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Theory of Mind in Children with Autism

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Brigid Hogue

on 2 July 2011

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Transcript of Theory of Mind in Children with Autism

Definition: ToM in Autism Over two decades ago, Baron-Cohen suggested his Theory of Mind Hypothesis to explain the social and communication deficits frequently found in children. (Tager-Flusberg, 2007, p. 311) Research: Chin & Opitz (2000): Conclude that children with autism can be trained to show interest with someone else in a conversation and make appropriate utterances to maintain a topic.
Children with autism could incidentally learn ToM skills through False-Belief interventions but this connection is weak. Where do we go from here? Help children with autism learn how to manage ToM deficit.
Teach ability- not task (Chin & Bernard-Opitz, 2000, p. 570)
Single-Subject Design
Cost-effective Research question: Do short stories with emotion questions and pictures effect children with autism's ability to understand mental states associated with Theory-of-Mind? M
y Participants: Setting: Materials: Variables: Experimental Design: Data Collection Procedures: Theory of Mind in Children with Autism All baseline and treatment sessions will be conducted at each participants' home. Picture cards with illustrations of the short stories
Flashcards of emotions (different styles: realistic, cartoon, b&w, etc.)
"Throw-away" flashcards to create a field of three Independent: Dependent: Multiple baseline across participant design Three BCBAs will be present at all sessions. One will tell the stories and do the teaching and the other two will take data on opposite sides of the room from each other. The three BCBAs will rotate positions throughout the sessions.
The data will be taken as the number of correct emotions labeled during the probe over the emotions asked (10 total). Partial credit will be awarded.
Probes will be done once a day five days a week. Teaching sessions will occur three additional times a day five days a week. IOA, fidelity, social validity Interobserver Agreement Treatment Fidelity Anticipated Results: Social Validity References: The End. Hsiao Yun Chin, J.A., & Barnard-Opitz, V. (2000). Teaching conversational skills to children with autism: Effect on the development of a theory of mind. Journal of Autism & Developmental Disorders, 30 (6), 569-583. Colle, L., Baron-Cohen, S., & Hill, J. (2007). Do children with autism have a theory of mind? A non-verbal test of autism vs. specific language impairment. Journal of Autism & Developmental Disorders, 37 (4), 716-723. Wellman, H.M., Cross, D., & Watson, J. (2001). Meta-analysis of theory-of-mind development: The truth about false belief. Child Development, 72 (3), 655-684. Celani, G., Battacchi, M.W., & Arcidiacono, L. (1999). The understanding of the emotional meaning of facial expressions in people with autism. Journal of Autism & Developmental Disorders, 29 (1), 57-66. Taghva, H., Bagherian Khosroshahi, S., & Pouretemad, H. (2011). The efficacy of a group cognitive training for high functioning autistic children. European Psychiatry, 26 (1), 358. Happé, F. G. E. (1995). The role of age and verbal ability in the theory of mind task of performance of subjects with autism. Child Development, 66 (3), 843-855. Peterson, C.C., Wellman, H.M., & Liu, D. (2005). Steps in theory-of-mind development for children with deafness or autism. Child Development, 76 (2), 502-517. Steele, S., Joseph, R.M., & Tager-Flusberg, H. (2003). Brief report: Developmental change in theory of mind abilities in children with autism. Journal of Autism & Developmental Disorders, 33 (4), 461-467. Ruffman, T., Garnham, W., & Rideout, P. (2001). Social understanding in autism: Eye gaze as a measure of core insights. Journal of Child Psychology & Psychiatry & Allied Disciplines, 42 (8), 1083-1094. Swettenham, J.G., Baron-Cohen, S., Gomez, J-C., & Alsh, S.W. What's inside someone's head? Concieving of the mind as a camera helps children with autism acquire an alternative to a theory of mind. Cognitive Neuropsychiatry, 1 (1), 73-88. Tager-Flusburg, H. Evaluating the theory-of-mind hypothesis of autism. Current Directions in Psychological Science, (2007), 311-315. Lind, S., & Bowler, D. M. (2010). Impaired performance on see-know tasks amongst children with autism: Evidence of specific difficulties with theory of mind or domain-general task factors? Journal of Autism & Developmental Disorders, 40 (4), 479-484. aka: Mind-Blindness The ability to see "oneself and others in terms of mental states-- the desires, emotions, beliefs, intentions, and other inner experiences that result in and are manifested in human action" (Wellman, Cross, & Watson, 2001, p. 655). Eye gaze For example: Joint attention Understanding intentions Empirical Evidence for ToM: False belief: Understand that people have beliefs that can "contradict reality" (Wellman, Cross, & Watson, 2001, p. 655).
Tested by the Sally-Anne task or the Appearance Reality task. Baron-Cohen's research (1985) showed that 80% of the sampled high-functioning participants with autism failed the Sally-Anne task while almost all typically developing preschoolers and Down syndrome participants passed. (Peterson, Wellman, & Liu, 2005, p. 502) People with autism use language for a "limited range of communicative functions," rarely for a social function. (Chin & Bernard-Opitz, 2000, p. 569) Autistic speech characteristics: repetitve speech, poor turn-taking, difficulty maintaining a topic. (Chin-Bernard-Opitz, 2000, p. 569) Happé (1995): Did a thorough review of the previous studies done on ToM in autism and found to much variety in the participants, tasks and results.
Synthesized the previous research and found that although verbal ability was a good predictor to performance on the theory of mind tasks, children with autism required a much higher verbal ability to pass the tasks that the typically developing children or mentally retarded children. (p. 850) Colle, Baron-Cohen, & Hill (2007): Nonverbal cannot take the traditional false belief test so many low-functioning children with autism have not been represented in research. (p. 716)
Conducted a false belief and true belief test designed for nonverbal childen with autism and saw that they performed significantly lower than typically developing children and those with SLI. (p. 721) Procedure: Ruffman, Garnham, & Rideout (2001): Did a desire-behavior task using eye gaze to test if children with autism have cognitive deficits that are restricted to social knowledge.
The kids with autism, moderate learning difficulties and typical kids all performed the same on verbal questions but only the kids with autism were significantly less likely to look at the correct spot. Swettenham, & Baron-Cohen (1996): Used Zaitchik (1990)'s analogy of false beliefs as false photographs to teach children with autism how to understand mental states.
The eight kids tested were able to understand this strategy and were able to predict the character's behavior in the Sally-Anne task. S

T Appearance-Reality Task Three participants
Diagnosed with autism according to the DSM-IV criteria
Received a CARS rating of 50 or above.
Maximum verbal comprehension of two-years-old.
Maximum verbal production is less than two-years-old.
Age 4-6 years BCBA: "One night it started to rain very hard with lots of thunder and lightening. The big brother loves rain and watches out the window but the younger brother hides under his bed until the thunder stops."

"Point to how the older brother feels during the thunderstorm?"

"Point to how the younger brother feels during the thunderstorm?" The BCBA will tell five different scripted stories using nouns that the child can receptively identify. She will also use an illustration while telling the story. After finishing the story, she will ask the child to point to the individual emotions of the characters on the cards from a field of three. The BCBA will include several easy tasks for the child in between each story to make sure that the child stays correct at least 80% of the time. Reinforcements will be used throughout the probe. The two BCBAs taking data will compare data and use the interval agreement to determine the IOA.
[Agreements/ (Agreements + Disagreements)] x 100
Maintain IOA above 90%. Parents of the participants will be given a questionnaire to evaluate the effectiveness and necessity of the intervention. Questions will be rated on a scale of 1 to 5 so that the qualitative data can be quantified. The two additional BCBAs present at all sessions will keep each other accountable to implement the intervention correctly at each probe. Teaching sessions with stories composed of two to three sentences that are read aloud and then followed up with questions and teaching on the emotions in the story The ability to correctly identify the each character's emotions in the short stories and then generalized to real-life situations in the child's natural environment
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