Theories of Autism

Question 1

Prevelance of autism

Answer 1

1% of the population (700,000 in the UK) are autistic, most are adults, and many remain undiagnosed

Question 2

Aspergers syndrome vs autism spectrum disorder

Answer 2

• Autism Spectrum Disorder is the official term in DSM-V
• Aspergers Syndrome (AS) commonly refers to people on the spectrum without language delay or learning disability

Question 3

What is autism?

Answer 3

Clinically defined by a combination of:
- Impairments in social-communication
- Restricted and repetitive patterns of behaviour (including sensory processing differences)

Question 4

What is autism according to the DSM-V?

Answer 4

1. Persistent deficits in social communication and social interaction across multiple contexts, including:
   - Deficits in social-emotional reciprocity
   - Deficits in nonverbal communicative behaviours used for social interaction
   - Deficits in developing, maintaining, and understand relationships
2. Restricted, repetitive patterns of behaviour, interests, or activities
3. Symptoms must be present in the early developmental period
4. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
5. These disturbances are not better explained by intellectual disability or global developmental delay.

Question 5

What are the three main cognitive theories of autism?

Answer 5

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.

Question 6

False belief task in autism, Baron-Cohen et al., (1985)

Answer 6

• Sally-Ann task
• Sally put a ball in a basket and walks away .
• Ann moved the ball out of the basket
• Sally didn’t see this
• Children asked where Sally will look for the ball
• Found that autistic children will look where Ann put the ball as they haven’t developed ToM.

Question 7

Inferring mental states if geometric figure Kin (2000)

Answer 7

• Autistic people don’t attribute mental states to people, so they won’t attribute mental states to geometric shapes
• Autistic child explains the movement of shapes in a non-materialistic way
• Child without autism explains the movement of shapes attributed to mental states to shapes (e.g. called big square a bully)

Question 8

Smarties false belief task, Perner et al. (1989)

Answer 8

• child sees smarties tube and assumes smarties inside but it actually has a pencil in it
• asked autistic child what they think the next child will think is in the tube
• the autistic child will think they will say pencil
• can’t take into account someone will think differently despite thinking that way themselves

Question 9

Contradicting evidence for autism and ToM, Sparrevohn & Howie (1995)

Answer 9

found that autistic children with higher mental age more likely to pass ToM tasks

Question 10

Contradicting evidence for autism and ToM, Happe (1995)

Answer 10

• 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

Question 11

1st and 2nd order false belief in autistic children, Baron-Cohen (1989)

Answer 11

• Autistic people pass 1st order, fail 2nd order
• Proposed that ToM problem was a delay rather than a deficit
• But Bowler (1992) found that children with Aspergers pass 2nd order

Question 12

Is children failing ToM tasks unique to autistic children?

Answer 12

• Children with visual impairment showed difficulty with false belief (Minter, Hobson & Bishop, 1998)
• Children with hearing impairment have development delay in acknowledging false belief (Woolfe, Want & Siegal, 2002)

Question 13

What is executive control?

Answer 13

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
- flexibility of search and action.

Question 14

why was the theory of executive control proposed?

Answer 14

Proposed to account for social & non-social symptoms (repetitive behaviour)

Question 15

Do autistic children show executive control, Ozonoff et al, 1991

Answer 15

• 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 orderSome passed 2nd order

ToM tasks not common denominator worst at predicting autistic children performance

Question 16

Can executive control explain social/communication problems? Russell et al 1991

Answer 16

• window with chocolate inside, task was not to point at the chocolate or they won’t get to have it
• about resisting pointing
• autistic children failed this task
• Perhaps FB task not about lack of insight but more about failure to inhibit

Question 17

Is executive function the primary cause of ASD? Sodian and Frith (1992)

Answer 17

• Children had to lie to a ‘theif’ that their box of treasure wsa locked
• autistic children could not lie

Question 18

what is weak central coherence?

Answer 18

• attempts to explain social and non social symptoms
• proposes that autistic people don’t automatically process contextual meaning or use prior knowledge
• autistic people have a bias towards piecemeal or local (over global) processing

Question 19

Language processing in autistic people, Snowling and Frith, 1986

Answer 19

• Those with autism fail to use context when processing ambiguous homographs. (e.g. The actor took a bow.)
• literal
• difficulties with sarcasm and irony

Question 20

Embedded figures test, Shah and Frith (1983)

Answer 20

• autistic people found the shape faster than matched controls

Question 21

Embedded figures test, Pring et al. (1995)

Answer 21

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

Question 22

Visual illusions and autism, Happe (1996)

Answer 22

• some evidence to argue that autistic people are less susceptible to visual illusions
• but also evidence against

Question 23

social vs medical model of autsim

Answer 23

social model - recognises any difficulties a person experiences is not just within the person but also between them and the environment
- poor job prospects
- no ramps
- poorly designed buildings
- inaccessible transport

medical model - places autistc difficulties from inside themselves
- can’t work
- looking for a cure
- need help and careres

Question 24

Diffusion chains (Crompton et al., 2019)

Answer 24

Is autistic peer-to-peer information transfer more efficient than mixed autistic – non autistic?
- 3 of each chain, 1 all autistic, 2. non autistic, 3. mixed
- Matched on age, gender, IQ, education, diagnosis (exc. social anxiety)
- Autistic peer-to-peer information transfer more efficient than mixed chain

Question 24

The double empathy problem (Milton, 2012)

Answer 24

- when people with very different experiences of the world interact with eachother, they will struggle to empathise with eachother - autistic – autistic interactions more efficient than autistic – non-autistic interactions

Question 25

How are autistic people perceived? Sasson et al (2017)

Answer 25

- “thin slice judgements" - 12 autistic and 16 non-autistic adults recorded while interacting with someone - Groups matched on age, IQ, gender - 36 UG students rated the people from 10 images randomly sampled from the videos - Non-autistic people tended to rate autistic people less socially favourably (except for trustworthy + smart) - Not due to speech content, but other audio/visual cues

Question 26

How are autistic people perceived? (Sheppard et al., 2019)

Answer 26

Non-autistic people find autistic people relatively harder to read

Question 27

How are autistic people perceived? (Alkhaldi et al., 2019)

Answer 27

Non-autistic people might rate autistic people negatively because they are hard to read

Question 28

How are autistic people perceived? (Sasson & Morrison, 2019)

Answer 28

Disclosing autism diagnosis, and increased autism knowledge increases favourability ratings of autistic people

Question 29

Autistic Traits and Friendship

Answer 29

- DSM-V diagnostic criteria for autism includes deficits in forming stable long-lasting relationships - However, the DEP posits that this will only occur when each person has very different views and experiences - Will dyads with similar levels of autistic traits report higher friendship quality? YES! (Bolis et al. 2021)

Question 30

Enactive Mind intervention approach Klin (2000)

Answer 30

- social information might be less salient to autistic children which a knock-on effect on development - Perhaps providing learning opportunities to autistic children early on in development could improve social and communication skills

Question 31

The Transporters, Golan et al (2010)

Answer 31

- Video of trains with real emotion faces - Acted out social situations Predictable Uses interests Can be used by all autistic children - N=20 autistic children (4-7 years) watched everyday for 4 weeks - Emotion vocabulary and recognition compared pre/post intervention - Compared to no-intervention group (18 autistic and 18 non-autistic children) matched on age and IQ - Children were asked to match the correct emotion face to the situation - Used both emotions from the DVD, and new faces/contexts - Autistic children in the intervention group significantly improved across all measures - Whereas the control groups did not improve/change

Question 31

Thomas the tank engine vs the transporters, Young & Poselt (2012)

Answer 31

- 13 autistic children watched the transporters for 3 weeks, and compared to 12 autistic children who watched Thomas the Tank Engine - Autistic children who watched the transporters improved more in emotion recognition than children who watched Thomas

Question 32

what is applied behaviour analysis?

Answer 32

- Intensive early intervention for autistic children - Originally developed by Lovaas in 1987 - Follows behaviourist approaches using positive reinforcement to teach new skills and also repress “challenging behaviours” - Followed for years on 1-2-1 basis for 20-50 hours/week - Widely used, but is it effective, acceptable, useful to autistic people over the long term?

Question 33

Systematic review and meta-analysis showed limited evidence in support of ABA (Rodgers et al. 2020)

Answer 33

- 20 studies included, but all were biased/poor quality - Long term impact of the early interventions beyond 2 years was unknown - Wide range of effect sizes - Some evidence for positive effects on cognitive ability and adaptive behaviour (life skills, social and communication skills) - Testimony of autistic adults who experienced ABA as children about potential harms not captured in research (McGill & Robinson, 2020) - Kapp et al. 2019: Suppressing stimming removes a self-regulatory mechanism > feelings of not being accepted

Question 34

Autism acceptance training

Answer 34

- 238 non-autistic adults completed: autism acceptance training, general mental health training not mentioning autism no-training control - Survey assessed: Explicit autism knowledge, stigma, and impressions of autistic adults implicit association task about autism - Non-autistic adults in the autism acceptance training condition reported: more positive impressions of autistic adults, fewer misconceptions and lower stigma about autism endorsed higher expectations of autistic abilities expressed greater social interest in hypothetical and real autistic people - No effect on implicit biases: non-autistic adults associating autism-related labels with unpleasant personal attributes regardless of training condition