Do Autistic Children Lack a 'Theory of Mind'?

One of the prominent features of children with autism is their poor use and understanding of the spoken language. In 1998, Eisenmajer saw their obvious language delay as the most powerful predictor of their clinical outcome. Most parents of autistic children have reported that their child's development of language was unusual from the beginning. They show no attempts at 'enthusiastic babbling' popular with normal infants. But even when they do begin to vocalise they fail to show the usual pattern of language development. By the age of one, a child can use some simple, one-syllable words, but about half of the children with autism do not. When these children do begin to communicate, they use noticeably peculiar sounds and words. In the early stages, the child often uses a high-pitched, bird-like squeaking. When comprehensible sentences do finally start to emerge, autistic children display many of the grammatical errors of a normal child, but they are long lasting and peculiar. Language development doesn't proceed very far for some autistic children, and communication skills remain noticeably deficient. There is a lack of colloquialism, as conversation is stilted. Emotional tone is lost on them, and they fail to imitate gestures or initiate imaginative play. This was discovered by Smith and Bryson in 1998, who see these traits as crucial in the early stages of language development. Autistic children also fail to use non-verbal strategies to make their needs known. It is believed that the key to understanding communication deficits in children with autism lies in their lack of understanding of social interactions.

Usually the first symptoms that are observed in children with autism involve some aspects of their social behaviour. One striking characteristic is their obvious air of aloofness; it is a physical and emotional barrier from others that can be especially hurtful for parents. This type of behaviour reflects a fundamental failure to develop social attachments. In 1970, Hermelin and O'Conner found that an autistic child would rather spend time near a non-reacting adult than an empty chair. They do begin to gradually improve their social relationships, but not entirely. These children continue to show a lack of enthusiasm for cooperative group activities, they fail to make personal friendships, and have difficulty in responding appropriately to other people's feelings. In 1998 Charmin found evidence that suggests that children with autism have fundamental problems in understanding other people's expressions of emotion, and also in communicating their own emotions by using their own faces, voices and gestures. Baron-Cohen suggested in 1995, that autistic children suffer from 'mindblindness', as they don't understand that other people exist as separate individuals with their own ideas and feelings, and lack the ability to imagine what other people are experiencing. They can't make sense of other people's actions, and have trouble in decoding non-verbal cues of the human face and eyes.

Another prominent feature of autism is the child's 'insistence on sameness'. In 1999, Durand and Mapstone stated that even though many normal children can react badly to any sudden changes in their environment, children with autism, for many unclear reasons, experience this trait in a greatly exaggerated form. For example, repositioned furniture in the house can cause severe temper tantrums, school routes can be insistently regimented. This insistence on sameness is also shown in the way that these children use toys and other objects to make long lines or complex patterns, this system is more important to them than the actual function of the object. They can also become very attached to a certain object, however inappropriate or unusual. These intense attachments tend to interfere with their normal development and their everyday living in ways such as, hand-eye coordination can be effected if the desired object is large because the child's hands are not free to play with anything else. Also, if the object is lost, life for the child and its family can become unbearable. Some children with autism show signs of repetition in their motor behaviour and activity. The child might repeatedly move its fingers in a particular sequence or rock back and forth in its chair. Extreme cases have shown evidence of repeated self-injurious behaviour such as, banging their head against the wall until its bruised, or biting their own hands until they bleed. These types of behaviour often require physical restraints such as helmets or bandages to prevent the child from seriously hurting itself.

In order to investigate an autistic child's 'Theory of Mind' or lack of one, can be addressed by looking at different theories about their capacity of intelligence. Gittleman and Birch in 1967, Lockyer and Rutter in 1969 and Szatmari in 1989 all suggest that one of the best predictors of an autistic child's later progression is their measured IQ. They found that the higher scores tend to do better in a variety of educational and remedial settings. But in 1989, Ritvo stated that only about twenty-five to forty percent of autistic children score above seventy on IQ tests. One of the most mystifying things about autism is the added 'savant' capacity. This is an unusually high area of ability in an individual with low or adequate abilities in many other areas. Heavey, Pring and Hermelin discovered in 1999 that some autistic children show an amazing ability to identify a particular date associated with the day of the week with great speed and accuracy. Mottron, Belleville, Stip and Morasse also found in 1998 that some autistic children also had an exceptional ability to memorise many things. Other popular areas of ability are spatial, musical or artistic N.Tinbergen and E.A.Tinbergen are convinced that autistic children have a valid combination of social perceptiveness of over-sensitivity and exceptional intellectual or artistic gifts. This idea of exceptional talents being present in children who score in the retarded range of measures of basic reasoning can be confusing. It suggests that humans can have many different, separate mental abilities.

Lorna Wing suggests in her book (p22) that every child diagnosed with autism is mentally handicapped due to the fact that they lack an essential quality needed for normal intelligence and the ability to adapt to the demands of life. She also observed that unless autistic children have an additional handicap that affects their appearance, they do look normal, and are often very attractive. The diagnosis isn't usually confirmed until after the age of two, causing parents to go through a long period of doubt and anxiety that suggests that their child is different. The fact that the physical appearance is fine is reassuring. The child can also do something so skilful that it helps the reassurance that it is really intelligent.(p153) So due to the fact that their intellectual behaviour is so varied, schooling is very important. Evidence has shown that autistic children should start school from any age up to five, and should be in a structured environment where they are given plenty of individual attention. As they get older they need to be taught in small groups of three and four to start with. This should be gradually increased with age. The methods of teaching should also be adapted for children with severe language handicaps. The education that is provided should have a wide enough scope to help autistic children throughout the whole range of intelligence. This includes the above average to the severely subnormal. These conditions can easily be catered for in special schools.(p159) This immediately segregates them from a normal school environment, but is essential as their 'Theory of Mind' is not compatible with normal children, causing interaction problems for them.

All autistic children are different, and show signs of different behaviour traits, intelligence and gift. In 1973, Ornitz stated that the disorder progresses in two different directions after a child reaches the age of five. Some children continue with the same symptoms that they've always shown, but others may start to show a gradual change in their clinical picture. New features start to develop, revealing a need to use alternative or secondary diagnostic considerations. As the child reaches six, the disturbed relationship problem tends to continue, along with any language and communication disturbances that were experienced before the child reached the age of five. If this was the case then it will be unlikely that the child will ever develop any advanced speech. Ornitz says that if this situation s present in an autistic child then their intellectual development tends to remain at a standstill.

So to finally summarise the idea that autistic children lack a 'Theory of Mind', it has to be noted that autism is a very damaging disorder that classifies a child as mentally disabled or retarded. This suggests that autistic children do in fact lack some 'Theory of Mind', but I think that it's a case of autism giving a child a different way of thinking, and so producing different priorities in life, and a more focused mind that concentrates on one special gift such as music or art. I don't believe that an autistic child lacks a Theory of Mind', I just feel that they have a different 'Theory of Mind' to other people who don't have the disorder.