Asperger's disorder and high functioning autism: diagnosis, theory of mind and intervention

Abstract

The developmental disorder of autism has been the centre of much academic and clinical interest for the last fifty years. More recently much of this discussion has focused around a 'higher functioning' group of people with autism. These individuals have been diagnosed as Asperger's disorder (AsD) or high functioning autism. Collectively this group is less severely impaired, compared with the group with more classical autism, though marked difficulties are still observed in social behaviour and communication. Attempts to differentiate AsD from high functioning autism have led to differing interpretations ranging from the two disorders being separate entities, to the belief that there is one disorder with two labels. In the first of four studies presented in this thesis an attempt is made to determine whether the presenting children, with diagnoses of AsD or high functioning autism, can be separated on the basis of cognitive and adaptive functioning variables. No separation was possible. However, it was found that diagnosis by professionals, in Auckland, New Zealand at least, was relatively idiosyncratic. The children participating seemed best described as variable within the autistic spectrum. In Study 2, participants were then assessed on tasks of mentalising and divergent thinking. When compared with their non-clinical peers the clinical participants were found to perform poorer on tasks of mentalising. However, an age effect was also found, supporting the theory that children with high functioning autism can pass such tasks but at an older age than the non-clinical children. A related finding was that the clinical children were just as proficient at giving unique responses to divergent thinking tasks as the non-clinical children. Study 3 was a preliminary investigation into the amount of social eye gaze that occurs in children's small group play sessions. The information obtained here was used to give a guideline to 'typical' behaviour in order to assist the interpretation of Study 4. Study 4 investigated the efficacy of teaching children with AsD/high functioning autism a self-monitoring procedure to increase social eye gaze in small group settings. Despite increases in eye gaze no changes were observed in measures of social behaviour or mentalising tasks. The findings of these studies are brought together in a discussion of how people with AsD/high functioning autism think and how this relates to self-consciousness.