Postcards From My Mind: Perspectives of Asperger's Syndrome

Theory of Mind

“Imagine what your world would be like if you were aware of physical things, but were blind to the existence of mental things. I mean, of course, blind to things like thoughts, beliefs, knowledge, desires, and intentions, which for most of us self-evidently underlies behavior.”

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Andy, a boy with Asperger’s Syndrome, has attended a typical classroom since first grade. Although Andy’s language was two years delayed, his language has progressed to the point where he is able to speak with fluidity. Andy has a few friends that he plays with during and after school. Their favorite game is making a space ship from an old cardboard box and pretending to be astronauts. Andy attends our town’s swim program on Saturday mornings. According to the criteria defined by the Diagnostic and Statistical Manual (DSM), Andy should be cured. So why does Andy still appear so odd? Researchers, such as Simon Baron-Cohen, Uta Frith, and Francessca Happe, believe there is another category missing from the DSM IV’s list of criteria for the autism spectrum disorders. This missing category is called the Theory of Mind.

According to the DSM IV, a triad of impairments in language, social interaction, and symbolic play needs to be present in order to classify a person as having one of the autism disorders. If the acuity of the triad decreases through intervention (as it frequently does), logic would tell us that the child should appear fairly “typical”. Unfortunately, this is not generally the case. Even after these children acquire language, learn social skills, and comprehend symbolic play, many people still remain fairly atypical as compared to peers.

The symptoms of the triad account for the most outwardly atypical signs of the disorder, yet, in my opinion, these surface symptoms are the result, instead of the etiology (cause), of the disorder. One can spend years trying to rotely teach students the essence of emotions by holding up faces of people posing various emotions and asking the student to label the emotion. Eventually students on the spectrum will have no difficulty labeling this emotion. The student has learned the skill of labeling emotions, but not the underlying meaning of why emotions affect us. They have simply memorized the card or, as in my case, came up with rule-based logic to determine emotions such as the grid of faces that I described earlier.

In his book The Web of Life, Frank Capra said, “Information is presented as the basis of thinking where in reality the human thinks with ideas, not information.” This quote so powerfully describes the pitfalls of rote teaching. It’s not that I believe rote teaching is bad. On the contrary, it is a necessary component of learning skills. However, I want to emphasize the word component. We must balance teaching rote skills with teaching concepts. In order to have fully mastered a skill, one must be able to manipulate the information in one’s mind, pull it apart, and contort it, then put it back together. For example, I tell you last night I saw a green moon. I’m sure all of you said something to yourselves such as, “the moon isn’t green, what is she talking about?” In order to come up with this rebuttal, you must have imagined what I was talking about, taken all of your knowledge of the moon, tested the “green hypothesis” and came up with a conclusion. This was probably all done instantaneously and subconsciously

The Theory of Mind involves all the skills necessary to interpret another person’s perspective by importing mental states to him/her which involves inferring meaning from verbal and nonverbal cues, coming up with a range of possible answers, picking the most relevant possibility, and adjusting your information to match the current situation.

For example, I am having a conversation with Jack. I notice Jack is fidgeting in his chair. Then he looks at his watch, picks up his backpack, and gazes at the door. I will interpret this “body language” as either disinterest or needing to leave and hence will change the subject of discussion ending my conversation with a disengagement statement such as, “so that’s all. I’ll give you a call next week.” Many people diagnosed on the autism spectrum will not pick up these cues and will continue to talk regardless of the listener’s desire or interest. By not picking up on these nonverbal cues, one may be thought of as “non-verbally deaf”. As a result, the person on the spectrum is unable to get inside another person’s head to take that person’s perspective, and then make decisions based upon this information. It is for this reason that social skills can be quite difficult. The Theory of Mind webs into many different areas including: socialization, literal thinking, inferring, representation/symbolic play, turn taking, categorizing, perspective taking, reading comprehension, pretending, organizing, imagining, and dreaming.

Simon Baron-Cohen, a leader in Theory of Mind research, borrowed the term “Theory of Mind” from :

“Premack and Woodruff, two primatologists, who defined it as follows: In saying that an individual has a Theory of Mind, we mean that the individual imputes mental states to himself and others… A system of inferences of this kind is properly viewed as a theory, first because such states are not directly observable, and second, because the system can be used to make predications, specifically about the behavior of other organisms.”

“…[A] theory of mind is essential both to understand and predict much of human behavior and for competence in communication. Because social and communicative abnormalities comprise two key symptoms in autism, the idea that there might be an impairment in the development of the child’s Theory of Mind seemed a parsimonious candidate hypothesis…[I]n autism there are severe deficits in understanding belief, knowledge, thinking, pretense, and attention, whereas comprehension of desire and perception appears to be relatively intact.”

 

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