4.6 Emotions, relatedness and the developmental process
Cognitive style and ToM approaches both draw extensively on cognitive concepts to explain why functioning in autism is atypical. ToM has typically assumed that successful social interaction and communication involves processing information about other people in the form of social stimuli such as gestures, expressions, language and behaviour. The processes that promote emotional understanding and relatedness between people have been seen as essentially akin to the more ‘rational’ processes involved in understanding a person's factual knowledge or beliefs.
Peter Hobson (1993) approaches social understanding from a philosophically different standpoint. He proposes that rather than ‘processing information’ to derive ‘theories’ about the thoughts and emotions of others, people's primary emotional relatedness to others promotes empathy or direct understanding. Similarly, people's awareness of self is not a theory-like representation of their thoughts, but a sense of self as a ‘subject’ who is in relations with other ‘subjects’.
The basis for these ideas is Hobson's view that humans are first and foremost social beings, with an ‘innate’ capacity for personal relatedness. This view, prefigured by Kanner (1943), also echoes Bowlby's ideas about attachment. From this, Hobson elaborates an account that contrasts how typically developing and autistic infants engage with the world from birth. Key features are outlined in Box 7, followed by a summary of relevant evidence.
Box 7: Hobson's approach
The following key features of typical development are missing in autism:
human primacy: the infant engages emotionally and socially with humans in ways that are distinct from how he/she engages with the physical world.
reciprocity: the infant's early behaviour is ‘pre-programmed’ to elicit responses from his/her carer, and to respond to these responses. This triggers a continuous cycle of interaction in which each affects the other – a transaction that promotes emotional bonding.
inter-subjectivity: through the sharing of experience involved in such transactions the child acquires ‘direct’ knowledge of others as subjective beings with their own feelings, thoughts, intentions and beliefs.
reflexivity: the child acquires an understanding of self via his/her developing awareness of others as subjective beings.
Key predictions for the behaviour of children with ASDs are:
Difficulty in recognising self and others as distinct human ‘subjects’. In support, Hobson (1993) highlights difficulty in using the personal pronoun ‘I’. For instance, a child with ASD asked ‘do you want a biscuit?’ might respond ‘you want a biscuit’, meaning ‘yes, I want a biscuit’. Hobson interpets this as evidence that the child does not distinguish himself from other subjects, or from inanimate objects.
Atypical engagement with carers from birth. Lord (1993) provided evidence that infants later diagnosed as autistic have offered fewer and ‘poorer’ opportunities to their parents for engagement and interaction. Hobson also interprets failure to develop behaviours such as gaze-following and proto-declarative pointing (see Section 4.2) as supporting this prediction and as showing a failure to develop intersubjectivity.
Difficulty in recognising and expressing emotions. Hobson et al. (1989) studied the ability of children with autism to supply appropriate emotional terms in response both to pictures of faces and to voices depicting different emotions. Compared with appropriately matched control groups, these children showed a grasp of the vocabulary terms, but applied them haphazardly to the stimuli, suggesting they did not understand which expression was which.
While the evidence illustrated in Box 7is broadly consistent with Hobson's model, none of it is conclusive. For instance:
Atypical pronoun use could equally be part of wider pragmatic language difficulties, rather than reflecting specific problems of self recognition.
Evidence for atypical engagement with carers from birth depends on retrospective reconstructions, or on extrapolating from later behaviour. Failure to develop behaviours such as gaze-following do not necessarily imply atypical behaviour at birth, since these typically only appear at eight months. In a survey by Frith and Soares (1993) two thirds of the mothers of children with ASDs had not been disturbed by their children's behaviour in the first year. A surprising number of such children are also later rated as ‘securely attached’ (Rogers and Pennington, 1991).
Deficits in emotional understanding do not necessarily reflect a lackof emotional experiences. Sigman et al. (1995) studied the performance of ‘high functioning’ young people on a whole range of emotion tasks. In one task, the participants had to relate an occasion when they had experienced emotions such as pride, happiness, embarrassment, etc. The children were able to give responses, albeit slowly, but these tended to be atypical: for instance while food was given as a source of happiness, birthday presents or parties were not. Hence the children did not lack emotional experiences, but had made ‘odd’ connections between these and social contexts. Again these results do not clearly favour Hobson's account.
In general, it has been difficult to find clear evidence that favours Hobson's theory. A number of its predictions are similar to those of the ToM model: both assume that people with ASDs may fail to take a distinctive ‘stance’ towards the human world; both predict early impoverishment in use of gestures, and later difficulties in understanding other minds; both are consistent with evidence of genetic influences in autism, to be discussed in Section 5. Even so, Hobson's emphasis on the direct, inter-subjective quality of much social and emotional understanding is appealing. In a recent paper, Baron-Cohen (Baron-Cohen et al., 2002) also moved from the rational connotations of ‘mind-reading’ to a more relational notion of ‘empathising’. Hobson also provides a framework for considering how autism might ‘unfold’ developmentally, as a process involving both the infant and ‘significant others’ in his/her environment, such as carers and siblings. Yet like the other models discussed in this section, the main focus of Hobson's model remains individual: it has relatively little to say about how an atypical developmental trajectory might affect parents and family. We will conclude by briefly considering this contextual interplay.
Empathy: A direct or intuitive way of understanding other people's feelings and desires. Contrasts with the more rational or inferential understanding implied by ‘theory of mind’ or mind-reading.