autism

AUTISM
Autism is a rare developmental disorder that affects approximately four in every ten thousand children (Baron-Cohen, Leslie & Frith, 1985). Employing a clinical perspective, Kanner (1943) (as cited in Sachs, 1995) was the first to provide a description on the disorder of autism. However, in the 1970s, Wing (1970) (as cited in Sachs, 1995) applied a cognitive perspective in describing the mental structure of autism. This essay will therefore argue that autism is characterised by the lack of theory of mind (Premack & Woodruff, 1978, as cited in Baron-Cohen et al., 1985), which is a cognitive mechanism. It will further outline empirical evidence derived from the review of two studies, collectively known as false belief tasks. The Sally-Anne task and the Smarties task, in particular, will be discussed and interpreted in support with the arguing thesis.
There is no true causal definition of autism at a biological level, however, autism has been recognised to be a developmental disability affecting cognitive processing (Frith, 1997). The key behavioural deficits that characterises autism are, the inability to interact in social situations, impairments with comprehending verbal and non-verbal communication and the lack of understanding pretend and imaginative play (Wing, 1970, as cited in Sachs, 1995). Other behavioural characteristics contributing to the diagnosis of autism are, engagement in repetitive automatic movements and activities, preference to be alone, displays of self-destruction and aggressive behaviour, sensitivity to external stimuli, attacks of anxiety, and some display savant abilities (Sachs, 1995; Frith, 1997).
Baron-Cohen et al. (1985) applied Wimmer and Perners (1983) puppet play paradigm to test the hypothesis that autistic children are unable to attribute beliefs to others and are incapable of representing mental states. The participants comprised of 20 autistic children, 14 children with Down syndrome, and 27 normal preschool children. The procedure for this false belief task included setting up two doll protagonists, Sally and Anne. Initially, a naming question was asked to ensure participants could distinguish between the dolls. Sally then placed a marble in her basket. Sally exited the scene, and Anne takes the marble from Sallys basket and placed it in her box. Sally later returned, and the test question asked by the experimenter was Where will Sally look for her marble? (Baron-Cohen et al., 1985, p.41). The subjects also had to answer two control questions: a reality control question and a memory control question. Another trial was preformed, where conditions were changed, and included an additional location (experimenters pocket) to where the participants could point. The outcome for this study indicated that all subjects passed the naming, reality and memory questions. For the belief question, 85% of normal preschool and 86% of Down syndrome subjects passed both trials. However, only 20% of the autistic group passed the tested question (Baron-Cohen et al. 1985).


Interpretation of these results indicates the vast majority of normal preschool and Down syndrome children could contrast between what they see to be true and what the doll sees to be false. However, the 15% of preschool and 14% of Down syndrome children who failed the belief question need to be taken into account. It may be concluded that at the time of testing, the proportion of preschool children had not yet developed the complete theory of mind, which is a mechanism required to succeed in this study. Also, it can be assumed that the proportion of Down syndrome subjects who failed, simply did not fully understand the question being asked as they have a below average IQ range. Other possible reasons for the two control groups to fail on the belief question may be that they comprehended the question as ambiguous. For example, when asked the belief question, the proportion of the control groups who failed, could have registered the question as, If Sally looks in her basket and the marble is not there, where will she look?. In this case the correct answer would be the box. Instead, if the experimenter asked, Where will Sally look first, for her marble?, then that proportion of the control group may have passed. Another inconsistency is that 20% of autistic subjects passed the test. This may be that they were incorrectly diagnosed with the disorder, or they have experienced through rote learning that others have different beliefs to them, and therefore can apply this concept without understanding it. However, the fact that the majority of autistic subjects failed the task indicates they lack the ability to distinguish between their belief and the dolls belief. Therefore, this supports the thesis that autistic children lack a theory of mind.

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Perner et al. (1989) Smarties task (as cited in Happe, 1994) is another representation of a false belief task. This study involved a number of autistic and normal four-year-old children. The method involved the experimenter questioning the child to predict what was inside a closed Smartie box. The subjects would give the obvious answer, being sweets or Smarties. The box is then opened to reveal a pencil. The experimenter then closes the container, and poses the question, When the other child comes in, he will be shown this closed up Smarties box, like shown to you. What do you think he will say when I ask him what is inside? The consequence of this study showed that normal four-year-olds succeeded by answering sweets or Smarties. However, autistic subjects failed this task by answering pencil (Pern et al., 1989, as cited in Happe, 1994).


In analysing the results, it is shown that four-year-old normal children understood the concept that if a person like them, has not been exposed to the situation yet, they will give the obvious answer like them. However, autistic children, based on the fact that they lack the ability to represent mental states of others, and therefore not pose a theory of mind (Premack & Woodruff, 1978, as cited in Baron-Cohen et al., 1985) would assume that everyone else knows what they now know. The result of this study hence supports the thesis argued in this essay.
Possessing a theory of mind is fundamental for social interaction with others. For those who do not have this cognitive mechanism, it is merely impossible for them to understand other peoples beliefs, wants and desires. It has been shown that autism is characterised by the lack of this cognitive mechanism, theory of mind. In addition, research studies have supported this theory, that individuals with autism lack ability to comprehend others beliefs from their own. Future research should aim at applying a clinical perspective to help autistic individuals overcome this lack of theory of mind in order for social interaction to be less complex.

Autism

AUTISM: A Pervasive Developmental/Spectrum Disorder
Autism or PPD (pervasive developmental disorder) is defined by the Columbia encyclopedia as a rare neurodevelopmental disorder characterized by the inability to relate to and perceive the environment in a realistic manner. The onset of the disorder is in infancy or early childhood, generally before the age of thirty months, and males are affected four times as often as females. Symptoms include impairment in social interaction, fixation on inanimate objects, inability to communicate normally, and resistance to changes in daily routine (1).
Diagnosing Autism is based on four characteristics: difficulty with language, abnormal responses to sensory stimuli, resistance to change and difficulty with social interaction. “Other characteristics of autism may include: making the same repetitive motion for hours, repeating a sound or phrase, inability to hold a conversation, practicing unusual play patterns, and extreme sensitivity to sound and touch” (Riccio, 1999). Autistics can exhibit any combination of these characteristics in any degree. That is why autism is referred to as a “spectrum” disorder, because at one end of the disorder a child may be inflicted with some symptoms, while at the opposite end a child may be inflicted with multiple symptoms with many areas in between. Children who display few symptoms may be characterized as “mildly autistic”.
In 1943, a man by the name of Leo Kanner formally identified autism; he labeled the disorder “autistic disturbance of affective contact”. Autism was first described in America, officially, in 1980 with the publication of DSMIII (Peter E. Tanguay; Julia Robertson; Ann Derrick, 1980, p.1). There was much confusion, both before and after Kanner’s description, regarding the continuity of autism with schizophrenia and other then-recognized forms of psychosis (Lippcott/Williams ; Wilkins, 1999 p.8). Kanner noticed that autistic infants had a reverse pattern typically observed in normal infants. Infants are normally interested in social, as opposed to nonsocial environments.
The cause for autism remains unclear, although most neurological studies seem to indicate a dysfunction in the brain as a possible reason. Autism has been found in children with brain abnormalities such as congenital rubella syndrome, neurofibromatosis, and tuberous sclerosis. Autism can also be present in genetic syndromes such as fragile X syndrome and phenylketonuria. Some research has shown that there may be an autism gene, or two genes working together. These genes are thought to be on the seventh and thirteenth chromosome. The disorder is, in some instances, may be hereditary as shown by twin studies that cite there is a “substantially higher rate in identical twins-so much so that heritablity is over 90%”, says Joseph Piven (cited in Applied Genetics News p.1). In a Harvard Mental Health letter (1997) statistics found that the rate of autism and mild retardation in brothers, sisters and fraternal twins of autistics is 50-100 times higher than average and in id!
entical twins the rate is 65% to 90%. In 1980 it was found that among 11 families with a father diagnosed with autism more than half of their children were autistic. The apparently normal parents of autistic children had undiagnosed mild symptoms of autism when tested.
Early signs of Autism may appear in the first months of life. Autistic infants tend to stray away from other people, avoiding touch and become limp or stiff when picked up or help. Autistic children dont reach maturation as fast as normal children. A normal child will point to objects or smile when seeing their mother before the end of their first year, but children with autism develop this behavior much later. These symptoms may go on unnoticed by parents or doctors in infancy, but by the age of two to three it is clear that something is wrong.
The Center for Disease Control and Prevention states that one in 500 children in America suffer from autism. Autistic children are unable to recognize themselves or remember things that they have just done. For example, if an autistic child were to show someone a toy of theirs, they would forget they have just showed it and show the toy repeatedly as if they have never presented it before. They may examine a simple little toy or electronic device for hours without losing interest, or rock back and forth in a particular spot for an entire afternoon. The repetition of little things seem to be a grand achievement for these children.
In diagnosing, or assessing autism the child’s history is taken into consideration. For instance whether or not the family has autism in any other branches of its tree can help to determine whether a child may or may not have autism. The Journal of the American Academy of Child and Adolescent Psychiatry (1999) states: Aspects of the assessment will vary depending on the child’s age, history, and previous evaluations (p.6). The history would include the history of the pregnancy and development of the child, marking such milestones as communication and motor skills (i.e. child’s first words or steps), and when thought to be unusual. Doctors will often discuss their medical history, such as possibility of seizures, hearing and visual impairments along with other conditions or syndromes such as fragile X syndrome. Doctors will do this because there is not a specific laboratory test for autism at this point in time. These studies and discussions help in the search for a dia!
gnosis. A test for fragile X syndrome may be given because of its association with autism. Autistic children are often characterized by repetitive motions such as clapping, handflapping and rocking back and forth. Some are extremely sensitive to minor noises, scents and pain, and may even throw tantrums for no apparent reason at any given time.
Experts say early intervention is critical. Some treatments include special diets and vitamin supplements, and focus on drawing a child with autism away from their agenda. If an autistic child is geared away from what they want they tend to become aggressive. Autistic children tend to stray away from conversation or tasks in an irregular manner unable to focus on what others may want. Some signs of the disorder include a decrease in language skills and interaction in activity and attention with others. People with autism dont understand social norms or rules like normal people. Autistics are unable to learn from observation. They need to be taught the significance and meaning of a frown as a pose to a smile, or how to focus on the person that is talking to them.
Autism is easily confused with low intelligence, but many children with autism are in fact very smart. “While 70 percent of the children diagnosed with autism score below average on IQ tests, many are of normal intelligence, and a few are considered quite bright” (Riccio, 1999 p.1). Autistics can learn and improve their education and behavior, and this allows some of them to function as close to normal if not equal in society although most still need assistance with living and job skills throughout adulthood.
Every autistic child is unique. Not all therapies are universal. Each one has to be tailored for the specific patient. People with autism like a very structured environment. They like consistency in their surroundings. Even a slight change in their home setting, E.I.: the movement of a table, can be very unsettling and make the child agitated.
Although most autistic people are severely mentally retarded about 10 percent are autistic “savants”. A savant is a person who incredibly excels in a particular area, such as music or math. “A person who has autism yet can play a Beethoven sonata after hearing it just once, or can do complex mathematical equations, or tell you whether December 3, 1956, fell on a Tuesday or Wednesday” (p.1). Savants may be mentally retarded but they have what Dr. Pratt says is “a very strong, specific talent” (cited in Riccio, 1999). Savants may also have the ability to focus solely on one specific task, or talent while tuning out their immediate surroundings. The part of their brain that their talent is derived from may be intensified, and used almost to full capacity. Gary Anthes, a reporter for Computer World states that “autistic individuals are excellent candidates for computer programming and graphics positions” (1997, p.1). Because autistics can often exhibit strong talents and !
are able to focus so well these types of jobs would be greatly beneficial to themselves and their employers. Because of their lack of social skills they are able to focus solely on their work, and the fact that autistic people need a clear cut plan or goal, like the plans and goals programming offers, helps them overcome the obstacles of life with autism. The Americans with Disabilities Act of 1990 helped produce user-friendly work environments for those with physical impairments (Anthes 1997, p.2). This act has helped both the disabled and the employer realize the specific needs of each other and work together to suit the interests of both the employer and the disabled associate.
In conclusion, autism is a very complex disorder and because of the different extents of the disorder it is very hard to find a cure. With the technology of today improving at a rapid rate autism is now better understood and treated than fifty years ago when autism was first “announced”. People are starting to realize and understand that people with autism have something to offer, and just aren’t mentally retarded. Although this disorder is not very pleasant its condition has improved over the time it was first introduced as a pervasive development disorder, and hopefully within the next fifty years a possible cause or cure will be developed for autism.


Bibliography:
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Anthes, G. (1997, April). Autistic offer unique skills to IS. Computerworld, 31, 37
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Piven, J., Arndt, S., Bailey, J., Andreasen, N. (1996.) Regional brain enlargement in Autism: a magnetic resonance imaging study. Journal of the American Avademy of Child and Adolescent Psychiatry, 35, 530-537.
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Riccio, N. (1999, Dec.). Understanding Autism. Current Health, 26, 28
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(1993). Autism. In The Columbia Encyclopedia, 5, p.2668. Columbia University Press.
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(1981, March). Autism- Part I.

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Harvard Mental Health Letter. 13 1, 4
Article with a Print Counterpart
(1999.) Practice Parameters for the Assessment and Treatment of Children, Adolescents, and Adults With Autism and Other Pervasive Developmental Disorders. Journal of the American Avademy of Child and Adolescent Psychiatry, 38, 32s.
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(1999, Dec.). Possible Gene on Chromosome 13.
Applied Genetics, 20, NA

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