Saturday, November 29, 2008

Reflections from an assigned reading

Attwood, Tony. (2005). Theory of mind and Asperger's syndrome. In Baker, L. J., & Welkowitz, L. A., Asperger's syndrome: Intervening in schools, clinics, and communities (pp. 11-41). Mahwah, N.J.: Lawrence Erlbaum Associates.



With an impaired TOM, there are difficulties with the conceptualization
of feelings and desires of others and oneself. (p. 21)


In reading Atwood's chapter on Theory of Mind, several things stood out to me. The stress that the families of people on the Autism Spectrum is great. The parents are not only parents, but advocates and therapists among other things. All the effort and love they put into these roles may not be rewarded with “love.” Children and adults on the Autism Spectrum typically do not express or understand emotions in the same way that “typical” people do. Since their Theory of Mind is impaired, they do not fully understand, if at all, the emotions from the other person's point of view. They do not understand what goes into a relationship and their emphasis is not on how the other person feels; reciprocal relationships depend on this.

Working with these children in the school system, I see the effect this has on parents. Sometimes they express that they don't feel that their children love them. I've seen these children show the same attachment to their parents as to me. Their parents are confused to watch this occur. Many parents have also expressed feeling guilty or inadequate. Realizing that impaired Theory of Mind impacts their child's ability to “love” in the traditional sense may help them to understand how their child is expressing love.



People with Asperger's Syndrome might express their love in
more practical terms...it is love, but not as we know it. (p. 22)

People on the Autism Spectrum tend to focus their feelings differently than others do. In Atwood's article, he includes quotes from people with Asperger's Syndrome. The definitions of love include doing things with the other person, companionship, and the “attempt to connect to the other persons feelings and emotions.”

During Thanksgiving, I did an “I'm thankful for...” activity. Discussing what this means with one of my students, Noah*, we came up with the definition of thankful as something that makes us happy or we are happy to have. He named many objects, such as birds, chicken nuggets, and waffles. When I asked him if any people make him happy, he thought for a moment and said no. I've seen this child interact with his mother, grandmother, and sister and he does appear to enjoy their company. The basis of their relationship, however, is difficult for this boy to express or understand.

The children I have worked with focus on what their parents do for them, rather than how they feel about them. I asked Jacob*, an eight-year-old boy with Asperger's Syndrome, why he loved his grandmother. He stated, “well, we go bird-watching together.” When prompted further, he mentioned her cooking dinner and helping him with homework. While these are greats things in their relationship, Jacob was not able to attach any emotion to his grandmother.

Understanding how an impaired Theory of Mind can affect so many aspects of a child/adult's day, will help me to be a more effective therapist. Explaining this to teachers and parents may alleviate some of the daily stressors, such as behavior (“He did that on purpose!”), inappropriate comments (“I can't believe she said that to him.”) and difficulty expressing emotions (“Why doesn't my child love me.”).



A social story provides information on the where, when, who, what, and
why of social situations. [Social stories have been] found to be remarkably
effective in improving both understanding and social and emotional behavior in people with autism and Asperger's Syndrome (p. 31).


I have found using social stories to be an invaluable tool in teaching children with autism and Asperger's syndrome. By presenting a potentially uncomfortable situation in a safe environment and with needed supports and tools, proves to be an effective method of teaching vital information.

I have written and provided numerous social stories to my students. One in particular, Joey*, frequently reads through his social story library throughout the day. One of the stories is regarding behavior in the classroom. A page in the story states that using a loud voice can hurt his classmates ears. There is a picture of a person covering their ears with a sad face. When Joey first received this book, he read each page without a visible reaction. After a week or so, Joey would read the book out loud to his paraprofessional, and began getting upset at that picture. He eventually started to cry when reading that specific page. As Joey processed the information, it seems that he began understand how his actions affected his peers. His raised voice has begun to decrease.

Although this section states that no published studies exist regarding the efficacy of social stories on Theory of Mind tests, many of my students find them to be useful. This chapter made me think about the way in which to write these stories, including the four sentences: descriptive, perspective, directive, and control. Using these guidelines, I may be able to create more effective stories.

*All names have been changed to maintain confidentiality

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