Spurin, Hayley (2022) Social attention strategies and theory of mind understanding in autistic children and adolescents. (PhD thesis), Kingston University, .
Abstract
Autism is characterised by a persistent deficit in social communication (APA, 2013). A profound lack of Theory of Mind (ToM) awareness and an associated aversion to social information, has been used to explain impairments in social communication. Spontaneous (bottom-up) and voluntary (top-down) mechanisms seem to respond differently for autistic people. Previous research has suggested that autistic people can be slower to orientate to social stimuli, produce shorter fixation durations, display reduced visual explorations of scenes, observe the eye region less and show a preference for looking at mouths. These attention differences have been used to explain why autistic people have more difficulty understanding the intended behaviours of other people compared to their neurotypical (NT) peers. However, this picture is not a consistent one as eyetracking paradigms show autistic people do spontaneously orientate to social information and voluntarily prioritise the face and eye region in dynamic social stimuli. Furthermore, research has also found that autistic people can mentalise. This thesis sought to examine visual attention strategies of autistic individuals and associated ToM understanding using dynamic stimuli from the silent film the Artist. The thesis comprised of three experimental studies. Study one used eye-tracking methods and a forced choice paradigm to identify how autistic participants infer the mental state of another person. Study two used eye-tracking methods to understand visual attention towards dynamic stimuli that varied in intensity for social content with scene backgrounds (high, low and no-social content). The study had two conditions where participants observed the stimuli in a free-view and verbal condition where participants described the thoughts and feelings of the people in each scene under a think-aloud procedure. Study three used an experimental language analysis design using SALT (2010) to transcribe the verbal reports collected during study two. Each study was undertaken by the same autistic children and adolescents (7-18yrs), along with a control group of age matched NT peers. Results across studies showed that spontaneous attention for autistic participants was similar to NT controls. The voluntary attention strategies of autistic participants largely reflected the performance of NT participants. Social information was always prioritised, however fixation lengths reduced to faces for autistic participants during highly socially interactive scenes and scenes of high emotional complexity. Autistic participants showed that they were adaptive to task instructions and used their attention strategies to aid their understanding of others. Findings suggested that autistic participants were able to mentalise similarly to their NT peers. However, autistic participants had difficulty integrating their understanding of the thoughts and feelings of others into sensitive accounts to describe the intended behaviour of others. Findings suggested that the ToM understanding of autistic children and adolescents may be more inhibited by their grammatical capabilities than their ability to attend to social information. The studies in this thesis highlight that autistic people do use implicit ToM strategies but are inhibited by explicit ToM reasoning when describing the intentions of others. This difficulty could be described through weak central coherence theory of autism. The differences noted in the visual attention strategies of autistic compared to NT people aligned to the enhanced perceptual functioning theory of autism. The results of the studies in this thesis have practical implications when considering the integration of autistic people into busy social settings. Overall, the thesis has provided compelling evidence that alternative explanations for differences in ToM understanding in autism should be explored beyond a social attention and subsequently a social motivation framework.
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