autism (a level psychology)

AutismPSYB2 Specification: What you need to know

Definition and Symptoms, including lack of joint attention Autism as a syndrome: the triad of impairments Biological explanations: including genetics and neurological correlates Cognitive explanations: theory of mind, central coherence deficit, failure of executive functioning Studying autism: Sally-Anne test, Smartie tube test, comic strip stories Therapeutic programmes for Autism: including drug treatment, the Lovaas technique, parental involvement and behaviour modification Evaluation of these programmes

"A complex lifelong disability which affects a person's social and communication skills."

Prevalence of Autism- 8 in 10,000 people (0.6% chance)- 4x more likely in males. 3/4 autistics are male- 90% of people with Asperger's are male- 60 in 10,000 people with ASD

Kanner (1943)AutismAutistic AlonenessDesire for samenessIslets of Ability

Lack of empathy for othersInability to display love or emotionsDifficulties in understanding peopleGood at making sense of the worldLower than average language abilityLow levels of imaginative thinkingProblems with communicating with others and building social relationshipsLow IQA preference for order and organisation and a resistance to changeObsessional behaviour (Islets of ability, autistic savants)Stereotypical movements (head banging, rocking)Symptoms of Autism

DSM IV Criteria

Impairment (relevant to developmental level)BehaviourNumber of impairments in each category for diagnosisQualitative impairment in reciprocal social interactionPoor use of eye contact and gestures; lack of personal relationships; lack of spontaneous sharing, for example joint attention; lack of social/emotional reciprocityAt least twoQualitative impairment in verbal and non-verbal communicationDelay in the acquisition of language, or lack of speech; stereotyped and repetitive use of language; failure to sustain or initiate conversation; lack of varied, spontaneous make-believe playAt least oneRestricted repertoire of activities and interestsRepetitive or stereotyped movements, such as hand flapping, interests that are abnormally intense/narrow; adherence to specific, non-functional routines or rituals.At least one

The Triad of Impairments: Frith (2003)Frith argued that three features occur so regularly together in cases of autism that they simply cannot be a chance combination of symptoms.AO2: What symptom does this not explain?

Wing & Gould (1979)Aim: To investigate the number of children suffering from autism in a large population.

Method: 914 participants from 0-14 year olds were studied. All were known to be suffering from some form of mental or physical handicap. Most children had IQs below 70. Participants were separated into groups on the basis of their intellectual ability. A follow up study was conducted when child when aged between 16-30 years.

Results: 173 children showed at least one symptom from the triad of impairments. If a child had the mental age of 20 months or more, they would show all three symptoms associated with the triad.

Conclusion: The symptoms of autism should be seen as a triad of connected impairments.

Joint attention is when both infant and another person are attentive to the same object and another. This is usually achieved by gazing and pointing and the infant is not interested in only the object, but the caregiver's attitude and feelings towards that object.

Children with autism have a lack of joint attention - they do not seek to share attention to an object with anybody.

Sigmen (1986)Aim: To investigate joint attention activities such as pointing and showing in children with autism. Method: 3 groups of children were observed: autistic children, children with an intellectual impairment other than autism, and healthy children. Each play room was presented with various toys and the child's parents. Instances of pointing and showing objects were recorded.Results: The autistic children showed significantly fewer instances of pointing and showing than other groups of children.Joint Attention

Explanations you need to know:

Biological - Genetics - Neurological Correlates

Cognitive - Theory of Mind - Central Coherence Deficit - Failure of Executive Functioning

Cold Parenting - Bettelheim (1967)

Explaining Autism

The way psychologists study the cause of autism in genetic terms is through twin and family studies.

Family Studies - The University of Cambridge- Found that autistic traits cluster in families- 6% of siblings display traits of all three impairments- 10-12% display only two- 20% of siblings display only one

Twin Studies - Ritvo (1985)23 pairs of MZ, 17 pairs of DZ

MZ = 96% conc rateDZ = 23% conc rateBiological Explanations: Genetics

Gerschwind et al found an "autistic gene" in males that exists in chromosome 6 and 17. However it can only be found in boys.

Links have been found between autism and Tourette's Syndrome. TS is a genetic disorder. Comings and Comings (1997) noted that sufferers from both syndromes may share similar symptoms, including obsessive and ritualistic behaviours, need for routine and stereotypical movements.

Fragile X - Bee (1989)

Links with Fragile X syndrome and autism. 5-10% of people with autism also have Fragile X. More predominant in males.

Biological Explanations: Genetics

Can Autism be explained by genetics?Yes!- Concordance rates in Ritvo (1985)- Fragile X: Links with both syndromes- University of Cambridge Family Studies

No!- Conc rates should be 100% and 50%- Twins and families also share environment- No direct chromosomal link found by Gerschwind

This biological theory proposes that autistic individuals have one or more abnormalities in the brain. The areas with these abnormalities correlate with the areas responsible for normal communication, social functioning and play. This ultimately suggests that autism is due to these differences in brain structure.

There are two ways of studying neurological correlates:- Post-mortem studies- Neuroimaging

List the strengths and limitations of each method.Biological Explanations: Neurological Correlates

Theory of Mind - The ability to understand that someone else can think something different to your own thoughts.

First proposed by Frith (1989) who suggested that people with autism lack the ability to guess what others are thinking or are going to do. This is referred to as mind blindness.

A theory of mind is developed at around 4 years of age. When we are 3, we understand people have independent thoughts, but we can not understand what these may be.

Supporting Evidence:- Sally-Anne Test (1985)- Smartie Tube Test (1989)- Comic Strip Stories (1986)Cognitive Explanations: Lack of Theory of MindThese tests all support the idea that autistic individuals lack a theory of mind

Sally-Anne Test(Baron-Cohen et al, 1985)Aim: To investigate if autistic children could have a different belief to their own.

Method: 3 groups were studied: 20 autistic children, 14 children with Down's, control group of 27 healthy children, all with similar verbal ages.

The experimenter performs the following scenario with dolls:

"This is Sally, she has a basket. This is Anne, she has a box. Sally places the marble into her basket and leaves the room. Anne plays a trick on Sally. She takes the marble and puts it into her box. Sally comes back into the room."

The experimenter then asks the belief question:- "Where will Sally look for the marble?"

And then three control questions:- "Which one is Sally and which one is Anne?"- "Where is the marble now?"- "Where was the marble before?"

Sally-Anne Test: The ResultsCorrect response to the belief question as follows:

- Autistic: 20%- Down's Syndrome: 86%- Control Group: 85%

There were no failures in any of the control questions.

We can conclude that a lack of theory of mind is prominent in children with autism. However, the results suggest not all autistic children lack this theory of mind, therefore it is not generalisable. Also, it cannot be a specific impairment to autism as DS sufferers and "normal" children were also shown to lack a theory of mind.Try to write the end of an AO2 burger for this study. "This supports/conflicts the lack of theory of mind explanation because...."

A Smartie tube containing a pencil was shown to normal children and autistic children. Individually, they were asked:"What do you think is inside here?" They answer Smarties as they have no reason to believe otherwise.They are then shown that the tube contains a pencil. They are then asked:"Your friend is about to come in. What will he say is in the box?"

Children above 3 respond "Smarties" as they understand that their friend will not be aware there is a pencil is inside.Autistic children of all ages respond "pencil" as they do not have this understanding that others have different thoughts.Smartie Tube Test(Perner et al, 1989)Try to write the end of an AO2 burger for this study. "This supports/conflicts the theory of mind explanation because...."

Aim: To investigate whether autistic children would understand that someone else could have a belief that was different from theirs. Method: Autistic children were shown four pictures, which, when put into the correct order, would form one of three types of story: - A Mechanical Story, which did not involve any people. - a Behavioural Story, which did not require any understanding of what the people in the story were thinking. - A Mentalistic Story in order to put this story in the correct order, the child would need to know what the characters in the pictures were thinking or believing (i.e. the child would need theory of mind) The children had to put the four images into the correct order. Results: The children had no trouble with the mechanical and behavioural stories, as they didnt need to have theory of mind in order to understand the story. However, they performed very poorly on the mentalistic stories.

Conclusion: This adds further evidence to the idea that autistic children lack theory of mind.Comic Strip Stories(Baron-Cohen et al, 1986)Try to write the end of an AO2 burger for this study. "This supports/conflicts the theory of mind explanation because...."

Central Coherence: A tendency to process information for its general meaning rather than the specific meaning of each element.

Lack of Central Coherence developed by Frith as Theory of Mind does not account for the repetitive behaviours or exceptional skills shown by some people with autism.

For example, when we look at a picture we tend to attempt to make sense of the whole by imposing meaning on it; similarly we remember the gist of a message rather than each individual word.

According to Frith, it is this capacity for coherence that is diminshed in the child with autism.

The Ebbinghaus Illusion

Which of the middle circles is biggest?Cognitive Explanations: Central Coherence Deficit

Shah & Frith (1993) - Children's Embedded Figures TestTo investigate how well autistic children could locate a hidden figure.Standardised test used the CEFT. A group of autistic and non-autistic children of the same mental age had to locate a shape that was hidden in a larger drawing.Autistic children can identify the figures faster and more accurately than non-autistic children.Autistic children disregard context and do not succumb to the central coherence force. Children with autism seem to have weak central coherence.

Cognitive Explanations: Central Coherence DeficitAim:Method:Results:Conc:Hermelin and O'Connor (1967)Showed that autistic children could recall a lot of unrelated words just as well as they could recall related words and sentences. Control groups of non-autistic children fared much better in the related compared to the unrelated.

Strengths- CCD can explain communication impairment- CCD can explain social impairment- CCD can explain islets of ability

Limitations- Does not explain repetitive and stereotyped behaviours- Results from studies could also be explained by superior low level processingEvaluation of CCD

Executive Functioning:"A higher order mental functioning. Allows us to start activities as well as stop them - pay attention to some things and not others."

A failure of executive funcitoning could explain many of the symptoms of autism, as well as the Triad of Impairments: Islets of ability: Extreme focus and practice over one thing.Repeated/stereotyped behaviours: No control over start/stop

People with a failure of executive functioning would find it difficult to switch from task to task, plan ahead or break from routine.Cognitive Explanations: Failure of Executive Functioning

Wisconsin Card Sorting TaskSet of cards given to children that can be sorted by colour, shape or number. The researcher sets a sorting rule, but during the task the rule is changed without telling the sorter. The sorter must change the sorting pattern based on the response of the researcher as they place each card down.

This studies failure of executive functioning as it requires the ability to start and stop activities quickly. Autistic children fare much worse on this task than a control group.Cognitive Explanations: Failure of Executive Functioning

EvaluationExplains some features of autism not explained by theory of mind and other cognitive explanations.Frith (1996) has concluded that it is unlikely that one cognitive explanation can explain all areas of autism, and executive functioning can be used in conjunction with these explanations to provide a better overall picture.

, AQA AS Psychology B Cold Parenting (Bettleheim, 1967)

Treatments- Drug Treatments- Aversion Therapy- Parental Involvement- The Lovaas Technique (ABA)Therapeutic Programmes for Autism

vMedication can be used to treat certain aspects of autism such as:- Repetitive Behaviours- Aggressive Behaviours- Tantrums- Self-harming

One type of medication used in the UK are SSRIs - Selective Serotonin Reuptake InhibitorsExamples of these include Fluoxetine and Paroxetine.

However, a limitation of these is Serotonin Syndrome.

Drug Treatments

Drug TreatmentsOther drugs available for autism include:

Risperidone:An anti-psychotic drug. It can reduce social withdrawal, stereotyped behaviour and agression. However, many children do not respond to this drug and it has no effects on any symptoms besides these.

Fenfluramine:Lowers serotonin levels. Some evidence of improvement in behaviour and thought processes. However, no consistent effect has been found on language and cognitive levels. Effects are often subtle.Geller et al (1984)Fenfluramine used on 14 children with autism and found that they showed increased social responsiveness, improved behaviour and increased IQ.McCraken et al (2002)Double blind test with placebos. Children given risperidone results reduced by 56.9% compared to placebo improvement of 14.1%.

STRENGTHS

- Provides relief from specific symptoms- More ethical than aversion therapy/electrical shocks- Geller et al (1984)- McCraken et al (2002)LIMITATIONS

- No drug yet developed to combat all symptoms- Medication would need to be combined with other therapies to work- Side effects of drugs often outweighs gain- Many drugs have not even been tested!Evaluating Drug Treatments

Aversion TherapyUCSUCSCSCSCRUCRUCR+Lovaas (1997) found that self-harming behaviour could be extinguished almost immediately by using electrical shocks as an aversive stimulus.

Communication Impairment - seperated speech leads to no conversationSocial Impairment - Cannot understand conversation if everything is seperatedIslets of Ability - math, visuo-spatial awareness tasks will be better due to focus on seperation

autism (a level psychology)

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