L7 - Social Communication difficulties in Autism

Question 1

What is autism?

Answer 1

• Neurodevelopmental condition with atypical brain functioning
• Emergent in early childhood
• Causes unknown (can be env e.g parents/womb etc)
• Lifelong condition
• More common in boys & affects 1 in 100 individuals
• Behaviourally defined in DSM and ICD: complex and difficult to diagnose

Question 2

What is the autism spectrum?

Answer 2

• Individuals on the autism spectrum share certain difficulties in common but vary hugely
• Changed from 2013 (when categorised)

Question 3

What is The Birthday Party?

Answer 3

• Training film for front-line professionals
• Helping to understand there is variation in the way that the signs of autism present
• Helping them understand that the signs of autism can be subtle

Question 4

What are some types of autism?

Answer 4

• Avoidant style: less social interest/ability
• Active style: More social interest, directs a group, on own terms
• Passive style: More social interest, prefers one to one, copies to fit in

Question 5

What are difficulties with social communication?

Answer 5

• Impairment in social-emotional reciprocity
• Impaired non-verbal communication: eye gaze, facial expression, gestures
• Impairment in developing, maintaining and understanding relationships

Question 6

What are restricted and repetitive behaviours?

Answer 6

• Stereotyped or repetitive movements, use of objects or speech
• Insistence on sameness, inflexible routines and ritualised behaviour
• Intense or unusual interests
• Sensory difficulties

Question 7

How to diagnose autism?

Answer 7

• Clinician makes decision based on if child has a criterion number of behaviour
• Tools used like the Autism Diagnostic schedule&interview, but approach to diagnosis varies
• Not all children will show all behaviours but they will reach a certain criterion
• Some individuals do not receive a diagnosis until adulthood

Question 8

Why are we interested in cognition?

Answer 8

• Cognitive theories seek to identify atypical thinking styles in autism
• Informing us about processes underlying autistic behaviours
• Helps understand why behaviours occur

Question 9

How do psychologists attempted to explain autism in terms of a single underlying cognitive atypicality?

Answer 9

• Cognitive atypicality should be universal in individuals with autism
• Be unique to autism (discriminant variability)
• Show explanatory power by explaining all symptoms and relating to symptom severity

Question 10

Theory of mind in autism:

Answer 10

• Autistic people do not have a theory of mind: also known as mind blindness or a deficit in mentalising

Question 11

What was the study looking at the sally-anne task (Baron-Cohen et al. )

Answer 11

• 20 autistic children, 14 with Down Syndrome and 27 younger typically developing children
• 80% with autism cannot impute belief to others so cannot predict behaviours of others

Question 12

What is a criticism of standard false belief task

Answer 12

1) Does the sally-anne task actually capture real-life mentalising - people with good ToM do not find this effortful. Is not good at capturing if autistic people have good ToM as we give them a lot of time and strategies to work it out
- Counteracted by anticipatory looking and familiarisation tasks

Question 13

What is anticipatory looking?

Answer 13

• Used anticipatory looking paradigm - spontaneous false belief (without cog demand)
• Found 25 months children look in anticipation towards where a person with false beliefs would search
• Would autistic adults who can pass the Sally-Anne task show this type of spontaneous false-belief understanding

Question 14

What are familiarisation tasks?

Answer 14

• Actor’s goal is to obtain hidden ball following the cue a window will be opened
• Puppet changes his mind and removes ball
• Actor turns back to find ball

Question 15

What were the results? (Adults)

Answer 15

• Adults without autism = first anticipatory look was to window associated with actors false beliefs
• However, autistic adults showed no preference for one window over another = suggesting they are not attributing a false belief to the actor
• Data suggests an absence of spontaneous and intuitive theory of mind in autism, despite an ability to pass explicit tasks

Question 16

Second critique of standard false belief tasks:

Answer 16

• Classic ToM tasks are simple pass/fail responses
• How useful a task is when it has such limited variability

Question 17

What are Frith Happe animations?

Answer 17

• Two triangles act in a human life way that evoke mental state attribution
• They allow us to measure ToM by coding the spontaneous and intuitive use of mental state language
• Enables wider spread of scores going beyond pass/fail
  RESULTS:
• The autistic group made more inappropriate mentalising explanations than the other typical groups, despite performing as well as the control groups on standard false belief tasks

Question 18

Is ToM universal/unique/explanatory power

Answer 18

Universal: Not all autistic children fail standard FB tasks although this may reflect task factors

Unique: You can have difficulties with ToM and not have autism e.g blind/deaf people etc.

EP:
- Absence of ToM leads to critical breakdown in social communication
- Theory does not easily explain restricted and repetitive behaviours

Question 19

What is executive function?

Answer 19

• General set of skills or mental toolbox
• Cognitive processes that are important for flexible, goal-oriented behaviour, especially in novel circumstances
• Includes planning ability, working memory, inhibitory control, cognitive flexibility

Question 20

What was a study of executive functioning in autism?

Answer 20

• Hypothesis: autistic children show difficulties with aspects of executive function
• Impairment in planning: autistic children are impaired on the Tower of London task and find it hard to plan moves
• Impairment in cognitive flexibility: Impaired on Wisconsin card sorting task and find it hard to shift to sorting by a new rule - but display perseveration
• Working memory: more robust evidence for difficulty with spatial working memory than verbal - can do well on digit span tasks but more difficulty with spatial span
• Inhibition: mixed findings - No impairment on Stroop Task but evidence of difficulty on the windows task with inhibiting a prepotent response

Question 21

Is Executive Functioning universal/unique/explanatory power

Answer 21

Universal:
- Not all autistic children show deficits on EF tasks
Unique:
- Other clinical groups i.e ADHD show evidence of EF dysfunction
- Might be a specific profile of EF difficulties that is unique to autism
EP:
- Poor executive function = restricted and repetitive behaviours
- Poor cognitive flexibility = repetitive language = intense interests
- Poor inhibition = repetitive motor mannerisms, intense interests
- Poor EF can explain failure on the standard FB task as passing requires inhibition of the more salient reality and working memory
- DOES NOT explain any social and communication behaviour where EF demands are low