Reflections on Theory of Mind and Autism

Introduction

“Having a theory of mind is to be able to reflect on the contents of one’s own and other’s minds. (Simon Baron-Cohen, 2001)”. As has been discussed by Uta Firth, you cannot refer to the theory of mind without also referring to autism. Autism can be understood as a lack of theory of mind (Frith & Happe, 1994). This topic was of interest to me because it allowed me to reflect on previous professional experiences I had while working with a toddler whom I suspected to be autistic. I will be referring to this child throughout the essay and will, henceforth, use the pseudonym Mika.

I will provide a brief synopsis of the recommended reading, the classroom discussion, and how they relate to one another. I will discuss how this newly acquired information has allowed me to reflect on previous professional experiences. I will then reflect upon how this knowledge could inform my future intended practice as a children's psychotherapist. I will use insights gained from this experience in tandem with this new knowledge to identify important potential challenges which could arise in forming a trusting relationship and selecting the therapeutic approach I will take. These reflections can further help me in understanding and empathizing with future patients.

Reading

In the prescribed reading, Charman, Baron-Cohen, Swettenham, Baird, Cox & Drew examined the relationship between joint attention, play and imitation abilities, and the development of the theory of mind. There is currently little direct empirical evidence that supports the claims that these behaviors are directly linked to the later acquisition of the theory of mind (Charman et al, 2000). It has been suggested that these behaviors, in combination with language and theory of mind might “form part of a shared social-communicative representation system in infancy (Charman et al., 2000)”.

This suggestion caused me to wonder if it was possible to differentiate between the individual abilities which comprise this system and how it could help to inform our understanding of the widely diverse level of abilities apparent within the spectrum of autism. The age at which a diagnosis of autism can be diagnosed is 3 and a half (Charman et al., 2000). In my understanding, one of the goals of the study was to examine how these precursors in 18-month-old's can relate to future diagnosis of autism.

Seminar Discussion

In the seminar, we observed and discussed the precursors of this ability in an 18-month-old child. The age of the infant is significant, as Charman et al. discussed how infants at that age do not possess a complete theory of mind and are incapable of passing a false-belief task. Although a diagnosis before the age of three is uncommon, most parents of autistic children report concerns around 18 months, demonstrating that there are clear indications at this age (Rogers, 2000).

We watched a video of the child interacting with his mother and noted down signs of these precursors from an observation checklist. We discussed our findings and chose to focus on pretend play. It has been suggested that pretend play is an early expression of an infant's capacity for metarepresentation (Leslie, 1994).

Metarepresentation is important for developing a theory of mind, as it involves representing a representation and this, in turn, assists in our understanding the thoughts of others (Scott, 2001). We explored how to pretend play differs from functional play. There was confusion as to whether his play eating was functional or pretend because he was using the toys as they were intended to be. We concluded that this pretended play, as the toys were representational and the food imaginary. The child appears to understand that his mother knows that he is pretending to eat, which is indicative of a developing theory of mind.

Analysis

After observing the infant, discussing it in the seminar, and acquiring knowledge through further reading, it seems apparent that this child has reached the appropriate developmental milestones for 18 months about the acquisition of theory of mind. In contrast, when I first met Mika, he was approximately the same age and showed significant impairment in these areas. He had issues such as delayed speech, a lack of eye contact (Jones & Klin, 2013), difficulties communicating, and infrequent use of pretend play.

I had not received any training about autism, so my concerns were based on comparisons with other children. Based on what I now know, I believe I was correct to be concerned. In reflection, I should have insisted on him getting additional support. I can now better understand his challenging behaviors as being related to an inability to predict consequences, the behaviors and motivations of himself and others, and an inability to communicate. Without appropriate training, we were ill-equipped to support him, as our usual tactics were ineffective on him.

Outcomes

I would be interested to learn more about intervention programs that are currently being used for young children diagnosed with autism. It would be beneficial to be aware of newly developed and experimental interventions, especially programs which have had direct input from autistic individuals such as the SPELL approach.

I would like to acquire a better understanding of how to effectively and empathically handle challenging behaviors associated with autism in children. If I do become a children's psychotherapist, I need to gain an in-depth understanding of the theory of mind and autism. I can understand it on a theoretical level but have difficulty imagining how an impaired theory of mind might feel. One way this can be achieved is through qualitative research done with autistic adults and children, as has been done carried out by Mahdi, Viljoen, Yee, Selb, Singhal, Almodayfer, Granlund, de Vries, Zwaigenbaum, & Bölte.

Conclusions

Before the work done in the seminar and lecture, I had little knowledge and understanding of the theory of mind. The knowledge I have since acquired has allowed me to reflect on my previous experiences working in a kindergarten. I have been able to further understand behaviors related to autism and have evaluated how this understanding could have been beneficial in my previous position. I intend to take this knowledge and further build on it in my future practice as a children's psychotherapist. I have identified weaknesses in my understanding and areas that require further research.