Autism Flashcards
All of the explanations of autism and exam question layouts/techniques
What is autism?
Autism is a lifelong disorder that begins in childhood and impairs everyday functioning. It is a spectrum disorder, which means that everyone shares the same core difficulties, but they are affected to different degrees.
What are the two main categories of symptoms of ASD?
Social triad and the 4Rs
What are the key concepts in the social triad? (ASD)
Social communication, social interaction and social imagination
What does it mean when a person with ASD is impaired in social communication? What are some examples of these impairments?
Individuals with ASD have varying impairments in social communication. This means they have difficulty understanding speech, gestures, eye contact, tone of voice and language. E.g. Speaking in a monotone voice, struggling to understand sarcasm, not being able to use gestures or understand other people’s gestures, interpreting language literally, etc.
What does it mean when a person with ASD is impaired in social interaction? What are some examples of these impairments?
Individuals with ASD have varying impairments in social interaction. This means that they struggle with building and sustaining relationships, sharing, giving and receiving compliments, enjoying conversation, showing concern for others and understanding. E.g. children finding it difficult to instigate or join in play with others, struggling to show empathy and appearing ‘cold’ or not understanding social rules, like being too honest.
What does it mean when a person with ASD is impaired in social imagination? What are some examples of these impairments?
Individuals with ASD varying have impairments in social imagination. This means that they struggle with predicting reactions and events, problem solving, creative activities, coping with changes, relating to others and planning. E.g. may have difficulties playing team games or imagining how others feel.
What are the key concepts in the 4Rs? (ASD)
Repetitive behaviours, routines/rituals, restricted interests and usual reactions to stimuli.
What are some examples of repetitive behaviours? (ASD)
Repetitive behaviours, routines/rituals, restricted interests and usual reactions to stimuli.
What are some examples of rituals/routines/resistance to change? (ASD)
-Inflexibility to routines
-Carrying out behaviour step-by-step
-Demanding people use words in a ‘set’ way
-Overreacting to changes in routine
-Rigid thinking patterns
What are some examples of restricted and fixated interests?
-Individuals with ASD are often preoccupied with a narrow interest or topic (colours, numbers, symbols) to the exclusion of all others
-Become obsessed with very specific things, such as mesmerising the London underground or bus timetables
-‘Little professor syndrome’
What are some examples of unusual reactions to stimuli? (ASD)
-Becoming distressed by loud sounds
-Do not like to be touched (e.g. hugging or having hair brushed)
-They may be obsessive about the movement of objects, like opening and closing or spinning.
-First response to an object may be licking or sniffing it.
-May look at objects for periods for long periods of time for no reason.
Why are boys more frequently diagnosed with autism than girls?
-Current diagnostic criteria overlooks how ASD presents in girls, as it was developed using boys.
-Girls with ASD resemble typically developing boys in terms of social development, but show different brain development to neurotypical girls.
-Girls often diagnosed with ADHD, OCD and anorexia instead of ASD.
-Girls tend to ‘mask’ characteristics of ASD better than boys - leading to lower diagnoses.
A typical exam question for the characteristics of autism is:
Q) Outline the characteristics of autistic spectrum behaviour. [10]
How would you answer this?
-Briefly outline what autism is - “a lifelong disorder that begins in childhood and impairs everyday functioning. It is a spectrum disorder, so everyone experiences the same core difficulties but at varying degrees.”
-Describe the two categories of symptoms (Triad of impairments and the 4Rs) and provide at least 5 examples, e.g. unusual reactions to stimuli, such as covering ears and flapping arms, restricted interests and little professor syndrome, non-verbal communication, struggling to maintain relationships, etc.
-Mention the prevalence in males and explain why girls with ASD often go undiagnosed.
Another typical exam question for the characteristics of autism is:
Q) ‘Deborah has recently been diagnosed with autism spectrum disorder. Deborah’s parents have noticed that her behaviour and linguistic patterns are different to other children of her age.’ Describe how the characteristics of Deborah’s behaviour would be different to other children. [15]
10 marks for AO1:
-Describe the two categories of symptoms (Triad of impairments and the 4Rs) and provide at least 5 examples, e.g. unusual reactions to stimuli, such as covering ears and flapping arms, restricted interests and little professor syndrome, non-verbal communication, struggling to maintain relationships, etc.
-Mention the prevalence in males and explain why girls with ASD often go undiagnosed.
5 marks for AO2:
ALWAYS link back to the statement. For example, say “Deborah’s parents might notice that Deborah has unusual reactions to certain stimuli, such as covering her ears and becoming incredibly distressed when she hears loud noises, while other children are only slightly startled by loud noises.”
What are the two biological explanations of ASD?
Amygdala dysfunction and genetics
Explain the main ideas behind the amygdala dysfunction explanation of ASD.
The amygdalas of people with ASD develop differently in childhood compared to neurotypical people, so this is what causes social difficulties in people with ASD.
What is an example of evidence that supports the fact that ASD brains develop differently to neurotypical brains?
Nordahl et al (2012) found that from 2 years of age, there is a larger growth in the amydala volume n children with ASD (6-9%). by late adolescence/early adulthood there is no difference in amygdala volume between those with ASD and those without. The growth in volume occurs earlier in children with ASD and this may result in abnormalities in the neutral organisation of the amygdala and damage its functioning.
What is an example of research that supports the idea that amygdala dysfunction impacts social behaviour in those with ASD?
Baron-Cohen (2000) As the amygdala has neural connections with the frontal cortex, abnormal development of the amygdala in childhood is a casual factor involved in social and behavioural deficits. Therefore, those with ASD have difficulties in understanding the expression of emotions in other people. He investigated this using the ‘eyes task’.
What is the ‘eyes task’? (ASD)
Adults with ASD were matched with a control group of adults without ASD.
Participants were presented with photographs that only showed the eye area of people making different facial expressions and asked to identify the expression shown.
The brain activity was measured in an MRI scanner during the task.
What were the findings and conclusions of the ‘eyes task’? (ASD)
ASD performed significantly worse on the eye task than controls.
MRI scans showed that the left amygdala was not activated in the ASD participants at all, but was strongly activated in the controls. The left amygdala is involved when we infer emotional state from facial expressions (especially eyes) and this function is impaired in people with ASD.
How can the amygdala dysfunction explanation be applied to methods of modifying ASD?
Oxytocin
If research suggests that the amygdala dysfunction is a cause of ASD behaviours related to social behaviours and emotional processing, then improving the amygdala may help to reduce these behaviours. Intranasal oxytocin has been found to enter the brain effectively and work to increase oxytocin levels in areas such as the limbic system, where the amygdala is located. Some studies have shown that when people with ASD take intranasal oxytocin, they show improved scores on tests of social behaviours.
A typical exam question for the amygdala dysfunction explanation of autism is:
Q) Describe one biological explanation for autism spectrum behaviours. [10]
How would you answer this?
-Brief intro: Explain what the amygdala is and that it is key in emotional and social processing.
-Explain how amygdala development is different in those with ASD, provide evidence, e.g. Nordahl et al (2012)
-How is it dysfunctional? Use the Baren-Cohen study
A typical exam question for the amygdala dysfunction explanation is:
Q) Evaluate one biological explanation of ASD. [10]
How would you answer this?
-ve Some of the research isn’t fuly valid
Baren Cohen’s ‘eyes task’ study. A problem with this is that interpreting emotions is incredibly subjective and therefore may not be entirely valid.
+ve Supporting evidence
Kennedy et al (2009) did a case study on a woman called SM who had damage to the amygdala. Did not have ASD, but displayed similar social difficulties, such as not understanding personal space and not feeling fear.
-ve Inconsistent findings
Howard et al (2000) an increased amygdala volume was found in adults with ASD.
Pierce et al (2001) a decreased amygdala volume was found in adults with ASD.
What are the main ideas of the genetics explanation of ASD?
This explanation believes that schizophrenia is inherited through genes passed down through families. This is investigated through twin, family and adoption studies.
What is the difference between simplex and multiplex families? (ASD)
Simplex - families with only one member with ASD (‘one-off’ case’)
Multiplex - more than one family member diagnosed with ASD, or multiple members with autistic traits but not yet diagnosed.
In multiplex families, ASD is likely to be caused by a genetic variation that is inherited. In simplex families, ASD is likely caused by a ‘de novo’ mutation.
What is a de novo mutation?
A genetic alteration that is present for the first time as a result of a variant (or mutation) in a germ cell (egg or sperm) of one of the parents, or a variant that arises in the fertilised egg itself during early embryogenesis.
What are some examples of supporting research of family studies of ASD?
Szatamari (1991) combined the data from several studies to calculate ‘overall sibling risk’. This showed the proportion of siblings of people diagnosed with ASD that also meet the criteria.
The rate was 2.2% for someone with siblings with ASD, and 0.11% for someone without siblings with ASD.
Therefore, there is a 20x greater risk of developing ASD if you have a sibling with it.
What are some examples of supporting research of twin studies of ASD?
Bailey et al (1995) analysed data from the British Twin Study. The concordance rate for MZ twins was 60% and for DZ twins it was 0%.
The researchers then widened the definition of autistic behaviours to include other characteristics as well as social impairment, and found a 92% concordance rate for MZ twins and 10% for DZ twins.
Ritvo et al (1985) found concordance rates of 96% for MZ twins and 23% for DZ twins.
What are some issues of twin studies with ASD?
-Studies were conducted before 2013, meaning that they are based on old criteria for ASD (this is also true for family studies)
-Lacks temporal validity - may not be correct based on current criteria.
-There is a disagreement in concordance across studies - lack of consistency
-Lacks external reliability.
A typical exam question for the genetic explanation of autism is:
Q) Describe one biological explanation of autism spectrum behaviours. [5]
How would you answer this?
-Brief intro: The genetic explanation of autism states that you are more likely to be diagnosed with ASD if an immediate family member is also diagnosed.
-Family research suggests there is a greater risk in siblings, e.g. Szatamari (1991)
-Twin research suggests there is a greater risk in MZ twins, e.g. Bailey (1995)
-Explain the difference between simplex and multiplex families - mention the de novo mutation.
Another typical exam question for the biological explanation of ASD is:
Q) Evaluate one biological explanation of ASD. [10]
How would you answer this?
+ve Reductionist
P: One strength of the genetic explanation of ASD is that it is reductionist. By taking a reductionist viewpoint, researchers are enabled to focus on one component of ASD and study it in detail.
E: For example, the identification of the de novo mutation that can explain the onset of ASD in ‘one-off’ cases.
C: However, reductionism can also be a weakness as it oversimplifies the explanation for the onset of ASD. By only studying the genetic influence, other potential influences of ASD are being ignored, like the theory of mind, for example.
L: Therefore, even though a reductionist viewpoint allows for a more in-depth understanding of the genetic contribution to the onset of ASD, this perspective alone does not give us a holistic understanding of the potential causes of ASD.
-ve Problems with twin studies
P: One issue with twin research is that there is disagreement in concordance rates across studies.
E: Bailey et al (1995) found a rate of 92% for MZ and 10% for DZ twins, while Ritvo et al (1985) found a rate of 96% for MZ and 23% for DZ twins - meaning that the explanation lacks external reliability.
E: Both of these studies were conducted before 2013, meaning that they are based on old criteria for ASD. Lacking in temporal validity, as they may not be correct based on current criteria.
L: Therefore, the genetic explanation of ASD lacks sufficient evidence to have a strong argument, and relying on this research alone leaves the relevance of this explanation up for debate.
-ve Nature vs Nurture
P: Heavily biased towards nature
E: The explanation goes into depth on many aspects of genetic influences on ASD, such as the different family types that have a genetic influence on ASD (simplex and multiplex).
-Can be viewed as a positive, because it allows for a much more detailed explanation of the biological elements of ASD, leading to a more clear explanation of the cause of ASD.
C: However, because this explanation focuses only on nature, other potential influences on the development of ASD are ignored, e.g. refrigerator mother.
L: Therefore, not completely accurate as it doesn’t provide a full explanation.
Conclusion: Useful? Why/why not?
What are the two individual differences explanations of autism?
Theory of mind (ToM) and Weak central coherence (WCC)
What are the main ideas behind the theory of mind?
The theory of mind is the understanding that people have thoughts, emotions, desires, beliefs, and intentions that may be different from our own. Baren-Cohen argued that people with autism don’t have a fully functioning theory of mind.
What evidence is there to support the dysfunction of the theory of mind in ASDs?
Baren-Cohen (2000) Eye task. Adults with ASD matched with adults without. Shown only the eye area of faces making different facial expressions. MRI scans used. ASDs performed significantly worse than controls and left amygdala was not activated. Left amygdala is where we infer emotion - impaired in ASDs.
Baren-Cohen’s Sally-Anne task. Tested three groups of children aged 4: ASDs, down syndrome and neurotypical with two dolls. Only 20% of ASDs got test right compared to 86% down syndromes and 85% neurotypicals.
What were the findings of Baren-Cohen’s Sally-Anne task?
“Where will Sally go looking for her doll?” Correctly answered:
ASDs - 20%
Down syndrome -86%
Neurotypical - 85%
What are some pre-cursors of ASD? (Signs that a child has autism)
-Not engaging in pretend play
-Struggling to imitate others
-Not following another person’s gaze
These are all signs of a deficit in the ToM
What evidence is there for pre-cursors of autism?
Scaife and Bruner (1975) - stated that typically developing children will show these skills (pretend play, imitating others and following another’s gaze) by 14 months - this is delayed with children who go on to be diagnosed with ASD.
A typical exam question for the ToM explanation of ASD is:
Q) Describe one individual differences explanation explanation of ASD? [10]
How would you answer this?
-Brief intro to the ToM: Definition, explain that this is impaired in ASDs
-Precursors of ToM, e.g. not engaging in pretend play. Mention Scaife and Bruner (1975)
-Explain how deficits of ToM can explain the characteristics of ASD
-Give at least one study example, e.g. Sally-Anne task and how it links to ToM in ASD.
Another ypical exam question for the ToM explanation of ASD is:
Q) Evaluate one individual differences explanation of ASD. [10]
How would you answer this?
+ve Supporting evidence
P: One strength of the ToM explanation is that there is evidence to support it.
E: Baren-Cohen’s Sally-Anne task. Only 20% of children with ASD answered correctly.
C: Issues with study - pps only 4 years old, arguably too young to grasp the scenario. 15% of neurotypicals answered incorrectly when theoretically 100% should have answered correctly, as they have no ToM deficit.
L: Therefore, although Sally-Anne provides sufficient evidence to support ToM, results may have been skewed as task too difficult for young children. Could be improved.
-ve Not all ASDs have a ToM deficit
P: One weakness of the ToM explanation is that some studies have found that not all ASDs have a ToM deficit
E: Prior (1990) found that children with ASD could complete false belief tasks successfully. And, Baren-Cohen found that 20% of ASDs completed Sally-Anne task successfully.
E: This is a weakness, because it shows that quite a lot of people with ASD don’t struggle with a theory of mind deficit, since some people with ASD can perform successfully in false belief tasks.
L: Therefore, the ToM explanation isn’t entirely useful as it cannot be applied to all ASDs.
-ve Doesn’t provide a whole explanation of ASD.
P: One weakness of the ToM explanation is that it doesn’t provide a whole explanation of the behaviours displayed by ASDs.
E: The theory of mind is the understanding of other people’s thoughts, emotions, beliefs and intentions. Supporting research has found that ASDs have a ToM deficit, meaning that they often struggle to understand the emotions and actions of others, and cannot predict them either.
E: This explains the impaired social triad in ASDs (social communication, social interaction and social imagination), but completely ignores routines/rituals, restricted interests, unusual reactions to stimuli and repetitive behaviours.
L: Therefore, although the ToM provides a thorough explanation of the social impairments in ASDs, it fails to provide an explanation for other behaviours, and is therefore not useful.
Conclusion: Useful? Why/why not? How could it be improved?
Why was the weak central coherence theory created?
The weak central coherence theory is based on cognitive principles, similar to ToM. The WCC theory was developed as the ToM was seen to be incomplete as it could not explain all aspects of ASD, such as repetitive behaviours. The ToM also cannot explain the advanced perceptual abilities that some people with ASD have, e.g. detecting small changes in their environment. This is where the WCC theory comes in.
What are the main ideas behind the weak central coherence (WCC) explanation of autism?
Frith (1989) states that central coherence refers to our ability to integrate fine details into an overall pattern, to understand how elements come together in a meaningful way.
-E.g. When recalling a conversation you had with someone a few days ago, you would remember the ‘gist’ of the conversation, but not the specific details.
-ASDs perceive the world differently
-They have a cognitive preference for local processing, meaning they focus on the details.
What is weak central coherence?
Impaired global processing, but enhanced local processing
What are the two types of processing in WCC?
Global processing and local processing
What is global processing?
The act of processing a visual stimulus holistically - looking at the larger, overall image.
What is an example of global processing?
When looking at a city map, you’d note the general places of some key areas (supermarket, cinema, high street, beach).
What is local processing?
Looking at the individual features that make up the larger whole.
What is an example of local processing?
Looking at a city map and taking note of the location of every supermarket in the area.
What evidence is there to support the WCC theory?
Shah and Frith (1993) tested WCC with 20 ASDs, 13 young pps with learning difficulties, 17 young neurotypicals and 16 other neurotypicals. Pps were shown a 2D pattern on a card and had to recreate it using smaller individual blocks. ASDs performed better than other pps.
What were the conclusions of Shah and Frith’s block task?
Local processing is advantageous in tasks like this, as it allows you to focus on smaller details. It shows that people with ASD have weak central coherence, stronger local processing - they would have problems with tasks that requires a grasp of the ‘gist’.
A typical exam question for the WCC explanation is:
Q) Briefly describe one individual differences explanation of ASD [5].
How would you answer this?
-Brief intro: One individual differences explanation of ASD is the weak central coherence theory. Central coherence is a person’s ability to derive overall meaning from a mass of details.
-Explain the difference between local and global processing, giving examples.
-Use supporting evidence, e.g. Shah and Frith
Another typical exam question for the WCC explanation is:
Q) Evaluate one individual differences explanation of ASD. [10]
How would you answer this?
+ve Supporting evidence
P: One strength of the WCC explanation is that there is evidence to support it.
E: Shah and Frith (1993)
E: This shows that people with ASD have impaired global processing and enhanced local processing…
L: This is a strength because it can explain certain behaviours of ASDs, such as Little Professor Syndrome…
+ve Positive explanation of ASD
P: One strength of the WCC explanation is that it removes the negative stigma surrounding autism.
E: Other explanations of autism, such as ToM, heavily criticise ASDs and highlight the things they struggle with, such as understanding and empathising with the emotions of others.
E: The WCC explanation highlights the good aspects of autism, such as enhanced local processing, which allows them to focus on details that neurotypical people would often miss.
L: Therefore, the WCC explanation is helpful, because…
-ve Can’t explain more characteristics than other theories
P: One weakness of the WCC explanation is that it can’t explain many characteristics of autism.
E: The whole point of the WCC theory was to build upon the ToM to explain more behaviours of ASD, however the WCC theory can only explain restricted interests and little Professor syndrome, whereas ToM can explain the whole social triad of impairments.
C: However, it could be argued that the WCC explanation wasn’t developed as a stand-alone theory, and that it should be paired up with other explanations, such as the empathising-systemising theory.
L: Therefore…
Conclusion: Useful? Why/why not?
What are the two social psychological explanations of ASD?
Empathising-systemising (E-S) theory and the refrigerator mother explanation.
What are the aims of the empathising-systemising (E-S) theory?
This theory aims to explain the behaviours that the ToM couldn’t, i.e. repetitive behaviours, routines and rituals and the gender distinction in diagnosis (males more likely to be diagnosed with ASD than females).
What are the main ideas behind the empathising-systemising (E-S) theory?
There are two key concepts:
Empathising and systemising.
What is empathising?
Empathising: the ability to understand and share the feelings of another, e.g. lack of understanding of other’s emotional states and being unable to put oneself in another’s shoes.
What are the two components of empathy?
Cognitive element - recognising and understanding the mental state of others (explained in ToM as a deficit people with ASD have).
Affective empathy - ability to respond appropriately to people’s emotional state.
How do people with ASD empathise?
People with ASD respond to a person’s emotional distress with similar feelings of anxiety/upset (personal distress) - this is similar to neurotypical people, but ASDs have heightened personal distress.
Empathetic concern (feeling of sympathy and consideration for the other person) is impaired in those with ASD.
What is systemising?
Systemising: the drive to analyse or construct a system. A system is anything that follows rules and is thus lawful, e.g. little professor syndrome (extreme interests).
Some examples of this are memorising train/bus timetables.
Why is systemising important?
This ability is important in non-social contexts as it allows us to predict how systems will behave. We analyse systems to understand how they are structured and the rules underlying them to make sense of our world.
What does the E-S theory suggest?
This theory suggests that people with ASD had impaired empathising, but hyper-developed systemising ability.
What behaviours does impaired empathising and hyper-developed systemising explain?
Impaired empathising: difficulties in social interaction, difficulty maintaining relationships, inappropriate responses in conversation.
Hyper-developed systemising: ability to recall specific details accurately, narrow interests, repetitive behaviours.
What is the different between males and females with ASD?
Females are considered better empathisers than males - they are more sensitive to facial expressions of emotion, are more person-focused with a keener instinct about how other people feel.
Males are considered better systematisers than females. They have a greater ability to analyse systems and work out rules by which they operate (may be why we have more male engineers?).
What research is there to support the E-S theory?
Lawson et al (2004) - An experiment was devised to test the empathising-systemising (E-S) theory of autism. Three groups of participants took part in the study: males with Asperger Syndrome (AS) (n=18), males without AS (n=44) and females from the general population (n=45). Each participant completed two tasks: one that involved empathising and another that involved systemising. On the empathising task, females scored significantly higher than control males, who in turn scored higher than males with AS. Conversely, females scored significantly lower than both male groups on the systemising task, who did not differ significantly from each other.
A typical exam question for the E-S theory is:
Q) Describe one social psychological explanation of ASD. [10]
How would you answer this?
-Empathising-systemising theory developed to address the pitfalls of ToM…
-Explain empathising - define and describe the different components of empathy and what is underdeveloped in people with ASD.
-Explain systemising - define and explain diff types of systemising.
-Summarise how empathising is impaired in people with ASD and systemising is hyper developed and link clearly to the characteristics of ASD.
-Can add in Lawson study if you haven’t got enough.
Another typical exam question for the E-S theory of autism is:
Q) Evaluate one social psychological explanation of ASD. [10]
How would you answer this?
+ve Supporting evidence
P: One strength of the empathising-systemising theory is that there is supporting evidence.
E: Lawson et al (2004) study. Explain the study and the findings.
E: This supports the E-S theory, because it supports the gender differentiations in ASD, which usually consists of the females being better empathisers and worse at systemising and the males being better systematisers and poor empathisers.
L: Therefore…
-ve Reductionist
P: One weakness of the empathising-systemising theory is that it oversimplifies the complexity of the gender differentiation in ASD.
E: Valla et al (2010) studied 144 neurotypical male and female students, giving them a range of tasks to measure empathising-systemising abilities. It was found that neurotypical men scored highly for systemising and low on empathising, but women scored well on both empathising and systemising.
E: This study does support the greater prevalence of ASD in males, but it struggles to explain the onset of ASD in women, because it was found that women are good at both systemising and empathising.
L: Therefore…
+ve Practical applications
P: One strength of the E-S theory is that it has practical applications.
E: As it was found that people with ASD have high systematising abilities, especially the men, it has resulted in employers actively seeking those with ASD for jobs that specialise in systemising, such as transporters or bus drivers.
E: This has led to a surge in successful applications for those with ASD, suggesting that the E-S theory has potential removed some of the negative stigma around ASD and highlighted their special abilities rather than their deficits.
L: Therefore…
Conclusion: Useful? Why/why not?
How can empathising-systemising be applied to methods of modifying?
Empathising-systemising = Lego therapy
Research suggests that ASDs have hyper-developed systemising, we can use this to help children develop social skills.
Lego therapy is a child-led therapy that aims to improve social interactions of children with ASD by appealing to their ‘systemising’ brain. Children are given roles and asked to construct a model from Lego. To be successful, they must work together. The process of building Lego models appeals to children with ASD as the toy itself is suited to being systemised due to its predictable and systematic nature.
What are the main ideas behind the refrigerator mother explanation of ASD?
It was the idea that ASD is caused by cold-hearted mothers (experiences in childhood).
Where did the idea of the refrigerator mother originate?
Leo Kanner (1943) studied 11 children, who presented classical symptoms of ASD, and took notes on their behaviour. Kanner also observed the children’s parents, and found that the group sorely lacked in warm-hearted parents.
Kanner (1949) later described children with ASD as having been brought up in ‘emotional refrigerators’ - referring to what he considered to be the cold, distant and overly intellectual parents of these children (especially the mothers). He famously described these mothers as just happening to defrost long enough to produce a child.
How did the theory of the refrigerator mother become public?
Bruno Bettelheim (1967) brought attention to the refrigerator mother theory in his book: “Throughout this book I state my belief that the precipitating factor in infantile autism is the parents wish that the child should not exist”.
Bettelheim appeared on television shows and in magazines to explain his view that ASD is an emotional disorder caused by psychological damage inflicted on young children by their cold detached mothers.
He also famously compared children with ASD to prisoners of Nazi concentration camps (he had been in one himself).
A typical exam question of the refrigerator mother explanation is:
Q) Briefly describe one social psychological explanation of ASD. [5]
How would you answer this?
-Brief intro: One social psychological explanation of autism is the refrigerator mother. This theory suggests that…
-Briefly explain Kanner’s influence on the development of the theory - created first diagnostic criteria for ASD. Noticed behaviour of mothers ‘defrosted just long enough to have a child.’
-Briefly explain Bettelheim’s role in making theory public. Emotionless mothers = primary cause of ASD.
Another typical question for the refrigerator mother is:
Q) Evaluate one social psychological explanation of ASD. [10]
How would you answer this?
+ve Supporting evidence
P:One strength of the refrigerator mother explanation is that there is evidence to support it.
E: Kanner’s observation of 11 children with ASD. Found that they had cold parents. What does this suggest?
C: However, Kanner’s study has methodological issues. It was an observation with an incredibly small sample size, meaning that his findings are subjective and difficult to generalise to a broader population of ASDs.
L: Therefore…
-ve Socially sensitive
P: One weakness of the refrigerator mother explanation is that it is socially sensitive.
E: Bettelheim, a survivor of WW2, compared the experience of those with ASD to children in Nazi concentration camps.
E: Not only is this an incredibly problematic statement in itself, but it is also incredibly damaging to the parents of ASD. The parents are already referred to as cold-hearted and distant, but to compare them to Nazis is extreme. This is incredibly impactful on the parents of those with ASD, as it cause them to blame themselves for their children’s disorder.
L: Therefore…
-ve Cause and effect
P: Another weakness of the refrigerator mother explanation is that cause and effect cannot be established.
E: Kanner’s research found that children with ASD have cold and distant parents, which is the cause of the development of ASD.
C: However, it could be argued that the child having ASD is what makes the parents cold and distant, as it is difficult to take care of a child who has ASD.
L: Therefore…
Conclusion: Useful? Why/why not?
What are the two methods of modifying behaviour for autism?
PECs and RDI
What is RDI?
Relationship Development Intervention (RDI) is a form of CBT used for ASD.
-Developed by Gutstein and Shelly (2002) to address social and communication difficulties. It does this by modifying their perception of others’ thoughts and feelings (address the lack of ToM).
What are the main ideas behind RDI?
RDI is based on the view that children with ASD have missed important developmental skills that children would usually reach without special intervention (e.g. initiate conversation, share jokes, etc.).
Dynamic intelligence - ability to think flexibly and consider events from different points of view.
What are the objectives of RDI (six key areas of dynamic intelligence)?
-Emotional referencing
-Social coordination
-Declarative language
-Relational information processing
-Foresight and hindsight
What is emotional referencing?
Improving the child’s verbal and nonverbal communication skills to help them understand how other people feel, allowing them to share emotional experiences.
What is social coordination?
Controlling one’s own behaviour to fit other people’s emotions. For example, developing the ability to deliberately ‘put on a happy face’ to help someone else for the better.
what is declarative language?
Developing the type of verbal and nonverbal communication that allows the child to express interest in something, invite social interaction, share emotions and coordinate their behaviour with others. This is different from imperative language, which is most common in ASD, which the child uses to fulfil their own needs (e.g. make requests).
What is flexible thinking?
Also called set shifting, this is the ability to adapt quickly, smoothly and calmly to changing situations, even
What is relational information processing?
Putting ‘problems’ into a wider context and solving them even when they do not have an obvious right-or-wrong answer. The definition of ‘problem’ is very broad and includes many social behaviours that typically developing individuals take for granted (e.g. working out how loudly you should talk indoors or outdoors).
What is foresight and hindsight?
Foresight is anticipating what might happen as a result of your behaviour (e.g. being friendly). Hindsight allows you to recall an example of what actually happened once when you were or were not friendly. Putting the two together allows the child with ASD to predict future outcomes based on past experience.
What is the RDI process?
The process of RDI involves a trained, qualified and approved RDI consultant works closely with the family.
-The consultant and the family meet once or twice a week to establish aims, plan activities and evaluate progress in terms of the 6 objectives of RDI. Parents may video some of the everyday interactions with their child for the consultant to assess.
-Parents also attend workshops to develop their skills and meet with others using the treatment.
-Later in the process, the child is paired with another child undergoing RDI locally so that they can both apply their skills. More children are then placed together to form a small group.
-The child’s progress is monitored, and the family’s interactions are reassessed every 6 -12 months. Parents, teachers and other caretakers continue to apply the principles of RDI in the child’s daily life.
-Positive reinforcement is used to help the child improve social skills, adaptability and self-awareness.
How often do the consultant and the family meet when planning the aims and activities of RDI?
Once or twice a week
What do parents do during RDI?
-Video some of their child’s everyday interactions with their child for the consultant to assess.
-Attend workshops to develop their skills and meet with others using the treatment.
What happens later in the process of RDI?
-Child is paired with another child undergoing RDI locally, so that both children can apply their new learned skills.
-More children are then placed together to form a small group.
-Child’s progress is monitored. Family interactions are reassessed every 6-12 months.
What type of conditioning is used on children undergoing RDI?
Positive reinforcement
What evidence is there to support RDI?
Gutsein et al (2007) assessed the effects on children following RDI for 2 years.
-15 children were taught in special education classrooms, only 3 of them continued to be taught like this afterwards
-14 of the children were assessed as being in the ‘autism range’ before the programme, but only 2 afterwards
-Children became significantly more socially related, engaged in more reciprocal communication, functioned in school settings with less adult participation, and were perceived by parents as behaving in a dramatically more flexable and adaptive manner
-These gains in functioning remained stable, with children retaining their improvement for an average of over 3 years
A typical exam question for RDI is:
Q) Describe one method of modifying behaviour in ASD. [10]
How would you answer this?
-Brief intro: RDI as a type of CBT
-What does RDI aim to help with?
-Explain dynamic intelligence
-Explain the objectives of RDI (only have to name a few, not all)
-Explain the details of the process of RDI
Another typical exam question is:
Q) Evaluate one method of modifying behaviour for ASD. [10]
How would you answer this?
+ve Limited supporting evidence
P: One strength of RDI as a method of modifying autism is that there is limited evidence to support it.
E: Gutsein et al (2007) conducted research in which he assessed the effects on children that had RDI for 2 years.
E: The findings showed that children became significantly more socially related and engaged in more reciprocal communication.
L: This is a strength because it helps improve social communication difficulties in children with ASD.
-ve Unethical
P: One weakness of RDI as a method of modifying is that it has ethical issues.
E: There is very little evidence to support the effectiveness of RDI as a therapy, and the sole support for the use of RDI comes from Gustein himself.
E: This is unethical, as it is obvious that the person who developed it would support their own programme. It would be more appropriate to promote RDI if there was additional research from other psychologists, however, there is none.
L: Therefore, it is not ethical to promote RDI, as families will be spending large amounts of money on RDI when there is insignificant evidence to support its evidence.
-ve Social implications
P: Another weakness of RDI is that it has negative social implications.
E: The costs of RDI are up to £3520 annually. The treatment generally lasts up to 3 years 2
What is PECs?
Picture Exchange Communication System (PECs)
What is the aims of PECs?
The aim of PECS is to teach the child to initiate interaction with another person, it is designed to help them communicate spontaneously instead of in response to others.
What must be carried out before teaching PECs?
Pre-assessment
What is the pre-assessment?
Before teaching PECS, it is important to determine what the child likes and what is rewarding to the child. A reinforcer assessment is carried out, where the child is observed. Once the items a child likes are determined, it is helpful to prioritise them in a hierarchy. The child is presented with a choice between a pair of items. It is observed which one a child takes over a series of presentations. How much effort the child puts into obtaining what the trainer is offering is assessed.
What are the phases of learning PECs?
- Child is taught to initiate communication (2 people are involved at this state).
-Students learn to exchange cards for desired items or activities. - Distance and effort.
-Expands the use or pictures to other people, places and rewards.
-Students are taught to communicate with different people, places and to learn persistence. - Child makes specific choices between pictures (choosing the message) Just one other person involved now.
-Multiple pictures are introduced in a notebook for student to use. Not every item is available on request. - Teaches the child to construct simple sentences.
- Assures the child can respond to direct/ simple questions.
-Students learn to respond to “What do you want?”. - Teaches child to comment about various items and activities.
-Students express ideas such as “I see”, “I hear”, “I feel”.
What is the first phase of PECs?
- Child is taught to initiate communication (2 people are involved at this state).
-Students learn to exchange cards for desired items or activities.
What is the second phase of PECs?
- Distance and effort.
-Expands the use or pictures to other people, places and rewards.
-Students are taught to communicate with different people, places and to learn persistence.
What is the third phase of PECs?
- Child makes specific choices between pictures (choosing the message) Just one other person involved now.
-Multiple pictures are introduced in a notebook for student to use. Not every item is available on request.
What is the fourth phase of PECs?
- Teaches the child to construct simple sentences.
What is the fifth phase of PECs?
- Assures the child can respond to direct/ simple questions.
-Students learn to respond to “What do you want?”
What is the sixth phase of PECs?
- Teaches child to comment about various items and activities.
-Students express ideas such as “I see”, “I hear”, “I feel”
A typical exam question for PECs is:
Q) Describe one method of modifying behaviour in ASD. [10]
How would you answer this?
-What is it? (alternative communication system).
-Main aims of PECs (what part of ASD is being addressed).
-Pre-assessment.
-Summary of what happens across the stages.
-What the child should be capable of at the end.
Another typical exam question is:
Q) Evaluate one method of modifying behaviour for ASD. [10]
How would you answer this?
+ve Supporting evidence
P: One strength of PECs is its effectiveness.
E: A study conducted by Charlop-Christy et al (2002) found that boys who received 15-minute PECs sessions every week made significantly more spontaneous speech utterances compared to when they were undergoing speech training. One boy in particular improved from 28% spontaneous utterances to 100% spontaneous utterances, and this was maintained 12 months later. This suggests that PECs is incredibly effective for improving spontaneous communication compared to other treatments.
C: However, Flippin et al (2010) reviewed research published between 1994 and 2009. It was found that PECs was ‘fairly effective’, but there was no reliable evidence to suggest that improvements were maintained over time.
L: This suggests that although PECs is effective for improving spontaneous initiation, it is only effective when undergoing active treatment.
-ve Not accessible
P: The programme may not be accessible to all if families are not financially able to invest in the programme.
E: PECS is a trademarked training programme, they have commercially produced resources which are expensive to get.
C: However, the children that PECS is successful for, may be more independent in the future leading to reduced costs in wider society as social care may be required for those on the spectrum when they’re older for assistance.
L: Therefore, even though it is expensive to start the PECS programme it will help the children in the long run as the cost will be reduced when they grow up.
-ve Ethical implications
P: PECs is considered to be controversial by some, as much of the training is focussed on making requests.
E: Baren-Cohen (2000) is critical of a programme that relies on the use of external rewards, for example, ethical questions are raised over the withholding of the desired item until the child has exchanged pictures in step 1.
E: The concern here is that the range of communication is limited. There are those who argue that using behaviourist principles to shape and condition responses may actually delay speech. It is argued that using behaviourist principles to shape and condition responses may actually delay speech , which means that it is important to consider the appropriateness of the use of the programme for some of those on the spectrum. It should not be used to replace speech, but to complement it.
L: Therefore…
Conclusion: Useful? Why/why not?
