THE THOUGHT AND TALK OF INDIVIDUALS WITH AUTISM: REFLECTIONS ON IAN HACKING

Abstract: Ian Hacking proposes that ways of talking about autistic experience can shape, or even transform, what it is like to be autistic. I explore the grounds for two nonexclusive interpretations of this thesis. The informative interpretation holds that, because nonautistics cannot read mental states into autistic behaviour as they normally do with one another, autistic self-narratives give nonautistics unique insights into what it is like to be autistic. This in turn affects how nonautistics interact with autistic individuals, enriching their social environment in various ways. The more radical, transformative interpretation holds that autistic experience is itself moulded under the influence of developing a language-game for talking about autistic experience. I endorse both theses, albeit with some cautionary remarks.     

Typical hierarchical processing in autistic adults

ABSTRACT

Previous research suggests that autistic individuals exhibit atypical hierarchical processing, however, most of these studies focused solely on children. Thus, the main aim of the current study was to investigate the presence of atypical local or global processing in autistic adults using a traditional divided attention task with Navon’s hierarchical figures. Reaction time data of 27 autistic and 25 neurotypical (NT) adults was analysed using multilevel modelling and Bayesian analysis. The results revealed that autistic, like NT, adults experienced a global precedence effect. Moreover, both autistic and NT participants experienced global and local interference effects. In contrast to previous findings with children, the current study suggests that autistic adults exhibit a typical, albeit unexpected, processing of hierarchical figures.     

A COMPARISON OF PEER-INITIATION AND TEACHER-ANTECEDENT INTERVENTIONS FOR PROMOTING RECIPROCAL SOCIAL INTERACTION OF AUTISTIC PRESCHOOLERS

We compared two procedures for improving the social interactions of three autistic children. In a peer-initiation condition, confederates were taught to initiate interaction with the autistic children. In a teacher-antecedent condition, teachers prompted the autistic children to initiate with confederates, who had been taught to reciprocate. Using an alternating treatment design, differential effects were found. The peer-initiation procedure reliably increased the social responses of the autistic children, whereas the teacher-antecedent condition increased the initiations and responses of the autistic children. In addition, longer chains of social interaction occurred during the teacher-antecedent condition.     

Autism and the double empathy problem: Implications for development and mental health

This article proposes a link between autistic people being misperceived by the neurotypical majority and their being at risk of poor mental health and well-being. We present a transactional account of development in which the misperceptions (and consequent behaviour) of the neurotypical majority influences the perceptions and behaviour of autistic people such that they become increasingly separate and indeed isolated from mainstream society. This jeopardizes their mental health and prevents autistic people from developing to full potential. The situation is not only problematical for the development of autistic people but is also to the detriment of wider society, in so far as autistic people are effectively prevented from contributing fully. This account assumes that some (not necessarily all) autistic people yearn to be included, to be productive and to be useful. It thus directly opposes accounts that view autism as an extreme case of diminished social motivation.     

Caregiver interactions with autistic children

Caregiver interactions with young autistic children were contrasted with those involving caregivers and developmentally matched mentally retarded and normal infants. Caregivers of autistic children were similar to other caregivers in their responsiveness to child nonverbal communication bids and in their engagement in mutually sustained play. Caregivers of autistic children were similar to caregivers of mentally retarded children in their greater use of control strategies. However, these two groups of caregivers differed in the particular strategies they used to shape their children's behavior. Caregivers of mentally retarded children pointed to objects while caregivers of autistic children spent more time physically holding their children on task. Individual differences within the autistic sample indicated that caregivers regulated their children's behavior less and showed more mutual play and positive feedback to more communicatively able autistic children. These findings suggest that caregivers respond differentially to the specific deficiencies shown by their children.     

自闭症儿童行为评定与社会认知发展的研究

本研究用自闭症儿童发展评定量表,自闭症儿童基本社会认知问卷以及“ＴｏＭ”实验,对４９名自闭症儿童及３０名弱智儿童进行了行为评定与社会认知的研究。研究结果为目前国内自闭症的诊断和治疗提供了新的有效工具及进一步明确化的理论依据,并为其教育训练提供了标准的新的启示。     

Autistic traits in mentalization-based treatment for concurrent borderline personality disorder and substance use disorder: Secondary analyses of a randomized controlled feasibility study

Autism is suggested to be a dimensional construct and often represents a comorbid state. However, research on the clinical implications of the presence of autistic traits is scarce. This study aimed to investigate the impact of subclinical autistic traits in mentalization-based treatment (MBT) for concurrent borderline personality disorder (BPD) and substance use disorder (SUD). Based on the data of a randomized controlled feasibility study by Philips, Wennberg, Konradsson, and Franck (2018), secondary analyses were conducted. It was tested, if patients’ (N = 46) levels of autistic traits were associated with treatment outcome measured in the course of and after treatment using interviews and self-report measures. Participants’ autistic traits were not associated with the change in the severity of BPD throughout and at the end of the treatment. However, results showed associations between autistic traits and the change in patients’ consumption of alcohol in the course of MBT. Furthermore, there was an association between autistic traits and the change in mentalizing capacity at the end of MBT, indicating that elevated autistic traits were associated with an improvement in mentalizing capacity. Autistic traits on a subclinical level do not appear to be a complicating factor in MBT for concurrent BPD and SUD. On the contrary, in terms of mentalizing capacity autistic traits might be associated with a larger potential for improvement or facilitate treatment outcome. Further research is needed to explore the role of higher autistic traits in treatment of this special patient group.     

自闭症儿童依恋及其与功能领域关系的研究

以中国大陆16个特殊儿童康复机构的278名自闭症儿童作为研究对象,通过问卷法探讨自闭症儿童的依恋及其与功能领域的关系。结果发现:(1)自闭症儿童依恋总体水平偏低;(2)自闭症儿童依恋与各个功能领域的发展有着极为紧密的联系;(3)影响自闭症儿童总体依恋发展水平的因素是儿童自身的障碍程度,具体取决于交往、认知、感觉、生活自理等功能领域的发展情况。     

NORMAL PEER MODELS AND AUTISTIC CHILDREN'S LEARNING

Present research and legislation regarding mainstreaming autistic children into normal classrooms have raised the importance of studying whether autistic children can benefit from observing normal peer models. The present investigation systematically assessed whether autistic children's learning of discrimination tasks could be improved if they observed normal children perform the tasks correctly. In the context of a multiple baseline design, four autistic children worked on five discrimination tasks that their teachers reported were posing difficulty. Throughout the baseline condition the children evidenced very low levels of correct responding on all five tasks. In the subsequent treatment condition, when normal peers modeled correct responses, the autistic children's correct responding increased dramatically. In each case, the peer modeling procedure produced rapid achievement of the acquisition criterion which was maintained after the peer models were removed. These results are discussed in relation to issues concerning observational learning and in relation to the implications for mainstreaming autistic children into normal classrooms.     

Bion and Tustin: The autistic phenomena

This article examines   the implications of the proposal of autistic transformations within the general context of Bion's theory of Transformations. The aim is to confirm the coherence of this proposal of autistic transformations within the overall structure of Bion's theory of Transformations. She examines the relation between emotional links and their negatives, particularly –K. She questions in which of the dimensions of the mind the autistic phenomena are located, the relation between autistic phenomena and beta elements, and where to place them in the Grid. The author tries to form metapsychological support for the incorporation of the autistic area in Bion's theory of Transformations. She argues that, despite the incongruence and imprecision of this incorporation, such autistic phenomena cannot be excluded from the complexus of the human mind and should therefore be accounted for in Bion's t ransformations . She discusses the idea that the theory of transformations includes the field of the neurosis and psychosis and deals with emotions, whereas the autistic area is dominated by sensations. The author asks how to add the autistic area to Bion's theory. Clinical material of a child for whom the non‐psychotic part of the personality predominates and who presents autistic nuclei provides material for the discussion.     

自闭症幼儿的情感认知特点的实验研究

本实验采用3(组别)×4(基本情绪)×3(实验材料)×2(实验条件)的混合设计的方法对平均心理年龄24个月的6名自闭症幼儿和心理年龄与之相近的6名正常儿童和6名弱智儿童的情感认知特点进行了比较性的研究。实验结果表明:在“语言提示”条件下,自闭症幼儿的正答率远远低于正常儿童和弱智儿童,但在“表情提示”条件下,自闭症幼儿与弱智幼儿几乎没差距,在对“愤怒”和“惊恐”等情绪的认知中,正答率高于弱智幼儿。这意味着自闭症幼儿可能运用了其他的替代策略进行情感认知。     

The criterion-related validity of the Childhood Autism Rating Scale and the Autism Behavior checklist

The present study sought to examine the relationship between two popular instruments for screening autistic children: the Childhood Autism Rating Scale (CARS) and the Autism Behavior Checklist (ABC). The sample included 77 individuals. The records of 48 subjects contained firm diagnoses of autism, while the suggestion of autism was found in the remaining records. Correlations between the two scales ranged from –.16 to .73 (median=.39). The validity coefficient between the two total scores was .67. Using cutoff scores recommended by the authors, an analysis of the sensitivity of the two instruments was conducted. The CARS correctly identified 98% of the autistic subjects; it identified 69% of the possibly autistic as autistic. The ABC correctly identified 88% of the autistic subjects, while it identified 48% of those subjects considered possibly autistic as autistic. A phi coefficient was computed to estimate the degree of relationship between the nominal classifications produced by the two instruments. A moderate relationship was found, (r = .54). Implications of the results are discussed.     

Subgroups of autistic children based on social behavior display distinct patterns of brain activity

Two questions were addressed in the present study: (1) Do autistic and normally developing children exhibit regionally specific differences in electroencephalographic (EEG) activity? (2) Do subgroups of autistic children classified according to Wing and Gould's (1979) system which emphasizes degree of social impairment exhibit distinct patterns of EEG activity? Twenty-eight children with autism (5 to 18 years of age) and two groups of normally developing children (one matched on chronological age and the other on receptive language level) participated. EEG was recorded from left and right frontal, temporal, and parietal regions during an alert baseline condition. Compared to normally developing children, autistic children exhibited reduced EEG power in the frontal and temporal regions, but not in the parietal region. Differences were more prominent in the left than the right hemisphere. Furthermore, subgroups of autistic children based on Wing and Gould's system displayed distinct patterns of brain activity. Compared to autistic children classified as “active-but-odd,” “passive” autistic children displayed reduced alpha EEG power in the frontal region.     

BEHAVIORAL TRAINING FOR SIBLINGS OF AUTISTIC CHILDREN

The present study was conducted to investigate the effectiveness of a program designed to teach behavior modification procedures to normal siblings of autistic children. Three sibling pairs participated in a multiple-baseline analysis of the effects of training the normal siblings to use behavior modification procedures to teach their autistic brother or sister a variety of learning tasks. Results indicated that the siblings learned to use the behavioral procedures at a high level of proficiency, they used the procedures in a generalization setting, and there were observed improvements in the behavior of the autistic children. In addition, a social validation assessment of the normal siblings' statements about their autistic sibling indicated a decrease in negative statements and an increase in positive statements after training. These results are discussed in terms of the potential for incorporating siblings into the treatment plan in intervention programs with autistic children.     

Teaching autistic children to respond to simultaneous multiple cues

A number of studies have shown that autistic children tend to learn new discriminations by responding to only a restricted number of available cues and that this may be responsible for some of their abnormal behavior. Therefore, this investigation assessed the feasibility of teaching autistic children to respond to multiple cues. The results showed that four autistic children could learn a conditional discrimination requiring them to discriminate a multiple-cue complex from each of its two component cues. However, the autistic children did not learn this discrimination in the same manner as normal children. In the early trials, the autistics responded at a higher level to one of the two component cues. Only after many trials did the autistics respond equally on the basis of both component cues. The results of an initial attempt to teach a general set to respond to multiple cues showed that, when an autistic child was taught a series of successive conditional discriminations, the child eventually learned a set to approach new discriminations by responding equally on the basis of both component cues. The results are discussed in terms of understanding and treating autistic children's abnormal development.     

Animal Faux Pas: Two Legs Good Four Legs Bad for Theory of Mind,but Not in the Broad Autism Spectrum

Research shows that the general population varies with regard to both autistic traits and theory of mind (ToM) ability. Other work has shown that autistic individuals may not underperform on ToM tests when the agent of evaluation is anthropomorphic rather than typically human. Two studies examined the relation between ToM and autistic trait profiles in over 650 adults using either the standard Faux Pas Recognition Test (FPT) or an anthropomorphized version of the FPT (FPTa). Results showed that autistic trait profiles were related to faux pas detection ability in the FPT but not the FPTa. Furthermore, while those with the broad autism phenotype scored significantly worse than those who were typically developed on the FPT, scores did not significantly differ on the FPTa. These findings add to a growing body of work suggesting that ToM ability is not at a global deficit in those on the autistic spectrum, but may relate to the mindreading of specifically human agents.     

Sex-specific variation in facial masculinity/femininity associated with autistic traits in the general population

Reports linking prenatal testosterone exposure to autistic traits and to a masculinized face structure have motivated research investigating whether autism is associated with facial masculinization. This association has been reported with greater consistency for females than for males, in studies comparing groups with high and low levels of autistic traits. In the present study, we conducted two experiments to examine facial masculinity/femininity in 151 neurotypical adults selected for either low, mid-range, or high levels of autistic traits. In the first experiment, their three-dimensional facial photographs were subjectively rated by 41 raters for masculinity/femininity and were objectively analysed. In the second experiment, we generated 6-face composite images, which were rated by another 36 raters. Across both experiments, findings were consistent for ratings of photographs and composite images. For females, a linear relationship was observed where femininity ratings decreased as a function of higher levels of autistic traits. For males, we found a U-shaped function where males with mid-range levels of traits were rated lowest on masculinity. Objective facial analyses revealed that higher levels of autistic traits were associated with less feminine facial structures in females and less masculine structures in males. These results suggest sex-specific relationships between autistic traits and facial masculinity/femininity.     

HOW WE HAVE BEEN LEARNING TO TALK ABOUT AUTISM: A ROLE FOR STORIES

Abstract: Autism fiction has become a genre of novel-writing in its own right. Many examples are given in the essay. What does this activity do for us? There used to be no language in which autistic experience could be described. One characteristic difficulty for autistic people is understanding what other people are doing. So absence of a discourse of autistic experience is to be expected. Analyses advanced by Wolfgang Köhler and Lev Vygotsky already made plain long ago that social interaction is a precondition for a language of the inner life. One role for the wave of autism stories now being published, is to create such a language of autism. This in turn affects how autistic people think of themselves. It certainly affects how nonautistic, "neurotypical," individuals think about autism. Not all of this is a good thing, for all too many stories foster images of "the" autistic person as having special gifts that ordinary people lack.     

Affective exchanges between young autistic children and their mothers

This study examined autistic children's social behavior, affect, and use of gaze during naturalistic interactions with their mothers. Sixteen autistic children, 30 to 70 months of age, and 16 normal children, matched on receptive language, participated. Children and their mothers were videotaped during three situations: a free-play period, a more structured period during which communicative demand was made on the child, and a face-to-face interaction. In all three situations, autistic and normal children did not differ in the frequency or duration of gaze at mother's face. In the one condition (face-to-face interaction) during which affective expressions were coded, autistic and normal children also were not found to differ significantly in the frequency or duration of smiles displayed, and neither group displayed frowns. However, autistic children were much less likely than normal children to combine their smiles with eye contact in a single act that conveyed communicative intent. Autistic and normal children were not found to differ in the percentages of smiles they displayed to social versus nonsocial events. However, when autistic children's responses to mother's smiles specifically were examined, it was found that they were much less likely to smile in response to mother's smiles than were normal children. Finally, it was found that mothers o f autistic children displayed fewer smiles and were less likely to smile in response to their children's smiles, when compared with mothers o f normal children. These findings suggest that the autistic child's unusual affective behavior may negatively affect the behavior of others.We wish to thank the children and their mothers who participated in this study, and the staff at Division TEACCH at the University of North Carolina at Chapel Hill for their help in recruiting children for the study. Harriet Reingold generously allowed us to videotape the children in her infant observation laboratory at the University of North Carolina, Chapel Hill. Cathy Lord provided videotapes of some of the autistic children and their mothers. Mary Evers assisted in data collection. Kerry Hogan assisted in the coding of data; her help is gratefully acknowledged. The study was supported by a grant from the University of North Carolina at Chapel Hill.     

Three ways of understanding Ida

This paper aims to compare the psychoanalytic understanding of three analysts, sharing a similar theoretical background, with regard to the clinical material of an autistic girl with probable organic impairment. The conclusion is that, although the three analysts' ideas about the pathogenesis of the girl's developmental disorder are somewhat divergent, a tendency towards convergence can be noted as the therapy goes on. The paper concludes that there is some common ground of understanding about autistic phenomena among psychoanalysts sharing the same affiliation, that combining the individual views of different analysts may enlarge the understanding of the case as a whole and that the technique Tustin used to treat psychogenic autistic children can also be used to treat brain-damaged autistic children.