Understanding autism
Understanding autism

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Understanding autism

1.4 Theory of Mind and thinking literally

ToM is about understanding other people’s mental states, that is their beliefs, intentions, feelings and so on. Some researchers have suggested a link between ToM difficulties and ‘literal-mindedness’ in autism. As you learned in Week 2, in everyday situations, people often say one thing while actually meaning or intending something else. For instance, when people speak ironically or sarcastically, understanding what they really mean depends on ‘reading behind’ what they say to their intentions given the context. To test how autistic people interpret non-literal utterances, Francesca Happé devised the ‘Strange stories’ test (Happé, 1994).

Participants in the test were presented with stories like this one which contains an example of irony:

Ann’s mother has spent a long time cooking Ann’s favourite meal: fish and chips. But when she brings it in, Ann is watching TV, and she doesn’t even look up or say thank you. Ann’s mother is cross and says ‘Well that’s very nice isn’t it! That’s what I call politeness!’

The participants were asked:

  • Question 1: Is it true what Ann’s mother says?

  • Question 2: Why does Ann’s mother say this?

Described image
Figure 2 Ann and her mother.

While autistic participants were able to identify that what Ann’s mother says is not true, most struggle to identify why she might say it, suggesting, for instance, that she was ‘having a joke’. A person who has difficulty in reading the meanings and intentions behind other people’s utterances may find all such expressions, interpreted literally, really puzzling or disconcerting. The consequences can sometimes be really profound.

In this extract, Wenn Lawson describes how, years ago when autism was less well known, his literal interpretation of questions from a psychiatrist led him to be misdiagnosed with schizophrenia (Lawson and Roth, 2011).

Download this audio clip.Audio player: aut_1_wk04_lawson_adolescence_and_adulthood_clip.mp3
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Transcript

WENN LAWSON
The doctor asked me a couple of questions – he asked me if I heard voices, which seemed like a really silly question because as far as I was concerned voices are actually designed to be heard and most of us, unless we are deaf, hear voices, so I said ‘yes’. He said ‘what do these voices say to you?’ and I said ‘well it depends on whose voice it is’. He said ‘do you hear more than one?’, and I said ‘yes I hear many’. He then asked me if I see things, which also was a strange question because I’m not blind, although I only have sight in one eye, so I said ‘yes I do see things’. So he concluded I lived detached from reality, and that I had auditory and visual hallucinations, which equates to being schizophrenic, so he said to my parents that their daughter was mentally ill, that she was schizophrenic, would need anti-psychotic medication, and in fact they put me into a psychiatric hospital.
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In Week 2 you viewed two video clips [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]   titled ‘Socially awkward’ and 'Misunderstanding', which you might like to watch again, considering how ToM difficulties could affect the behaviour of the young man in the clip.

Just how ToM and language skills are linked is debatable (de Villiers, 2000). Autistic people with pronounced language problems are more likely to fail false belief tasks, possibly suggesting that language difficulties cause ToM difficulties rather than the other way round. With much greater awareness of literal-mindedness these days, organisations like the National Autistic Society advocate clear, straightforward language for communicating with people in the autistic community.

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