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Developmental > Cogntive Theories Of Autism (MindBlind) > Flashcards

Cogntive Theories Of Autism (MindBlind) Flashcards

1
Q

Autism spectrum disorder

A

•Autism Spectrum Disorder is the official term in DSM-V, but some use the term ‘condition’ - less stigmatising
•Aspergers Syndrome (AS) / High functioning Autism refers to autism without language delay or learning disability
–AS introduced in 1992, recently removed from DSM-V(!), but still in use in ICD-10 in Europe …
–High functioning in terms of what? Be specific

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2
Q

Kenny et al 2016

Recent research has showed that

A

‘autistic people/person’ is preferred by people on the spectrum, and ‘person with autism’ is preferred by professionals

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3
Q 
History of diagnosis 
Hans Asperger (1944)
Leo Kanner (1943
A
  • Innate inability to form the usual biologically provided affective contact with people
  • Poverty of facial expression
  • Many stereotypical movements that do not convey meaning
  • Impulsive and stimulus driven
  • Can have excellent logical and abstract thought
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4
Q

Kanner’s cardinal features:

A

Autistic aloneness

–Obsessive insistence on sameness

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5
Q

Wing and Gould 1979

Triad of Impairments

A

Socialisation
Communication
Imagination (Repetitive behaviour interests)
Delay or atypical functioning in at least one, with onset prior to age 3 years

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6
Q

Impairment of social interaction / development includes

A

Social attachment
Understanding others minds/thoughts/feelings
Emotion regulation / coping with change

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7
Q

Impairment of social interaction/development

Social attachment:

A
  • indifference to other people; difficulty making friends
  • may seem independent as a toddler, resists or does not seek affection
  • can be affectionate and show attachment on a simple level, but…….
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8
Q

Impairment of social interaction/development (triad)

•Understanding other’s minds/thoughts/feelings

A
  • difficulty interpreting other person’s need for affection
  • difficult to understand other people’s thoughts and emotions
  • irregular eye contact -> do not follow gaze -> seem to be ‘in a world of their own’
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9
Q

Impairment of social interaction/development (triad)

•Emotion regulation/coping with change

A
  • difficulty managing emotions, -> expressed as outbursts of anger or aggression
  • difficulties coping with new situations
  • difficult to accept simple social rules, causing problems at school
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10
Q

•2. Impairment of social communication (triad)

Non verbal

A

–difficulty to read body language and facial expressions
–lack of appreciation of the social uses and pleasure of communication
–Don’t develop usual non-verbal (e.g., pointing) skills or imitation skills

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11
Q

Impairment of social communication (triad)

Verbal

A

–don’t develop the usual verbal skills like typical children
–trouble with understanding meaning in spoken or written language
–not babble or point by the age of one, not respond to their name, not learn two words by the age of two
–repeat learned words over and over again (echolalia)
–unusual use of language (e.g., reversal of pronouns I vs you), and difficulty starting conversations
–severe autism may never speak at all (but can be helped with signing or using picture symbols)
–unable to understand jokes or sarcasm

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12
Q

Impairment of imagination (narrowing interests and behaviour) (triad)

A
  • inability to play imaginatively with objects or toys (pretend play) or others
  • is an outward manifestation of this impairment
  • may be overly interested in repetitive activities, resistance to novel topics
  • may take up a special interest at a young age, such as collecting, or music and art
  • older children/adolescents may develop obsessions (excessive interest in timetables or lists, storing up trivial facts/encyclopaedic knowledge)
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13
Q

Other symptoms

A
  • sit up or walk later than most children
  • be oversensitive to noise or touch
  • have odd mannerisms such as rocking back and forth, hand flapping, walking on tip- toes or head banging
  • be clumsy and struggle with physical activity
  • like sticking to the same routines, and may get very upset if these are disturbed
  • be over or undersensitive to sight, sound, smell, touch and taste
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14
Q

Features of ASD

Wing and Gould 1979

A

Triad of impairment (socialisation, communication, imagination)

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15
Q

Non-social features of ASD

A
  • restricted area of interest/preoccupation with parts of objects
  • desire for sameness and routine
  • excellent rote memory
  • savant abilities
  • islets of ability
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16
Q

ASD as a spectrum

A

–Some require special educational provision

–Others have less severe difficulties (e.g. Asperger’s Syndrome)

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17
Q

Gillberg & Billstedt, 2000

A

High co occurrence with other difficulties
•Attention or motor difficulties (ADHD, DCD, DAMP)
•Unspecific – (e.g. Cognitive impairment - 80%)
•Specific - (e.g. Associated medical disorder or chromosomal disorder – 10-25%)

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18
Q

Lever and Geurts, 2016)

A

79% meet criteria for at least 1 psychiatric condition

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19
Q

Prevalence

A

–ASD- affects up to 1% of children

–Boys outnumber girls 10:1 (but this is changing …)

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20
Q

How is autism diagnosed?

A

•Experienced clinicians use a range of assessments to establish whether the behaviour of an individual meets specific criteria.
•(e.g. Diagnostic and statistical manual for mental Disorders -DSM-V).
•Standard assessments of ASD:
–Autism Diagnostic Interview (ADI)
–Autism Diagnostic Observation Schedule
(ADOS)

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21
Q

Early research on cognitive abilities argued

A

autism arises from a primary cognitive deficit.

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22
Q

What makes a good theory

A

–Specificity
–Uniqueness
–Universality

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23
Q

3 main theories

A

1.Theory of Mind
failure to acknowledge others have their own thoughts and beliefs
2.Executive Dysfunction
deficits in inhibition, planning and executive memory
3.Weak Central Coherence
preference for local details over the global whole or context.
-Perceptual & conceptual

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24
Q

Theory of mind

A

failure to acknowledge others have their own thoughts and beliefs

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25
Q

Executive dysfunction

A

deficits in inhibition, planning and executive memory

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26
Q

Weak central coherence

A

preference for local details over the global whole or context.
-Perceptual & conceptual

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27
Q

Theory of mind

Agent without mind =

A 
Machine 
•how do you treat a machine?
–socialisation?
–communication?
–Imagination?

without understanding other minds

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28
Q

Baron Cohen et al 1985
Socialisation difficulties
[autism and false belief]

A

social and emotional problems secondary to cognitive problem

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29
Q

Klin 2000

Inferring mental states of geometric figures

A

What happened was that the larger square - which was like a bigger kid or bully - had isolated himself from everything else until two new kids come along and the little one was a bit more shy, scared, and the smaller square more like stood up for himself and protected the little one…

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30
Q

De Gelder 1987

Autism and false belief

A
  • Why should people with autism attribute mental states to dolls?
  • Why test understanding with a game that involves make-believe when children with autism are known to be weak at that?
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31
Q

Autism is the result of a

A

Complex interplay between multiple factors and cannot be explained by a single cognitive deficit

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32
Q

Likely that several functional

A

Neural pathway are implanted and that all impinge on neurocognitive /social functions that are crucially impaired in autism

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33
Q

Autism is very

A

Heterogeneous

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34
Q

Alternative theories of ASD

A 
Mirror neurones theory 
Extreme male brain 
Social motivation theory 
Enhanced perceptual functioning 
Enlarged temporal binding window 
Sensorimotor theory of autism
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35
Q

Mirror neuron theory

Williams et al 2001

A

Brain level explanation

Not well supported

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36
Q

Extreme male brain

A

More descriptive than explanatory

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37
Q

Social motivation theory

Chevalier et al 2012

A

Not cognitive but motivational / reward deficit

38
Q

Enhanced perceptual functioning

A

Accounts for inconsistencies in WCC literature

39
Q

Enlarged temporal binding window

A

Explains ASD symptoms at a sensory level

40
Q

Sensorimotor theory of autism

A

Could be a more parsimonious explanation of autism

41
Q

Current disganosis of Autism

DSM-5

A 
•Changes to categories
•The terms  ‘autistic disorder’, ‘Asperger disorder’, ‘childhood disintegrative disorder’ and ‘PDD-NOS’ have been replaced by the collective term 'autism spectrum disorder'.
•No more Asperger’s Syndrome
•New emphasis is on an individual needs:
•Three levels of severity
–Level 1 - requiring support
Level 2 - requiring substantial support
Level 3 - requiring very substantial support
42
Q

Three levels of severity

A

–Level 1 - requiring support
Level 2 - requiring substantial support
Level 3 - requiring very substantial support

43
Q

There is a new emphasis on

A

Individual needs

44
Q

Changes in criteria

A

DSM 4 > DSM 5
Triad > Dyad
1) social communication and interaction.
2) restricted, repetitive patterns of behaviour, interests or activities. (Includes sensory abnormalities!)
Socialisation, communication and imagination is now social communication and restricted repetitive behaviour / interests

45
Q

Is Autism a unitary disorder
Happe et al 2006
Happe and Ronald 2008

A

The triad of impairments do not correlate highly in normal population

Each component may have a different cause

• Autism may be a mixture of conditions

46
Q

Happe and Ronald 2008

Autism cannot be explained by a single cognitive deficit

A

Fractionation of the triad

47
Q

The 3 main cognitive theories explain some symptoms of ASD, but not all of them.

A

•Specificity?
may be domain-general or specific (multiple deficits?)
•Uniqueness? none to ASD
•Universality? none to ASD

48
Q

Challenges of WCC

A

Differentiating itself from other theories which attempt to explain non-social features of Autism

–Enhanced Perceptual functioning (Mottron & Burack, 2001; Mottron et al., 2006)
–Reduced top-down processing (Loth, Gómez, & Happé, 2010; Mitchell, Mottron, Soulières, & Ropar, 2010; Ropar and Mitchell, 2002)

49
Q

Is WCC a primary cause of ASD

A

Good specificity, however…..

Not universal (Not all individuals show WCC)

Unique?
- Children with pragmatic language impairment (PLI) also have problems with processing context (Norbury et al. 2002)

50
Q

Norbury et al 2002
Is WCC a primary cause of ASD
Unique?

A
  • Children with pragmatic language impairment (PLI) also have problems with processing context
51
Q

Inconsistent evidence for WCC

Happe 1996

A

reduced susceptibility to visual illusions, but see…

-Ropar & Mitchell (2001)

52
Q

Inconsistent evidence for WCC

Mottron et al 1993

A

Reduced global precedence in Navon task but see….

Plaisted

53
Q

WCC and perception
Islets of ability
Embedded figures test
Shah & Frith 1983) Block design Shah & Frith 1993)

A

ASD significantly faster than matched controls

54
Q

WCC and perception (islets of ability)

Pring et al 1995

A

Individuals with autism were as fast at solving a jigsaw upside-down as right-way-up

55
Q

WCC and social difficulties in ASD

Language processing - Snowling and Frith 1986

A

–Those with autism fail to use context when processing ambiguous homographs. (e.g. The actor took a bow.)
•Literal
•Difficulties with sarcasm & irony

56
Q

what is WCC

Frith 2003

A

Weak central coherence

57
Q

Weak central coherence
Frith 2003
Attempts to explain social and non social

A

–Do not automatically process contextual meaning or use prior knowledge
– A bias towards piecemeal or local (over global) processing.

58
Q

Leslie and frith 1988

Perner et al 1989

A

Converging evidence problems with acknowledging own believes
Widely replicated in different tasks
Autism linked to deficits in theory of mind

59
Q

Communication impairment
Mitchell and Isaac 1994
Mitchell et al 1997

A

Message desire task
normally we interpret this request as non-literal as based on false belief
•participant asked to judge
–(1) which item the mum really wants (interpret) and
–(2) which item the mum put in the drawer (memory)

• ASD more errors in interpreting desire (i.e. Mum wants bag in cupboard) than in judging that bag of wool mum put in drawer is now in cupboard (memory)

•Those with ASD incorrectly interpreted utterances literally
suggesting difficulty making non-literal interpretations

60
Q

Leslie 1987

Link between cognitive impairment and

A

Lack of pretend play

61
Q

Pretend play is a

A

basic expression of understanding other minds.

62
Q

Engaging in imaginative play with another person requires

A

acknowledging another person’s non-literal thoughts/beliefs.

63
Q

Theory of mind Hypothesis if autism

A

Good specificity for triad
•powerful & convincing
•difficulties in relating, communicating, etc.
•all related to understanding of the mind

64
Q

Theory of mind Hypothesis of autism
Not universal
Happe 1994

A 
•Happe (1994): what about those who pass?
–solve differently (and how counts)
–not autistic?
–ToM hypothesis wrong?
–not primary element of ASD?
65
Q

Sparrevohn and Howie 1995

Theory of mind Hypothesis

A

ASD with higher verbal mental age more likely to succeed

66
Q

Theory of mind d Hypothesis of autism

Happe 1995

A

•Happe (1995) – meta analysis on ASD & ToM:
–Relationship between child’s verbal mental age and passing FB tasks
–Verbal mental age of 12 able to pass compared to 4yrs in typically developing children

67
Q

I think that he thinks that she thinks

aka 2nd order false belief

A
  • Mary and John saw the ice cream van in the park
  • Mary went home for some money and meanwhile John saw the ice-cream van move to the church
  • Mary unexpectedly sees the ice-cream van at the church
  • John sets out to find Mary, whom he is told has gone for ice-cream.
  • not where John thinks the ice-cream van is, but where John thinks Mary thinks the ice-cream van is
68
Q

I think that he thinks that she thinks
aka 2nd order false belief
Baron Cohen 1989

A

– ASD pass 1st order, fail 2nd order
–Proposed that ToM problem was a delay rather than a deficit
•BUT: Aspergers pass 2nd order (Bowler, 1992)
•-> Deficit of ToM not universal!
•perhaps not primary
–Even if not deficit, but delay
–Impaired ToM is not the same as ASD!

69
Q

Children with visual impairment showed difficulty with…
Minter, Hobson & Bishop, 1998
(Uniqueness)

A

False belief

70
Q

Children with hearing impairment have development delay In…
Woolfe, Want & Siegal, 2002
(Uniqueness)

A

Acknowledging false belief

71
Q

Communication disadvantage during early years

A

leads to delay in understanding minds

72
Q

Language and communication is important for

A

Understanding other minds

73
Q

Deficit of theory of mind not unique to

A

ASD

74
Q

Does Theory of Mind have good specificity?

A 
•Accounts for triad 
•But:
–insistence on sameness
–routines
–narrow interests
–Repetitive behaviour
75
Q

Executive control is proposed to account for

A

Social and non social symptoms (repetitive behaviour)

76
Q

Ozonoff et al 1991

A 
•“The ability to maintain an appropriate problem-solving set for the attainment of a future goal; 
it includes behaviours such as:
–planning
–impulse control
–inhibition of prepotent but irrelevant responses
–set maintenance
–organized search
–and flexibility of search and action.”
77
Q

Tower of Hanoi

A

Planning

78
Q

Wisconsin card sort

A

Set shifting

79
Q

Ozonoff et al 1991

Tower of Hanoi, Wisconsin card sort and theory of mind tests

A

•Tower of Hanoi:
Acted impulsively, could not plan several moves ahead, shifted all loops directly, etc
•Wisconsin Card Sort:
Unable to shift attentional focus, persevered to sort by established system
•Theory of Mind tests:
Many passed 1st order
Some passed 2nd order
More accurate basis for discriminating between who was and was not autistic compared with tests of false belief
Not common denominator

80
Q

Can EC explain social/communication problems?
Russell et al 1991
Windows task

A
  • Perhaps FB task failure due to insufficient flexibility in imagination to give correct judgment?
  • Children <4 yrs and autistic children unable to inhibit pre-potent response (Russell et al 991)
  • It’s about resisting to point to attentional focus/salient part
  • Perhaps FB task not about lack of insight but more about failure to inhibit?
  • also Hughes & Russell, 1993; Hala & Hughes, 2003
81
Q

•also Hughes & Russell, 1993; Hala & Hughes, 2003

A

Can EC explain social/communication problems?

82
Q

Executive control and autism-

is EC it a primary cause of ASD? Specificity?

A

•Unexpected transfer task: Rigidity and repetitve behaviour
–Point impulsively to where the chocolate is
•Deceptive box: pattern of behaviour in theory of mind tests
–Say impulsively what we know to be in the box
•Windows task:
–Point to where the chocolate is
•EF leads to acting impulsively on environment

83
Q

Is executive dysfunction (ED) the primary cause of ASD

Sodian and Frith 1992

A 
Study: ASD no problem in sabotage, 
but cannot withhold information 
(fail deception)
➢Impairment is not an EF deficit
➢Not specific
•adults onset ED not cause ASD
•Children with PKU show ED, 
but are not ASD (Welsh et al, 1990)  - also in Tourette’s
–Not unique
•no evidence for Executive Dysfunction 
in autistic pre-school children 
(Griffith, et al. 1999; Dawson, et al. 2002)
–Not universal
84
Q

Welsh et al 1990

Children with PKU…

A

show ED
but are not ASD - also in Tourette’s
–Not unique

85
Q

(Griffith, et al. 1999; Dawson, et al. 2002)

No evidence for…

A

Executive Dysfunction

in autistic pre-school children

86
Q

Can executive dysfunction be a primary cause of ASD?

Specificity?

A

can explain many of the deficits, but doesn’t always hold up

87
Q

Can executive dysfunction be a primary cause of ASD?

Universality?

A

Not all individuals with ASD show EF problems

88
Q

Can executive dysfunction be a primary cause of ASD?

Uniqueness?

A

Not unique to ASD

89
Q

Stephen Wiltshire

A

Drawn a very detailed picture of London Bridge from memory

90
Q

However need to explain

A
  • non-social features of autism
  • savant abilities
  • anecdotal reports of heightened perceptual abilities
  • uneven intellectual profile

Developmental (10 decks)

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