Beyond action control: a systematic review unravelling the sense of agency in Autism Spectrum Disorder

Introduction: In recent years, the sense of agency (SoA) – the feeling of control over one's actions – has gained attention due to its clinical, cognitive, and forensic implications. The relevance of SoA is highlighted by its inclusion in two domains of the RDoC framework – social processes and sensorimotor systems – supporting a dimensional approach to mental disorders. Although several studies have investigated SoA in Autism Spectrum Disorder (ASD), a comprehensive systematic account of action control and sensorimotor perception in ASD is lacking. This systematic review aims to address this gap by examining how both explicit and implicit SoA are expressed in this clinical population. Methods: We systematically searched the literature using PubMed, PsycINFO, Web of Science, and Scopus, following PRISMA guidelines. Results: Twelve studies were included. Despite substantial heterogeneity in sample characteristics and methodologies, the findings indicate that explicit SoA tasks in ASD generally show no differences compared to control groups, whereas results from implicit tasks are more inconsistent. Discussion: In line with the Agency in Brain Disorders framework, our findings support the hypothesis that top-down cognitive processes underlying explicit judgments of agency are relatively preserved in ASD, except for metacognitive aspects of SoA. Combined impairments in motor control, atypical sensory experiences, and deficits in multisensory integration commonly observed in ASD may contribute to the heterogeneous manifestations of SoA. Finally, we highlight the need for future studies to focus on developmental stages and to incorporate neuroimaging techniques to better clarify the variability of findings reported to date.