Friday, 12 January 2018

More Thoughts on Theory of Mind

And the hits keep coming.  My little corner of the autism universe has been blowing up with angry articles by adults with autism complaining about scientific assumptions that they lack theory of mind, which is the ability to understand that other people have different thoughts, experiences and emotions than they do.  Generally, this tends to affect people with autism in the following ways:

- inappropriate reactions (eg laughing when someone is upset)

- problems anticipating others' reactions to their behaviour (eg expecting others to remain calm when they have been throwing a tantrum)

- assuming "universal knowledge" where what they experience, think, and feel is what everyone experiences, thinks, and feels.

- Difficulty with social rituals (eg taking turns in a conversation)

- Difficulty with pretend play (problems understanding character's motivations)

There is a real issue when lack of theory of mind is understood as a lack of empathy.  People with autism do not lack empathy.  They may have trouble picking up on expressive cues, but that is something which can be taught.  And many describe themselves as feeling overwhelmed by other people's emotional reactions, which is certainly not a sign of a lack of empathy.

However, there is a real gap in their perceptions which needs to be addressed (and here's my disclaimer that I'm not a psychologist or other accredited professional, this is based solely on my own experience , research and understanding).  I see these challenges on a regular basis, from both the high and low functioning communities.  Examples such as someone getting angry over something and assuming ill intent on the part of the other person, or failing to understand that their hurtful words have an impact past the immediate moment.

Some people will point out that many neurotypical people can show the same symptoms, and they're right.  There are plenty of people on both sides of the spectrum who lack a fully developed theory of mind, so perhaps the community has a point in that those with autism should not be singled out.  However, it is crucial for parents and educators to understand that those with autism likely will need help.  Most people will develop theory of mind through observation and imitation.  However learning through observation and imitation is one of the areas where people with autism have the most difficulty.  They will need to be taught explicitly, rather than assuming they will "grow out" of it or "just get" it.

There's certainly a valid debate as to whether or not the theory of mind problems are a result rather than a cause.  If a person has trouble with observing and understanding others, is that a result of an assumption of universal knowledge or is the universal knowledge a result of the fact that it's hard for them to understand and observe?  That's a question that professionals should be pursuing.

But for parents, the needs are a lot simpler.  They need to understand that their child's behaviour should not be taken personally, but understood as a different way of perceiving the world.  They need to understand that these skills can and should be taught, and can be developed with practice.  That's it.  

So here are some things that parents can do:

- practice recognizing emotional expressions and body language.  We did this using books and television, pausing stories to identify what the characters were feeling.

- talk about others' experiences.  Again, using books or movies, we practiced understanding what the characters felt (eg, why is Grover sad because Ernie can't play right now?)

- practice social rituals, like "Say 3 things and then ask the other person a question" to avoid monopolizing a conversation.

- praising appropriate reactions, such as apologizing, keeping one's temper, and being considerate.

None of these are particularly difficult or intrusive but they can be helpful.  And I don't feel that they are an attempt to "fix" autism (another common complaint from the community).  I see teaching these skills as a necessity.  My kids may choose not to socially interact when they become adults, and that's fine, but if they do, they will have the skills they need.

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