1.4 A framework for this course
The different perspectives explored in the course are linked by several explanatory threads:
Different levels of analysis
Different kinds of evidence
The question of ‘difference’.
Each of these ‘threads’ is introduced briefly below.
Theory-practice interplay: The psychological work on autism discussed in this course represents a variety of professional perspectives that share the twin goals of establishing effective theoretical understanding, and of harnessing this understanding to provide effective support and therapy. The perspectives vary in their theoretical assumptions and in the extent to which they emphasise research or practical advances in diagnosis, therapy and education. As you will see, there is no clear-cut division between ‘pure research’ and ‘practical application’, and the narrative throughout the chapter highlights the close interplay between theoretical and applied activities.
Multi-disciplinary approaches: Theoretical and applied activities may involve the same people, or different individuals within one team. Such team work is therefore multidisciplinary. Autism can result in problems in family, school and social settings, as well as involving medical complications such as epilepsy. So, while this course features the work of research, clinical and educational psychologists, it also includes the work of psychiatrists, neurologists, and other medical specialists, teachers and health visitors. Families and carers of people with autism also make important contributions to this team work.
Different levels of analysis: The three-level framework proposed by Frith (1999) provides, with one modification, a key organising dimension of this course – as you progress through the different sections, you will find that the major focus shifts between these levels as outlined below:
Behavioural level: work on the identification, diagnosis and mapping of ASDs, discussed in Sections 2 and 3, is extensively (though not exclusively) informed by descriptions of the observable behavioural manifestations of autism. Some of the therapeutic work discussed in Section 6 is also targeted at altering behaviour, rather than dealing with ‘underlying’ problems.
Socio-cognitive level: this level is termed socio-cognitive to emphasise that it embraces all of the person's mental functioning – the processes by which a person with autism makes sense of the social world are as much affected as those used to recognise objects and events; emotional functioning is affected as well as more intellectual thought processes. This level is the focus for Section 4, and it also informs the diagnostic advances and therapeutic work discussed in Section 6.
Biological level: this level is comprised of several sublevels: damage or faults in the genes that a person inherits may in turn affect the biochemical and physiological functioning of neurons and other cells, body organs and endocrine (hormonal) systems, and the structure and functioning of brain areas and circuits. There may even be evolutionary factors to consider. Section 5 considers the role of such biological influences in autism while some of the therapeutic work discussed in Section 6 is informed by biological ideas.
Remember that the individual's environment provides a context that can influence (or be influenced by) each of the levels we have identified. This may be the biological environment in which the nervous system develops, the physical environment in which we operate as living organisms, or the social environment in which we function as human beings. It is important to think of autism as involving a developmental trajectory – a process that unfolds across time, in interaction with these multiple environmental contexts. Current understanding of these interactions is limited, but they are considered at the end of Sections 3, 4 and 5.
Different kinds of evidence: much of the work represented in this chapter necessarily approaches autism from an outside perspective whereby the researcher or practitioner seeks to describe, explain and address a psychological problem within a framework of dispassionate observation, theorisation and therapy. But as we saw at the beginning of this section, personal or insider accounts offer a different type of evidence that can inform and enrich outsider perspectives. Arguably, parents' understanding of their children has something of this ‘inside’ status, so parental accounts are treated as a further special source of evidence.
The question of difference: at each stage of the course we will encounter some of the tension between highlighting differences between people and stressing their similarities. In particular, the difficulties of clearly demarcating the boundary between the autism spectrum and ‘normality’ will be apparent.
Psychiatrist: Medical doctor specialising in the diagnosis and treatment of psychological problems or disorders.
Neurologist: Medical doctor specialising in the diagnosis and treatment of disorders of the nervous system.
Developmental trajectory: The notion that development occurs over an extended time span and takes a particular pathway, in interaction with multiple environmental contexts.
Section 2 opens this account of work on autism by considering the diagnostic process. Remember that most of the features of behaviour described will be shown by all children at some time or another. A psychologist or psychiatrist will make a careful evaluation of a wide range of evidence before making a diagnosis of autism.