Exploring Theory of Mind, Weak Central Cohesion, and Executive Functioning in ASD

The variation of cognitive impairments in individuals with an autism spectrum disorder (ASD) presents a challenge for developing unifying theories of the core weakness.

Over the past 20 years, researchers in psychology have attempted to develop unifying theories of the central deficit present in individuals with ASD. While research into these areas is common, no one theory can truly explain all of the behaviors exhibited by any particular individual with ASD.

However, teachers, parents, and individuals on the spectrum may find that viewing strengths and challenges through any one of these lenses provides some insight into appropriate interventions. In addition, a better understanding of deficits can help us understand challenging behaviors in a new light. A brief description of three psychological theories of ASD and their potential implications are included below.

Theory of Mind Deficit (ToM)

One of the most common and most researched theories of autism is the Theory of Mind (ToM), hypothesis developed by Simon Baron-Cohen. ToM was originally developed when researchers were examining characteristics that may or may not be unique to the human species. The idea was that an individual with a theory of mind should be able to identify mental states within themselves and others, and use this information to make predications regarding others’ behavior (Premack & Woodruff, 1978).

After reading about this concept, scientist Simon Baron-Cohen developed the ToM hypothesis of autism. He suggested that it is precisely this ability that is impaired in children with autism. In essence, this theory suggests that it is impairment in taking the perspective of others that results in many of the common deficits in autism, such as intentional communication, pretend play, and inferring others’ emotions and beliefs (Baron-Cohen, 1999). This deficit is often termed “mindblindness.”

A deficit in ToM results in individuals on the autism spectrum performing less well on tasks that require “mind reading” compared to their typically developing peers.

A deficit in ToM means that individuals with ASD may struggle in the following areas:

Explaining their behaviors
Understanding their emotions
Predicting the behaviors or emotional state of others
Understanding the perspectives of others
Inferring the intentions of others
Understanding that behavior impacts how others think and/or feel
Differentiating fact and fiction

Due to these deficits, explicit teaching regarding how to understand the emotions of others and how to problem solve in social situations is a necessity. Strategies such as visuals, role-play, or social narratives to remind individuals with ASD about emotional states or appropriate behaviors can be useful.

In addition, parents and teachers working with individuals on the spectrum should be careful not to place blame on behaviors that have repercussions that are not fully understood by that child or adult. Consider explaining how behaviors impact others or make others feel before reprimanding.

Books with more information

Mindblindness: An Essay on Autism and Theory of Mind (opens in a new window) by Simon Baron-Cohen
Teaching the Basics of Theory of Mind (opens in a new window) by Kristina Ordetx
Teaching Children with Autism to Mind-Read: A Practical Guide for Teachers and Parents (opens in a new window) by Simon Baron-Cohen
Teaching Theory of Mind: A Curriculum for Children with High Functioning Autism, Asperger’s Syndrome, and Related Social Challenges (opens in a new window) by Kristina Ordetx

Learn more from the expert

Autism expert Dr. Sylvia Diehl talks about Theory of Mind in children with ASD. See the full interview with Dr. Diehl.

Transcript

The next of the core characteristics that I’d like to address is theory of mind. Theory of mind is being able to take someone else’s perspective. Do I think I know what you’re thinking? You know, and then later on, do I think I know what you think about someone else? And when we talk about theory of mind we don’t just talk about feelings.

We also talk about words like knowing and remembering and thinking, and understanding, “How do I think? What is my opinion?” as well as, “How do you think, and what is your opinion?” We have those two things on the cognitive level, and then on an affective level we have, how does someone feel when they fell down and skinned their knee? Or how do I feel?

Many times when I’m with children and they’ll have fallen down and they have a skinned knee and it’s obvious they feel awful. And I’ll say, “How do you feel?” And they’ll say “Happy,” because they want to give you the answer that they’d like and they’re not as in touch with their feelings at that point. So we spend a great deal of time trying to get them to understand not only how they feel but how others feel, and get what they know and what other people would know.

When we think about it in terms of reading comprehension, the impact is just huge. If you have a narrative story, especially if they have multiple characters, well, why did Anne want to get to the top of the hill? And why did Joe want to get to the top of the hill? Why did they have that argument? Did they feel proud of each other when they were done? All that kind of character perspective and their own background and what their motive is comes into it. And it’s all pretend, so someone has to, “It’s not real,” which may be difficult for children with autism. The reader has to say, “Oh, this is a pretend story about Polly, but this is what Polly is thinking.” A lot of times when we’re dealing with theory of mind we have to really talk about the difference between someone speaking and someone thinking and what they might be thinking.

What might be their motive behind those things? And that’s very difficult for children with autism.

I think in anything, especially when you’re talking about people’s emotions and how other people feel, that connection is so important. That’s one of the reasons why it’s very important that we use evidence-based strategies like activating schemas. You know, you have to start with a child with autism where they are, what their functional experience is.

What have they done, what do they know? And bring those in, so they can organize their brain and say, “Oh, I understand. That’s like when I did” — whatever. And that brings their learning in and organizes their learning so it makes sense.

Weak Central Cohesion (WCC)

An additional psychological theory of ASD is that individuals on the spectrum have Weak Central Cohesion (WCC). The WCC theory suggests that individuals on the spectrum struggle to incorporate information at different levels, and as a result, fail to integrate detail into global entities (Frith, 1989). Some describe this by saying they are not able “to see the forest through the trees.”

This theory has been used to describe both assets and deficits in individuals with ASD. For example, this would explain why individuals with autism quite frequently develop very strong skills in math or science, but have difficulty grasping the gist of a story.

It is possible that WCC may be related to ToM because in order to understand the thoughts and feelings of another person in a real life situation, an individual needs to be able to take into account the social context and integrate diverse information from a variety of sources (Happé, 1995).

However, studies examining WCC in populations of children and adults with ASD have provided inconsistent results. While researchers have shown that participants with ASD perform better on visual processing tasks requiring detailed information processing than people without ASD (Siegel, Minshew, & Goldstein, 1996), other studies have reported no differences between participants with ASD and control groups on these tasks (Ozonoff, Pennington, & Rogers, 1991).

A deficit in WCC means that individuals with ASD may struggle in the following areas:

Fixation on details
Reading comprehension
Literal thinking (i.e., “black-and-white” thinking)
Generalizing information learned to different domains

Individuals with WCC may require help combining information from several sources to “see the big picture.” Consider using guiding questions and visual organizers to support individuals in drawing connections and generalizing to other scenarios.

It is also important to remember that this type of thinking can be beneficial and results in several strengths as well. For example, individuals with ASD can be very detail oriented and may have the ability to focus intently for extended periods of time. Using these skills in functional tasks can showcase their strengths.

In addition, the WCC theory has been linked to strong visual processing. Individuals with ASD will be able to take in a great deal of information when it is presented visually as opposed to other formats.

Books with more information

Learn more from the expert

Autism expert Dr. Sylvia Diehl talks about central coherence in children with ASD. See the full interview with Dr. Diehl.

Transcript

The last cognitive characteristic I’d like to talk about is central coherence. Central coherence is simply the ability to take clues that you find and form a higher meaning. So there’s a trunk, there’s some twigs, there’s a branch, there’s some leaves — “Oh, it must be a tree.”

Children with autism may look at that leaf and see every vein on that leaf much, much more in depth than we may ever see, but seeing where that leaf fits in the whole tree may be difficult for them. Now there is a little controversy about central coherence. Some people believe that children with autism have central coherence, but you have to tell them to use it.

For instance, if I gave you a worksheet with words that sound the same but mean differently according to context — if I say, “Okay, just fill in the right word in the sentence,” they may not do as well than if I say, “I’d like to look — you to look at the sentences very carefully, and from what the sentence says pick out the right word that goes in that sentence.”

So sometimes they have a lot of knowledge and a lot of abilities, but they aren’t really sure when to use those knowledge and abilities. As it looks on the surface, without going deeper, children with autism have a terrible time with main topic, with summarization where you have to take out those important details, leave those unimportant details alone, all of those things that make you form a bigger whole. Because from their perspective they’re usually only seeing those little parts of things rather than the big picture.

Executive Functioning Disorder

An additional theory that explains the deficits in ASD is the executive functioning disorder hypothesis, or what some refer to as the complex information processing theory. Pennington and Ozonoff (1996) proposed the executive dysfunction theory of autism when they observed that individuals with ASD struggled in complex tasks involving abstract concepts such as reasoning and planning.

This theory has been expanded using neuropsychological tests. Researchers have generally observed that individuals with ASD struggle more than their peers when their brain needs to process more information at once. Minshew and Goldstein (1998) found that as the complexity of tasks were increased, individuals with autism were more impaired than those without autism.

Children and adults with a diagnosis of attention deficit hyperactivity disorder (ADHD) often have impaired executive functioning, as well.

A deficit in executive functioning means that children with ASD may struggle in the following areas:

Planning ahead, preparing for the next activity
Keeping things organized
Following multi-step directions
Combining information from several sources to problem solve

Any individual that is struggling with executive functioning will require a lot of environmental support to be successful. This includes daily planners, checklists, and homework logs between teachers and parents to keep kids organized and to support homework completion.

Also, a posted schedule at home or in the classroom is very important. In addition, be sure to allow extra time for students to process directions, supply directions one step at a time, or repeat directions as needed.

Books with more information

Solving Executive Function Challenges: Simply Ways to Get Kids with Autism Unstuck and on Target (opens in a new window) by Lauren Kenworthy and Laura Anthony
Executive Function “Dysfunction”– Strategies for Educators and Parents (opens in a new window) by Rebecca A. Moyes
The Impulsive, Disorganized Child: Solutions for Parenting Kids with Executive Functioning Difficulties (opens in a new window) by James W. Forgan and Mary Anne Riche

Learn more from the expert

Child psychologist Dr. Joyce Cooper-Kahn talks about executive function in children with ASD. See the full interview with Dr. Cooper-Kahn.

Transcript

Generally the kids who have high functioning autism have difficulty with working memory, impulse control and organization. And there’s a pretty good research to back that up, but in terms of daily functioning, what we tend to see is dis-organization and inflexibility. So the kids tend to be rigid, they have trouble problem solving in the moment. If they are disappointed or things don’t go the way they expect them to, the way they did yesterday they have trouble problem solving for what they do instead.

They have trouble problem solving about their own emotions. So that need to step back and think about your own feelings and decide what you’re going to do in relation to what you feel is often surely out of whack for these kids. So we need to teach them better flexibility and then they’re often very disorganized and so we need to help them to learn habits and routines that foster better organization.

Early in their development, folks who are high functioning tend to have problems with impulse control. That seems to get better over time and the kids, the teens, the young adults tend to be less impulsive, better able to manage impulsiveness.

What we do about that problem with flexibility, the problems with organization, they’re not that much different than what we do for any child because the interventions are not diagnosis-specific, it’s only the combination of problems that can sometimes be diagnosis-specific. And there’s so much overlap. There is no way that we can go into brains at this point and change them, and so what we’re doing is we are teaching them how to manage these tasks in life better at the same time that we’re supporting them until they can learn those strategies and until their brain develops.

References

Baron-Cohen, S. (1999). Theory of mind and autism: A fifteen year review. In M. Corbalis and S. Lea (Eds.), The descent of mind: Psychological perspectives on hominid evolution (pp. 3–16). Oxford, UK: Oxford University Press.

Happé, F. (1995) The role of age and verbal ability in the theory of mind task performance of subjects with autism. Child Development, 6, 843–855.

Frith, U. Autism: Explaining the enigma. Oxford, UK: Blackwell; 1989.

Minshew, N. J., & Goldstein, G. (1998). Autism as a disorder of complex information processing. Mental Retardation and Developmental Disabilities Research Reviews, 4(2), 129–136.

Ozonoff, S., Pennington, B. F., & Rogers, S. J. (1991). Executive function deficits in high functioning autistic individuals: Relationship to theory of mind. Journal of Child Psychology and Psychiatry, 31, 343–361.

Pennington, B. F., & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37(1), 51–87.

Premack, D. & Woodruff, G. (1978). Does the chimpanzee have a theory of mind? The Behavioral and Brain Sciences, 4, 515–526.

Siegel, D. J., Minshew, N. J., & Goldstein, G. (1996). Wechsler IQ profiles in diagnosis of high-functioning autism. Journal of Autism and Developmental Disorders, 26, 389–406.

Citation

Merrill, A. (2015). Linking theories to practice: exploring theory of mind, weak central cohesion, and executive functioning in ASD. The Reporter E-Newsletter 20(7). Retrieved from https://www.iidc.indiana.edu/pages/linking-theories-to-practice

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Exploring Theory of Mind, Weak Central Cohesion, and Executive Functioning in ASD

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Exploring Theory of Mind, Weak Central Cohesion, and Executive Functioning in ASD

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Theories of cognition in autism: understanding the challenges and strategies for success

Theory of Mind Deficit (ToM)

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Learn more from the expert

Weak Central Cohesion (WCC)

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Executive Functioning Disorder

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