Our natural drive to conform is powerful. It makes professionals do all kinds of unsettling things from repeating incorrect vital signs (T. Beran 2015), to being silent about dangerous conditions, resulting in tragedies like the Challenger disaster (Moorhead, Ference, and Neck 1991), to changing an entire discipline’s ethics to code to allow healthcare professionals to support torture (Pope 2018). Failing to conform to group expectations makes us so uncomfortable that we will often go against our better judgement to fit in. Specific brain regions have been identified as responsible because of chemical responses that leave us feeling so uncomfortable when we do not follow a group, that we feel compelled to fix it to feel better.
In fact, if you suppress certain brain regions (e.g., the posterior medial frontal cortex), people are more likely to go against the crowd (e.g., Stallen and Sanfey 2015; Klucharev et al. 2011). Our brains are literally wired to conform. Occasionally, however, there are people who are willing to speak out, to go out against the crowd, to do something different because of something they believe in because they possess an important trait: positive nonconformity.
Positive nonconformity or positive deviance involves going against group norms in a way that helps solve problems or benefits communities. Positive deviance has sometimes been defined as “effectively taking action to prevent harm and negative consequences […] and counter behavior that erodes professional values or creates negative outcomes (Violato et al. 2022).” Thankfully, research suggests that when we see just one person refusing to conform to a group, we are more likely to follow suit and rebel as well (Morris and Miller 1975; Sloan et al. 2009).
The world needs people high in positive nonconformity. We know autistic people are sometimes motivated to mask and compensate for differences by copying people around them because of the stigma associated with being different (Miller, Rees, and Pearson 2021; Pearson and Rose 2021; Hull et al. 2019), but research also suggests that autistic people are less affected by social influence (Izuma et al. 2011; Chevallier et al. 2012; Chevallier, Molesworth, and Happé 2012) and are more likely to go against the group (Bowler and Worley 1994; Mailoo 2018; Yafai et al., 2014) and many of our autistic role models show positive nonconformity (Dupere, 2017). While autistic people’s nonconforming behavior is often devalued (Sasson et al. 2017; Bolton, Ault, and Meigs 2020), positive nonconformity can effectively transform groups and organizations (Jordan, Fitzsimmons, and Callan 2021), and can be quite literally life-saving (T. Beran 2015).
Medicine is a field dominated by conformity, obedience to authority, and respecting hierarchy (Moore, Kinnear, and Freeman 2020; T. Beran 2015; T. N. Beran et al. 2014; Peadon, Hurley, and Hutchinson 2020; Landgren et al. 2016). Reviews of the experiences of medical professionals have generally suggested that clinicians at multiple levels experience pressure to conform to those around them and obey those above them even when it is not in the best interest of patients (Pattni et al. 2019; T. N. Beran et al. 2014; Landgren et al. 2016).
For example, research shows that medical and nursing students will often repeat an incorrect vital sign given to them by someone else rather than speak up and say something different (based on simulations). Nursing students are especially likely to conform to medical students who state the wrong vital signs because of the role of hierarchy (T. N. Beran et al. 2014). Similar research has shown that nursing and medical students will then make an incorrect diagnosis based on conforming to incorrect vital signs given to them by people who were being purposely deceitful (e.g., Kaba, Beran, and White 2016).
One of the simplest and easiest ways for doctors to save lives is to wash their hands, but it is difficult for health professionals to speak up to even ask each other to do this basic task. One study showed that as a health care professionals authority increased, the willingness of other people to ask them to wash their hands decreased, with about 88% of people willing to ask an intern to do so, but only about 40% being willing to ask a consultant (Dendle et al. 2013). The most common reason given for not saying anything was that it is “not their place,” but handwashing literally saves lives (Hadaway 2020).
Researchers have argued that medical staff should be trained directly in how to go against the crowd and how to challenge authority because it is so important for patient safety (T. N. Beran et al. 2014; Pattni et al. 2019; Green et al. 2017). Our understanding of what it’s like to be an autistic healthcare professional is still evolving, but autistic healthcare professionals tend describe their autism as something that helps them avoid conforming in spite of the pressure (Blair 2023; Moore, Kinnear, and Freeman 2020; McCowan et al. 2022; Sun 2023).
Schools are among the most powerful socializing agents. The actual purpose of education has been described as “the transmission of culture,” the process by which the culture of a society is passed down to its children (Saldana 2013). This happens most obviously through the formal curriculum, but it also occurs through the “hidden curriculum”—the unwritten rules and unspoken values transmitted to children by their schools, sometimes unintentionally (Giroux and Penna 1979; Jackson 1968).
Teachers have the power through direct modeling and through explicit instruction to shape the future. Teachers are socialized from the beginning to conform to the culture and expectations of other school staff and especially to avoid going against anything that their supervisors suggest, given that they are dependent on them to maintain their careers (Roberts and Graham 2008).
Although the research on autistic teachers is limited, what is available, not surprisingly, shows that autistic teachers feel pressure to conform, but also tend to bring a unique perspective and ability to create change (StEvens 2022; O’Neill and Kenny 2023). With school avoidance (or school-induced anxiety (Boren 2022)) becoming a crisis both in the U.S. (Rodriguez 2023) and in the U.K. (Hinsliff 2023), there is no question that we need change in schools. It will be people who are willing to be different who will make that change.
Dr. Robert Chapman, autistic philosopher, says “Mass school refusal among neurodivergent children is an early form of resistance to neuronormativity.” (Chapman, 2023). Firsthand accounts from autistic teachers have suggested that the strong sense of justice that autistic people often experience, combined with being motivated by their own difficult experiences in school might set them apart as being particularly good changemakers (Coward, 2022). Furthermore, with large numbers of students, especially disabled and Black students, being affected by the school to prison pipeline (Skiba, Arredondo, and Williams 2014; Welch, Lehmann, Chouhy, and Chiricos, 2022), the time for change in schools is now.
Much of the experimental literature on autism has focused on autistic deficits because autism has been seen through a pathological lens for so long, but even within that literature, autistic people’s reduced susceptibility to other people’s expectations and willingness to stick to their own convictions is evident. For example, a researcher presented a series of drawings to autistic and nonautistic adolescents and had them rate them. Then, in the presence of the artist, the adolescents were given a chance to change their ratings. While nonautistic adolescents tended to change their answers and rate the drawings more positively in front of the artist, autistic adolescents tended to stick with their original ratings (Chevallier et al. 2012).
Similar studies have found that autistic people are less likely to change their prosocial behavior (e.g., donating to charity) depending on whether someone is watching, whereas nonautistic people tend to be less prosocial when no one is watching and more generous when someone is watching (Izuma et al. 2011; Hu et al. 2021). Researchers have concluded that autistic people are not as motivated by what other people think and autistic people have said that they are more motivated by doing the right thing than pleasing people (e.g., Cope and Remington, 2022).
Peer influence cannot only affect how we behave, but even affect how people perceive the world (e.g., spinning objects specifically), but autistic adolescents are less influenced by what peers tell them (Large et al. 2019). In an ingenious study that I like to call the “bad advice study,” researchers showed people objects spinning in space and asked them to indicate which direction the objects were spinning. They had a peer give bad advice, telling them the objects were spinning in a different direction than they really were. Whereas getting bad advice seemed to actually change how nonautistic people perceived the objects, this effect did not seem to be as strong in autistic people. At adolescence, they were more likely to go against the bad advice and give the correct answer.
In the 1950s and 1960s, social psychologists showed that about a third of people will disregard what they see right in front of them in order to conform to others. For example, in a line judgment task, Asch (1951) asked participants to choose a line that was the same length as another line. He had a group of actors give the wrong answer so that each participant would have to go against the crowd to give the correct answer. Over a third of the people in the study chose the wrong answer to go along with the rest of the crowd (Asch, 1951). Researchers have repeated these tasks across cultures and have found that, in general, about a third of people tend go along with a wrong answer if the rest of the group gives that answer (Bond and Smith 1996). Spins on Asch’s classic experiments have shown that autistic children and adults are significantly more likely to give a correct answer even if the answer is not popular, compared to their nonautistic peers (e.g., (Bowler and Worley 1994; Yafai et al., 2014). What does this mean in the real world?
Many autistic people describe examples of how they show positive nonconformity in the workplace (Cope and Remington 2022). For example, when being interviewed about autistic strengths in the workplace, autistic participants shared that they were often the ones to speak out about something not being right because they are more motivated by their own internal ethical compass than what other people think:
In situations where something seriously wrong was happening, I was the one to speak up about it (former prison officer).
And
I have a strong sense of right and wrong, and if I am asked to cover up something untoward, I refuse (police officer).
We also have numerous real-world examples of outspoken autistic role models who exemplify positive nonconformity. Dr. Michelle Dawson is an excellent example. Diagnosed with autism in adulthood, she has been prolific in advocating for autistic rights through research, writing, and community action. Dawson’s co-researchers have commented that some of the huge change she has made (e.g., in how people see autistic intelligence) is due to not caring about what is popular and instead centering what is true. For example, it was not popular to research intelligence because it was considered too controversial, but Dawson helped create an entire field of literature on autistic intelligence, completely reframing how we see autism (Woodford, 2006). She continues to share direct, honest thoughts about autism research on social media, and she is not afraid to speak out about problems both inside and outside of the autism research community.
Dr. Lamar Hardwick is an inspirational role model that has advocated not only for autistic people, but people with physical disabilities. He has brought understanding about autism to the church community because of not being afraid to stand out and share his own experiences as an autistic pastor. Also, many people are silent or withdrawn when they develop cancer, not wanting to talk about it openly. But Dr. Hardwick has been open about his journey, inspiring others with his honesty and describing details about his treatment such as adjusting to using a colostomy bag—something that has often been considered a taboo topic. His activism includes writing several books on valuing disability and he has a fourth one coming out that discusses both ableism and racism: bakerpublishinggroup.com/books/how-ableism-fuels-racism/415830.
Finn Gratton, LMFT, is another example of someone who exemplifies and celebrates nonconformity and mentors and supports those who do the same. They specialize in working with “out-of-the-box” people, including autistic people and gender nonconforming people. They are one of the few openly autistic nonbinary therapists. An influential thought leader, they have have published a book and numerous articles on supporting transgender autistic youth and provide consultation and training to people around the world on how to do the same: www.grattonpsychotherapy.com.
The draw of social conformity is extremely powerful. Resisting it even in simple situations is difficult. When there is a lot at stake, it is especially hard. People with positive nonconformity have the power to overcome obstacles and change the fields of medicine, education, and other major spheres.
To autistic people reading this, I encourage you to continue to stand up for what you believe in, and do not conform for conformity’s sake when you can. Sometimes masking is needed for survival and it’s not possible to speak out, but know that there are other people who value your willingness to be different when you can.
Sometimes finding community with other autistic people can be a huge source of inspiration in being able to continue to stand up for what you believe in. Continuing to read resources like Thinking Person’s Guide to Autism can help inspire you. I also highly recommend meeting other autistic people online, such as through a large free group run by autistic social worker, activist, and community organizer, Zack Siddeek, MSW. You can join here: www.meetup.com/Squarepegs. Autistic people in helping professions in Washington State can also join the Autistic Social Caring Network run by Zack Siddeek and team (join here: www.meetup.com/autscn).
For people who care about autistic people, next time you are annoyed by an autistic person’s failure to comply or their different way of doing something or seeing the world, stop and consider the power of positive nonconformity and be grateful for those who dare to be different.
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