The autistic spectrum: From theory to practice
The autistic spectrum: From theory to practice

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The autistic spectrum: From theory to practice

4.4 Theory of mind and self-awareness

One of my most recurrent problems throughout middle childhood was my constant failure to distinguish between my knowledge and that of others. Very often my parents would miss deadlines or appointments because I failed to tell them of these matters. For instance my parents missed the school's Open House in my fifth grade and my mom asked me afterward, ‘why didn't you tell us about it?’ ‘I thought you knew it,’ I replied.

(Sarah, in Sainsbury, 2000, p. 60)

Sarah's lucid comment on her childhood highlights the way ToM deficits can lead to communication difficulties resulting from failure to understand another person's state of knowledge. But it also reflects Sarah's capacity, now, to reflect accurately on how her communication problems arose. This emergence of self-awareness in parallel with ToM is consistent with Mead's claim that children acquire a sense of self through taking the role of others. Note that such developing self-awareness could also be seen as enhancing one of the dimensions of consciousness.

Capacity for ‘mind-reading’ and enhanced self-awareness are both characteristics that may help diagnosticians to define the ‘Asperger's’ sub-group more adequately than the current problematic diagnostic criteria, and to establish specific therapeutic needs. As we have seen, the benefits of having insight into self and others can be accompanied by feelings of pain and isolation for ‘high-functioning’ individuals, calling for sensitive therapy.


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