Cognitive theories of Autism spectrum disorder

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How many people have ASD?
50,000 people
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How many children have ASD?
1 in 100 children
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What word is more likely to be used to describe ASD?
Condition
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What is high functioning autism?
Refers to autism without language delay or learning display
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What are the symptom of autism?
poverty of facial expression, stereotypical movements that do not convey meaning, impulsive and stimulus driven, excellent logical abstract
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What are Kanner's cardinal features/
Autistic aloneness, obsessive insistence on sameness
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What was autism described as in the 1940s?
Children came into the clinic could not form emotional relationships with other humans, such as mother or father and lack of facial expressions
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What is the triad of impairments?
Socialisation, communication, imagination (delay or atypical functioning in at least one, with onset prior to age 3 years
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What is the 1st one?
Impairment of social interation/development
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What is social attachment?
Indifference to other people, difficulty making friends, may seem independent as a toddler, resists or does not seek affection, can be affectionate and show attachment on a simple level
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How might people with autism find it difficult to understand other's minds/thoughts and feelings?
Difficulty interpreting other person's need for affection, difficult to understand other people's thoughts and emotions, irregular eye contact --> do not follow gaze --> seem to be in a world of their own
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How might people with autism find it difficult to regulate emotions?
Difficulty managing emotions --> Expressed as outbursts of anger or aggression, difficulty coping with new situations, difficult to accept simple social rules, causing problems at school
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What are the impairments of social communication?
Non verbal and verbal
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What is non verbal social communication?
Difficulty to read body language and facial expressions, lack of appreciation of the social uses and pleasure of communication, dont develop usual non verbal skills or imitation skills
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What is the verbal communication?
Don't develop the usual verbal skills like typical children, understanding meaning of spoken or written language, unable to understand jokes or sarcasm, reversal of pronouns, severe autism may never speak at all
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What is the 3rd triad of impairment?
Impairment of immagination
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examples?
Inability to play imaginatively with objects or toys, outward manifestation of this impairment, overly interested in repetitive activities, may take up interest at a young age, such as collection or music and art, adolescent form obsessions
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What are some examples of other symptoms?
sit up or walk later than most children, be oversensitive to noise or touch, odd mannerisms, hand flapping, be clumsy and struggle with physical activity, same routines, over or undersensitive to senses
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What are non social features?
Restricted area of interest/preoccupation with parts of objects, desire for sameness and routine, excellent rote memory, savant abilities, islets of ability
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What is ASD as a spectrum>
some require special education provision, others have less severe difficulties
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What is the high occurance with other difficulties?
Attention or motor difficulties, unspecific, specific (fragile X syndrome) 79% meet criteria for at least 1 psychiatric condition
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What is the prevalence?
ASD affects up to 1% of children, boys outnumber girls 10:1 (but this is changing)
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How is autism diagnosed?
Experienced clinicians use a range of assessments to establish whether the behaviour of an individual meets specific criteria, autism diagnostic interview, autism diagnostic observation schedule
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How do you understand autism at a cognitive level?
Specificity, uniqueness and universality
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What are the 1st main theories?
Theory of mind? Failure of acknowledge others have their own thoughts and beliefs,
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What is the 2nd main theory?
Executive dysfunction: Deficits in inhibition, planning, executive memory
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hat is the 3rd main theory?
Weak central coherence: Preference for local details over the global whole or context
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What is early research on cognitive abilities find?
Mixed findings or deficits not unique in ASD< often dependent on intellectual abilities rather than autism, mid 80s proposed that autism mightarise from a primary cognitive deficit
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What did Baron-cohen et al 1985 find for socialisation difficulties?
Social and emotional problems secondary to cognitive problem, adapted unexpected transfer task - Sally - Anne task (with marble in basket)
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What did he find?
80% of ASD children failed, even those with mental age above 4 --> deficient ToM, Not due to learning difficulties/general developmental delay as down syndrome not failed
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What is inferring mental states of geometric figures?
REcent reconceptualisation of ToM to enactive mind hypothesis, autistic mind not attuned to social world (Gaze following, eye region attention capture), started with social attribution task (Heider: silent animation of figures)
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What would a child with autism say?
The big square went into the box. There were a small square and a circle. The square went out. The shapes bounce of each other. The small circle went inside the box. The big square was in the box with the circle.
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What would a child without autism say?
the larger square - which was like a bigger kid or bully - had isolated himself from everything else until two new kids come along and the little one was a bit more shy, scared, and the smaller square more like stood up for himself and protected Smal
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What is autism and false belief?
Why should people with autism attribute mental states to dolls? Why test understanding with a game that involves make believe when children with autism are known to be weak at that?
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What did Leslie and Frith do?
Another version of unexpected transfer task, participant involved directly, penny under one cup --> Where will Leslie look for his penny? Real people rather than dolls, therefore, dont have to use fake believe or imagination.
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What did Perner use?
Deceptive box task, verbal mental age above 4 but cant solve
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What did Mitchell and Isaac, 1994 investigate?
Children with autism and down syndrome watched enactment: Mum has two bags of wool, puts one in the drawer and one in cupboard, left scene: Jane swapped items the other way round, mum wants wool in drawer: ASd children fail
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What is communication impairment?
Participant asked to judge: 1) Which item mum really wants and which item the mum put in the drawer
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What does ASD interpret?
Mum wants to bag in the cupboard than in judging that bag of woll mum put in the drawer is now cupboard, those with aSD incorrectly interpret utterances literally suggesting difficulty making non literal interpretations
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Leslie, 1987
Link between cognitive impairment and lack of pretend play
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What is imagination impairment?
Pretend play as a basic expression of understanding other minds, engaging in imaginative play with another person requires acknowledging another person's non literal thoughts/beliefs eg: pretending a banana is a phone
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What is the good specificity for triad?
Powerful and convincing, difficulties in relating, communicating, all related to understanding of the mind but not universal
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Happr (1994) What about those who pass?
Solve differently (and how counts), not autistic, TOM hypothesis wrong, not primary element of ASD
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Sparrevohn and Howie (1995)
ASD with higher verbal mental age more likely to succeed
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HAppe (1995)
Meta analyssi on ASD and Tom, relationship between child's veral mental age and passing FB tasks, verbal mental age of 12 be able to pass compared to 4 years in typically developing children
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What is 2nd order false belief task?
Mary and John saw the ice cream van 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 IC
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Baron-Cohen (1989), what do ASD pass and what was suggested?
ASD pass 1st order, fail 2nd order, proposed that ToM problem was a delay rather than a deficit
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What happened to people with aspergers?
Pass 2nd order, deficit of ToM not universal, perhaps not primary
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What did Baroncohen suggest?
90% of typically developing children pass at age 7.5 years, 60% of down pass but non of ASD, do not have a fully representational ToM
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What about adults with ASd?
73% of ASD young adults pass
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What do children with hearing have?
Development delay in acknowledging false belief
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Therefore?
Deficit of ToM is not unique to ASD
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Does theory of mind have good specificity?
- Accounts for triad - But: Insistence of sameness - Routines - Narrow interests - Repetitive behaviour
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What is executive control?
The ability to maintain an appropriate problem solving set for the attainment of a future goal
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What behaviours include?
Planning, impulse control, inhibtion of prepotent but irrelevant responses, set maintenance, organised search and flexibility of search and action
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What does the tower of Hanoi show?
Poor Planning
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What does Wisconsin card sort- set shifting?
- Sort by colour or symbol based feedback – change strategy at some point, change from shape to colour. Some people have problems with changing the way the cards are organised
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Ozonoff et al, 1991 What was found about ASD patients with different techniques?
Tower of Hanoi: Acted impulsively could not plan several moves ahead, shifted all loops directly, wisonsin card sort: Unable to shift atttentional focus, persevered to sort by established system, theory of mind test: Many: 1st order, some 2nd order
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What is the windows task?
• Perhaps FB task failure due to insufficient flexibility in imagination to give correct judgment? • Children
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Can failure on fb be explained by EF?
stage: boxes without window - some learning trials, stage- box with window so pp can see where choc, choc in one, if point to choc, experimenter eats it, need to point to empty box to get a reward
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What is it about?
Seems to be about deception, but its about resisting to point to attentional focus/salient part, acting impulsively - being unflexible and unable to inhibit, resist blurting out what have discovered
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What is shown in unexpected transfer task?
Point impulsively to where the chocolate is, rigidity of behaviour
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What is the deceptive box?
Say impulsively what we know to be in the box, repetitive behaviour
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What is the windows task?
Point to where the chocolate is, pattern of behaviour in ToM tests
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What is the study to show executive dysfunction?
ASD no problem in sabotage, but cannot withhold information (fail deception) • Impairment is not an EF deficit • Not specific • adults onset ED not cause ASD • Children with PKU show ED, but are not ASD
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What is there no evidence of?
Executive dysfunction in autistic pre school children
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Sodian and Frith Method
- Prevent burglar to gain access to treasure box - Pps can lock treasure box and not give key (sabotage) or - tell burglar lie that box locked (deception
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What is the task about?
The task is about deception, and sabotage - ASD kids have no problem with latter, they dont act impulsively. Deficit is not about EDF but a specific ToM deficit. They cant help telling the thief what is in the box,
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What dont they have a problem doing?
Manipulating a person's behaviour, they have a difficulty with false belief
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What is specificity?
Can explain many of the deficit by doesnt always hold up
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What is universality?
Not all individuals with ASD show EF problems
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What is uniqueness?
Not unique to ASD
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However what is needed to explain?
- Non social features of autism - Savant abilities - Anecdotal reports of heightened perceptual abilities - Uneven intellectual profile
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What does Weak central coherence attempt to explain?
Do not automatically process contextual meaning or use prior knowledge, a bias towards piecemeal or local processing
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what is there evidence for?
That individuals with aSD tend not process information in context and in many instance ignore the overall meaning, evidence for this has been found in language processing, as well as perceptual judgement or discrimination tasks
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What is language processing?
Those with autism fail to use context when processing ambiguous homographs, literal, difficulties with sarcasm and irony
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WCC and perception?
Embedded figures test and block design, ASD significantly faster than matched controls, Pring et a (1995): individuals with autism were as fast at solving a jigsaw upside down as right way up
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What is inconsistent evidence for Wcc?
Happe reduced susceptibility to visual illusions, Mottron et al, reduced global precedence in Navon task but see plaisted
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Is WCC a primary cause of ASD?
Not universal, unique? children with pragmatic language impairment also have problems with processing context
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What are challenges of WCC?
- Differentiating itself from other theories which attempt to explain non social features of autism - Enhanced perceptual functioning - Reduced top down processing
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What is the changes to criteria?
Triad > dyad, social communication and interaction, restricted repetitive patterns of behaviour, interests or activities
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What is there emphasis on?
Individual needs
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What are the levels of severity?
o Level 1 - requiring support Level 2 - requiring substantial support Level 3 - requiring very substantial support
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What are the alternative theories of ASD/
- Mirror neuron theory – brain level explanation, not well supported. (Williams et al., 2001) - Extreme male brain – more descriptive than explanatory - Social motivation theory – not cognitive but motivational/reward deficit (Chevallier et al. 2012)
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What are other alternative theories of ASD?
- Enhanced Perceptual functioning - accounts for inconsistencies in WCC literature. - Enlarged temporal binding window – explains ASD symptoms at a sensory level - Sensorimotor theory of autism – could be a more parsimonious explanation of autism?
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How many children have ASD?

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1 in 100 children

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What word is more likely to be used to describe ASD?

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Card 4

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What is high functioning autism?

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What are the symptom of autism?

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