Representational Difficulties in
Individuals with Autism Spectrum
Disorders
Sharon Weiss-Kapp Med CCC SL/P
Adjunct Clinical Assistant Professor
MGH- Institute of Health Professions
Boston MA
Senior Clinical Associate
Autism Language program
Children‘s Hospital Boston
Areas to be addressed
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Representational ability
Joint attention
Intentionality
Theory of mind
Associative learning
Generalization of concepts
Gestalt vs. analytical language
Imitative behaviors/Role reversal imitation
Use of Symbols
Symbolic equivalency
Mental states are said to have "intentionality"
— they are about or refer to things,
Mental representations have semantic
properties
Imagination is a sequence of representations
Representational Ability
―Mind does not just copy reality, but provides
a representation of the world‖ (TagerFlusberg)
Close your eyes and describe this
room.
Is your description a direct copy or
a representation?
Are you processing at the
representational level or at the
perceptual level?
Systematizing: Baron-Cohen
• Inanimate objects have predictable actions
that are processed visually
• These actions are successfully predicted
based on physical characteristics and
physical laws
Systemizing cont‘d
• Human behaviors are motivated by internal
states that may not follow objective,
predictable patterns
• ToM is dependant on perceiving others as
―like me‖. (Metsoff and Moore 1995)
• Persons must simulate internal states of
others through motor, cognitive, and
emotional representations.
Theory of Mind
• Theory of mind is the ability to attribute
mental states—beliefs, intents, desires,
pretending, knowledge, etc.—to oneself and
others and to understand that others have
beliefs, desires and intentions that are
different from one's own.
Joint Attention,ToM and Play
• Basis of joint attention-involves ability to respond
and use visual signals and conventional gestures
for sharing attention
• Child must read cues to extend invitations and
gain entry into social groups e.g., ―My turn‖
Subtext is ―I expect you to set aside your
agenda while I take a turn because I expect that
you will know that this will please me
Joint Attention and ToM
• Joint attention requires understanding of intent and
the ability to plan communicative intent
• Egocentric stage (Tomasello)Pre-9month old has a
relationship to an object or an adult, but not to the
intent of the interaction among the three
• Post 9 months the triad becomes significant, the
child recognizes the intent of the adult, and begins
to recognize the ―other mind‖
ToM – Metarepresentational
cognition
• Capacity of one individual to mentally
represent the mental representations of
another
• Allows one to mentally represent the
psychological status of others
• Poor ToM is an interference to correctly
identifying the communicative intent of
others
Two Theories of ToM
Simulation Theory
The ability to interpret others‘ actions through
simulation
Places one in the ―mental shoes‖ of another
and allows for understanding of the
thoughts emotions and intentions behind
their behavior
Two Theories of ToM
Theory-theory
Individuals develop ToM during the first few
years of life by testing rules regarding the
functions of objects and organisms they
interact with and develop a cognitive theory
of what others are thinking (Gopnik &
Meltzoff,1997)
False Belief Task (Baron-Cohen)
• Meta representational component: ―Child thinks about
where the other person thinks the object is‖.
• Typical 3-5 year olds can disregard own knowledge to
solve this problem
• Children with ADS more likely to demonstrate
representational deficits on social-cognitive tasks than on
analogous non-social cognitive tasks
• Problem solving is more linear when not having to factor
in the intentions or expectations of another.
(Leekam & Perner; Leslie & Thaiss; Scott & Baron-Cohen).
ToM cont‘d
ToM difficulties result in poor usage of:
• Denial negation
• Use of ―wh‖ questions
• Provision of new information for
conversational repairs
ToM is fundamental to:
• Perspective taking, empathy, sharing,
comforting
ToM cont‘d
• ToM impacts on ability to add new
information and extend a conversational
topic over several conversational turns
• Difficulty stems from a lack of awareness
that communication exceeds just achieving
goals, but also to exchange and clarify
information (Tager-Flusberg)
Attention
There are two components to attention:
• Selection-choosing what to attend to and
shifting among several foci
• Allocation-the amount of time and effort
needed to maintain that focus
Repetitive Behaviors (―Stimming‖)
Children with ASD may engage in repetitive
behaviors e.g., spinning, hand flapping,
tapping, to provide a focus that enables
them to exclude disorganizing or
threatening environmental input (Baranek,
Foster, and Berkson)
Working Memory
• Simultaneous processing and storage of
information
• Critical for integrating transient, context
specific information from diverse sources
(Pennington & Ozonoff)
Inhibition
• Ability to stop oneself from from carrying out a
well-practiced and ―ready‖ response when that
response is not adaptive. (Rogers & Bennetto)
• ASD individuals are found to inhibit well on
simple cognitive and motor tasks but have more
difficulty inhibiting when required to shift
attention to a new stimuli. (Hughes)
Cognitive Flexibility
• Shifting attention from one stimulus to
another
• Shifting focus from one idea to another
• Poor set shifting results in perseveration of
thoughts and actions
Executive Difficulties and
Stimulus Overselectivity
Stimulus Overselectivity: tendency to focus on a
small, often irrelevant subset of cues (TwachtmanCullen)
Is this a deficit in the selection and allocation of
attention?
• Results in restricted concept development
• Tendency for ―missing forest for the trees‖ (Frith)
• Interferes with organizing discrete parts into a
cohesive whole
Automaticity in ASD
• Intact EF behaviors support development of
automaticity
• Lack of organizational strategies, and/or poor
time-effective processing, leads to reduced
automaticity.
• Reduction in automaticity leads to poor recall,
poor adaptive learning strategies, and less
opportunity to access HOT (Ameli, Courchesne,
Lincoln, Kaufman, & Grillion)
Referential Indeterminancy (Quine)
With no common view, novel expressions can
not be accurately interpreted as:
• A reference to an event
• A participant in an event
• Some part of the participant‘s body
• Other referents
Continuum of Flexibility in
Imitation
• Copying surface behaviors literally
• Copying what others are trying to do, not
what they are actually doing
Ability to read intention is the critical
construct
Role Reversal Imitation
• How does the process of observation
interact with the child‘s broader skills of
cognition and social interaction
• How is observational learning specifically
impacted by the child‘s ability to read the
intentions of others (Carpenter, Tomasello
& Striano)
• Role reversal imitation- imitatively learning a
communicative convention means imagining myself in the
adult‘s role and enacting the action
• Requires:
• Understanding communicative intentions
• Role reversal imitation-using the symbol in the same way
as the adult and for the same communicative purpose as
the adult used it towards them
• Child learns to take a perspective on an object different
from his own
• Social Pragmatic view is that children must:
• Live in a world that has structured social
activities
• Understand their role within a structure that
they understand
Find the splark
• Response /termination
Plox the pencil
• Accidental/intentional
Cont‘d
• Children with ASD perform equally well on recall
of nonsensical information as meaningful
information when visual and auditory stimulus
input was presented
• Typical children do better with meaningful series
• Above interpreted by Hermelin and O‘Connor as
impairment in categorization and coding of
information
Reenactment
Reenactment is the linear repetition of a single
event or sequence of events in anticipation
of an associated outcome
• Reenactment is pre-symbolic
• May be necessary for some children with
ASD to acquire communicative behaviors at
the reenactment level before they become
symbol users
Concept Formation
• How is new information generalized
• How is similarity perceived
– characteristics
– function
Associative Learning
• Whisk broom
Gestalt Language Forms
• Gestalt language forms are multiword
utterances memorized and produced as
single chunks (Peters, Prizant)
• Gestalt language involves little analysis of
internal linguistic structure
• Results in little or no comprehension of the
utterance
Analytical Language Forms
• Analytical forms involve the application of
previously acquired linguistic rules
• Results in greater comprehension
• Also greater flexibility in generating
utterances
Echolalia
• Observation indicates that most verbal individuals
with ASD demonstrate a gestalt style of language
acquisition in early utterances described as ―rigid
echolalia.‖ (Ricks and Wing)
• Inflexible information processing relying on
memorization of unanalyzed ‗chunks‖ of speech
as well as visual input. (Prizant ,Wetherby and
Schuler)
Echolalia cont‘d
• Analytical processing allows for reference
to prior experiences interrelating relevant
aspects for constructing meaning
• Gestalt processing is storage of information
to be later reproduced in an identical
fashion. (Fay and Schuler, Prizant)
Joint Attention Skills
Children with ASD have deficits in joint
attention skills including:
• Referential looking- gaze alteration between
object and adult( Charman et al.)
• Declarative pointing and showing-looking
where others look and point (Baron-Cohen)
• Social referencing
Joint attention and Language
Acquisition (Carpenter, Nagell, and
Tomasello)
―Children‘s emerging ability to engage in nonlinguistically mediated joint attentional activities
with adults at approximately 1 year of age is
integrally related to their emerging language
skills.‖
The above is noteworthy as it demonstrates the age
correspondence between joint attention and the
acquisition of first words
Referential Indeterminancy (Quine)
With no common view, novel expressions can
not be accurately interpreted as:
• A reference to an event
• A participant in an event
• Some part of the participant‘s body
• Other references
Communicative Intention and
Language Learning
Without understanding of communicative
intention, language would be primarily
learned associatively to specific items or
situations, or through training and
reinforcement e.g., requesting
Symbolic Communication
• The symbol stands for and is separate from
its referent
• The symbol is used with intention
• Are symbols always representational?
Stimulus Equivalency
Airplane
• Spoken word
• Written word
• Photograph
• Drawing
• Airport symbol
All of the above should have equivalency
Levels of Representation
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Proxy
3-D photograph
Photograph
Picture
Line drawing
Spoken language
Written language
Perceptual to Symbolic Matching
Tasks
• Identical matching
• Matching to task
• Matching to concept
Perceptual vs. Symbolic Matching
Tasks
Identical match
• Can be a perceptual match
Categorical match
• Symbolic-relies on stimulus equivalence
Stimulus equivalence is a behavioral process that
allows physically dissimilar objects to be treated
equally, for example, when a child is able to relate
the written word ―cat‖ to the actual animal (e.g.,
Sidman, 1992; Sidman & Tailby, 1982).
Semantics
Schematic Understanding:
• Background knowledge
• World Knowledge
• Procedural knowledge
Vocabulary
• Lexical –specific dog
• Intentional- all dogs have critical features that
group them into a category
Comprehension
Comprehension is …―the essence of language‖
(Savage-Rumbaugh & Lewin, 1994)
• Children with ASD have weakness in declarative
knowledge (concept formation)
• Children with ASD have strength in procedural
knowledge (knowledge for doing things)
(Goldstein, Minshew, & siegel 1994)
Comprehension cont‘d
Individuals with ASD have difficulty in
―metaphorical‖ language
• Requires understanding of communicative intent,
and a shared social reference
• Particularly difficult when the entire message is
dependent on the intangible aspects of
communicative behavior e.g., facial expression ,
tone and social understanding (TwachtmanCullen, 1997)