PSY2001 Lecture 9 - Neurodivergence and Autism

Causes of Developmental Conditions - genetic mutation

Down syndrome (extra copy of chromosome 21)

Causes of Developmental Conditions - Prenatal factors

Damage while in womb

• Oxygen deprivation, maternal infection, structural differences in brain

• Ex: Cerebral Palsy

Causes of Developmental Conditions - Unknown combination

Genetic, environmental, psychological, neurological

Early descriptions of autism

Kanner (1943) & Asperger (1944)

• Low IQ

• “autistic aloneness”, inability relate to others

• “desire for sameness”, upset by changes

Triad of impairments

Wing & Gould (1979)

A: Impairments in social interaction

• Lack of eye-to-eye contact, failure to develop peer relations

B: Impairments in communication

• Language delay, lack of varied make-believe play

C: Restricted, repetitive patterns of behaviour

• Narrow interests, ritualistic or compulsive behaviours

DSM-V Criteria

A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and deficits in all of the following:

1. Social-emotional reciprocity

2. Nonverbal communicative behaviors

3. Developing and maintaining relationships

B. Restricted, repetitive patterns of behaviour, interests, or activities as manifested by at least two of the following:

1. Stereotyped or repetitive speech, motor movements, or use of objects

2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behaviour, or excessive resistance to change

3. Highly restricted, fixated interests that are abnormal in intensity or focus

4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment

C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)

D. Symptoms together limit and impair everyday functioning.

Description & Diagnosis

• Different characteristics and combinations of criteria, varying severity

• May show “islets of ability”: equivalent to, or better than neurotypical people(e.g. rote memory, spatial tasks)

• ~3x more men/boys diagnosed than women/girls

  • Might be down to different presentation/outdated or biased view of autism

  • Similar difficulties in diagnosis with non-binary individuals and ethnic minorities

Causes of autism

Hereditary component

• Some evidence from twin and family studies

Structural differences in the brain

• Connection or structural differences in the brain

• Differences between girls and boys (e.g. Smith et al, 2019)

  • NEED MORE DATA! (Mo et al, 2021)

BUT: To date, no clear genetic/ neurological explanation

Problems with Diagnosis

• Diagnosed and defined using behavioural criteria

  • Some signs appear early (12-18 months)

  • Typically around 3+ years, but can go undiagnosed

• Increase recently in numbers, largely due to better diagnostic material and understanding of impairments

• Developmental outcomes highly variable

  • Why so much variability in terms of what develops, when, and in whom?

“Traditional” theories of Autism

Attempt to explain differences, including:

• Executive Functioning

• Weak Central Coherence

• Theory of Mind Deficit

Executive Functioning (EF) in individuals with Autism

Ex: planning, organising, inhibition, impulse control, sustaining attention

Repetitive, restricted behaviours may be explained by impairment in executive control

• Early difficulties in EF might play role in developmental outcomes

• Correlation between EF and ToM

Weak Central Coherence in individuals with Autism

• Central coherence: ability to derive overall meaning from a mass of details.

  • WCC: Bias for feature or local information/details

• Proposed to explain certain aspects of autism (Frith & Happe, 1994)

  • Ex: Islets of ability, excellent rote memory, preoccupation with parts of objects

• Could be a superiority in detail, rather than deficit in global.

Rote memory

A learning technique that involves repeating information until it's memorized

ToM deficit lead to social impairments

• Effective social understanding

• Interpreting behaviour of others

• Communication

• Indirectly explains sameness and routine

Apply the same tests used with neurotypical children

Baron-Cohen et al (1985) procedure

Sally-Anne false belief task

• Typical aged 4

• Autism with mental age >4

• Down’s syndrome with mental age >4

Baron-Cohen et al (1985) Results

• 80% of TD & DS solved

• Only 20% of autistic group

Supported by: Perner et al (1989) - similar results with Smarties task

Baron-Cohen et al. (1986)

Picture-sequencing task

• Autistic children could order & explain mechanical and behavioural stories

• Difficulty ordering “mentalistic” stories

• Randomly ordered, and only reported what they could see, no mental state.

Limitations of ToM hypothesis

Not all children fail these tasks

• Autistic children sometimes perform at TD levels

• Challenge universality of ToM deficits, and thus the hypothesis

Response to limitations of ToM hypothesis

Happe (1995)

• Autistic children don’t solve until much older than TD children

• Perhaps relying on different strategies on simpler tasks

Second-order beliefs (Baron-Cohen, 1989b)

“Where does Anne think Sally will look for the marble?”

Some autistic individuals can solve these tasks

Strange Stories Task

• More natural, complex challenge than false belief tasks (Happe, 1994)

• Participants read short story and are asked why a character says something they don’t mean literally (white lie, pretend, joking, idioms)

• Even those who passed 2nd order ToM tasks were impaired

  • Perhaps too vocabulary-loaded

Baron-Cohen et al. (1997)

Eyes task

• Infer mental states from eyes alone

  • Designed to address ToM abilities beyond those of a 6-yr-old

  • Choose between correct emotion and “foil” (ex: concerned vs. unconcerned)

• Autistic group significantly impaired compared to TD group and Tourette Syndrome group

Test has been criticized, particularly by autistic people, for not measuring ToM.

Real-world consequences of Baron-Cohen’s studies

Impact of “harmless theorising”

• Offensive, ignorant, flawed and easily debunked

• Still being taught every day outside of academia, even after 30 years.

• Presented as if it is fact and embedded in professional thinking

Gernsbacher & Yergeau (2019)

“Empirical Failures of the Claim That Autistic People Lack a Theory of Mind”

• Failures of specificity

• Failures of universality

• Failures of replicability

• Failures of validity

Gernsbacher & Yergeau (2019) - Failures of Specificity & Universality

Many non-autistic individuals fail these tasks, such as:

• Children with other developmental conditions

• Neurotypical children with fewer siblings, fewer close adult relatives

Not all autistic participants fail these tasks because:

• ToM tasks rely heavily on spoken language

• Longitudinal studies suggest vocabulary predicts performance on false belief tasks more than age

• Meta-analyses found that vocabulary predicts false belief performance more than whether or not an individual is autistic

Importance of considering comminucation impairments

Gernsbacher & Yergeau (2019) - Failure to replicate earlier findings

Ex. Baron-Cohen et al (1986)

• No other study has found the same differences

• Strange stories and Sally-Anne tasks also mixed results

• Small sample sizes→ large effect size in original studies

Gernsbacher & Yergeau (2019) - Failures of convergent validity

Performance on many ToM tasks isn’t correlated, providing evidence ToM test aren’t measuring the same construct:

• Performance on strange stories and reading the mind in the eyes tasks

Gernsbacher & Yergeau (2019) - Failures of predictive validity

Evidence that ToM performance does not significantly predict socioemotional function:

• Empathy/emotional understanding

• Social skills

• Peer relations/pro-social behaviour and more

Double-empathy problem

(Milton, 2012; Mitchell et al, 2021)

• Autistic and non-autistic people have different social communication styles

• Breakdown in mutual understanding

• Mitchell et al’s (2021), transactional model

Transactional model of development - Mitchell et al (2021)

1. How A person behaves →

2. How A is perceive by others →

3. How others behave towards A →

4. How A perceives and interprets the behaviour and/or attitudes of others.→ 1.

Sheppard et al (2016)

Autistic and Non-autistic people filmed during 4 conditions (joke, waiting, telling story, telling compliments)

• Non-autistic participants better able to correctly identify condition for other non-autistics (in all except ‘joke’ condition)

Not because autistic participants reacting “less expressively”

• In a separate study, rated just as “expressive” as non-autistic people in all conditions except “compliments”

Acknowledging biases and impacts on autistic people

• Traditional ToM deficit account has been accused of dehumanizing autistic individuals

• Perspectives of autistic people rarely taken into consideration! (Jaswal & Akhtar, 2018)

Acknowledging different expressions of social behaviour

• Neurotypical people fail to read minds of autistic people (Sheppard et al. 2016)

• Different ways of viewing the world leading to breakdown in understanding

Acknowledging the impact these perceptions can have on development

• Clinical practice

• Parent-child interactions

• Self-esteem and well-being