In light of the researchfound on theory of mind, a wave of data was conducted on the relationshipbetween ASC and theory of mind. The theory of mind in a child diagnosed withASC, was of particular importance for researchers as it allowed for a furtherunderstanding of the intact and impaired abilities found in the everyday lifeof those diagnosed with ASC (Frith & Happe, 1999).
The particular conditionof ASC is genetically based, and is ascribed to as adeficiency in the neuro-cognitive mechanism of the brain which usually allowsfor the development of “Theory of mind” (Frith & Happe, 1999). As a result of thisdeficiency, a number of early emerging abnormalities arise in language,symbolic play, and social interaction (Dawson & McKissick, 1984). Inattempts to assess and address the relationship between the deficiency of ToMand the symptoms of ASC, Barhon-Cohen (1995) put forth the mindblindnesstheory: this theory claims that children diagnosed with ASC may find thatthe actions of people are confusing or unpredictable to them, because of adelay in the development of their ToM that leaves them with an impaired set ofmechanisms for attributing and predicting the mental states to others. This is exemplified in anumber of studies that have used different measures to evaluate this notion. Forexample, a notable study by Leslie (1987), found that a striking feature foundin a child diagnosed with ASC is their lack of ability to pretend play due tothe inability to attribute the notion that others can pretend to be somethingthey are not, and therefore showing incapability of second-orderrepresentations. These results, encouraged researchers to investigate if achild diagnosed with ASC has an impaired ability to attribute false beliefs.
Usingthe Sally-Anne task, a study by Barhon-Cohen et al. (1985) found that some of thosewith low functioning ASC have an impaired understanding of deception and thusfail at the Sally-Anne task. Moreover, a study by Frith & Happe (1994)looked into the neuro images of children with ASC conducting the tasks on falsebelief, and found that the prefrontal cortex, an area which is normallyactivated when using theory of mind, is inactive in those diagnosed with ASC.
Notably, a main critiquefound on the mindblindness theory points out the theory’s failure to address thedifficulties found in self-referential processing in those diagnosed with ASC(). Limbardo & Barhon-Cohen (2010) argue that it is important to take intoaccount that impairments in the self-referential processing system in a person asit may have a critical role in providing a fuller understanding of the symptomsbehind ASC. This in turn, may encourage researchers to allocate greaterattention on the deficits of theory of own mind, rather than just simplyfocusing on the inability to attribute mental states to others. In combination, much of the research found on theory of mind,tends to allocate great attention on “reading the minds of others” whileneglecting focus on the critical role of attributing mental states to oneself(Williams & Happe, 2009). As a response to the criticism and evidence foundon the mindblindness theory, a controversial question oftheoretical importance in the field of theory of mind was born.
This questionlooked to assess whether a lack of theory in mind in ASC essentially meant alack of self-awareness (Frith & Happe, 1999). Self-awareness, can be generally defined asthe ability to be reflect upon your thoughts, perceptions, attention and physicalappearance knowing they are your own through a self-referential process (Huanget al., 2017). As suggested by the “looking glass self” concept, the linkbetween theory of mind and self-awareness is vital because the ability tounderstand other peoples’ beliefs and perceptions of you, has a substantialimpact on how one perceives themselves (Lombardo & Barhon-Cohen, 2010).Usinga variety of paradigms, the majority of literature on this topic has attemptedto investigate aspects of self-awareness that are diminished in ASC. This isexemplified in a number of social, imaginative and communicative symptomsdisplayed by those with ASC. An illustration of this is found in individualswith ASC who fail to effectively use language as a tool to guide their own behaviorand regulate their emotions. This is attributed to their deficiency of innerspeech which usually allows for regulation of behavior (Solomon et al.
, 2011). Rubinand Lennon (2004) suggest that this may result in ineffective socialcommunication and awkward situations which may stress the individual with ASC.Additionally, Powell and Jordan (1993) characterize ASC by deficiency inrecalling and encoding personal episodic memories, they associate this toself-awareness by explaining that that the lack of ability to encode personalepisodic memory impairs their ability to to reflect on personal experiences, aswell as the ability remember themselves performing an action or possessingcertain knowledge. As a consequence, this hinders the development ofexperiencing the self and the skill of problem solving (Elmose, 2016).
Itcan be concluded that, findings of such place emphasis on the importance ofaccounting for the importance of self-awareness and its impact on theory ofmind in individuals with ASC in empirical studies. The distinctive symptoms found in ASC in relation to self-awareness,have therefore encouraged researchers to assume that individuals with autismlack awareness of their own mind to the same extent that they lack awareness ofthe minds of others (Frith & Happe, 1999; William & Happe, 2010). Inattempts to empirically demonstrate this notion, a significant study by Frith& Happe (1999) was put forth. In their paper, Frith & Happe (1999)claim that those with ASC lack introspective awareness, and can only comprehendfirst-order representations of experiences but are unable to processsecond-order representations to these experiences. They supported this claim byproviding examples of three prominent studies, first a study by Perner et al.,(1989) explored the awareness of knowledge in children with ASC.
This was doneby conducting a task where a confederate participant and an ASC participantwere shown boxes and informed that different objects were placed in them. Then,the experimenter allowed one of the two participants to look into the box. Theparticipants were then asked a) whether they knew what was inside the box b)whether the other participant knew what was inside the box. Results of this study illustrate thatchildren with ASC provided answers indicating overestimated knowledge of boththemselves and the participants in regards to what was in the box. Although this study was backed by Kazak etal., (1997), it should be noted that results in the latter study were notsignificant in comparison to the control group and thus cannot be seen asstrong enough evidence to support the notion that Frith & Happe (1991)proposed (Williams, 2010). Moreover, another example used, looked at theability of an individual with ASC to recognize their own intentions.
This wastested by Phillips et al. (1998) using a rigged shooting game, in whichparticipants were asked to shot at an intended target. Results in this studydemonstrated that those with ASC were likely to report the hits as intentionalif they received a prize, and unintentional if they did not. This indicatesthat those with ASC confuse their desires with their intentions and thereforehave a diminished self-awareness. Thereby, Frith & Happe used the evidencepresented as support for the conclusion that those with a lack of theory ofmind of others also lack a theory of their own mind. Notably, Frith & Happe added onto these cognitive accounts onlacking introspective awareness in individuals with ASC, by providingautobiographical accounts of individuals with high functioning levels of ASCknown as Asperger’s syndrome, using an introspective sampling method byHulburt (1990).
In this assessment, Frith and Happe (1999) asked three highfunctioning adults with autism to report their thoughts and feelings every timea device they provided beeped. In these reports, Frith and Happe (1999) foundthat out of the three, those who did well on the advanced false belief taskswere able to report their thought process effectively and the one who did thepoorest, was the least able to report his thought process. Moreover, usingthese reports Frith and Happe (1999) saw that the three individuals with highfunctioning levels of autism mainly described their thoughts and feelingsthrough visual images, this is suggested to be a consequence of the lack ofability to produce inner speech (Lind & Bowler, 2009). Additionally, in response to the paper presented by Frith (1999), numerous studies have attempted to develop their notion bymeasuring different dimensions of psychological self-awareness.
Aneuro-cognitive study on ASC and self-awareness put forth, findings thatdemonstrate the inability of individuals with ASC to place symbolicrepresentation of themselves, which is evident in a range of studies which findthat those with ASC usually refer to themselves in third person. This providesevidence supporting the notion that those with ASC may lack self-awarenessbecause language is essential for creating a clear identity for self and others(Lyons & Fitzgerald, 2013). Although the study by Frith and Happe (1999) was highlyinfluential in generating research on this topic, a few psychologists havecriticized the measures used and the statements proposed in this paper. To begin with, the use of autobiographicalaccounts in Frith & Happe(1999) in order to prove lack of self-awarenesswas highly controversial, a number of researchers argued that accounts of suchshow rather the opposite (Williams, 2010). A study by Mcgreer(2004) challengestheir paper by suggesting that the ability to provide such vivid sensoryexperiences of their experiences by ASC individuals must in some sense suggestthat these individuals must have some sort of awareness of their own mentalstate in order to be able describe such thoughts and feelings even if at thetime they are unable to attribute beliefs to others effectively.
This notionwas refuted by Bruck et al. (2007) who claims that autobiographical accountsare not in any way reliable as they can easily be confabulated. Especially dueto the lack of personal episodic memory found in individuals with ASC (Huang etal., 2017). This is evident in an experiment by Bruck et al (2007) who foundthat those with autism were more likely to give detailed reports that are falseabout a staged event given by experimenter.Furthermore, another criticism that the article by Frith and Happe(1999) received was from Raffman (1999) who challenges the notion that thosewith ASC lack a sense of self –awareness.
Rather, Raffman (1999) argues thatthese difficulties can be seen as deficits in the ability to represent anddiscuss mental states rather than an inability to be aware of these states.This notion found further support in a meta-analysis conducted by Huang et al(2017) who found that a multitude of articles have a consensus following thenotion that in specific, those with high functioning levels of ASC are aware oftheir social deficits but are simply unable to address them. The most significant issue that a multitude of papers looking intoself-awareness and ASC face is, the lack of distinction between psychologicalself-awareness and physical self-awareness. In specific, Williams (2010) arguesthat although it can be said that psychological self-awareness is dependent onmeta-representations and involves the same cognitive mechanisms used in theoryof mind, such representations are not necessary for physical self-awareness andthus it can be argued that those individuals with ASC are self-aware to someextent.
This notion on physical self-awareness in ASC has been investigated ina few studies, one study by Spiker and Ricks (1984) looked at the ability ofindividuals with ASC to recognize their own physical body. This was assessedusing a common test of bodily self-awareness known as the mirrorself-recognition task, in this assessment the experimenter placed a pigmentedcolor on of the participant discreetly and examined their reactions. DespiteLewis (2003), suggesting that awareness of ones’ own body is a meta-representationrather than a first-order representation, the findings indicate thatrecognition of own body, is actually intact with ASC individuals with anaverage of 74% of ASC participants being able to recognize themselves in themirror.
One argument that is necessary to point out is that althoughindividuals with ASC did not show any impairments in their ability to recognizetheir selves, a study by Dawson & McKissick (1984) does provide evidencesuggesting that those with ASC did not show any sense of coyness orself-consciousness when looking at the mirror, and individuals with ASC alsocommunicated less and tended to touch their own bodies frequently. Thus, it canbe implied that expression of coyness or self-consciousness requires theability to attribute mental states to self, and that even when physicalawareness is intact, psychological awareness can be present (Dawson &McKissick, 1984).As an extension to this notion, a study by Lind & Bowler (2009)looked at delayed recognition.
In thisstudy, the experimenter attempted to examine how aware an individual with ASCwas of their own place and continued existence through time. This was done bydiscreetly placing a sticker on the participants head, this is filmed and thenreplayed to the participant. Lind and Bowler (2009) predicted that those whohave temporally extended self-awareness would recognize that the sticker stillremains on their forehead “here-and-now” and not only “there-and-then”. Findings on this study, further prove thatthose with ASC do have physical self-awareness as the majority of themrecognized that the sticker was still on their forehead. Lastly, in attempt to look at an additional dimension of physicalself-awareness, an experiment by Russel and Hill (2001) was presented with aimsto look at the awareness of individuals with ASC in tracking their own actions.
This relates to the capabilities of recognizing the difference betweenworld-caused and self-caused changes. An assessment of this was done by lookingat whether individuals with ASC were aware of which square on the computerscreen was under their control. Notably, the paper by Russel and Hill wascriticized for its weak methodology, thus Williams and Happe (2009) carried outa similar study and found that those with autism showed almost identicalabilities of typically developing children in their performance. In fact, itwas suggested that those with ASC actually have better use of their motorfeedback as opposed to visual feedback in comparison to typically developingchildren.
Therefore, it can be summarized, that although those with ASC showdifficulty in reflecting on their own knowledge, intentions and language, theyusually have an intact self-awareness in dimensions such as self-recognition,delayed self-recognition and in monitoring their actions. It is important tonote that, the reason behind the intact self-awareness in physical dimensionsare only intact because they do not require meta-representations and thus areunlikely to affect those with ASC. In conclusion, this paper has attempted to examine the importanceof theory of mind and its relationship with ASC and self-awareness. Theliterature in this field has indicated that the lack of ability to attributemental state to others, results in the failure to attribute mental states toones’ self, in specific using ASC as a model, a number of studies have arguedthat due to the distinctive symptoms of the lack of self-awareness found in ASC,that it is an exemplary model that can be used to understand and aid those withASC. Moreover, a prominent study by Frith and Happe (1999) on this topic,provided insight on autobiographical accounts of three individuals withAsperger’s syndrome and also put forth the idea that the failure inself-awareness is caused by the same underlying cognitive mechanism that isused for theory of mind. A multitude ofresearch has provided findings that both support and refute the proposal madeby Frith & Happe (1999).The literature found on the Autism spectrum condition andself-awareness indicates that the extent to which an individual with ASC can beconsidered to lack self-awareness is dependent on the dimension ofself-awareness being measured. Most of the literature on this topic, doessuggest that psychological self-awareness in ASC seems to be severely impaireddue to a deficit in the underlying mechanism that is also responsible fortheory of mind.
However, other studies have successfully pointed out the importanceof looking at physical self-awareness, because the empirical evidence found onthis dimension of self-awareness suggests that those with ASC have an intactsense of physical self-awareness of their own agency and body. Moreover, anumber of studies have suggested that those who are diagnosed with Asperger’ssyndrome, have shown to have awareness of their social deficits, but are simplyunable to reflect on them. Thus, it can be said that individuals with ASC havean impaired psychological self-awareness to a great extent, in comparison tophysical awareness which seems to remarkably be intact. Such findings allow forthe development of peoples understanding on what ASC is and how it should behandled.