1 5. Autism What is Autism Prevalence of Autism Autistic Spectrum Disorders Characteristics of Autism Diagnosing Autism Theories –the theory-of-mind deficit theory –the executive function deficit theory –the central coherence theory Learning Outcomes

2 What is Autism? complex developmental disability Autism first described by Kanner (1943) typically appears during the first three years of life most severe childhood neuropsychiatric condition triad of impairments –socialisation –communication –imagination

3 Prevalence of Autism 2-6 cases per 1,000 growing at a rate of percent per year boy:girl 4:1 Usually identified before 30 months No racial or socioeconomic differences

4 Autistic Spectrum Disorders Autism is one of five disorders coming under the umbrella of Pervasive Developmental Disorders (PDD) –Autistic Disorder –Asperger's Disorder –Childhood Disintegrative Disorder (CDD) –Rett's Disorder –PDD-Not Otherwise Specified (PDD-NOS)

5 Characteristics of Autism Persons with autism may exhibit some of the following traits. –Insistence on sameness; resistance to change –Difficulty in expressing needs; uses gestures or pointing instead of words –Repeating words or phrases in place of normal, responsive language –Laughing, crying, showing distress for reasons not apparent to others –Prefers to be alone; aloof manner –Tantrums –Difficulty in mixing with others –May not want to cuddle or be cuddled –Little or no eye contact

6 –Unresponsive to normal teaching methods –Sustained odd play –Spins objects –Inappropriate attachments to objects –Apparent over-sensitivity or under-sensitivity to pain –No real fears of danger –Noticeable physical over-activity or extreme under-activity –Uneven gross/fine motor skills –Not responsive to verbal cues; acts as if deaf although hearing tests in normal range. Characteristics of Autism

7 Language development delayed and deviant peculiar use of sounds and words Echolalia Pronominal reversal - use 'i' where 'you' is meant and vice-versa –e.g. 'do you want a drink' instead of 'i want a drink' denial of personal identity? (psychoanalysts) or just related to echoing Use of '-ing' –'daddy piping', 'boy bubbling' (boy blowing bubbles) - 9 yr old autistic girl (Wing 1976)

8 Social development physical and emotional distance from others failure to develop social attachments lack of cooperative group play difficulties in reacting to or recognising other people's feelings

9 Intellectual development poor on verbal ability may perform above average on memory or spatial tasks may be talented in music or drawing 1/4 - 1/3 have IQ>70

10 Diagnosing Autism no medical tests for diagnosing autism Early Diagnosis Diagnostic Tools The NICHD lists these five behaviors that signal further evaluation is warranted: –Does not babble or coo by 12 months –Does not gesture (point, wave, grasp) by 12 months –Does not say single words by 16 months –Does not say two-word phrases on his or her own by 24 months –Has any loss of any language or social skill at any age.

11 several tests have been developed that are now used in diagnosing autism –CARS rating system (Childhood Autism Rating Scale) –The Checklist for Autism in Toddlers (CHAT) –The Autism Screening Questionnaire –The Screening Test for Autism in Two-Year Olds Diagnosing Autism

12 Theories Some current psychological theories of autism –the theory-of-mind deficit theory –the executive function deficit theory –the central coherence theory

13 Theory of Mind autistic children cannot engage in meta- representations, therefore cannot develop ToM –autistic children don't seem to show pretend/symbolic play (Baron- Cohen, 1987) –Therefore predict poor performance on false belief tasks –Baron-Cohen, Leslie & Frith (1985) found this poor performance. Also: –chance performance on mental-physical distinction (Baron-Cohen, 1989) –poor understanding of functions of the mind (Baron-Cohen, 1989) –fail appearance-reality tests (Baron-Cohen, 1989) –don’t know that “seeing leads to knowing” (Baron-Cohen & Goodheart, 1994; Leslie & Frith, 1988)

14 –chance performance on recognising mental state words (Baron- Cohen et al., 1994) –don’t produce range of mental state words (Tager-Flusberg, 1992) –difficulty understanding complex causes of emotion (Baron- Cohen, 1991) –don’t know that eye region indicates thoughts/wants (Baron- Cohen & Cross, 1992) –fail to make accidental-intentional distinction (Phillips, 1993) –unable to deceive (Baron-Cohen, 1992) –don’t understand intentionally non-literal statements (Happé, 1994) –poor use of pragmatics (Baron-Cohen, 1988) Theory of Mind

15 Problems with ToM Prior et al (1990) found autistic children could succeed on Baron-Cohen et al's (1985) task a child may fail a test for any number of uninteresting reasons such as lack of motivation, attention or task comprehension

16 Executive Dysfunction Executive function: –suppress incorrect response –retain relevant information in working memory executive function involved in flexible planning –e.g. Tower of Hanoi deficit occurs with frontal brain damage leading to perseverative behaviour false photograph test (Leekam & Perner, 1991; Russell et al., 1999)

17 Not specific to autism –also occurs in schizophrenia obsessive-compulsive disorder Gilles de la Tourette syndrome ADHD Parkinson’s disease…and more. So - by itself, executive dysfunction cannot explain autism may co-occur with ToM deficit Executive Dysfunction (2)

18 Problems with ToM & Executive Dysfunction Deficit accounts of autism fail to explain why people with autism show not only preserved but also superior skills in certain areas. Savant skills –ten times more common in people with autism than in others with mental handicap –occurring in approximately one in ten individuals with autism

19 Weak Central Coherence Central coherence (Frith, 1989) –people need/desire high-level meaning –everyday tendency to process incoming information in context for gist –this feature of human information processing is disturbed in autism 'weak central coherence' autism biased toward local vs global info processing –"inability to experience wholes without full attention to the constituent parts” –do not succumb to visual illusions (Happé, 1996) –failure to use context in reading (Happé, 1995)

20 The Ebbinghaus Illusion (from Frith, 2003)

21 predicts: –relatively good performance where attention to local information (i.e. relatively piece-meal processing) is advantageous e.g. can recognise object from a single part –poor performance on tasks requiring the recognition of global meaning or integration of stimuli in context e.g. cannot integrate fragments to identify an object cognitive style rather than cognitive deficit. Weak Central Coherence

22 Embedded figures test (from Frith, 2003)

23 Weak Central Coherence Evidence: –Perceptual coherence. –Visuo-spatial constructional coherence –Verbal-semantic coherence weak coherence and theory of mind – independent (Happé, 1995) savant skills –musical talent –graphic talent

24 Wechsler Block Design Task (from Frith, 2003)

25 3 Complementary Theories? Theory of Mind deficit –Social and communication impairments Executive Function impairment –Stereotyped behaviour and narrow interests Weak Central Coherence –Special talents and peaks in performance Do these theories address three primary deficits affecting different brain systems?

26 Learning Outcomes Be able to describe autism and the characteristics of the disorder Be able to describe and evaluate research on autism Be able to describe and evaluate theories of autism Be able to compare and contrast theories of autism

27 Reading Essential Reading (on Digital Resources): Frith, U. & Happe, F. (1994) Autism: Beyond Theory of Mind. Cognition, 50, pp Frith, U. & Hill, E. (2004) Autism: Mind and brain. Oxford: Oxford University Press. Chapter 1. Further Reading: See pdf handout

28 Questions to ask What are the different theories of autism (at the cognitive level)? What does the research into autism tell us? Does the research support the theories?