Autism Spectrum Disorder May Not Be Linked to Impairment of Self-Awareness

Sooraj Shah ’24

Figure 1: Testing of ToM in participants with ASD showed a negative correlation

Autism Spectrum Disorder (ASD) affects nearly 1 in every 44 children in the United States, and can cause a variety of symptoms such as delayed movement skills, nonverablity, and intellectual disabilities. A major impairment associated with  autism has been thought to be in theory of mind (ToM). ToM refers to the ability of an individual to understand that another individual’s mental state is different from their own, and includes the awareness of individuality. A study led by Dr. Matthew Lerner from the Clinical Psychology department at Stony Brook University, however, focused on directly testing ToM in adolescents to better understand whether those with ASD truly have this impairment. 

The study tested 78 adolescents aged 11-17, 48 of which were diagnosed with ASD. ToM vignettes, visual illustrations of situations using characters in a four quadrant block, were used. The vignettes contained a storyline which appeared in each quadrant of the block one at a time until the story was completed along with narration of the situation. One example of a vignette described two children flying kites, after-which the narration asked a question relating to the reasoning and mental health behind the character’s actions (ie. Why does Julia say this?). The participants would then answer questions and would be monitored by an electroencephalogram, which records brain activity. 

The results revealed an electrical brain marker called Late Positive Complex (LPC), an electrical stimulus detected in the brain in response to a direct sensory event. LPC was correlated with ToM accurate responses and did not align with symptoms of ASD. The study also found that the absence of the marker resulted in statistical impairment of ToM, while the presence was associated with positive ToM responses. Having ASD, therefore, may not necessarily mean a deficit in ToM. The results also showed that impairments in ToM in participants with ASD may occur early in cognitive development, which are rooted in difficulties with metarepresentation, or being able to reflect on one’s own decisions and actions throughout the day. This is due to LPC being detected in adolescents.

Previous research has not focused on the connection between ASD and ToM, but rather assumed having ASD resulted in negative ToM responses. This study supported a correlation between having ASD without showing a deficit in ToM, meaning further research is needed to understand the neurological pathways and better treatment early on in adolescents with ASD. 

Works Cited:

  1. Libsack, E. J., Trimber, E., Hauschild, K. M., Hajcak, G., McPartland, J. C., & Lerner, M. D. An electrocortical measure associated with metarepresentation mediates the relationship between autism symptoms and theory of mind. Clinical Psychological Science, 10(2), 324–339. (2021). 

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