Childhood Disorders 639
discovery that in 2005 more children had autism in counties of the Northwest states
(California, Oregon, and Washington) that had more days of rain from 1987 to
- The researchers conjectured that bad weather may lead children to spend
more time indoors, possibly increasing their television viewing, their risk for a vita-
min D defi ciency, or their exposure to household cleaning products.
Like autism, Asperger’s disorder appears to have a genetic basis: Compared to
the general population, relatives of someone with Asperger’s are more likely to have
an autism spectrum disorder (Cederlund & Gillberg, 2004).
Psychological Factors: Cognitive Defi cits
Neurological factors give rise to psychological symptoms, particularly cognitive def-
icits in shifting attention and in mental fl exiblilty (Ozonoff & Jensen, 1999). These
defi cits underlie the extreme diffi culty in transitioning from one activity to another
that individuals with autism spectrum disorders experience; people with autism also
tend to focus on details at the expense of the broader picture (Frith, 2003). However,
these defi cits are not part of the DSM-IV-TR diagnostic criteria.
Another problem—also not noted in the DSM-IV-TR criteria—is diffi culty in
recognizing facial expressions of emotions (Serra et al., 2003). For example, in one
study 3- and 4-year-olds’ brain activity was assessed with EEG while they were
shown photographs of faces that either expressed fear or had neutral expressions.
Normal children exhibited greater brain activity in response to the fear expressions
than to the neutral expressions. But children with autism responded to both types of
facial expressions with the same pattern of brain activity (Dawson et al., 2004).
People with autism also have diffi culty viewing the world from another per-
son’s perspective—with using a theory of mind, which is a theory about other
people’s mental states (their beliefs, desires, and feelings) that allows each of us to
predict how others will react in a given situation (Tager-Flusberg, 1999). Because
a theory of mind requires thinking about somebody else, by defi nition, this ability
involves both psychological and social factors. An impaired theory of mind is dem-
onstrated with the false belief test (Baron-Cohen, Leslie, & Frith, 1985), which
requires that the participant keep in mind the point of view of someone else: Two
dolls, Sally and Anne, are used to act out a scene. Sally puts a marble in a basket
and then leaves the room without taking the basket. Anne then quietly moves
the marble from the basket into a box. The child is then asked to say where Sally
will look for the marble when she comes back in the room. The correct answer,
that Sally will look in the basket, requires the participant to appreciate the point
of view of Sally, who does not know that the marble was moved. In this study,
80% of the children with autism answered incorrectly that Sally would look in
the box. These children were not able to override what they knew and take Sally’s
perspective. Although some individuals with milder symptoms of autism may be
able to answer correctly on the false belief test, they are not able to do so when
the task involves more complex processing of social cues, such as understanding
white lies or irony (Happé, 1994).
People with Asperger’s disorder also have an impaired theory of mind. How-
ever, these problems are less severe than in people with autism (Ziatas, Durkin, &
Pratt, 2003). In addition, even the normal siblings of individuals with Asperger’s
have an impaired theory of mind (Dorris et al., 2004), which provides further sup-
port for the inference that genes play a role in this disorder.
Social Factors: Communication Problems
The earliest indications of autism arise in interactions with other people: Children
with autism pay attention to other people’s mouths, not their eyes (Dawson, Webb, &
McPartland, 2005) and don’t respond to their own name or to parents’ voices
(Baranek, 1999). Moreover, they don’t develop normal communication skills—
verbal or nonverbal. As they get older, they don’t develop the typical ability to
recognize faces, and they also have problems recognizing emotion, both in voices
(Rutherford, Baron-Cohen, & Wheelwright, 2002) and in facial expressions (Bölte &
Poustka, 2003). These cognitive defi cits make social interactions confusing and
unpredictable.
Theory of mind
A theory about other people’s mental states
(their beliefs, desires, and feelings) that
allows a person to predict how other people
will react in a given situation.
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N
P S
N
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N