Theories of Autism

Question 1

Which syndrome commonly refers to people on the spectrum without language delay or learning disability but was recently removed from the DSM but is still used today?

Answer 1

Aspergers Syndrome (AS)

Question 2

Autism is clinically defined by a combination of

Answer 2

Impairments in social-communication
and
Restricted and repetitive patterns of behaviour
(including sensory processing differences)

These are extremely heterogeneous (diverse) in terms of core clinical features and associated neurocognitive profile

Question 3

What is the name of the American criteria that provides standardised criteria to help diagnose ASD?

Answer 3

DSM-5 (V)

Question 3

DSM-5 area A explains?

Answer 3

Persistent deficits in social communication and social interaction across multiple contexts

Person has to show 1+ difficulties in multiple areas

Question 4

Difficulty with back-and-forth conversation would be an example of which deficit?

Answer 4

Deficits in social-emotional reciprocity

DSM-5 section A

Question 5

Difficulty understanding and using gestures would be an example of which deficit?

Answer 5

Deficits in nonverbal communicative behaviours used for social interaction

DSM-5 section A

Question 5

Difficulties adjusting behaviour to suit various social contexts would be an example of which deficit?

Answer 5

Deficits in developing, maintaining, and understand relationships

DSM-5 section A

Question 6

DSM-5 area B explains?

Answer 6

Restricted, repetitive patterns of behaviour, interests, or activities

Stereotyped or repetitive motor movements, use of objects, or speech

Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behaviour
E.g., need to take same route or eat same food every day
Highly restricted, fixated interests that are abnormal in intensity or focus
E.g., strong attachment to or preoccupation with unusual objects
Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment
E.g., apparent indifference to pain/temperature

Question 7

What is an example of stereotyped or repetitive motor movements, use of objects, or speech?

Answer 7

Idiosyncratic phrases
(Phrases that use normal words in an abnormal way such as
“Leg sleeves” when describing trousers)

DSM-5 section B

Question 7

Needing to take same route or eat same food every day is an example of which deficit?

Answer 7

Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behaviour

DSM-5 section B

Question 7

Strong attachment to or preoccupation with unusual objects is an example of which deficit?

Answer 7

Highly restricted, fixated interests that are abnormal in intensity or focus

DSM-5 section B

Question 7

Apparent indifference to pain/temperature is an example of which deficit?

Answer 7

Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment

DSM-5 section B

Question 8

Which section of the DSM-5 explains that symptoms must be present in the early developmental period (3 yrs)?

Answer 8

DSM-5 Section C

Question 8

Which section of the DSM-5 explains that the symptoms must cause clinically significant impairment in social, occupational, or other important areas of current functioning?

Answer 8

DSM-5 Section D

Question 9

Which section of the DSM-5 explains that these disturbances are not better explained by intellectual disability or global developmental delay?

Answer 9

DSM-5 Section E

Question 10

Early research on cognitive abilities argued autism arises from a primary cognitive deficit.

What is the 3 criteria that is proposed?

Answer 10

Specificity
Uniqueness - not found in other conditions
Universality - has to be present in that condition all over the world

Question 10

What are the 3 main theories put to describe Autism?

Answer 10

Theory of Mind
-failure to acknowledge others have their own thoughts and beliefs

Executive Dysfunction
-deficits in inhibition, planning, and executive memory

Weak Central Coherence
-preference for local details over the global whole or context.

Question 10

Preference for local details over the global whole or context is known as which theory?

Answer 10

Weak Central Coherence

Question 11

Socialisation difficulties (autism and false belief):
Which task is used to see whether an autistic child has a theory of mind?

Answer 11

Unexpected Transfer Paradigm (Sally Anne Task)
-Child has a false belief that sally moved ball where anne cannot see it

Findings:
80% of autistic children say sally will look in the wrong area
Only 20% of autistic children can answer correctly (show ToM)

Compared to 85% normal children+ down syndrome children who answer correctly

Question 12

The Inactive Mind Hypothesis suggests that?

Answer 12

Autistic children are not entuned to their environment at a young age which has an effect on their development

They do not find info in the environment salient
eg. not capturing facial expressions as a child makes it harder to understand them on other people when older

Question 12

Inactive Mind Hypothesis:

When inferring mental states of geometric figures autistic children lack?

Answer 12

Lack an inactive mind.
This lead to the development of ToM.

Question 13

Socialisation difficulties (autism and false belief):
Which task other than the sally anne task is used to see whether an autistic child has a theory of mind?

Answer 13

Smarties in box task
‘what is in the smarties tube?’
Autistic children will say the other observer will see pencils

Widely replicated in different tasks -> autism linked to deficit in ToM

Question 13

Advantages of ToM theory:
Good specificity for autism characteristics
powerful & convincing
difficulties in relating, communicating, as it is all related to understanding of the mind

What are the disadvantages?

Answer 13

Not universal!
Some autistic children pass this task (20%)

It may be a developmental delay rather than a deficit:
12yrs=pass compared to 4yrs=normal child

Some solve the task differently (and how counts)
ToM hypothesis wrong, may not primary element of ASD?

Question 14

Which task does this passage represent?

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.

Right answer: John will look for Mary where John thinks Mary thinks the ice-cream van is.

Answer 14

What does the 2nd order false belief task: I think she thinks

Found:
Autistic people pass 1st order (sally anne), fail 2nd order
Proposed that ToM problem was a delay rather than a deficit

BUT: Aspergers pass 2nd order

Question 14

Bowler, 1992 found that BUT: children with Aspergers passed the 2nd order false belief task (John icecream). What does this evidence show?

Answer 14

This is evidence of Deficit of ToM not being universal!

May even be a DELAY not a deficit

So ToM cannot be used as a diagnosis of Autism on alone basis! Impairment of ToM is not the same as ASD!

Question 14

Due to communication disadvantages during early years ToM is present in a lot of other conditions such as visual/ hearing impairment, besides autism.
Which criteria does this go against?

Answer 14

Uniqueness

Question 15

Tom accounts for social and communication impairments (specifity)

Answer 15

But not for
insistence on sameness
routines
narrow interests
Repetitive behaviour

Question 15

Which theory describes the ability to maintain an appropriate problem-solving set for the attainment of a future goal?

Including behaviours such as:
planning
impulse control
inhibition of prepotent but irrelevant responses
set maintenance
organized search
and flexibility of search and action.”

Answer 15

Executive Control Theory

However, there is no evidence for executive dysfunction in autistic preschool children (not universal)

Question 15

The Tower of Hanoi (planning task) and The Wisconsin Card Sorting Set shifting are used to measure which theory?

Answer 15

Executive Control Theory

Found Autistic had difficulties with both tasks
Tower of Hanoi:
Acted impulsively, could not plan several moves ahead, shifted all loops directly
Wisconsin Card Sort:
Unable to shift attentional focus, persevered to sort by established system

Question 15

The Tower of Hanoi (planning task) and The Wisconsin Card Sorting Set shifting are 2 Executive Control tasks. Difficulties in executive functioning are more or less accurate basis for discriminating who was/wasn’t autistic?

Answer 15

More accurate basis for discriminating who was/wasn’t autistic compared to ToM tasks!

Question 15

Can Executive Control explain social/communication problems when using the window task?

For example, a child points to the right box but says the wrong response shows the children find it difficult to resist pointing at the attentional focus (opaque window with the chocolate in).
This suggests that understanding false belief tasks may not be due to lack of insight but due to?

Answer 15

Failure to inhibit a proponent (wrong) response

However, there is no evidence for executive dysfunction in autistic preschool children (not universal)

Question 15

ToM false belief tasks involve sabotaging the ability to withhold information, what does this suggest?

Answer 15

Autistic children may have a specific difficulty with lying for ToM but not with inhibitory control

Question 15

Which theory attempts to explain social and non social difficulties of not automatically processing contextual meaning or using prior knowledge and having a bias towards piecemeal or local (over global) processing that autistic children have?

Answer 15

Weak Central Coherence Theory (WCC)

Question 15

What factor do autistic children have trouble processing in relation to the Weak Central Coherence Theory?

Answer 15

Language processing

Those with autism fail to use context when processing ambiguous homographs. (e.g. The actor took a bow pronounce it as hair bow.)

Difficulties with sarcasm & irony (take it literal)

Question 16

Weak Central Coherence Theory and Perception (islets of ability):

Do autistic children do better or worse on The Embedded Figure Test and The Block Design Task?

Answer 16

ASD significantly faster than matched controls

Individuals with autism were as fast at solving a jigsaw upside-down as right-way-up
Suggests that they have a tendency to look at pictures in sectional parts and are not biased by the whole picture

Question 17

Which task is evidence against the Weak Central Coherence Theory?

Answer 17

Visual illusions

Question 17

Is Weak Central Coherence Theory a primary cause of ASD?

Answer 17

It has good specificity, however not universal
(Not all individuals show WCC)

It is not unique as children with pragmatic language impairment (PLI) also have problems with processing context

Question 18

Can autism be explained by a single deficit?

Answer 18

NO
Autism is the result of a complex interplay between multiple factors and cannot be explained by a single cognitive deficit.

(Several functional neural pathways are implicated)
All impinge on neurocognitive/social cognitive functions that are crucially (but possibly not specifically) impaired in autism.
Autism is very heterogeneous!

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

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

Question 19

Which study task measures how many correct details are continued in information transfer in autistic people?

Answer 19

Diffusion Chains

Question 19

Which model of disability criticises the disability being within the person themselves?

Answer 19

The Medical Model of Disability

Question 19

Which problem explains the idea that people in society have different experiences from autistic people’s experiences, thus finding it difficult to empathise with one another?

Answer 19

The double empathy problem

Question 19

Which model of disability criticises the disability for being societies fault as the environment isn’t adjusted to their needs?

Answer 19

The Social Model of Disability

Question 20

Which Diffusion Chain
either all autistic, all normal, or mixed was more efficient?

Answer 20

All autistic

shows evidence in support of the double empathy problem as autistic people can communicate much better with other autistic people who share similar experiences

However, not representative, and P were all aware of diagnostic status and chains were not gender balanced

Question 20

NOTE SLIDE:

Non-autistic people consistently rated autistic people significantly unfavourably. This may be due to?

Answer 20

Them being harder to read.

Increased knowledge of autism, and disclosure of autism diagnosis could lead non-autistic people to view autistic people more favourably

Question 20

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?

Answer 20

YES!

Question 21

Which model argues autistic people have a range of cognitive and behavioural deficits?

Answer 21

Medical model

Question 22

Which model argues autistic people have a unique way of processing information and interacting with others, which is difficult for non-autistic people to interpret?

Answer 22

Social model

Question 22

What is an intensive early intervention for autistic children that 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?

Answer 22

Applied Behaviour Analysis

-may not be effective long term

Question 22

Who is Autism acceptance training aimed at?

Answer 22

Non-autistic people

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

Found explicit attitudes did not carry over
Implicit was harder to change

Question 22

Social information might be less salient to autistic children which a knock-on effect on development. So what could improve social and communication skills?

Answer 22

Providing learning opportunities to autistic children early on in development

The Transporters
Video of trains with real emotion faces acted out social situations
Predictable
Uses interests
Tested emotional vocabulary

Testing Efficacy: Children were asked to match the correct emotion face to the situation
Used both emotions from the DVD, and new faces/contexts

Can be used by all autistic children and showed significant improvement in emotional recognition