactions with others and take an interest in building friendships and other relationships. Overall, this behavioural category views a person’s overall interest in and enjoyment from social interactions (Yager & Iarocci, 2013). Social inferencing reflects an individual’s ability to pick up on various social cues, for example someone’s mental state, and respond appropriately in different social situations. This category measures an important skill that looks beyond a person’s verbal expressions to assess whether they understand and respond appropriately in various social interactions (Yager & Iarocci, 2013). Demonstrating empathic concern refers to an individual’s ability to recognize and understand distress and provide comfort. This can be measured by an individual’s ability to share feelings with others and feel compassion towards someone who is in distress. This relates closely to the social inferencing category, above, which could include an individual’s ability to respond appropriately to another person’s emotional state (Yager & Iarocci, 2013). Social knowledge reflects an individual’s ability to read social situations and adjust their behaviours accordingly. For example, an individual may act differently toward peers compared to an authority figure. This behavioural category measures an individual’s ability to understand various social situations and respond accordingly as well as the ability to identify dangerous or risky situations (Yager & Iarocci, 2013).
Verbal conversation skills reflect an individual’s ability to understand and demonstrate the proper rules of verbal conversations. For example, this behavioural category measures an individual’s ability to “take turns, to understand how to initiate, join and leave conversations, and to know when to maintain or change conversational topics” (Yager & Iarocci, 2013, p. 633 ). Nonverbal conversation skills reflect an individual’s ability to display proper physical gestures and facial expressions according to various social situations. For example, this behavioral category measures an individual’s understanding of the appropriate time to smile or to convey a look of concern when another individual is in distress (Yager & Iarocci, 2013). This behavioural category also includes other non-speech related aspects of social interactions like volume and prosody (i.e. rhythm and sound). Emotional regulation reflects the ability to regulate one’s emotions. This involves “monitoring, evaluating, and controlling the intensity of one’s internal emotional experiences and outward emotion-related behaviour to attain desired affective states” (Yager & Iarocci, 2013, p. 633 ). The MSCS includes 105 items that are divided across these seven behavioural categories to measure an individual’s social competence. This study will use the seven behavioural families as they have been directly translated into scales that were designed for young adults in Trevisan et al. (2018). Therefore, the primary source for determining the level of social competence of Dr. Shaun Murphy in The Good Doctor will be discussed through the seven behavioural families created by Yager and Iarocci (2013). Media Effects In the early days of studying mass communication and media effects, Paul Lazarsfeld explored these subjects through the lens of sociology (Katz, 2001). Lazarsfeld focused narrowly
Media effects theory has been studied by many scholars who have sought to understand how mass media can affect individuals and society as a whole. According to Katz (2001), “mass media can affect knowledge, attitudes, opinions, and behaviour of individuals. These effects can be immediate or delayed, of short duration or long-lasting. Effects upon individuals might slowly become transformed into institutional changes” (p. 274). Therefore, mass media can have a significant effect on individuals and society to a point where attitudes, knowledge, opinions, and behaviours may be altered. This is important for work in communication and media studies as it is essential to understand the ways individuals can be affected by the media that they consume. According to Katz (2001), “mass media tend to reinforce the status quo rather than influence change” (p. 275). The idea is that not only can media lead individuals to change but they can also affect them in such a way that it produces no change, leading to the reinforcement of the status quo and stereotypes. It is important to understand that the effects caused by the media are complex and everchanging. There are indirect effects, which may influence the public or the audience to change or reinforce their attitudes, behaviours or knowledge (Valkenburg et al., 2016). Valkenburg et al. (2016) argue that the area of mediated health communication and health behaviour can especially have an effect on certain beliefs and attitudes. Therefore, for the purpose of this study it is important to understand that media can have both direct and indirect effects on the audience. In this case, The Good Doctor television series will be explored in terms of the accuracy of its representation of ASD and the related effects and implications of including the representation of ASD on television. The Good Doctor
The Good Doctor is a relatively new television drama series that takes place in a hospital following the lives of the surgeons who work there. Dr. Shaun Murphy is the main character in the series as he is a young surgeon with ASD and savant syndrome. Throughout the first season, Dr. Murphy relocates from a small town to San Jose, California where he starts his surgical residency with help from the president of the hospital, Dr. Glassman, who has known Shaun for most of his teenage and adult life. Dr. Murphy has an extraordinary medical gift which allows him to save lives even though his colleagues and superiors often challenge him. Dr. Murphy has some difficulty connecting with others in the beginning due to their skepticism of him and his place within the St. Bonaventure hospital; however, he proves his worth throughout the first season. Dr. Murphy diagnoses and saves many patients and slowly gains the trust and confidence of his colleagues and superiors. He meets many new people and forms connections with them throughout the first season. The Good Doctor joins other popular doctor drama series. There has been a large audience for shows such as Grey’s Anatomy and House. The Good Doctor is a twist on a South Korean show with the same name that was sold and produced by Sony Pictures Television (source). The show was renewed after the first season despite some criticism, and Freddy Highmore (the actor who plays Shaun Murphy) was applauded for his performance. This television show is one of the first of its kind that explicitly includes an individual with ASD in a medical role; however, it is not the first instance of a television doctor having savant abilities (e.g. Grey’s Anatomy and House ). Throughout this case study, I analyzed recent depictions of ASD on television to determine whether or not they are accurate. After thoroughly researching the indicators of social competence, I watched the good doctor in order to in order to assess whether the television show
Chapter 2: Literature review Inclusivity on Television It is important to understand that there are stereotypical ways of portraying all types of individuals on television, and the inclusion of different groups has not and will not always be an accurate portrayal. The result can be significant amounts of harm to individuals who are being misrepresented or underrepresented. Media scholars argue that the media are an incredible priming agent, which can influence social judgement (Ford, 1997). There has been growing demand by viewers for inclusivity of various groups in television and on other media platforms. For example, there has been an increase in demand for racial (Ford, 1997), LGBTQ+ (Monaghan, 2020), and disability inclusion and representation (Mantilla & Goggin, 2020). The inclusivity of a variety of characters in television represents a changing and evolving society, which will ideally become more tolerant of differences in people. It is important to study the evolving representation and inclusivity to understand the ways media has adapted and included these individuals. Often, these individuals are misrepresented or underrepresented, which can lead to harmful outcomes and stereotypes (Campbell & Hoem, 2001; Crewe, 2015; Ford 1997; Tyree, 2011). Race Throughout the evolution of television there has been an increasing racial diversity in the characters in television series. For example, African Americans as well other minority groups began to appear on prime-time television more frequently in the 1970s and 1980s (Ford, 1997). However, according to Ford (1997) the roles being played by African Americans were often stereotypical and extremely limited in nature. For example, in a comedy show, an African American was more likely than a Caucasian to be portrayed in menial occupations (Ford, 1997).
Moreover, Ford (1997) points out that the use of humour, in the context of African American portrayals on a comedy television show, often resulted in Caucasians viewing African Americans in this stereotypical manner being that they solely occupy menial occupations. More recently, there has been significant pressure from the public, activist groups outside of the media industry, and professional groups within the industry for a more positive portrayal of African Americans on television (Tosi, 2011). Not only has there been a long fight for simple representation and inclusion of African Americans on television and other media, but scholars argue that there is an even more significant fight against stereotypical representations of African Americans (e.g. Albert, 2008; Dixon, 2000; Ford, 1997; Rada, 2000; Tosi, 2011). Earlier research has shown that the previous portrayals of African Americans in the media affirmed other individuals’ racial attitudes towards this group through the use of stereotypes and one-sided depictions (e.g. Coover, 2001; Ford, 1997; Rada, 2000; Taylor, 1983; Tosi, 2011). LGBTQ+ To switch gears to a different group that has been recently included in television, let us now explore the representation of members of the LGBTQ+ community. Monaghan (2020) argues that LGBTQ+ individuals have been severely underrepresented in television drama series. This study was conducted in Australia; however, the researchers draw on the research done in the US and UK. This study ultimately found that there has been an underrepresentation specifically of lesbian or bisexual women compared to gay or bisexual men (Monaghan, 2020). Further, this author suggests, LGBTQ+ individuals have been stereotyped in television roles and presented in a negative light. Research on the roles that gay men and women often play on television reinforce the stereotypical gender roles (Ford, 1997). For example, throughout the 1970s and
Poe and Moseley (2016) argue that while the inclusion of ASD characters specifically in television has grown, they argue that this representation has framed ASD as a disease and as something that can be prevented or even cured. Many studies have analyzed the representation of ASD in television and film (e.g. Kiggins, 2020; Orta, 2016; Pinchevski & Peters, 2016; Poe & Moseley, 2016; Prochnow, 2014; Stern & Barnes, 2019; Young, 2012; Zuger, 2018) and most have concluded that the majority of the portrayals of ASD are stereotypical in nature. It is very difficult to depict the range of characteristics of individuals with ASD through television and movie characters as the spectrum is so broad (Prochnow, 2014). Partly for that reason scholars have raised concerns about the accuracy of these representations (Prochnow, 2014). For example, an early representation of ASD in the media appeared in the film Rain Man where one of the main characters in this film was an autistic savant (Pinchevski & Peters, 2016). However, Prochnow (2014) claims that Rain Man, as well as other film examples, do not present a severely autistic character because they often omit various behaviours and symptoms of ASD. For example, these representations show little range in characters’ behaviors, mannerisms, and intellectual levels. Instead , they more often portray high functioning individuals, who do not fairly represent the majority of individuals who are diagnosed with ASD. Orta (2016), in her study of media portrayals of teens with ASD, argues that the gap in television representation of teenagers with autism does not provide audiences with knowledge on the topic, leading to real-world social isolation of teenagers with the condition. As such, accurate representation of people with autism could be important in encouraging positive relationships in real-world scenarios. Orta (2016) found that stereotypical representations of ASD characters in television shows results in a presentation of a lack of agency and lack of independence. These representations are often negative and can have long lasting negative effects on people’s ideas
about what ASD is (Orta, 2016). Similarly, other research has argued that there is a fine line between beneficial and detrimental portrayals in the media (Nordahl-Hansen et al., 2018). These portrayals often result in the strengthening of stereotypes, including that the majority of individual’s with ASD also have savant syndrome. These portrayals have the potential to affect general knowledge about disabilities and skew individuals’ views about aspects of disability, including ASD (Worrell, 201 3 ). Overall, the representation of disabilities is both limited within the sphere of television and often negative (Worrell, 201 3 ). There are many ethical principles to be taken into consideration with these representations, especially if information is misleading or inaccurate. The idea of presenting individuals with some sort of heroic or superhuman ability can be detrimental and diminish those who live with that disability in the real world (Worrell, 201 3 ). Finally, the media has a great deal of power in influencing and shaping the lives and minds of individuals and it is important to portray these individuals accurately to reduce the amount of harm done to them (Worrell, 201 3 ). Savantism and ASD One of the major misconceptions that could come from portrayals in television and film is that every person with ASD has savantism. Savantism or savant syndrome is characterized by an individual possessing supernatural abilities. Prochnow (2014) states that characters with savant syndrome are often portrayed as “out of this world” or magical and that hese abilities come from their diagnosis with ASD. Prochnow (2014) argues that rather than a negative representation of a character’s diagnosis of ASD, this diagnosis makes them more special and more interesting than the average person. Prochnow (2014) defines the savant as “a person with less-than-average intelligence levels that somehow has certain abilities beyond what is normal for even a typical, average-intelligent person” (p. 137). She goes on to state that “although being a savant is a real,
The conceptual framework used for the study is social competence. In general, social competence as having been defined by many scholars and researchers with varying components. Social competence relates to a person’s ability or inability to interact appropriately in social interactions (Blumberg et al., 2008). For the purpose of this study social competence will be defined and operationalized as a “broad construct that may involve judgements about specific social behaviours but is focused primarily on how an individual’s adaptive social behaviour characteristics are viewed in general” (Merrell and Caldarella, 2002, pp. 7-8). The research questions outlined in the introduction clearly relate to the concept of social competence because, as seen in the literature, individuals with ASD typically have social deficits and therefore it is important to understand whether that aspect of ASD is being portrayed accurately in the media. Most literature outlines how these portrayals are often negative or overly positive and that they are an extremely skewed view of the disorder. For example, some of the literature focuses on the individual’s savant abilities even though these abilities are not reality for many individuals with ASD (Poe & Moseley, 2016). Therefore, I argue that one area of ASD that has not been studied within these portrayals is the character’s ability to maintain relationships and interact with people effectively. I believe that it is important to study this in order to understand what kind of expectations could arise as a result of the portrayals. ASD and Social Competence Many scholars have researched the link between ASD and social competence (e.g. Kuan- Hung, 2018; Paymon 2019; Rajska, 2009; Szidon & Hedges, 2015). As discussed in the introduction chapter, the DSM-5 outlines one of the main deficits associated with ASD as social communication. In other words, individuals with ASD often lack knowledge of and the ability to
engage in effective social interactions and thus have severe difficulty when interacting with others. Kuan-Hung (2018) conducted a study to better understand the level of social competence of individuals with ASD, which has resulted in a consensus that these individuals tend to have severe social deficits in all age brackets. Rajska (2009) states that the social competence deficits include lack of eye contact, lack of ability to initiate social interactions, and poor interpretation of social cues. The researcher also states that people with autism often have a particularly hard time understanding the emotions of others and being able to respond appropriately (Rajska, 2009). An inability to interact socially prevents individuals with autism from understanding those around them (Semrud-Clikeman, 2007). These deficits include lack of social-emotional reciprocity, inappropriate nonverbal communicative behaviours, and problems with developing, maintaining and understanding relationships. Other scholars have argued that children with ASD have deficits in attention, responsivity to social bids, social initiations, and the use of gestures for communication (Paymon, 2019). These social deficits could prevent individuals with ASD from enjoying positive relationships including dating relationships and friendships; therefore, these individuals could benefit from learning more about how to successfully and safely form relationships (Szidon & Hedges, 2015). Other scholars have conducted research to better understand the fixation patterns of autistic individuals within social situations. For example, Klin et al. (2002) found that typically adolescents and young adult males with ASD spent the most time fixating on the mouth area rather than making eye contact or body gestures. This generally relates to social competence because it is necessary for an individual to be able to read and display nonverbal communication to succeed in social situations. Scholars have also found that social competence and academic
