Date:    Mon, 10 Aug 1998 09:21:52 -0400
From:    Tracey McMullen <tracey.mcmullen@SICKKIDS.ON.CA>
Subject: Theory of Mind articles

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Hi, here it is finally for all those who asked - a short list of some =
articles that indicate that some children with autism are able to =
demonstrate "theory of mind" in the classical experimental manner.  =
Typically, studies about the presence of a "theory of mind" prove or =
disprove this by looking at:  a child's ability to perform a false-belief =
task (practice deception) or engage in pretend play or their ability to =
attribute mental states (infer another's emotions).  If a child can not =
carry out one of these tasks, the research then concludes that the child =
does not (yet?) possess "theory of mind".
The following are some articles that indicate that the inability to do =
some of these tasks could be because of problems with executive function =
or inhibition (like perseverating).

Yirmiya, N. et al. (1996) Ability to maniputlate behavior and to =
understand manipulation of beliefs:  A comparison of individuals with =
autism , mental retardation and normal development.  Developmental =
Psychology, 32, 62-69.

Ozonoff, S. et al. (1991) Executive functioning deficits in high =
functioning autistic individuals: Relationship to theory of mind. Journal =
of Child Psychology and Psychiatry, 32, 1081-1105.

Hughes, D.H. & Russel, J. (1993) Autistic children's difficulty with =
mental disengagement from an object: Its implications for theories of =
autism. Developmental Psychology, 29(3), 498-510.

Jarrold, C. et al. (1994)  Comprehension of pretense in children with =
autism. Journal of Autism and Developmental Disorders, 24(4), 433-455.

Russel et al. (1991) The 'windows task' as a measure of strategic =
deception in preschoolers and autistic subjects.  British Journal of =
Developmental Psychology, 9, 331-349.

(author?) (1992)  Autistic social dysfunction: Some limitations of the =
theory of mind hypothesis.  Journal of Child Psychology and Psychiatry, 33(=
5), 861-876.

Ozonoff, S. et al. (1990)  Are there emotion perception deficits in young =
autistic children? Journal of Child Psychology and Psychiatry, 31(3), 343-=
361.

Disclaimer:  this does not mean I personally disagree with the theory of =
mind deficit hypothesis in children with autism, just that I'm not so sure =
that we have all the information yet.
Date:    Sun, 8 Sep 1996 14:52:41 -0400
From:    MK <uualien@P3.NET>
Subject: JADD article on Theory of Mind

Dear ListMates,

        I found a copy of the JADD article (Vol. 25, No. 4, 1995) which Bud Newsome
mentioned the other day, called "Teaching Theory of Mind: A New Approach to
Social Skills Training for Individuals with Autism" by Sally Ozonoff and
Judith Miller (University of Utah).  I prepared a summary of this article
for the students in my language disorders class and I thought I'd send it
off to anyone on  the List who might be interested: (For those MeListers who
might not have tracked the previous discussions about this topic, Theory of
Mind, or TOM, refers to a person's ability to infer the mental states of
others).

        Anyway, Ozonoff et al's study involved 9 adolescent boys who met the
DSM-III criteria for Autistic Disorder or PDD-NOS.  All boys had Full Scale
IQ scores above 70. The boys were divided into two groups (treatment and
control) so that any differences in their performance following treatment
could be related to the treatment rather than to normal maturational
factors. Assignment of the boys to one or another of the groups was done on
the basis of scheduling convenience (rather than on the basis of
randomization, the preferred procedure in research).  The treatment group
included 5 boys (mean age = 13.8,  ranging from 13.5 to 14.0) and the
control group included 4 boys (mean age = 13.6, ranging from 11.3 to 16.2).

        The boys in the treatment group participated in fourteen (14) 90-minute
group sessions over a 4 1/2 month period.  Each session consisted of 6
parts: 1) a discussion of the particular social skill being targeted that
day,  2) a discussion of the importance of that skill in daily life,  3) the
presentation of role plays enacted  by the trainers,  4) the boys'
engagement in role play  which was videotaped,  5) a review of the
videotapes with reinforcement and constructive feedback given for specific
behaviors, and 6) a fun activity (see below)

        The curriculum for the group sessions involved two basic modules,  each
presented in 7 of the 14  consecutive sessions.  The first module addressed
basic interaction and conversation skills (e.g., how to begin, maintain, and
appropriately end conversations, how to choose topics that interest others,
how to read, interpret and appropriately express nonverbal signals and
emotional expressions, how to negotiate and share, how to listen, how to
give compliments, how to express interest in others).  The activities for
this module came from two published curricula. One is called THE WALKER
SOCIAL SKILLS CURRICULUM: THE ACCEPTS PROGRAM by Walker et al. (1983),
published by Pro-Ed. The other is called THE PREPARE CURRICULUM: TEACHING
PRO-SOCIAL COMPETENCIES  by Goldstein (1988), published in Champaign,
Illinois by Research Press.

        The second unit focused on teaching perspective taking and theory of mind
skills.  The activities here were variations on procedures published
initially by Baron-Cohen (1989) and others.  Theory of Mind (TOM) skills
were first addressed concretely by having group members lead a blindfolded
trainer through a maze. "Children were taught to take the blindfolded
person's physical perspective, providing a good description of obstacles and
possible routes, without assuming the blind-folded person could see what the
child could see."

        Next, the emphasis shifted to how cognitive points of view could differ
(e.g., how one person could know something that another person does not
know).   Role playing was used to illustrate this. For example, child A and
child B were instructed to hide a toy together. Then, child B changed the
hiding place while child A was not looking. The group members were then
asked to predict where child A would look for the toy.

        Next, the emphasis shifted to "second-order perspective taking" (i.e.,
predicting what one person THINKS another person THINKS). "For example, in
one role play, children A, B, and C decide to go bowling together later that
evening. After child A leaves to change clothes before bowling, B and C
revise the plans, deciding instead to see a movie. B and C then part ways as
well. On the way home, B stops by A's house to tell him of the new plan.
They agree to meet at the movie theater and A heads there. C, after changing
his own clothes, stops by A's house and finds he is not there.  The group
members were then asked to predict where C would think A had gone."

        Another goal of the treatment was to demonstrate that social interactions
can be fun and desirable. To this end, each treatment session was ended with
a game or other pleasurable activity. The games which were used often
addressed particular social skills which had been targeted throughout the
meetings. For example, clues in a game of Wheel of Fortune might have
included "a nonverbal signal that shows you are listening" or "what people
do when they are frustrated."

        Also,  community outings were scheduled between the group treatment
sessions .  Outings included such things as visits to arcades, restaurants,
malls.  And at each outing each boy would be given certain social goals to
work on (e.g., initiating 2 conversations with the boy they were seated next
to).  The boys received feedback after the outings about their performance
of the targeted behaviors.

        The boys in the treatment group also participated in planning several
parties to which adults and children from outside the group were invited.
In so doing,  the boys were encouraged to select foods and activities which
the guests would enjoy (rather than just those which the boys themselves
would enjoy). Emphasis was placed on taking the perspective of the guests
and inferring what they would enjoy.

        In order to assess whether this treatment would impact  the TOM of the
children in the treatment group, ALL  children in both groups were given
pre- and post-tests (before and after the end of the treatment protocol).
There were 4 tests in all, and they are described as follows:

1. M&Ms False Belief Task (based on Perner et al., 1989) - This is a "first
order" perspective taking task. "The boys were shown a box of M&Ms and asked
what it contained.  After a response was given, the box was opened to reveal
that it actually held a pencil. Subjects were then asked to predict what
another child, who had never seen the box, would think it contained. A pass
was scored if the subject responded "M&Ms" or "candy"

2. Second Order Belief Attribution Task (based pm Baron-Cohen, 1989)  - This
task utilized a model of a town constructed from railroad miniatures.
"Subjects were told a story about two children, John and Mary, playing in a
park. After seeing the story enacted, subjects were asked to predict Mary's
beliefs about John's whereabouts (Belief Question).  A correct answer
required subjects to recursively reason about mental states (e.g., What does
Mary think John thinks?) and from this, predict where she would believe he
had gone.  There was also a Justification Question.. . [To answer this],
subjects were asked to explain why Mary held the belief she did. Responses
were scored according to the number of mental state attributions made by the
subject (0= no mental states mentioned, 1= mental states attributed to only
one character, and 2= mental states attributed to both characters).

3. Overcoat Story (based on Bowler, 1992) - This task also measured second
order belief attribution abilities, but was more difficult because no visual
cues were provided. "subjects were asked to predict what one person thinks
another person thinks and then explain why. Scoring was the same as above.

4. Prisoner Story (based on Happe, 1994) - This was an advanced  TOM
measure. "...Subjects read a short story about a prisoner of war who is
being interrogated about the location of his army's tanks. The story states
that the interrogators assume the prisoner will lie. In an effort to save
his comrades, the prisoner instead tells the truth. Subjects were asked to
predict where the interrogators would look for the tanks (Belief Question)
and why (Justification Question). Scoring was the same as above.

        In addition to the direct pre- and post-testing of the boys' performance,
teachers and parents were asked to rate each boy's behavior in the natural
environment by completing a Social Skills Rating (SSR) questionnaire.  The
teachers were blind to each boy's group membership and time of testing.

        The boys' test performance results were analyzed in several ways. The
pre-and post-test  scores were compared across groups to evaluate effect
size (i.e., the degree to which the treatment group improved relative to the
control group subjects).  Also analyzed was the proportion of boys in each
group who improved and the generalizability of the improvement.

        Results indicated that there were no differences between the two groups at
pre-treatment testing; however, the treatment group's performance had
improved at post-treatment assessment while those of the control group had
not. ... The magnitude of the differences suggested that the intervention
was effective in improving performance on the false belief tests. Also, 80%
of the treatment group (4 of 5 subjects) had improved while only 25% (1 of
4) of the control group did... The treatment group demonstrated improvement
on 65.4% of the tests not initially passed, while the average improvement of
the control group was only 23.5%.  However, generalization of effects
APPEARED not to be significant based on the results of the ratings provided
by teachers and parents.  However, the authors noted that the SSR
questionnaire used to obtain the ratings did not specifically include
questions which addressed TOM issues (i.e., perspective taking). In other
words, the teachers and parents were asked to rate the boys on the basis of
behaviors which were not directly relevant to the treatment.

        Based on the results of this study, the authors call for further research.
For example, if the boys in the treatment group really did not generalize
their TOM skills into the classroom or into their family life, the question
remains whether one can actually teach TOM to ASD children or whether one
can only teach specific skills that reflect TOM in restricted contexts.  The
authors believe that TOM can be taught, but they indicate that future
research must utilizes more sensitive tools in assessing this question.
Additionally, the TOM tasks in this study assessed only a small range of
perspective taking skills (i.e., inferences about another person's
knowledge, belief, deception,  intention). It is also important to explore
the modifiability of other mental state inferences (e.g., knowedge of
desire, pretense, and misunderstanding).  And finally, treatment effects
should be assessed in terms of their durability. If an ASD child can be
taught to respond to a TOM task appropriately, how long will this skill
remain in his/her repertoire without further specific and deliberate
reinforcement?

I hope that some of you found this information interesting or useful.  MKDate:    Sun, 28 Apr 1996 17:51:38 -0400
From:    Cheryl Bomba <CLBomba@AOL.COM>
Subject: Theory of Mind

To Mariko and anyone else who may be interested:

Basically, "theory of mind" refers to the ability to conceive of mental
states: that is, the ability to know that *other people* know, want, feel,
believe in things, etc. Although the term has been around since the 1970's,
it did not become "popular" until the late 1980's.

In typically developing children, the ability to understand that another
person's perspective may be different from one's own (and to figure out what
that perspective might be) starts to develop at around age 2 and, according
to Piaget, is not fully developed until age 9 or 10. However, Piaget's
research has been criticized in recent years and most child development
professionals now believe that this ability is established much earlier.

One of the tests used to demonstrate people with autism's difficulty with
theory of mind involved three groups of participants - typically developing
children, children with mental retardation and children with autism - all
matched for cognitive ability and receptive and expressive language levels.
The experimenter took the children one by one and showed them each a candy
box. The experimenter shook the box so the children could hear that there was
something inside. When the experimenter asked, "What do you think is in the
box?" the children answered (excitedly!) "Candy!" The experimenter then
opened the box and showed that it contained not candy, but pencils.

For the next step of the test, the experimenter said, "Let's bring your
friend John in and show him the box. What do you think he'll say is inside?"
The typically developing children and the children with mental retardation
all said that John would say there was candy in the box; they "got the joke"
and thought this would be hilarious. But when the experimenter asked the
children with autism this question, they all said that John would say there
were pencils in the box. They just didn't "get" how someone could think
something different than what they knew to be a fact; they couldn't "put
themselves in John's shoes" and see the situation from John's point of view.

Since the children in this test were matched for cognitive ability and
receptive and expressive language levels, children with autism's inability to
understand theory of mind may be a deficit independent of general
intellectual functioning, and may explain the lack of pretend play and
pervasive difficulties with social exchanges often seen in children with
autism.

New research is investigating whether or not children with autism can be
*taught* theory of mind. Eden is currently working with Dr. Alan Leslie on a
study involving the development of theory of mind in autistic children; I
will keep everyone posted as the project progresses.

If anyone would like to read more, Uta Frith's book "Autism: Explaining the
Enigma" is a good place to start. "Understanding Other Minds" edited by Simon
Baron-Cohen, Helen Tager-Flusberg and Donald Cohen is also good, but highly
technical.

Hope this information was helpful!

Cheryl Bomba, M.A.T.
Assistant Director for Technical Support
Eden Family of Services
Princeton, NJ

Date:         Tue, 23 Jan 1996 22:17:06 +0100
Reply-To: SJU Autism and Developmental Disablities List
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Sender: SJU Autism and Developmental Disablities List
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From: Anders Ebenfelt <Anders.Ebenfelt@MAILER.GU.SE>
Subject:      Theory of mind and some more
To: Multiple recipients of list AUTISM <AUTISM@SJUVM.STJOHNS.EDU>

>Tuberous Sclerosis is a late onset (with exception) variant of autism.
>Normal social development can occur up to one year of age in many cases
>before the appearance of infantile spasms which is the precusor to the
>development of autism. Many autistic children pass the milestone of the
>development of joint social attention which normally emerges at about six
>months postnatal, but the vast majority of autistic have consistently been
>shown to perform poorly in theory of mind tests. The development of a
>theory of mind occurs normally at around 48 months, therefore it is
>unlikely that there is a single narrow window of oppurtunity (ie those who
>state that it is a second trimester. disorder) for the early neurological
>damage to occur.
>
>Bob Jensen

Yes, but I think there is still a possibility for aquiring the disorder
(autism) from environmental factors during some of the first years of life.
Still, there are some children with onset around and after 3 years of age
(my son for example). The development of theory of mind is of some authors
statued occuring at 48 month, but I think this must be a mistake. I have
three children and it is obvious that two of them (including my now
autistic boy, but not the girl with Mb Down and autism I also have !)
developed theory of mind early in life. It is easy to possess that when
talking to a child. Further, I don't think that the lack of theory of mind
in autistic individuals is a general rule. Things are more complicated than
so. In the original experiment in this subject, by Uta Frith I think, I
think (dont remember exactly) that 4 out of 14 children with autism passed
the test (Sally-Ann test) correct whilst all non-autistic individuals did
the same. It is a striking difference, yes, but what about the 4 who did
correct. They had autism but yet they passed the test and thus had theory
of mind if the test is considered to be a proof of that.
Best Regards

Anders Ebenfelt

Date:    Mon, 29 Apr 1996 19:49:02 -0700
From:    Kirk Schumacher <kschumac@INTERSERV.COM>
Subject: Re: Theory of Mind

Hi all,

I was very concerned as to whether my son had a theory of
mind while he was in the process of recovery.  I had read
a great deal about theory of mind including several
articles by Uta Firth.  I found theory of mind to be
disturbing because it seemed to indicate a lack of what
one might consider the essence of being human, emphathy.
I was at first anguished when my son failed the tests which
had been published by Uta Firth et al.  Then many months later
I realized that my son had not understood questions.  I
realized that fact after sitting through one of the several
IQ tests he took to isolate deficits.  I knew that my son
frequently knew the answer, but the phrasing of the question was
just enough off to lead him to give the wrong answer.  When
I repeated the theory of mind tests at a language level
where I was confident he understook the question, he clearly
demonstrated a theory of mind.

I have serious reservations whether the researchers are fully
able to match for language proficiency.  Athough my son
increased his IQ scores by some 50 points, I don't think he got
any smarter.  I think it was all in the testing, even "nonverbal"
IQ tests contain a great deal of language content.  We need to
see a lot more and better controlled research to make any conclusions
as to autistics failure to develop a theory of mind.

Kirk S. Schumacher
KSchumac@Interserv.com
Date:         Wed, 25 Oct 1995 21:32:07 GMT
Reply-To:     SJU Autism and Developmental Disablities List
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From:         dgoble@WOMBAT.AMERICAN.EDU
Organization: Box Hill College of TAFE
Subject:      Re: Aaaaaagh - I've changed my mind

>From my readings of the many post on this topic, it seems that Frith is getting
forked in the neck for using terms such as Theory of Mind (ToM) and
mind-blindness.  Lets set the record straight once and for all.

I do not intend to write a thesis on this topic but some things need to be put
into perspective.  Frith did not, and never claimed to, "invent" the theory of
mind hypothesis.  It has been around for many years and was coined, I believe,
by Premack and Woodruff in 1978 in their paper, "Does the chimpanzee have a
"theory of mind"? _Behavior and Brain Sciences, 4_, 515-526. (I'm providing
full citations so that interested readers can access them for themselves).
Indeed since then there has been an enormous amount of research into ToM, but
this is related to developmental psychology generally, not specifically to
autism.  As an area of developmental research, ToM, or "mindreading" as some
prefer to call it, is a fascinating topic and has produced such publications as

        Whiten, A. (1991). _Natural theories of mind: Evolution, development
                and simulation of everyday mindreading_. Oxford: Basil
                Blackwell.

and

        Wellman, H.M. (1990). _The child's theory of mind_. Cambridge: MIT
                Press.

ToM is defined as an "implicit capacity which involves the person postulationg
the existence of mental states and then using these to explain and predict
another person's behavior".  I shall quote further. "...This capacity implies a
need to represent other people's representations; accordingly, the implicit
"theory of mind" requires the usage of "second order representations" or
"meta-represenations"...it is this specific cognitive skill which is postulated
to be at fault in autistic individuals" (Klin, A., Volkmar, F., &Sparrow, S.
(1992). Autistic social dysfunction: Some limitations to the theory of mind
hypothesis, _Journal of Child Psychology and Psychiatry, 33_, 861-876).

What Frith, and indeed MANY others, have done is to test the hypothesise that
what people with autistic spectrum disorders are experiencing is a ToM defecit
or delay.  The research findings in support of this hypothesis are compelling
and cannot be ignored or dismissed out of hand.

It is true that most children display a lack of ToM but it is also generally
accepted that by the age of 4 years, most children have begun to move away from
an egocentric point of view and demonstate an increasing awareness of others'
points of view.  Piaget referred to this stage of development as
the period of "intuitive thought".  From 4 to 7 years, the child is seen to be
able to take other peoples' perspectives into account.  The person experiencing
an autistic spectrum disorder, however, might be thought of as being delayed in
this area.  Notice the use of the term "delayed" which implies that some may
eventually develop this skill although the path taken to reach it might deviate
from the norm quite markedly. Others, however, may never develop that skill,
i.e they can be seen as having a ToM deficit (not a mind deficit - the
distinction is important).

Frith, I believe, now prefers to use the term "mentalising" to refer to ToM
skills.  As for the term, "mind-blindness", it was only used as a metaphor to

allow educators to appreciate that the condition can be accommodated.

        "Dyslexia can be seen as word-blindness and autism as mind-blindness.
        The metaphor is helpul as a means of thinking about the education and
        management of children suffering from a disorder....People can be made
        mindful of the needs of the blind person, and the physical enviornment
        can be adapted so as to be safe for someone who cannot see.  Exactly
        the same applies to people with word-blindness or mind-blindness".
        (Frith, U. (1992). Cognitive development and cognitive deficit, _The
        Psychologist, 5_, 13-19).

Using my own theory of mind, this does not appear, to me, to be the writing of
someone who is desirous of introducing big words into the autistic vocabulary
in order to make a name for herself. On the contray it seems to me that she is
fighting to allow autistic people to be recognised as individuals in the same
way as those with other forms of disability are.  "Surely, to recognise that
some people have a disorder means to recognise that they have the right to an
allowance being made for their [disability].  This is at least a first step
towards a kinder treatment" (p.19).

I hope I have presented this discussion in a fair way that nips in the bud the
assertions that Frith is in this for her own notoriety.  The ToM hypothesis may
have a long way to go but it has certainly provided researchers and
practitioners in the field with more information about the condition than we
have ever had before.  We can therefore thank Frith and her colleagues for
their efforts.

Cheers

David Goble
Melbourne, Australia
Date:         Wed, 25 Oct 1995 10:36:27 GMT
Reply-To:     sndrake@mailbox.syr.edu
Sender:       SJU Autism and Developmental Disablities List
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From:         "Stephen N. Drake" <sndrake@MAILBOX.SYR.EDU>
Organization: Syracuse University, Syracuse NY, USA
Subject:      Re: Aaaaaagh - I've changed my mind!

Ian Wedge (Wedge@redtwo.demon.co.uk) wrote:

: What is the problem with "Theory of Mind"? Is there are an alternative
: explanation for the results of the Sally-Anne test or the Smarties test?

: Judging from the post below the theory isn't restricted to the UK, but I
: really don't know. I'd appreciate some feedback on this.

Hi Ian,

Sorry to jump in on this so late, but I dug out a few abstracts that look
at the Sally-Anne test and variations on it.  It turns out that
performance can depend on a host of factors, most of them easier to
define and evaluate than "theory of mind".  Abstracts are below:

Steve
***********************************************************************

TI: Theory of mind in children with autistic disorder: Evidence of
    developmental progression and the role of verbal ability.
AU: Sparrevohn,-Roslyn; Howie,-Pauline-M.
JN: Journal-of-Child-Psychology-and-Psychiatry-and-Allied-
    Disciplines; 1995 Feb Vol 36(2) 249-263

AB: Investigated developmental progression of theory of mind ability
in 30 autistic children (aged 5.8-15.2 yrs) and examined the role
played by verbal ability in task performance. Two groups of Ss with
different verbal mental ages (15 high vs 15 low) but comparable
nonverbal ability and chronological ages performed a range of theory
of mind belief tasks. Results show hierarchical patterns of
performance across tasks, suggesting a developmental sequence of
emerging aspects of theory of mind ability. There was clear evidence
that verbal ability is an important contributor to successful task
performance.
*******************************************************************
TI: Autistic children's difficulty with mental disengagement from an
    object: Its implications for theories of autism.
AU: Hughes,-Claire; Russell,-James
JN: Developmental-Psychology; 1993 May Vol 29(3) 498-510

AB: Exp 1 demonstrated that autistic Ss continue to fail a task
originally designed as one of strategic deception when there is no
opponent present: They perseveratively indicate the target object.
The authors argue that this behavior is better explained in terms of
failing to disengage from an object than in terms of a theory-of-mind
deficit. To ensure that their difficulties were not due to failure to
construe the task in a competitive manner, the authors ran a 2nd
study, on detour reaching. Compared with control Ss, the autistic Ss
had great difficulty with the task. Children's difficulties with
these 2 tasks are discussed in light of recent evidence that autism
is associated with failing executive tasks, and it is argued that
viewing the syndrome as an executive deficit has clear advantages.
*********************************************************************

TI: Performance of autistic and control subjects on three cognitive
    perspective-taking tasks.
AU: Reed,-Taffy
JN: Journal-of-Autism-and-Developmental-Disorders; 1994 Feb Vol 24(1)
    53-66

AB: 22 autistic Ss (aged 5-39 yrs), 22 normal control Ss (aged 3-17
yrs), and 10 intellectually retarded Ss (aged 6-52 yrs) were tested
on a task involving 2 dolls (the "Sally/Anne" task) proposed by S.
Baron-Cohen et al (see PA, Vol 73:30090) and on 2 other perspective-
taking tasks that involved more predictable interactions and
nontransient cues. Autistic Ss differed significantly from the
control Ss in their ability to perform the Sally/Anne task but not
the other tasks. As well the autistic Ss performed significantly
differently on the 2 types of tasks. Failure of the autistic Ss on
the Sally/Anne task with their concurrent success on the other tasks
is attributed to the nontransient nature of the stimuli used and the
predictability of the protagonists' reactions in the 2 tasks on which
they succeeded.

Date:         Fri, 13 Oct 1995 02:06:24 -0400
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From: Natalie Whatley <whatley@INFORAMP.NET>
Organization: InfoRamp Inc.
Subject:      Theory of Mind (very long post)
To: Multiple recipients of list AUTISM <AUTISM@SJUVM.STJOHNS.EDU>

This was Jay Ingram's column in the Toronto Star on Oct. 8/95.

"Why you can be in two (or more) minds"

"It is a difficult truth of research into the human brain: people who are the
victims of disabling brain damage sometimes offer the greatest insights into
how the undamaged brain works and the more unusual the condition, the greater
the leap of understanding may be.

Such is the case with Williams syndrome. Williams syndrome is a genetic
disorder affecting only about one child in 20,000. children with Williams
syndrome are usually described as being 'elfin' in appearance with wide
mouths, flared nostrils and full cheeks. they are also severely mentally
impaired, usually scoring in the 50s on IQ tests.

But their mental impairment is quite uneven. While they are apparently
incapable of even simple reasoning and problem solving, they are eerily
skilled in their use of language and at recognizing faces and facial
expressions. They can decipher incredibly complex sentences and when asked to
name animals, they are likely to come up with 'ibex' or aardvark' as they are
'cat' or 'dog'.

This srange pattern of a few islands of ability in an otherwise dismal sea of
mental incompetence has attracted the attention of many researchers in the
last 10 years.

A team of English and American scientists recently tested the idea that there
might be a set of centres in the brain that deal exclusively with social
interaction, a set the might somehow be spared in Williams syndrome. If such
speculation could be proven it would go a long way toward supporting the
general idea that the brain - rather than being and intelligent mush - is
instead a collection of smaller brains or 'modules' designed to accomplish
specific tasks.

One way of demonstrating that the brain has a set of these 'social
interaction' centres would be to find another mental ability that is preserved
in Williams syndrome children. The researchers chose to test the children's
ability to detect and identify what's on someone else's  mind. for example, if
I see you glancing repeatedly at the cake on the table, and I realized that
you want to eat it, then I have some knowledge of your mind.

One of the reasons these researchers chose this particular mental ability is
that in another much better-known condition, autism, the ability to know
what's going on in another's mind is strikingly impaired. Even autistic
individuals with normal IQs have great trouble figuring out from the most
obvious clues what someone is thinking.

If that single ability can be knocked out in autistic kids, could it be
preserved in Williams syndrome? After all, Williams kids are good at
interpreting faces and language, two other important social skills. Maybe
knowing what others think would be a third part of that mental package.

And it was. Williams syndrome children were very good at understanding what
others are thinking. A perfect example is a little scenario involving two
dolls. As the child watches, doll Number 1 hides a toy in a toy box while doll
Number 2 looks on. Then doll Number 2 leaves the room. Doll Number 1 now takes
the toy out of the toy box and hides it instead in a drawer. doll Number 2
returns. The child is then asked, 'Where will doll Number 2 look for the toy?'

Autistic children usually get this wrong. They seem to assume that because
they know the toy has been moved, doll Number 2 knows that too. They can't put
themselves into the second doll's mind. But Williams syndrome shildren have no
trouble understanding that doll Number 2 couldn't possibly know that the toy
had been moved. They even use the word 'think' as in, 'He will look in that
box because he thinks it's still there.'

These experiments don't just reveal a third intact mental ability in Williams
syndrome children. They also suggest that those intact abilities - language,
understanding faces and knowing what's on someone's mind - are all the mental
skills required by a social life. they may even represent a set of
interconnected brain centres that have been spared in the devastation of this
condition.

Where are these supposed centres? No one knows. Why are they intact? Same
answer. But the mere fact they exist is further evidence that our brains are
many, not one. Singleminded we are not.

(Jay Ingram hosts the TV program @discovery.ca on the Discovery Channel)

I found this article fascinating; hope you did too.

Natalie
& Date:         Fri, 17 Feb 1995 11:21:29 EST
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              <AUTISM@SJUVM.STJOHNS.EDU>
Sender: SJU Autism and Developmental Disablities List
              <AUTISM@SJUVM.STJOHNS.EDU>
From: Lisa S Lewis <LISAS@PUCC.PRINCETON.EDU>
Subject:      Executive Function References
X-To:         Autism <AUTISM@SJUVM.STJOHNS.EDU>
To: Multiple recipients of list AUTISM <AUTISM@SJUVM.STJOHNS.EDU>

Belinda asked for these...they might be useful to others.
Lisa
 

(C) AMERICAN PSYCHOLOGICAL ASSN.
AN Journal Article:  82-01806.
AU Ozonoff, Sally;  Strayer, David L;  McMahon, William M;  Filloux, Francis.
IN U Utah, Dept of Psychology, Salt Lake City, US.
TI Executive function abilities in autism and Tourette syndrome: An
   information processing approach.
SO Journal of Child Psychology & Psychiatry & Allied Disciplines. Vol 35(6)
   1015-1032, Sep 1994.
AB Used an information-processing paradigm (IPP) to describe the nature of
   processing deficits underlying autism. IPPs were also used to isolate
   specific cognitive operations and to examine their association with autism
   and Tourette's Syndrome (TS). 14 nonretarded autistic children (aged 8-16
   yrs), 13 children with TS (mean age 12.9 yrs), and 13 control children
   (12.2 yrs) completed the Go-NoGo or the H&S task. Autistic and TS Ss also
   completed clinical interviews and intellectual assessments. Autistic Ss
   performed as well as controls on tasks requiring global-local processing
   and inhibition of neutral responses. However, autistic Ss were
   significantly impaired on a measure of cognitive flexibility. The
   performance of Ss with TS did not differ from that of controls on any task.
   (Japanese abstract) (PsycINFO Database Copyright 1995 American
   Psychological Assn, all rights reserved).
 

    2
   (C) AMERICAN PSYCHOLOGICAL ASSN.
AN Chapter:  94-210022-006.
AU Romanczyk, Raymond G;  Lockshin, Stephanie B;  Navalta, Carryl.
IN State U New York, Binghamton, NY, US.
TI Autism: Differential diagnosis. [References].
BK Autism in children and adults:  Etiology, assessment, and intervention.
   (Johnny L. Matson, Ed.), pp. 99-125.
SO Brooks/Cole Publishing Co, Pacific Grove, CA, US; xi, 275 pp. 1994.
AB Content Representation: (from the chapter)  focus on differential diagnosis
   in (autism) / question ...to what extent autism is associated with specific
   cognitive deficits that differentiate it from other diagnostic categories
   (such as mental retardation) /// diagnostic issues / Asperger's syndrome /
   issues of onset / diagnostic instruments / differential diagnosis:
   cognitive functioning (perception and attention, language disturbance,
   performance patterns on tests of intellectual functioning, problem solving,
   executive function, concept formation, social cognition).

    3
   (C) AMERICAN PSYCHOLOGICAL ASSN.
AN Journal Article:  81-25956.
AU Happe, Francesca G E.
IN MRC Cognitive Development Unit, London, England.
TI Annotation: Current psychological theories of autism: The "Theory of Mind"
   account and rival theories.
SO Journal of Child Psychology & Psychiatry & Allied Disciplines. Vol 35(2)
   215-229, Feb 1994.
AB A discussion of psychological theories of autism shows that recent focus
   has been on social impairment as the key feature. Theories strive to
   explain the triad of handicaps in communication, socialization, and
   imagination in terms of one or more psychological deficits (biologically
   caused). It is suggested that other features of autism (e.g., stereotypies,
   obsessive interests, lack of generalization of skills, islets of ability)
   have been neglected. A wider focus on the cognitive style of individuals
   with autism (executive function deficits, uneven profiles on IQ tests)
   might encourage theories of autism accounting for the impairments and the
   assets and abilities of effected individuals. (PsycINFO Database Copyright
   1994 American Psychological Assn, all rights reserved).

    4
   (C) AMERICAN PSYCHOLOGICAL ASSN.
AN Journal Article:  81-06087.
AU Ozonoff, Sally;  Rogers, Sally J;  Farnham, James M;  Pennington, Bruce F.
IN U Utah, Salt Lake City, US.
TI Can standard measures identify subclinical markers of autism?.
SO Journal of Autism & Developmental Disorders. Vol 23(3) 429-441, Sep 1993.
AB Compared the executive function and theory-of-mind abilities of siblings of
   18 autistic Ss to those of siblings of 18 learning-disabled controls. One
   sibling (aged 8-18 yrs) of each proband participated in the study. Three
   different analyses of the dependent measures provided convergent support
   for a potential subclinical marker in the executive function domain. No
   group differences in theory-of-mind abilities were found. However, power
   analyses revealed that the measures employed in this study, which are
   typically used with autistic individuals, were not sufficiently sensitive
   to detect any group differences that might exist in "unaffected" family
   members. (PsycINFO Database Copyright 1994 American Psychological Assn, all
   rights reserved).

    5
   (C) AMERICAN PSYCHOLOGICAL ASSN.
AN Journal Article:  80-29937.
AU Bishop, D V.
IN MRC Applied Psychology Unit, Cambridge, England.
TI Annotation: Autism, executive functions and theory of mind: A
   neuropsychological perspective.
SO Journal of Child Psychology & Psychiatry & Allied Disciplines. Vol 34(3)
   279-293, Mar 1993.
AB Summarizes literature which shows that a neuropsychological approach to
   autistic symptoms can provide new ways of analyzing cognitive deficits in
   autism. A proposal by A. R. Damasio and R. G. Maurer (see PA, Vol 63:9969)
   that implicates the mesolimbic system and associated frontal lobe
   structures is said to offer a plausible interpretation of the neurological
   basis of autism. Studies using neuropsychological tests with autistic
   people have highlighted the similarities between autistic symptoms and
   executive function deficits in frontal lobe patients. It is argued that to
   suppose that frontal lobe lesions will necessarily make children autistic
   is an oversimplification. Lack of conclusive evidence of brain damage from
   neuroimaging studies suggests that the underlying problem may not be
   destruction of neural tissue, but some other process such as depletion of
   neurotransmitter or developmental cortical malformations. (Japanese
   abstract) (PsycINFO Database Copyright 1993 American Psychological Assn,
   all rights reserved).

    6
   (C) AMERICAN PSYCHOLOGICAL ASSN.
AN Journal Article:  79-16810.
AU Ozonoff, Sally;  Pennington, Bruce F;  Rogers, Sally J.
IN U Utah, Salt Lake City, US.
TI Executive function deficits in high-functioning autistic individuals:
   Relationship to theory of mind.
SO Journal of Child Psychology & Psychiatry & Allied Disciplines. Vol 32(7)
   1081-1105, Nov 1991.
AB 23 high-functioning autistic individuals (aged 8-20 yrs) were compared to
   20 nonautistic controls matched on verbal IQ, age, and socioeconomic status
   (SES). Differences were found on executive function, theory of mind,
   emotion perception, and verbal memory tests, but not on spatial or other
   control measures. Second-order theory of mind and executive function
   deficits were widespread among the autistic group, while 1st-order theory
   of mind deficits were found in only a subset of the sample. (PsycINFO
   Database Copyright 1992 American Psychological Assn, all rights reserved).

    7
   (C) AMERICAN PSYCHOLOGICAL ASSN.
AN Journal Article:  79-16458.
AU Ozonoff, Sally;  Rogers, Sally J;  Pennington, Bruce F.
IN U Utah, Salt Lake City, US.
TI Asperger's syndrome: Evidence of an empirical distinction from
   high-functioning autism.
SO Journal of Child Psychology & Psychiatry & Allied Disciplines. Vol 32(7)
   1107-1122, Nov 1991.
AB Compared the neuropsychological profiles of 13 Ss with high-functioning
   autism (HFA) and 10 Ss with Asperger's syndrome (AS). In comparison with 20
   matched nonautistic controls, both groups were impaired on executive
   function tests. Only the HFA group demonstrated deficits in theory of mind
   and verbal memory, performing worse than both controls and AS patients. HFA
   and AS Ss appear to be distinguishable on measures independent of
   diagnostic criteria, and impairment on theory of mind measures may not
   universally be found among Ss with autistic spectrum conditions. (PsycINFO
   Database Copyright 1992 American Psychological Assn, all rights reserved).
 

    8
   (C) AMERICAN PSYCHOLOGICAL ASSN.
AN Journal Article:  79-05879.
AU Rogers, Sally J;  Pennington, Bruce F.
IN U Colorado Health Sciences Ctr, Denver, US.
TI A theoretical approach to the deficits in infantile autism.
SO Development & Psychopathology. Vol 3(2) 137-162, 1991.
AB Discusses deficits specific to the syndrome of infantile autism (IFA) and
   suggests that early social capacities involving imitation, emotion sharing,
   and theory of mind are primarily and specifically deficient in IFA. These
   capacities involve forming and coordinating social representations of self
   and other at increasingly complex levels via representational processes
   that extract patterns of similarity between self and other. D. Stern's
   (1985) theory of interpersonal development is offered as a continuous model
   for understanding the development and deficits in IFA and as a means for
   integrating competing theories about the primary deficits in autism. A
   neuropsychological model of interpersonal coordination involving prefrontal
   cortex and executive function capacities is also suggested. (PsycINFO
   Database Copyright 1992 American Psychological Assn, all rights reserved).

From: "Lynda W. Huggins" <HUGGINS@MERLIN.NLU.EDU>
Subject:      "Mindblindness" Addtnl Info
X-To:         AUTISM%SJUVM.BitNet@pucc.PRINCETON.EDU
To: Multiple recipients of list AUTISM <AUTISM@SJUVM.STJOHNS.EDU>

For those that asked...

The review of the book "Mindblindness" by Simon Baron-Cohen appeared
in a booklet by The MIT Press, 55 Hayward Street, Cambridge, MA 02142.
It reviews their Spring 1995 publications.

This book is part of the Learning, Development, and Conceptual Changes
series.  A Bradford Book.  May publication, 6x9, 208pp, 43 illus.,
$22.50, 0-262-02384-9, Cognitive Science/Neuropsychology/Philosophy.

Lynda in Louisiana
Date:         Wed, 1 Feb 1995 11:47:25 -0600
Reply-To: SJU Autism and Developmental Disablities List
              <AUTISM@SJUVM.STJOHNS.EDU>
Sender: SJU Autism and Developmental Disablities List
              <AUTISM@SJUVM.STJOHNS.EDU>
From: "Lynda W. Huggins" <HUGGINS@MERLIN.NLU.EDU>
Subject:      Review of new book
X-To:         AUTISM%SJUVM.BitNet@pucc.PRINCETON.EDU
To: Multiple recipients of list AUTISM <AUTISM@SJUVM.STJOHNS.EDU>

New Book on Autism:

"Mindblindness, An Essay on Autism and Theory of Mind" by Simon
Baron-Cohen is due for publication this spring.

In "Mindblindness", Simon Baron-Cohen presents a model of the
evolution and development of "mindreading."  He argues that we
mindread all the time, effortlessly, automatically, and mostly
unconsciously.  It is the natural way in which we interpret,
predict, and participate in social behavior and communication.  We
ascribe mental states to people: states such as thoughts, desires,
knowledge, and intentions.

Building on many years of research, Baron-Cohen concludes that
children with autism, suffer from "mindblindness" as a result of a
selective impairment in mindreading.  For these children, the world
is essentially devoid of mental things.

Baron-Cohen develops a theory that draws on data from comparative
psychology, from developmental, and from neuropsychology.  He
argues that specific neurocognitive mechanisms have evolved that
allow us to mindread, to make sense of actions, to interpret gazes
as meaningful, and to decode "the language of the eyes."

Simon Baron-Cohen is Lecturer in Psychopathology in the departments
of experimental psychology and psychiatry at the University of
Cambridge.

&  25 Jan 1995 16:28:24 -0500
Date:         Wed, 25 Jan 1995 12:20:34 GMT
Reply-To: black@bach.demon.co.uk
Sender: SJU Autism and Developmental Disablities List
              <AUTISM@SJUVM.STJOHNS.EDU>
From: Andrew & Lesley Black <black@BACH.DEMON.CO.UK>
Organization: Black Household
Subject:      Re: Other Minds
X-To:         SJU Autism and Developmental Disablities List
              <AUTISM@sjuvm.stjohns.edu>
To: Multiple recipients of list AUTISM <AUTISM@SJUVM.STJOHNS.EDU>
In-Reply-To:  <9501240036.aa27726@punt.demon.co.uk>

In message <9501240036.aa27726@punt.demon.co.uk> you recently said:

> Has anyone read S.Baron-Cohen's _Understanding Other Minds:  Perspectives Of
> Autism_?  Is there anything interesting there?
>
> Jenee Woodard

Yes I have.  I rushed to buy it when it came out about 18 months ago.  I
have a bit of an obsession about theory of mind research as I have found
these ideas very helpful in understanding the way my son might be seeing the
world, particularly when he was younger.  The book is quite weighty,
literally and metaphorically; it has over 500 pages.  It is also not cheap,
though I believe it's now out in paperback.  If you have a particular
interest in the subject, it's brilliant, otherwise probably a waste of time.

I'm appending an edited version of a review I wrote for our local
newsletter. This is geared for a UK audience, but there are also US
contributors e.g. Cathy Lord, Helen Tager-Flusberg, Fred Volkmar and Jerome
Bruner.

Understanding Other Minds - Perspectives from Autism
Eds. Simon Baron-Cohen, Helen Tager-Flusberg and Donald Cohen
Pub. Oxford University Press

Those readers familiar with the work of Uta Frith and Simon Baron-Cohen will
know of their hypothesis that autistic people fail to develop a 'theory of
mind', that is to say they have difficulty taking account of other people's
knowledge, beliefs and intentions.

This new book brings together current research in the field of 'theory of
mind' such as can normally only be found in academic journals.  It is
therefore a boon to those like me who have no access to a research library.
Contributors come from all over the world; names familiar to British readers
will be: Simon Baron-Cohen, Uta Frith, Peter Hobson, Patricia Howlin and
Michael Rutter.  The book is particularly interesting in that it covers a
wide range of opinion.  While most of the contributors acknowledge that
people with autism do have difficulty understanding other minds,  not all
agree that this is the primary cognitive problem.

The main body of the book is made up of chapters on language, pretence,
deception and social development in autism among many others.  All these
areas are examined with reference to 'theory of mind'.  There are also
perspectives from normal child development, animal studies, philosophy and
psychoanalysis.

On the whole this is a detailed academic text, highly recommended if you
have a theoretical interest in 'theory of mind' research.  There is not much
of direct practical value to the average parent.  However ch.21 by Simon
Baron Cohen and Pat Howlin on questions of teaching and diagnosis might be
of interest.
 

I hope this is the sort of information you were looking for.

--
Lesley Black

Date: Thu, 19 Nov 1998 13:58:39 -0700 From: Carolyn Johnston <cpj@VEXCEL.COM> Subject: theory of mind and thanks

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I wanted to make an observation about the theory of mind controversy, i.e. whether or not TOM is a core issue for autistics: I note that whenever I've read about TOM, the authors talk about failed experiments with TOM on autistics as if they are static matters that one can never hope to remediate. What does this prove about anything? You may as well throw up your hands and say, "My kid can't talk. I may as well give up, that's a fundamental problem with autistics!"

Seems to me that you might have a case that TOM is a core defect for autistics if you tested a whole range of spectrum members and found that not only could none of them do it, furthermore none of them could even learn it. I don't believe this for a second.

I think efforts to find the core cognitive defect in autism are probably doomed to failure, and when the answers come they'll come from neurobiology and genetic studies rather than from psychology. It's going to be one of life's mysteries for a while.

Yvette, please don't get discouraged because your son can't do TOM problems right now and other kids can: as with everything else, from speech to play to conversation and other social skills, our kids don't pick up perspective-taking naturally the way NT kids do, but they can learn it. I think what's upsetting to you is the idea that has been promoted in recent years, that TOM problems are diagnostic of autism and are permanent and intractable. I'll bet the Sumlins and others with recovered kids could tell you otherwise.

For what it's worth, I've also heard that TOM concepts are kind of shaky even in NT kids through ages 3 and 4.

Thank you, listers, for your help with our school problem. Your replies have been an enormous help, you just don't know how much. I would love to hear from anyone else who wants to weigh in on this issue, I am benefitting enormously from everyone's experiences.

Thank you again!

Love, Carolyn

Date: Thu, 19 Nov 1998 20:52:42 -0800 From: Steve Hamilton <arbutus@ISTAR.CA> Subject: theory of mind/reading and printing

****** This is a confidential, unmoderated list. ****** Responsibility for posts to this list lies entirely with the original author. -------------------------------------------------------------------------------

Hi everyone,

In response to a few who have emailed me privately:

By the time we looked into "theory of mind" our son was nearly recovered. We realized that we had been working on this all along without realizing it. J loves Playmobil, so we did a lot of work with the dolls. "How do you think Robert feels?" "What do you think will happen if...?" We also did a lot of work with story books. Richard Scarry and Mercer Mayer are good. "Why did Anne say....? How do you think she felt?" Luckily J really liked these activities.

Having an aide at preschool helped as well. She would asked J, "Why do you think Cyril got so angry?" "Maybe he really wanted to play with the truck. Maybe he had a bad morning and he's feeling grumpy today. Maybe....." The aide would talk about the other children's feelings and emotions at lot.

By the time I found out about the simple theory of mind tests, my son had no problems passing the tests. (money, pencils, or candy in box) What a relief!

PS. The Distar method of teaching reading is so effective. "Teach Your Child To Read in 100 Easy Lessons" is terrific. I highly recommend it. Thank-you to others on the me-list for letting me know about it. We compliment it with Sadlier Phonics and Working Words in Spelling. Both are colourful workbooks, published in the US, available through Nelson Canada. Another workbook we used previously was good also. I think it was called "The Fisher Price Giant Preschool Workbook." It was simple and colourful, and Fisher Price toys were featured.

Jane