Autism Spectrum Conditions Flashcards
What is Autism?
A life-long neurodevelopmental condition - means brain develops and functions differently to other people.
two core characteristics for diagnosing autism:
- difficulties in social communication and interaction (initiating and responding, understanding body language)
- repetitive behaviours and focused interests (means doing the same thing repetitively such as finger twisting and insist on things being the same way all the time as they struggle when things change or ar unpredictable, are fascinated about a particular topic)
- Sensory sensitivities - over or under sensitive to different aspects of the environment, for example, finding fluorescent lighting uncomfortable, certain sounds/textures or enjoying watching spinning things.
- Differences in verbal ability & support needs - some people might use few words whereas others might be highly articulate, some require life long support while others can be independent.
- Strengths and abilities too - great eye for detail, less influenced by people, honest.
quick note for the word ‘spectrum’:
refers to the spectrum of strengths and difficulties within the individual person concerning their language, motor skills, perception, executive function, and sensory.
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A note on language
•I will be using ‘identity-first’ language such as saying autistic person rather than ‘person-first’ and saying person with autism, to reflect the preferences of the autistic community (Bury et al., 2020; Botha et al., 2021; Kenny et al., 2016)
•Autism is not a separable part of a person
•We should not need reminders that autistic people are people too
•‘On the autism spectrum’ is considered a more neutral term
Some statistics and facts:
•Autistic males are more likely to receive a diagnosis than females –the current ratio of males to females is 3 to 1
•In the UK, 1 in 100 people are autistic
•Up to 30% of autistic people also have a co-occurring intellectual disability
•Autistic people are much more likely to have co-occurring mental health conditions, with some estimates as high as 80%
•Autism is thought to be caused by both genetic and environmental factors –with no one specific gene
•Research into the causes and cures of autism is nota research priority for the autism community
•Autistic people experience barriers to inclusion in many different areas e.g. education, employment –change is needed throughout society
Cognitive Theories of Autism
EXECUTIVE FUNCTION
What are EF’s?
•Executive functions (EFs) = include a wide range of cognitive abilities such as shifting focus, self-regulation, self-control, inhibitory-control, forward planning, remembering and following instructions
•EFs are important for acquiring knowledge, thus crucial within development
•EF also links to lots of other aspects of cognition (like theory of mind and language ability) and behaviour
How might EFs link with the core characteristics of autism?
some theorists have argued that autistic individuals have difficulties with executive function. this might help to explain some of the core characteristics of autism. looking back to those core characteristics, firstly social communication and interaction, you might argue that many of these executive functions are needed or helpful for communicating.
for example, we need to shift focus during a conversation. we also need to use inhibitory control to monitor the things we say. researchers have found that executive functions are correlated with aspects of social cognition.
in terms of the second core characteristics, for example, an insistence of sameness could be explained by difficulties in shifting focus. also, a difficulty in self-regulation might link to the repetition of a certain behaviour. hence the difficulties with executive function have been proposed to explain autism.
Evidence of difficulties in Executive Functions in autism:
•Autistic individuals have difficulties with some of these executive functions –and there is lots of heterogeneity (Ozonoffet al., 1991)
•Example 1 – the “Windows” task, testing inhibition (Russell et al., 1991)
the child plays a game where they are told they must point to a box to win chocolate, the child tells the experimenter which box to look in and if the experimenter looks in the box and they find chocolate, the experimenter gets to keep the chocolate. but if the box is empty, the child gets to open the other box and keep what’s inside. the child can see what is inside the boxes but the experimenter cannot.
•Don’t point to the baited box!
results: non-autistic 4yr olds will point to the empty box, however the majority of the autistic children kept pointing to the box with the chocolate. they didn’t seem to inhibited this response to keep pointing to the baited box.
•Example 2 –Wisconsin Card Sorting Test to measure cognitive flexibility (e.g. Guertset al., 2004)
•Told to match the cards but not how to match them, and the rule changes every ten cards… (therefore you could match in relation to colour or shape)
•Autistic children tend to make more errors
Executive function in autism - critique
•Difficulties are not specific to autism
•Not universal –not all autistic individuals will have EF difficulties
•May impact outcomes for autistic individuals but does not explain autism
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“WEAK” CENTRAL COHERENCE
this theory suggest that autistic individuals;
•Process things differently by focusing on the parts rather than the whole (Frith, 1989) e.g. Embedded Figures Task
focuses on a cognitive style, a way of information processing.
the theory argues that autistic individuals have a weakness or difficulty in seeing the whole picture which is referred to as global processing. whereas seeing the details is local processing
Embedded Figures Task (Frith, 1989):
for example, you must find the shape of a triangle within the main picture of something, in this case a pram. autistic people tend to be better at this task. non-autistic people tend to focus on the whole rather than the detailed parts so it takes them longer to process where the triangle might be.
How does the WCC theory explain autism?
in the case of the first core characteristic, it is difficult to evidence links between social domain and weak central coherence. the theory doesn’t offer a strong explanation of the social difficulties experienced by autistic people. you might argue that this local processing style might interfere with viewing the wider picture in social situations, or maybe when looking at emotional processing the autistic individual might focus on the individual facial characteristics rather than the overall emotion being expressed.
perhaps the WCC theory has better utility in explaining the repetitive behaviours and focussed interested seen in autistic individuals. for example, perhaps particularly explains the focussed and passionate interest seen on particular topics.
“Weak” Central Coherence evidence:
•Autistic children are less susceptible to visual illusions (Happe, 1996) (i.e. they don’t fall for them as much)
for example, the Titchener circles illusion asks whether the circles in the middle are the same size. 32% of autistic children fell for the illusion compared to 57% of non-autistic children.
for example, the Herings illusion asks whether the vertical lines are straight or curvy. 46% of autistic children fell for the illusion compared to 76% of non-autistic children.
for example, the Kanisza illusion asks how many triangles there are. only 8% of autistic children fell for it compared to 57% of non-autistic children.
Critique of “Weak” Central Coherence
•Other similar theories focus on the enhanced processing skills and argue global processing not automatic (e.g. Enhanced Perceptual Framework, Mottronet al., 2006)
•Meta-analytic evidence does not provide supporting evidence for enhanced local/reduced global processing (Van der Hallenet al., 2015)
•A move toward seeing superiority in a detail-focused cognitive style (Happe& Frith, 2006)
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THEORY OF MIND
most well known theory of autism
Theory of Mind
•The ability to understand that other people have thoughts, feelings and beliefs (“mind reading”)
•Recall: Non-autistic children develop this ability around the age of 4
Theory of Mind hypothesis of autism
•Do autistic children have a Theory of Mind? they used the false belief task to test this which they called the Sallye-Anne Task (Baron-Cohen et al., 1985)
task - you meet sally and anne, sally puts her ball in the yellow basket and walks away. anne moves the ball to her box. where will sally look for her ball?
•23/27 typically developing children passed
•12/14 children with Down’s syndrome passed
•4/20 autistic children passed…
•Conclusion –autistic children do not have a Theory of Mind
How might ToM link with the core characteristics of autism?
might explain the social difficulties seen - if you struggle to understand someone else’s thoughts and beliefs, it would then make sense that this would translate into real challenges with social interaction. however, this theory cannot explain all aspects of autism, such as the restricted and repetitive interests. it makes no attempt to explain this characteristic for autism.
Further evidence for the ToM hypothesis
•Autistic children are less likely to deceive others:
- Participants can lie or sabotage to stop opponent getting into a box –autistic children did not lie (Sodian& Frith, 1992)
- Penny-hiding game: aim is to not reveal which hand the penny is in. Autistic children make errors (Baron-Cohen, 1992)
•Autistic children use less mental state language (Abellet al., 2000) - used a triangle video to test the mental states of autistic children use to describe whats happening in the video. with typical non-autistic children, they often use mental states terms (ascribe thoughts and feelings to the triangles). with autistic children, they did this less.
Counter-evidence to the ToM hypothesis
•Not all fail ToM tasks: Can pass competitive false belief task (Peterson et al., 2013)
•Asked ‘who should open the box?’ either dot who doesn’t know where the item is, or midge who does.
•74% of autistic children pass Dot-Midge task (chose midge) vs. 13% pass Sally-Anne task
•(Note -Typical 4-year-olds pass rates 77% vs. 23%)
Explicit (automatic/subconsious ToM) and implicit (conscientious ToM) ToM in autism:
•Perhaps more a difficulty with implicit but not explicit ToM?
•Autistic children may explicitly work out / use strategies to answer false belief questions (Happe, 1994)
•Eye tracking studies (implicit task) – autistic children do not look in the false belief location but they pass the verbal question, suggests the verbal ability may be important when it comes to explicit theory of mind and provides evidence that they struggle with the automatic ToM process (e.g. Senju et al., 2010)
Other issues with the ToM hypothesis
•Having a theory of mind touted as ‘what makes us human’
•This perpetuates a damaging narrative and dehumanises autistic people (Gernsbacher& Yergeau, 2019)
•Remember –communication is two-way! so autistic people may find it difficult to understand what people are thinking, but does the non-autistic person have any idea what the autistic person might be thinking?
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NEW WAYS TO THINK ABOUT AUTISM
Neurodiversity
•A paradigm shift, with autistic people at the forefront
•Variation in ways of thinking, experiencing and behaving –autistic people as neurodivergent
•Focuses more on well-rounded appreciation of strengths, differences and difficulties rather than deficits
•Fits with the social model of disability -autistic people are disabled by a society which does not accommodate them (Den Houting, 2019)
Double empathy problem
•Interactional clashing between autistic and non-autistic people –neither understand each other well (Milton, 2012)
•Focus on the two-way nature of communication •Predicts that non-autistic people have poor theory of autistic minds
•Autistic people spend significant time and energy trying to fit in to the non-autistic world, and this effort is not reciprocated
Double empathy problem: Example evidence
•Edey et al. (2016) asked autistic and non-autistic people to direct triangles depicting mental states
•Non-autistic and autistic participants then had to identify the mental state being portrayed
•Non-autistic participants were better at identifying the mental state animations by non-autistic people
•Autistic participants were equally able to identify both group’s mental state animations
Double empathy problem: Example evidence
•Crompton et al. (2020) tested information transfer between autistic and non-autistic people
•Steeper decline in information transfer for the mixed chain group
•Poorer rapport reported in the mixed chain
How do we move forward?
•Listen to autistic people’s accounts
- Involve autistic people in research itself, and support autistic autism researchers
•Find ways in which we could reduce the ‘gap’ between autistic and non-autistic people
- If non-autistic, how could you adapt your communication style?
- Challenge normative expectations!
- Recognise challenges –and abilities
- Change the environment, not the autistic person
