Monday, May 23, 2005

Theory of mind of my own

One of the most fascinating concepts I've encountered on this journey with autism is the idea of the "theory of mind." In short: people with autism struggle with being able to look at things from another person's perspective. One of the classic tests of theory of mind goes something like this:

Sally and Anne have a marble, a basket, and a box. Sally puts the marble in the basket, then leaves the room. While she is gone, Anne moves the marble and puts it in the box. Sally comes back into the room. Where does Sally look for the marble?

Most typically developing three-year-olds will know that Sally will look in the basket, because she thinks that's where the marble is even though we know that Anne moved it. Most childrens with Down Syndrome will look in the basket as well. But children with autism will look in the box: "for goodness sake, we just saw Anne put the marble in the box, people!" It will not occur to the child with autism that Sally doesn't know what we know, that Sally's thoughts are different from our thoughts.

I tried this experiment with Bud. We acted it out with Ernie and Bert dolls. Ernie - that prankster - moved the marble while Bert was away, and I made a big deal about Ernie thinking it was very funny to play a joke on Bert. Bert came back and I asked Bud where Bert thought the marble was. With a big grin, Bud went straight for the box and produced the marble.

I also made the connection recently that the answers Bud often gives to "why" questions may have to do with theory of mind. Bud has always struggled with why questions, and it's something we've been working on. We've also been working on empathy. So, often, when we see someone exhibiting an emotion - in a book, in a store, on tv - I'll ask Bud to name the emotion, and he usually does it pretty well. We were in a bookstore and a littel girl fell down and was crying. I asked Bud, "How does she feel?"

He said, "She's sad."

"Yes, she feels sad. Why is she sad?"

"She's tears."

Aaahhhh. He hears "why is she sad" not as "what makes her feel sad?" but as "why was sad the right word for you to choose?" (answer: because I see tears, and tears mean she's sad.) His answer was from his own perspective; no theory of mind.

But it's not that simple. There are other times, in other situations, where it is clear that Bud knows I'm thinking something different from what he's thinking. This often happens when I'm angry - or, more frequently, when he does something that he thinks might make me angry. I usually know that this has occurred when he comes up to me and says "Mama, you not angry face, you happy face!" And since I'm not sure what has happened and clearly have no face at all yet, it's clear that Bud is projecting for me how he thinks I might feel, and how he wishes I would feel. That's theory of mind, right?

A few weeks ago we had some cognitive testing done with a psychologist who works a lot with autism spectrum disorders. It was very difficult to get an accurate assessment of his abilities for a variety of reasons, but let me give you one example:

The task the doctor presented looked like this. There were four pictures: a head, a foot, a hand, and a nose. The doctor handed Bud a card with a sock on it. Bud was instructed to put the card on the picture that went with it. The activity was designed so that each successive set was more challenging than the last.

Bud was delighted. This was just like the Zoboomafoo computer game he loves to play, and he decided he would play it exactly the same way - except, since these pictures wouldn't talk, he would have to do the talking for them.

He picked up the picture of the sock, plopped it down on the head and announced "No, that's not right. Try again!"

He picked it up again, plopped it onto the hand and said "No, that's not right. Try again!"

He picked it up again, plopped it onto the nose and said "No, that's not right. Try again!"

Then, finally, he plopped it onto the foot and squealed "Mangatsika! You're great at this!"

For Bud, getting the right answer in a computer game - or, clearly, in an intelligence test - is irrelevant. It is as much fun to see what happens when you get the wrong answer as it is when you get the right answer. And if you choose the right answer first, you only get to play once on this screen; if you choose the wrong answers first, you get to play four times.

But you can imagine how tedious it was to the psychologist doing the testing. The four "warm up" questions took about 15 minutes, and unless we were prepared to spend the rest of Bud's childhood in the testing room we were going to have to move things along. I gently suggested to Bud that he try to get the right answer first on the next question. He did, and then promptly lost interest in the game and disengaged from it completely.

The psychologist characterized this (in so many words) as a theory of mind issue: Bud didn't understand that the psychologist had an agenda, and that he had expectations for what Bud should do. He said that most children want to please the tester, and are excited about showing that they can get the right answers.

Maybe. Maybe not. It might be a "theory of mind" issue. Or it might be a "mind of my own" issue. It might be that Bud had discovered a fun, exciting game and the psychologist turned it into a boring, dull game. Regardless of what expectations the psychologist had, for Bud dull and boring is a waste of time.

I've been watching Bud since that testing to see if I can find other examples of Bud utilizing a theory of mind perspective.

Last night, 30 minutes after bedtime I could still hear singing coming from his room, followed by a very distinctive thump-thump-thump that told me the singing was accompanied by a little soft shoe routine. I started up the stairs, and just as I came into view I saw his little body hurl through the air in his room as he dove head-first into his pillow. By the time I walked through the door he was tucked in his bed, snugly under the covers, and he looked up at me and did a classic Vinnie Barbarino "What?"

Theory of Mind meets Mind of My Own meets Mind Your Own Business, Mom.


Gwuinifer said...

Vinnie, baby, yeah!!!

I can just imagine the chirpy voice sing-songing, "No, that's not right. Try again!" Our boys have a promising career in radio announcing ahead of them, if naught else... *grin*

We've been playing a Lion King game on a TV console setup, and he is not great on the controls yet (his sister is doing really well, though) but he LOVES LOVES LOVES the repetitive narrator-commentary play-by-play. "Yellow!" chimes the voice, when you pass something yellow.
"You're so smart!"
"Uh-oh, not THAT way! Try again!"
He now has the soundtrack pretty well memorized. Which, in a "normal" kid, would mean he was learning his colors at very least. But somehow I feel that might not be the bit that's sticking with him... I'm waiting for the moment his sister bites the dust on her tricycle and he squeaks, "Uh-oh, not THAT way! Try again!"

Moi ;) said...

There's a really good book out there that is for kids with Asperger's (kids with PDD-NOS can use it, too) by Catherine Faherty - it's called What Asperger's Means to Me. It's a workbook that you use with them, they love it - and it helps them understand all that stuff -

Marta said...

Interestingly, the psychologist didn't try and get Bud's theory of mind (and a lot of teachers don't either), even though they are supposedly non-autistic, adult and professional. Most people are trying and trying to put our square children through round holes, and keep complaining about the children not conforming...