AUTISM SPECTRUM
DISORDER
Understanding Theory of Mind
Autism Spectrum Disorder (ASD)
■ Developmental disabilities that can cause significant challenges in areas
– social
– communication
– behavioral
■ Wide range of symptoms and severity  spectrum
– different and unique per case
■ Prevalence: 1/54
■ Signs usually appear by age 2 or 3
Diagnostic Criteria
A. Persistent deficits in social communication and social interaction across multiple
contexts, as manifested by the following, currently or by history:
1. Deficits in socio-emotional reciprocity ranging from abnormal social approach and failure
of normal back-and- forth conversation; to reduced sharing of interests, emotions, or affect;
to failure to initiate or respond to social interactions .
2. Deficits in nonverbal communicative behaviors used for social interaction ranging from
poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and
body language or deficits in understanding and use of gestures; to a total lack of facial
expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understanding relationships ranging from
difficulties adjusting behavior to suit various social contexts ; to difficulties in sharing
imaginative play or in making friends; to absence of interest in peers.
Diagnostic Criteria
B. Restricted, repetitive patterns of behavior, interests, o activities, as manifested by at least
two of the following currently or by history: Stereotyped or repetitive motor movements, use
of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects,
echolalia, idiosyncratic phrases).
1. Insistence on sameness, inflexible adherence to routines , or ritualized patterns or verbal
nonverbal behavior (e.g. extreme distress at small changes, difficulties with transitions rigid
thinking patterns, greeting rituals, need to take same rout or eat food every day).
2. Highly restricted, fixated interests that are abnormal intensity or focus (e.g., strong
attachment to or preoccupation with unusual objects, excessively circumscribed or
perseverative interest).
3. Hyper- or hyperreactivity to sensory input or unusual interest in sensor y aspects of the
environment (e.g. , apparent indifference to pain /temperature , adverse response to specific
sounds or textures, excessive smelling or touching of objects visual fascination with lights or
movement).
Diagnostic Criteria
C. Symptoms must be present in the early developmental period (but may not become fully
manifest until social demands exceed limited capacities or may be masked by learned
strategies in later life).
D. Symptoms cause clinically significant impairment in social, occupational, or other
important areas of current functioning.
E. These disturbances are not better explained by intellectual disability (intellectual
developmental disorder) or global developmental delay. Intellectual disability and autism
spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum
disorder and intellectual disability, social communication should be below that expected for
general developmental level.
Specify:
With or without accompanying intellectual impairment
With or without accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavioral disorder
Severity Levels
Essential Symptoms
■ Deficits in social communication and social interaction
– interpersonal relationships
– social reciprocity
– poor eye contact
■ Restricted, repetitive behaviors, interests of activities
– self-stimulatory behavior
– excessive attachment to routines
– resistant to transitioned
– special interests
Other Possible Impairments
■ Sensory
– over-sensitivity/hypersensitivity
Activity
Look at the picture and share
with someone next to you
where Sally look for her
marble? And why?
Theory of Mind (ToM)
■ Understand that others have beliefs, desires and intentions that
can be different from our own
– Taking perspective
– Empathy
– Imitating
What you might see in your students
■ Students may lack
– joint attention
– picking up social cues
– understanding other’s desires
Why students with ASD lack ToM
■ People with an ASD diagnosis use language for a “limited range of communicative
functions,
■ and rarely for social functions (e.g., Chin& Bernard-Opitz, 2000)
■ nA meta-analysis of ToM tasks found that children with ASD required a much higher
verbal ability to pass ToM tasks than typically developing children or children with
Intellectual Development Disorders (Happe, 1995)
■ n...However, children with ASD are still delayed on non-verbal ToM tasks (Colle et al.,
2007)
What can we do?
■ Direct instruction of social skills
– socio-emotional learning
– social stories
■ Reinforcement systems for prosocial behaviors
■ Fluency of transitions
■ Mediate social interactions
– play time
– structured group activity
Using Social Stories
Use visuals and
story formals to
teach students
routines,
expectations, and
prosocial
behaviors
Reinforcing Prosocial Behaviors
■ Find what the student
finds reinforcing
■ Explain the exact
behavior they are being
reinforced for
Transition Fluency
■ Review today’s schedule and
expectations
■ Discuss all possible transitions
Mediate Social Interactions
■ Play time
■ Group work
■ Conversations
Questions?