Wednesday, 22 July 2009

In the kingdom of the blind the one-eyed man is king

One of the more commonly known issues with Asperger's Syndrome (AS) is empathy. When I think of empathy I always think about putting yourself in the shoes of someone else when they are undergoing a physical process...like being hurt when falling down, or feeling sad after a break-up. It seems that empathy tends to encompass more than that though, such as how another person sees the world in general. I found this out after reading some research material about autism (not specifically AS) and what tests have been conducted to show the differences between autistic children and non-autistic (NT) children.

One of the tests they do is seeing if a child knows how another child perceives the world. The classic example is that Child A has a ball in a basket and leaves the room, and Child B takes the ball from the basket and puts it in a box. When Child A comes back to the room do they look for the ball in the basket or the box? A child who knows how Child A perceives the world will say "basket", but a child who only knows how they themselves perceive the world would say "box".

What interested me most was the importance of the age of the children involved when it comes to these tests. The study is quite explicit in that it isn't saying that NT children will say "basket" and autistic children will say "box". What the study shows is that NT children of a specific age (4 in this case) will say "basket", where an autistic child of 4 would say "box". However by the time the autistic child reaches 6 they would also be saying "basket". It brought home how important it is to diagnose autism in children and how hard it must be to do in adults. It also explains the rather blasé attitude I found in professionals when trying to get diagnosed myself. After all...if these key tests can't be done at the right age then in fairness how can they ever be sure to truly diagnose autism? All they can do is give it their best shot.

It also comforted me in a way as I've read the odd thing about how children with AS act that sometimes don't resonate with me. However maybe that is because while I don't remember exhibiting a certain deficiency, the real issue is that I'm remembering how I was at an older age. So it's not that I was exhibiting "normal" behaviour so maybe I don't have AS, but that that "normal" behaviour was only happening years after it should have been happening. So while I remember thinking "basket", I was thinking it later than I should have been. Further that it is this delay in the development process that is the vital key to knowing if a child is autistic. I now fully appreciate why childhood diagnosis is so important, or failing that information from the parent if it is an adult that is seeking diagnosis. I can't be expected to know at what age certain behaviours came and went, but my parents should.

This possible delay in development ties in with my memories of my parents always showing concern about how immature I was and how I tended to prefer the company of children younger than me. Maybe my development was out of phase by a year or two? If autistic children do eventually learn what their NT counterparts learned a few years previous I suppose it's not unusual that we develop many coping strategies and grow "more normal" as we get older.

The paper did occasionally mention AS specifically and said that sometimes children with AS were able to pass these "theory of mind" tests even though children further up the austic spectrum often could not.

This concept of knowing how others see the world made me think about another vivid childhood memory I have; when watching television I'd often wonder if other people were seeing the show in the same way. When the news came on and the newsreader had a moustache I'd ask someone "does that person have a moustache?" When I saw a red car I'd ask "is that car red?" It must have seemed quite strange to others, but I was genuinely wondering if everyone saw everything the same way. Was my desire to understand the world causing me to confront my lack of knowledge on how others saw the world?

Coming full circle - I initially said that I considered empathy as knowing how someone felt after a physical event...this paper also touched on the fact then when asked what functions a brain did, autistic children tend to concentrate on the physical (tells our muscles to move, heart to beat, let's us see) while completely ignoring the emotional functions, but NT children consider both.

1 comment:

Catana said...

Asking questions about things that most people consider obvious may seem strange, but it'may be the only way we can learn about things that either don't come naturally to us, or that we have taken for granted as normal. As a child, you asked about things like the man's moustache. As adults, we discover things about ourselves that we realize may not be the norm. When I learned about faceblindness and realized that I'm mildly faceblind, I had to ask whether it's normal to memorize faces automatically. I have to make a real effort to memorize them, and can still not remember one I thought I memorized. Turns out that's not normal, but I wouldn't have known without asking.