“The development of mentalizing and empathising” Chris Ashwin & Simon Baron-Cohen Autism Research Centre University of Cambridge

“In any well-made machine one is ignorant of the working of most of the parts - the better they work the less we are conscious of them…it is only a fault which draws our attention to the existence of a mechanism at all.” --Kenneth Craik, The Nature of Explanation (1943)

humans are social animals socialising and mentalising seem automatic and effortless autism illustrates a fault in mentalising

Mentalising is an important aspect of normal social functioning also termed Theory of Mind (ToM) the ability to recognise and understand the mental states of self/others and use this to predict behaviour

Empathising: Simon Baron-Cohen’s Model (The Essential Difference; Baron-Cohen, May 2003) new framework for investigating and understanding mentalising a slightly broader concept than ToM stresses two component processes

Empathising (1) Cognitive component (2) Affective component

Cognitive component Involves 4 processes: 1) setting aside your own perspective (inhibition) 2) attribution of a mental state to another person/animal/agent 3) inferring the likely content of their mental state, given their experience 4) predicting behaviour based on the mental states

Empathising Affective component adds in a crucial 5th step: 1) setting aside your own perspective (inhibition) 2) attribution of a mental state to another person/animal/agent 3) inferring the likely content of their mental state, given their experience 4) predicting behaviour based on the mental states 5) an appropriate affective response to the affective state of another person

How does empathising develop and how do we know this? Early Views: Piaget (1929) argued that preschoolers are realists think of mental states in terms of physicality great difficulty with mental phenomena this issue re-addressed in the 1980’s

False Belief Task benchmark task for empathising ability shows understanding of mental states separate from reality reliably passed by 4/5 years of age but empathising doesn’t just suddenly appear as a present on the 4th birthday

Development of empathising babies have an innate preference for looking at social stimuli this could be an evolutionary mechanism serving to facilitate social development a biologically based sex difference in social preference in newborn babies

Study of early social preference newborns appear to have a preference for looking at faces over non-face items newborns will follow face like objects longer than non-face objects (Johnson & Morton, 1991) early in life infants are interested in gaze monitoring (Baron-Cohen, 1995; Butterworth, 1991)

Connellan, Baron-Cohen et al, 2000 social preference in human neonates (24 hrs old) study included male and female babies (N= 103) experimenters were blind to the baby’s sex compared looking times of newborns to either a real face (social stimuli) or to a mechanical mobile matched on relevant variables (size, colour, luminance, shape etc.)

Results: male newborns looked for longer at the mobile females looked for longer at the face newborn males show preference for object perception; females for person perception demonstrates sex differences in person perception apparently biological in nature and not from postnatal experience (ie. cultural)

Early Empathising: emotion perception 1 day old infants can discriminate happy and sad faces (Field & Walder, 1981) 5 month olds can discriminate emotional vocalizations (Walker-Andrews & Grolnick, 1983; Walker-Andrews & Lennon, 1991) and can match congruent facial and vocal expressions of emotion (Walker, 1982)

Empathising in the toddler period social referencing joint attention gaze monitoring social imitation pretend play

Empathising in the toddler period social referencing –between 10 and 12 months infants will search for the emotional expression of another to resolve a state of uncertainty, and will regulate their behaviour accordingly by approaching or avoiding (Campos & Sternberg, 1981)

Empathising in the toddler period social referencing –infants likelihood of interacting with a stranger is influenced by the emotional message sent by the parents (Feinman & Lewis, 1983) –therefore, can use emotional information to alter their behaviour

Empathising in the toddler period joint attention (Baron-Cohen, 1987) –protoimperative pointing (pointing to request) –is relatively intact in autism –protodeclarative pointing (pointing to share interest) –is impaired in autism

Empathising in the toddler period gaze monitoring: –by months most infants will follow the gaze of another person (Scaife & Bruner, 1975) –this is reduced in autism (Leekam & Baron-Cohen, 1989)

Empathising in the toddler period social imitation –in the first year of life infants will imitate the actions of persons, but not mechanical objects –Legerstee (1991) found that 5 to 8 week old babies imitate mouth and tongue movements of an adult, but not similar behaviours of an object

Empathising in the toddler period pretend play (Harris) –most children begin to pretend by 18 months –by 2 years they are producing varied pretense –by 2 and a half they are using the word “pretend” and understand others are pretending –children with autism show reduced pretend play (Baron-Cohen, 1987)

Repacholi & Gopnik, 1997 had 18 month olds taste crackers and broccoli an adult tasted the two and said ‘Mm’ and smiled to one, and ‘Eww’ and frowned to the other when the adult liked broccoli, and asked for more snacks, the 18 month olds gave adult broccoli 14 month old children gave crackers therefore, at 18 months can understand desires as subjective and separate from their own

Meltzoff (1995) child sees actor fail to pull apart a dumbbell 18 month old children more likely to complete the actors unfulfilled goal they never observed, than the failed action they actually saw interpreted that the children understood the intentions behind the overt actions

Preschool age understanding of false belief –normal 4-year-olds can keep track of how different people might think different about the world (Wimmer & Perner, 1983) –typically 4/5 year olds pass false belief tasks –children with autism have difficulties attributing a false belief (Baron-Cohen et al, 1985)

Individual differences the age that children can first pass false-belief tasks can vary from 2.5 to 5 years why is this important? shows relationship between differences in social experiences and early empathising abilities often overlooked

Variables affecting empathising ability number of siblings –children with one or more siblings pass false-beliefs at higher rates than only children (Perner et al, 1994) play experiences that enhance –co-operative play between siblings (Dunn et al, 1991) –play with older, versus younger, siblings (Ruffman et al, 1998) –interacting with older people in general (Lewis et al, 1996)

Variables affecting empathising ability frequency of pretense play (Howe et al, 1998) richness of the pretense experiences (Taylor & Carlson, 1997) family conversations, particularly feelings –more talk = better empathy (Dunn et al, 1991)

Empathising beyond 4/5 years of age false beliefs appropriate for up to 4/5 year olds too easy for older children dearth of tasks appropriate for older children

Later childhood Understanding faux pas (Baron-Cohen et al, 1999) few mentalising tasks for older children a faux pas refers to a socially inappropriate behaviour the task involves judging if someone said something they shouldn’t have said (because it would be hurtful) investigated in 7, 9 and 11 year old males and females

Faux pas task Results: sex difference emerged in faux pas, with girls 2 yrs ahead in understanding of faux pas than boys children with autism impaired at faux pas detection compared to the control children but might this also be explained by a weak central coherence? what if we try to limit the contribution of WCC...

Adulthood Reading the Mind in the Eyes task (Baron-Cohen et al, 1997, 2001) –involves pictures of just the eye regions of peoples faces –4 possible choices to describe the emotional expression they are displaying

Reading the Mind in the Eyes task

Adulthood Results: although people find this difficult, in fact they are quite good at reading the emotional state of others from the eyes this task reveals a sex difference in reading the emotions of others from the eyes, females score higher than males F > M people with autism are impaired compared to controls minimum WCC or EF involved

Empathising over the life span empathy continues to develop throughout the life span, requires more investigation recently, Happe et al (1998) found that elderly subjects actually scored higher than younger subjects on measures of ToM (though see Maylor et al, 2002) could be that the elderly participants had learned successful strategies through experience

Modularity and Empathising there is much evidence that autism/AS involve deficits in empathising (Baron-Cohen, 2001) evidence of normal functioning in other cognitive domains like EF (Baron-Cohen et al, 1999) this suggests domain specificity or modularity of empathising abilities (Karmiloff-Smith et al, 1995) evidence from Baron-Cohen et al, 1999; Fine et al, 2001; Rowe et al, 2001 for dissociation of empathising and EF

Later effects of abnormal empathising development/experience autism/AS involve abnormal gaze behaviour (APA, 1994; Kanner, 1943) tasks show evidence of deficits in using gaze/eye information to infer mental states might people with autism be using different strategies to ‘read the eyes’, and can we see the effects in the brain? initial neuroimaging studies suggest yes (Baron- Cohen et al, 1999)

Gaze judgement in autism; an fMRI study 3 sec videos of gaze towards a pen judge whether person looking at or past pen direct gaze conditions (experimental) averted condition (baseline) direct gaze trial averted gaze trial

Controls Autism/AS Results Main Effect: Direct gaze judgements - averted gaze

Empathising in autism: Issues contribution of EF, WCC, language, to findings contribution of innate abnormalities vs. abnormal experiences to findings are mechanisms in autism abnormal, deficient or just ‘different’ (brain imaging) specificity of empathising deficits to autism: evidence of possible deficits in schizophrenia, conduct disorders, and psychopaths

The End

Empathising variables (Cognitive) a) attribution of mental states recognising that others have mental states, and these may differ from our own understanding the actions of other people are based on these mental states such like intentions, desires, etc…...

Empathising variables (Cognitive) b) prediction of behaviour on the basis of others mental states once one knows that others have mental states and that these may vary from ours, we can then try to understand and predict actions of others on the basis of these mental states

Empathising variables (Cognitive) c) making sense of behaviour in terms of mental states

Empathising variables (Affective) d) an affective reaction and response to the affective state of another person –having an affective state triggered by the emotional state of another person does not necessarily lead to an affective response though –for example sympathy might involve an emotional reaction, but not an emotional response towards another person