Sunday, 22 April 2018

Theory of Mind and Autism


Over the past few years since we received L's and then O's ASD diagnosis, I have heard a lot about and have read a lot of articles that focus on the idea that individuals diagnosed with autism lack Theory of Mind.

I've very briefly touched on Theory of Mind in a previous post so I thought that it was time for a more detailed post on this subject.

Theory of Mind, or ToM as it is often written, can be briefly defined as having an understanding that the minds of others are different from our own. In particular the understanding that other individuals have different thoughts, feelings and perspectives than our own. Theory of Mind provides us with the ability to put ourselves in the place of others to try and figure out what or how they may be feeling or thinking at any particular moment in time.

Theory of Mind is crucial for us all as we navigate through social interactions. We use Theory of Mind when analyzing, judging, and making calls on the behaviour of others. We use Theory of Mind to predict the behaviours of others based on what we think that they might be thinking. For example Theory of Mind assists us when we are empathising with someone who is having a tough time, even though we may be having a great day.

Every time I hear or read about Theory of Mind, the same example is shown or spoken about. It is called the Sally-Anne task. In the Sally-Anne task, a child must determine what another child's response would be as to the location of an object. One of the examples that I have seen is that Sally places an object into a hiding spot and then leaves the room. Anne then moves the object to another hiding spot. When Sally returns to the room, the child (who is observing this) must indicate when Sally WILL look for the object.

If the child's Theory of Mind has developed, the child usually answers that Sally will look in the original hiding spot as she is not aware that the object was moved after she left the room. In terms of a developing Theory of Mind, this is the response that researchers are looking for.

If a child's Theory of Mind has not developed, the child will usually answer that Sally will look in the other hiding spot. That's the last spot that THEY spotted the object in so therefore they think that Sally will know that is where the object is hidden. 



In typically developing children, Theory of Mind usually begins to emerge between the ages of 4 and 5. During this period, children typically start to think about other children's thoughts and feelings. In the Sally-Anne task, researchers have shown that the responses of children under the age of four years, is inconsistent. Whereas the responses of children aged 4 to 5 years, become more consistent in that they understand that while they have seen where the object was moved to, Sally didn't.

Theory of Mind continues to further develop as a child grows older. For the next few years, they learn to predict that what one person feels/thinks about a topic is not necessarily the same as the next person. As Theory of Mind further develops, children begin to understand complex language that relies heavily on Theory of Mind such as lies, sarcasm and figurative language.

There is a train of thought that our Theory of Mind is constantly developing even as adults as we have more opportunities to experience life, and observe people and their behaviour. I tend to agree with this.

So how does Theory of Mind relate to Autism?

It is thought and has been shown that Theory of Mind doesn't develop fully in individuals diagnosed with ASD until much later in childhood. In some cases, Theory of Mind doesn't begin to fully develop until individuals reach adulthood.

The reason behind this thought is that most individuals who have been diagnosed with autism, lack the awareness that others can have different thoughts, beliefs, opinions and so on from themselves. Individuals diagnosed with autism need to work much harder to develop their own Theory of Mind.



Well, O and L are both examples of individuals whose Theory of Mind is still developing. Yes they are only 9 and 6, but compared to typically developing children O and L's Theory of Mind is still in the developmental stages.

At the age of 9 O is well aware that she thinks differently from others in that she thinks in pictures and sounds, but she struggles to put herself in others shoes in relation to the idea that not everyone thinks and feels the same as her. She is developing more skills in this but she also still struggles.

Both O and L struggle to interpret particular social cues especially the non-verbal cues that we all take for granted that are scattered throughout social interactions.

As a young child, L exhibited inappropriate reactions and responses to others emotions. He often would not respond to us or to O when we were sad or angry. He wouldn't respond when we were happy. And if he did respond, it would be a totally inappropriate response. He still occasionally struggles with his responses. The look on his face now is that he knows he should respond in some way, he just isn't sure how to respond.

For a time O also struggled with this. One example that I can recall vividly is when I took her to watch the movie "The Good Dinosaur" at the cinemas. All throughout the movie, particularly in scenes that I thought were quite sad, O was laughing her backside off. In fact she thought that the entire movie was quite hilarious. Meanwhile other movie goers were crying during different scenes in the movie. Although they did end up laughing due to how loud O was laughing!

O struggles in responding the social expected way when someone says hello, good morning or good afternoon to her. If you are in the place where you are meant to be, ie: at home, she often won't respond. You're where you are meant to be, in her mind, she shouldn't need to greet you. However if she spots you in a setting where she doesn't expect you to be, then you can expect a completely different response.

O struggles to understand why children her age say one thing and yet they mean another.

L still struggles to show empathy towards others. And yet O on the other hand can be over-empathetic at times. She lacks the understanding that at times there is such a thing as too much cuddles. I've lost count of the number of times when we've had to remind her that the child she is cuddling, really doesn't want to be cuddled anymore, which is why they are struggling to get away from her!

Both O and L regularly cause frustration in each other and in us when they say "Do you know where the thing is?" or "Did you see that?" What thing?????? At times they simply do not comprehend that we either didn't see something happen or that we haven't seen the toy/book/object that they're referring to. We constantly have to remind them that they need to describe said object or toy or movie scene that they're referring to so that we know what they are talking about! Although I have a feeling that this is all children in general but it does relate back to a child's Theory of Mind!

All of the above examples can be indicators that a childs's Theory of Mind is still developing.



So how can we assist a child's theory of mind to develop? How can we help a child to tune into the thoughts and feelings of others as well as tune into their own thoughts and feelings?

When talking with O and L, we talk about how we feel or what we are thinking in particular situations. This gives O and L a different perspective on what they might be feeling or thinking at that particular time. It begins to embed the idea that others DO think and feel differently than them.

When we see other people experiencing different emotions, we talk about why they might be feeling happy or sad. We provide O and L with the language that they may need to describe how they are feeling.

When we read books we talk about how and why the different characters in the story might be feeling or what the characters might be seeing in the story. Doing this helps my little superheroes to put themselves into the shoes of others. We'll then often relate how the characters are feeling back to a time that O and/or L were feeling that same way so that they begin to understand that other people have the same thoughts and feelings as they do.

We encourage both O and L to engage in role play games and if we are included in the game, we step out of the parent role and into the role that we're playing in the game. Role playing in itself assists in developing a child's Theory of Mind as it encourages the child to think and act out the role of the person that they are playing. They have to actively think like the other person.

Just simply talking with O and L about how we all feel and think provides the opportunity for them both to think deeper about their own thoughts and feelings. Talking embeds the idea that others have different thoughts and feelings from their own. It also begins to embed the idea that the way we all act is often based on what we think and feel.

All of these strategies assist in the development of O and L's Theory of Mind.

But one of the most important strategies that we keep in mind at all times is that the emotional perplexing behaviours that O and L often show are not done deliberately. They're done to communicate the difficulties that they are both having in understanding Theory of Mind.

4 comments:

  1. This is so interesting! I have no one in my close circle that has autism, so I do not understand it very well. This honestly helps me a lot. Thank you for making things clearer!

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  2. Wow. So much to take in and consider. Thanks for the in-depth theory on this. :)

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  3. I love this- "We encourage both O and L to engage in role play games and if we are included in the game, we step out of the parent role and into the role that we're playing in the game. Role playing in itself assists in developing a child's Theory of Mind as it encourages the child to think and act out the role of the person that they are playing. They have to actively think like the other person."
    I think we all need to do this (adults and children) as only then can we really feel empathy for one another.

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  4. Autism is a very sensitive health issue. Thank you for giving us awareness. I'll share this to my mom friends.

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