Understanding the challenges children with ASD face within their surroundings Overview Background facts What is different about the ASD view of the world? Social difficulties Non-social difficulties Non-social assets
Sensory difficulties Conclusions Prof. Francesca HappĂŠ Francesca.happe@kcl.ac.uk
Background facts Diagnostic
criteria: Social impairment, Communicative impairment, Evident by 3yrs Rigid/repetitive behaviour and interests
1%
of population may have an autism spectrum disorder (ASD): includes autism, atypical autism, Asperger’s syndrome
Males
out-number females
Increase
in numbers with ASD probably due to better recognition, widening criteria, etc
Associated
difficulties: intellectual disability, epilepsy, sensory abnormalities
The ASD triad: No single explanation? Social impairments “Theory of mind”
“Executive functions”
Problems recognising thoughts and feelings?
Problems generating, planning, monitoring?
Communication impairments
Restricted/ Repetitive Behaviours & Interests
“weak coherence” Detail-focused cognitive style?
What is different about the ASD view of the world? Social difficulties ‘Theory of mind’ = recognising others’ thoughts, beliefs, desires …putting yourself in another person’s shoes Tested by ability to attribute a false belief (3 years+)
Manifest in everyday social skills (2 years+) e.g. making secrets pretending lying
Social Insight is a ‘gatekeeper’
Neurotypicals learn through social interaction
• orient to others’ eye gaze, pointing, etc • interested in what others find interesting • infer thoughts/feelings behind actions • imitate others’ actions Paying attention to others becomes second-nature
People with ASD are typically less oriented to others • may look less at faces • interested in what they find interesting • interaction may be puzzling/frightening Figuring out what others think/mean is hard work
Eye-tracking studies: What captures ASD attention?
Klin et al
Eye tracking studies – what do people with ASD pay attention to?
→ Environmental features may distract from social interaction
Social and Communication problems well explained by ‘Mind-blindness’ Most ASD children fail simple ‘false belief’ tests that 3- to 4-year-old ordinary children pass ‘Mind-blindness’ may explain: e.g. -social interest but difficulty, -lack of communication, -over-literal understanding, -apparently callous behaviour -lack of pretend play
Understanding emotions ‘Reading
minds’ and ‘empathising’ may be distinct abilities Difficulty knowing what others are feeling is not the same as not caring about others’ feelings Our study of ‘callous/unemotional’ traits showed these are unrelated to ASD severity – although a ‘double hit’ can occur
Mind-blindness in the Classroom? Look at me when I‟m talking to you!
Even signs need some mindreading
„Everyone‟ ≠„John‟
Angry, embarrassed, or hot?
Painful honesty… & upsetting fascinations
Social insight has costs
‘Neurotypicals’ like what others like
Shutts, Banaji & Spelke, 2009, Dev Sci •3-yr-olds choose toys, foods, games, clothes endorsed by same sex, same age •Are apparently unaware of source of their preference
‘Herd effects’ (see Raafat, Chater & Frith, 2009, TICS)
Social insight, conformity and talent?
3 ways that mindblindness may enhance talent? 1. No ‘blinkers’ from shared thoughts? 2. Don’t spend time/neural space on social ‘savant’ skills?
3. Better able to achieve unself-conscious (implicit?) performance… ‘flow’?
Repetition isn’t necessarily the enemy of creativity
What is different about the ASD view of the world? Non-social difficulties
Executive Functions Planning & Monitoring
Control & Flexibility
Generating & manipulating ideas
Many people with ASD have difficulty - dealing with the unexpected - planning ahead - controlling impulsive behaviour - shifting between tasks
Wisconsin Card Sort Test: Flexibility
Difficulties with flexibility and practicalities of life often limit independent living, even with very high intelligence
Executive dysfunction in the classroom? Scaffolding planning & imaginative rehearsal?
What do we do when our frontal lobes are overloaded?
Reducing impulsivity?
Easing transitions?
What is different about the ASD view of the world? Non-social assets -
-
-
„Weak central coherence‟ exact memory jigsaw puzzle and other spatial skills... Perfect pitch, attention to details (miss the whole?) Distress at ‘tiny’ changes?
What is different about the ASD view of the world? An eye for detail
Changes in your environment... What counts as a ‘tiny’ change?
Can you spot the difference?
What matters to you is never ‘tiny’…
Embedded Figures Test
Object Recognition from fragments
Example of consecutive frames from the Fragmented Figures Test (Snodgrass et al, 1987): Booth, 2006.
Central Coherence as Cognitive Style
‘weak’------------------Central Coherence-----------------‘strong’ e.g. good proof reading
e.g. good gist recall
A continuum of cognitive style from ‘weak’ to ‘strong’ coherence? Both extremes have costs and benefits? Possible sex differences? Around 50% fathers & 30% mothers of ASD boys show weak coherence (Happé, Briskman & Frith 2001)
Does detail-focus spark talent? Eye for detail is related to talent in music, maths, art of memory (HappĂŠ & Vital, 2009) Passionate special interests can be used to motivate wider learning
Drawing by Gilles Trehin http://urvillecity.free.fr/
‘Weak coherence’ in the classroom? What‟s “cow”?
Reading a story…
What does the person with ASD see?
Teaching „zooming out‟?
…or reading a list?
What counts as the same?
Sensory Abnormalities in ASD Sensory
sensitivity e.g., covering ears to loud, unexpected sounds; restricted food preferences
Sensory
under-responsivity e.g., failure to orient to name or react to pain
Sensory
seeking e.g., rocking, hand flapping, noise-making Ben-Sasson et al. 2009
Sensory Abnormalities Are very common in individuals with ASD
95% of young children with ASD show some degree of sensory processing dysfunction Tomchek & Dunn (2007) Also found in intellectually disabled individuals without ASD
Can occur in any sensory modality e.g. impairments in auditory, visual, touch, & oral sensory processing are commonly reported in ASD Kern et al. (2007)
over 90% of children with ASD have sensory symptoms in multiple domains Leekam et al. (2007)
Sensory Abnormalities Can show patterns of both over- & under-responsivity ď ľ ď ľ
Chen, Rogers, & McConachie (2008) some studies suggest under-responsivity may be more frequent in ASD Rogers & Ozonoff (2005) sensory seeking behaviours are often interpreted as counteracting underresponsivity to sensory stimuli Dunn (1999)
Sensory abnormalities and adaptation Sensory
symptoms associated with restricted repetitive behaviours Rogers, Hepburn, & Wehner (2003)
Under-responsiveness,
sensory seeking, and auditory filtering difficulties predict poorer school performance in HFA Ashburner, Ziviani,& Rodger (2008)
Sensory difficulties correlate with maladaptive behaviors: – parent-reported child anxiety, social relating, communication disturbances, self-absorption and antisocial behaviors. Baker et al (2008)
Sensory abnormalities: sources of difficulty Sensory symptoms might reflect: Eye for detail? Failure
to use context? (predictionreduced perceived intensity)
Abnormal
Genuine
attention?
physiological differences?
Sensory abnormalities: what might help? Sensory
likes and dislikes are idiosyncratic, vary between and even within individuals with ASD
But
some are more predictable, and can be considered in planning the environment….
Common
dislikes – florescent light flicker – loud/unexpected/shrill noise – light touch
Common fascinations - spinning objects, glitter - echo of own vocalisations - deep pressure
Concluding thoughts Challenge Social
of translation between ASD and ‘Neurotypical’ views
stimuli are the most salient aspect of environment for NTs
Special
interests and sensory fascinations can be great motivators (or distractions)
ASD Best
eye for detail means we need to consider ‘trees not just forest’ environments will scaffold deficits, enhance assets
Thanks to All the participants in our research studies SRS Team: Steph Lietz, Emma Colvert, Emma Woodhouse, Nicola Gillan, Tori Hallett, Catherine Ames Angelica Ronald, Robert Plomin and the TEDS Team
MRC Wellcome Trust Autism Speaks francesca.happe@kcl.ac.uk