Social understanding in autism

Theoretical underpinnings for interventions to develop social understanding amongst learners within the autistic spectrum. Hillingdon Autistic Care and Support Mike Blamires, Principal Lecturer Canterbury Christ Church University

The Context: Putting theory to work for learners with Autistic Spectrum Disorders and their teachers, their helpers and their carers.. A useful website… www.canterbury.ac.uk/xplanatory/

Extending horizons: A developmental model of inclusion:

Is it a good career move to have a label of autism ? E thical D imensions… L abels and B aggage Is the label a signpost to understanding ?

Learning Components of a social model of learning (Etienne Wenger 1997) practice Learning as doing community Learning as belonging meaning Learning as experience identity Learning as becoming

Gray’s Water Balloon Survey Imagine yourself at 9 years old. In the front yard of your home there is a large wonderful climbing tree. This tree extends over the sidewalk below. If you climb into the tree and stay very quiet, people passing by under the tree do not know you are there. One day, you decide to surprise people by dropping water balloons on them from the tree. Your aim is 100%. What follows is a list of people who pass under the tree that day. For each person listed, rate the decision to drop the balloon on the following scale: 1 – No Risk 2- Somewhat Risky 3 – Risky 4 – Definite Risk 5 - I am not going to drop the balloon Your older brother (age 12) Your younger sister (age 5) A girl you do not know (age 4) Mum Dad Your best friend Mrs Woods (a neighbour) Your Rabbi, Priest or Minister Next door’s dog The neighbourhood bully (age 9) a baby in a push chair

Strategy 1: Clarity of what is expected Strategy 2: Predictability / Novelty Strategy 3: Feedback (Reward System) Strategy 4: Interaction/ group work Available time for tasks Strategy 6: negotiation/conflict (Choice) Strategy 7: level of work (Complexity) Strategy 8: Modality Strategy 9: Language demand The 9 Key Strategies (?) Strategy 5:

Possible factors your reading of the situation your empathy your understanding of the consequences and whether you think it will be worth it your sense of justice your sense of mischief knowledge of ‘just how lucky you are’ your notion of responsibility = Social Knowledge

Do you mind ? Mind out ! Don’t mind me ? You must be out of your mind ! I’ll mind the store. Never mind the buzzcocks! I don’t mind if you do ? Can you mind the baby ? Mind the gap. If you don't mind…

Daniel Dennet (1996) suggests that minds can work at different levels to interpret their world. The Physical Stance: Where the world is predicted physical laws e.g. stones drop The Design Stance : Works with designed things including nature e.g. Press a button and the light goes on or plant a seed and it might grow. The Intentional Stance: Where complex things have goals and desires. We use the intentional stance for people and animals and s ometimes we even apply it to photocopiers.

The ability to attribute intentions is clearly a component of the theory of mind and it may be that people with autism tend to use a physical or design stance to interpret the social world which sometimes requires complex understandings of levels of intentionality. (1st) I believe something (2nd) I believe you believe something (3rd) I believe that you believe that I believe something (4th) I believe that you believe that I believe that you believe something Dennet (1996) suggests these Orders of Intentionality

One of our secretaries used to have a sign above her desk which summed the difficulties that some people have with orders of intentionality: I KNOW THAT YOU BELIEVE YOU UNDERSTAND WHAT YOU THINK I SAID BUT I'M NOT SURE YOU REALISE THAT WHAT YOU HEARD IS NOT WHAT I MEANT

Social Language Thought & Behaviour Distractibility Difficulty in generalising Sequencing Difficulties Organisational Difficulties Love of Routine Impulsiveness Semantics Pragmatics Pedantic/literal Aloof/Odd Withdrawn/passive Elaborate / little or no language Pointing

Literal – Understanding at a design or physical level “ My sister thinks you are fat but I don’t. I think you are just wide.” “ Just call me coach” “ I am sorry I have a little frog in my throat.” “ Watch the road!”

Stefan, would you like to stop talking with Freda and Vanya and get on with your work ?

Please Leave ! Grey as a mouse, As Big as a house, Nose like a snake, I make the earth quake, With horns in my mouth, I walk in the south. What am I ?

An illustration derived from a comic strip conversation after Carol Gray

An anthropologist on Mars.... It has to do , she has inferred, with an implicit knowledge of social conventions and codes, of cultural suppositions of every sort. This implicit knowledge, which every normal person accumulates and generates throughout out life on the basis of experience and encounters with others, Temple seems to be largely devoid of. Lacking it, she has to 'compute' others' intentions and states of mind to try to make algorithmic , explicit , what for the rest of us is second natures. She herself, she infers may never have had the normal social experiences from which a normal social knowledge is constructed. Grandin in Sacks (1996)

A student in London.... At seventeen I was able to begin at the sixth form college .. where I worked hard on my A-levels but managed to turn myself into a serious target for other students’ teasing and torment, but it was also at this time when I first began learning how to stick up for myself, also realising that there were many unwritten rules about behaviour and conduct which every else knew except me. …. Marc Segar (19996) A Condensed Guide To Coping For People With Borderline Autism p2

A student in London.... “ Autistic people tend to remember detail, normal people tend to remember the plot. It is remembering plot all one’s life which enables most people to learn the unwritten rules of society.” Marc Segar (19996) A Condensed Guide To Coping For People With Borderline Autism p3

An american being ironic.... “ You know where you stand with rules and you know how to act with rules. Trouble is, rules change and if they do not, people break them. I get terribly annoyed when either happens. … most rules fade the moment they inconvenience someone.” Lianne Holliday Wiley Phd (1999) Pretending to Be Normal p 36

An Enthnomethodologist on Earth Harold Garfinkel (1963) The experimenters were 'instructed to engage an acquaintance or friend in an ordinary conversation and without indicating that what the experimenter was saying was in any way out of the ordinary, to insist that the person clarify the sense of commonplace remarks.'

“ Bloody Mindedness” Most people would guess that this experiment would cause trouble. They even might call it an act of 'bloody mindedness' because it is only 'common sense' how people will react. It was this 'common sense' that Garfinkel was trying to demonstrate.

Case 1 The subject was telling the experimenter, a member of the subject's car pool, about having had a flat tire while going to work the previous day... S: I had a flat tire E: What do you mean you had a flat tire ? She appeared momentarily stunned . then she answered in a hostile way; What do you mean ? What do you mean ? A flat tire is a flat tire. That is what I meant. Nothing special . What a crazy question !

Case 3 On Friday night my husband and I were watching television. My husband remarked that he was tired. I asked, How are you tired ? Physically, mentally or just bored ? S: I don't know, I guess physically, mainly. E: You mean your muscles ache or your bones ? S: I guess so. Don't be so technical. (After more watching) S: All these old movies have the same kind of old iron bedstead in them. E: What do you mean ? Do you mean all old movies, or some of them, or just the ones you have seen ? S: What's the matter with you ? You know what I mean. E: I wish you could be more specific. S: You know what I mean ! Drop dead !

Case 6 The victim waved his hand cheerily. S; How are you ? E: How am I in regard to what ? My health, my finance, my school work, my piece of mind, my... s : (Red in the face and suddenly out of control.) Look ! I was just trying to be polite. Frankly, I don't give a damn how you are.

'reciprocity of perspectives' More succinctly Garfinkel (1967) states 'much that is being talked about is not mentioned, although each expects that the adequate sense of the matter being talked about is settled." If this is expectation is breached, it is very noticeable how quickly the communication breaks down leading to self righteous indignation being displayed by the innocent party. Garfinkel stresses that the maintenance of this expectation of 'reciprocity of perspectives' is not merely a cognitive task but one in which each participant 'trusts' the other as 'a matter of moral necessity". Hence the outrage.

The Stock of Common Knowledge Schutz (1962) suggested that individuals develop a personal and shared stock of knowledge about the world. This knowledge assumes a 'common world' which goes beyond an individual's private experience and includes an understanding that people have motives and emotions. This knowledge is sustained and developed through social engagement. Garfinkel has given us evidence of what happens when people refuse to make use of the shared stock of knowledge.

The Stock of Common Knowledge S.O.K. & Culture Schutz (1962) suggests that the stock of knowledge comprises · type constructs of objects e.g. mountains, trees animals, fellow men · typified 'recipe knowledge' concerning the 'how to do it' of all kinds of courses of action"

Shut off or break the rules Angela Dyer (1995) "Most of us shut off if we listen to foreign language we don't understand. A child with autism is the same: if one or two sentences go over their head, the shut off. You need to keep checking that they are listening and understanding" If too many references are being made to a knowledge base that the child does not have then it is not surprising that the child "switches off".

Making the Implicit Explicit... Donaldson(1992) suggests that it is difficult to acknowledge these understandings. We can know in different ways. Some of our knowledge is explicit, out in the open. We know that we know it. We can give an account of what we know, and sometimes of how we came to know it or how we would justify the claim that it is 'knowledge'. But we also have knowledge that is to varying degrees implicit in the dark - not spoken of, sometimes not able to be spoken of.

Tacit and Explicit... Ways of knowing You may be able to walk, ride a bike, make friends, instinctively know what’s right and have gut feelings about it all... But how do we teach these things when we need to ?

Stock of Knowledge & Autism A person without this stock of knowledge or shared understandings will find it difficult to engage in a conversation. He or she has to make everything explicit because they cannot take short cuts as nothing can be taken for granted. The person sounds very formal and often verbose. This is what a person with Asperger Syndrome often sounds like.

Autism & The Crisis of Meaning Durig (1997) suggests three types of thinking help us to map the terrain of interpersonal interaction: induction: from the specific to the general deduction: from the specific to the specific abduction : from the general to the specific

Cognitive Style and Social Stories Cognitively, anecdotal evidence and some research evidence suggests that people with autism find formal inductive thinking and making use of context (to abduce) difficult whereas deduction may be less difficult but not always easy.

Semantic map supported by drawings (after Myles & Simpson, 1998) Dogs Cats

Circle Semantic map supported by drawings (after Myles & Simpson, 1998) sheep llama dog guinea pig mouse pig Mammals

Maybe after school, I will have an ice cream Thoughts: Words and pictures of the mind. Other people have thoughts.

Combinations of colours : Confused Conversation Colours BROWN: Comfortable, cozy BLUE: Sad, uncomfortable PURPLE: Proud YELLOW: Frightened BLACK :Facts, things we know ORANGE: Questions RED: Bad ideas, teasing anger, unfriendly GREEN : Good ideas, happy, friendly Carol Gray (1994)

Go on , jump into that big puddle. It will be fun . What colours should these words really be ? (Green is good and fun Red is teasing, unfriendly, bad idea)

When two people are already talking Interrupt : When words bump into words from other people

When someone is not finished talking Interrupt : When words bump into words from other people

When someone talks just to me. Listen : Keeping my ears ready to hear words that other people say.

Listening as part of a group. Listen : Keeping my ears ready to hear words that other people say.

Cognitive Imperialism or the defence of standards ? Just who is being Autistic here? M oral D imensions…

A social story introduces appropriate social knowledge in the form of a story which provides a visual prosthetic for the pupil. The different types of sentences within a social story give the pupil information about a situation and provide clear guidance on possible ways to respond. The stories are written by professionals or parents to describe social situations that the child with autism is finding difficult or to describe a success. According to Attwood (1998) it would appear that this technique is proving to be very effective, in enabling individuals with autism to understand cues for specific social situations.

Social stories are usually written in the first person, as though the pupil is describing the event, and Gray (1994) suggests that they should contain three types of sentence: Descriptive sentences describe what happens, where the situation occurs, who is involved and what they are doing and why. Perspective sentences describe the reactions and responses of others in the target situation and sometimes the reasons for those responses. They may also describe the feelings of others. Directive sentences describe the possible responses to the social situation. Gray recommends a ratio of between 2 & 5 descriptive sentences to every directive sentence. …. Why ?

‘ It is the beginning of a new year and I am once again having a difficult time explaining my Autistic spectrum related learning needs to professors. When I mention auditory processing, people seem to think this means I’m deaf and they start to shouting in my ear (that’s physically painful). When I try to explain Aspergers, I’ve had professors act like I’ve got ADHD or they treat me like I am not smart (that’s emotionally painful). I think it is hard for people to understand that a person with a cognitive disability could be in University; or that a University student could have a cognitive disability’ M oral D imensions…

‘ I can’t do eye contact and think/listen/talk at the same time. Pretending I can makes me very anxious and overwhelmed, this results in me creating a normal impression to others but I have no idea what we talked about and am not prepared for things that I have agreed to do.’ M oral D imensions…

Vignette 1 : Simon. All of the adults reported that each day, with exception, Simon would shout at the top of his voice that the other children were 'disgusting'. He would scream and struggle with his support assistant if she tried to hold his hand in order to take him to the hall. This daily battle usually resulted in Simon eating away from the other children with his support assistant supervising him.

Vignette 1 : Simon. The adults agreed that Simon was persuaded to enter the dining hall only once or twice each week and that if he did enter the hall he became preoccupied with shouting at the other pupils in order to let them know that they were 'disgusting' and 'noisy'. This behaviour was felt to be having a detrimental effect on the other pupils; particularly the youngest children of the school .

Vignette 1 : Simon. The assistant who looked after Simon at lunch time was extremely anxious about the situation and felt that she no longer wanted to continue providing this support. The head teacher added that she had asked Simon's parents to take him home for lunch and although they had initially refused she felt that she would have to insist that this happen within the next week. .

Vignette 1 : Simon. Simon's parents said that they did not want to take him home for lunch as they felt that this course of action would be a backward step in integrating him into mainstream school. They acknowledged the fact that this situation at school was very difficult both for Simon and everyone else involved.

Vignette 1 : Simon. The assistant who looked after Simon at lunch time was extremely anxious about the situation and felt that she no longer wanted to continue providing this support. The head teacher added that she had asked Simon's parents to take him home for lunch and although they had initially refused she felt that she would have to insist that this happen within the next week. Simon's parents said that they did not want to take him home for lunch as they felt that this course of action would be a backward step in integrating him into mainstream school. They acknowledged the fact that this situation at school was very difficult both for Simon and everyone else involved.

Vignette 1 : Simon. Evidence was collected of any strategies previously tried. The adults were then asked if any strategies had already been put in place and if so what they were and how successful had they been. The class teacher, learning support assistant and parents reported that they had frequently explained to Simon how he should behave and why. When questioned after these discussions he had appeared to know how he should behave. A seat had been positioned at the end of each long table so that Simon did not have to sit directly opposite another child. It was felt this seating arrangement might also help as he would be at the edge of the dining hall rather than amongst the other children and their noise.

A Social Story About Lunch Time Before lunch I am usually in the playground. A dinner lady tells me when go and have lunch. I get my lunch box and then I walk to the hall. When I go into the hall for lunch there are lots of people there. Usually it is not just my class. A grown up usually shows me where to sit. There are lots of children in the hall who are eating their lunch. Children often like to talk while they are eating There are lots of children in the hall who are talking at the same time. If the children get too noisy a grown up asks them to talk quietly. Sometimes children forget to close their mouths when they are eating. I will try to stay calm and quiet if I see children opening their mouths when they are eating. I will try to eat my own lunch and not worry about the way the other children are eating their lunch. ---------------------------------------------------------------------------------- C. Rowe 1998

Vignette 2 : Martin One little boy, Martin, was having difficulty lining up after play. He would come to the teacher for a moment, then run off. The teacher felt that he had understood, but was just being naughty. When we observed him closely, however, with autism in mind, it became evident what was happening.

Vignette 2 : Martin Martin has a very literal understanding of language and is slow to process verbal instructions. The children were told ‘to line up to go back into class’ - and this was what he did. His lack of understanding of the purpose for lining up and his literal response to what he was told, meant that he did exactly what he thought he had to do. Once it was pointed out to him that in order to join the line he must: stand behind the last person already in the line; stay behind that person and walk in the line into class, he was able to get it right. It needed to be explained to him each time he was expected to line up. Joan Ratcliffe Bexley LEA

Vignette 3 : Rajik Rajik is a primary aged boy who has had problems in dealing with P.E. lessons. Rajik has co-ordination difficulties and poor social skills.

A Social Story When Mrs Bowen tells me that I am going to be doing P.E., some children from my class will go and get the PE bags. They give them out to each table. I will try to get changed quickly and quietly. Sometimes we will go to the hall. Sometimes we will go to into the playground or on the field I like to play the different games and activities. I can join in with the other children. When P.E. has finished, I will go back to my class quietly with the other children. I will try to get changed as quickly and quietly as possible. I take of my shorts and T Shirt and put them into my PE bag. I then hang up my bag on my peg. I will try to sit quietly until everyone is ready.

Vignette 3 : Rajik Rajik found it difficult to read on his own even though it contained a lot of language used by his teacher and so was helped by the Learning Support Assistant. It did help him to get into his PE kit quietly and quickly. His enjoyment of PE did not increase.

Social understanding in autism

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