ASD: Think and feel

Posted by Talking Matters on 27 April 2013

Today is a the last of a series of blogs on autism for Autism Awareness Month. Today we are looking at some topics that challenge kids with High Functioning Autism and Asperger's Syndrome: developing theory of mind and understanding and managing emotions. These areas impact on social interactions, friendships and other relationships but kids can be supported to develop their skills in these areas.

Theory of mind is the ability to understand that other people have different knowledge, thoughts and feelings to our own. Theory of mind is important for communicating effectively, developing social skills and empathy. Children develop theory of mind over time and this can be particularly difficult for children with autism and Asperger’s syndrome.

Research done in the 1980's tested children’s theory of mind by showing children some pencils and then placing the pencils in an empty Smartie packet. Another person would then enter the room and the child would be asked what the visitor thought was in the box. Children who had developed theory of mind would know that the new person would think the box had Smarties inside, because they had not seen the pencils. Children who had not yet developed theory of mind would say the person thought there were pencils in the box because that was what they, themselves knew. Typically developing children could see the other person's perspective by 4 years of age, while children on the autism spectrum were around 6 years of age before they understood this task. More recent studies used more complex tasks to assess older children and adults and found that all people on the autism spectrum found these tasks difficult even those with very high intelligence.

Understanding theory of mind requires a number of skills:

understanding facial expressions and emotions
relating what is seen or said to the context in which it happens
relating previous experience to what is happening
taking into account what you know about the other person and their knowledge and life experience

Even with all this information there is an element of "filling in the gaps", inferring information that is not known as a fact that typically developing children do with little effort but those on the autism spectrum find very difficult.

Some behaviours you may see in children who have not yet developed theory of mind may include:

A child who cries but does not try to tell you what they want because they think you know
A child who does not tell the teacher that the other child hit them first because they do not realise that the teacher did not see it happen
A child who has difficulty telling about what they did at school because they think the parent has the same knowledge of what happened that they do
A child (or adult) who talks endlessly about dinosaurs because they find them interesting and do not realise that others are not so interested
A child who laughs when another child falls over because it looks funny and they do not understand that the other child is hurt
A child who is blunt and direct to others, not realising that what they say may hurt another's feelings
A child who is set up by others that they think are their friend because they cannot read the child's intentions

To help your child develop theory of mind you can try:

Teaching your child to understand emotions and facial expressions.

Using barrier games to help your child develop an understanding that other people's knowledge is different to theirs and that they need to take this into account when giving information to others.

Talk aloud to your child about your thoughts and feelings and compare it with theirs. "I am feeling hungry because I did not have a snack. You had a snack, are you hungry?"

Use lots of "cognitive verbs" when talking to your child, watching movies or reading stories together. These are words that describe what is happening in your head, like think, feel, wonder, decide.

Talk to your child about how different people have different thoughts, feelings and interests. "You like trains so you are having fun, but your sister does not like trains so much so she is a bit bored with this long trip". You can use social stories and visuals to reinforce these ideas.

You can draw faces and thought bubbles with older children to show that people have different thoughts about the same thing.

You can draw a face with a thought and speech bubble to show your child that people can think and say different things, such as you may say "I like your hat grandma" while thinking "Grandma will feel hurt if I say I do not like her new hat".

Children begin to learn about emotions very early. They need to know how to recognise, understand and manage their emotions for many reasons and parents are often the first people who model these skills. Most children quickly develop the ability to communicate emotions initially through facial expressions and body language and later through words. While this is happening they also start to learn how to manage the many different emotions they will feel. For some children these skills do not come as freely, but there are things that can be done to build these skills.

Emotional development includes:

Identifying feelings? i.e. What is happy, sad and angry?
Identifying their own feelings. i.e. "Am I sad or angry?"
Understanding about feelings – how and why do I feel this way? i.e. "What is this feeling I have and what made me feel this way?"
Successfully reading and understanding the feelings of their peers and adults. i.e. "Are they feeling happy or sad? I know why they are feeling happy."
Developing skills in managing the way they feel. They begin to realise when they are upset and remove themselves from the situation. "What can I do to feel better?"
Changing the way they behave to fit situations. I am angry but it is not OK to have a tantrum here.
Learning to recognise feelings that are being felt by another person. Alex looks sad, I wonder what happened?
Developing empathy for others. Alex must be feeling sad that his cat is lost.
Developing and maintaining good relationships with friends, family and others by responding appropriately to others emotional cues.

To help your child learn to understand emotions:

Begin with…

Happy
Angry
Sad
Surprised
Afraid
Disgust

Work towards…

Excited
Embarrassed
Disappointed
Hurt
Terrified
Worried
Lonely
Curious
Proud
Mad
Frustrated
Silly
Okay
Anxious
Scared
Guilty
Confused

To support your child’s emotional development:

Actively engage and play with your child. Allow them the opportunity to feel secure and attached to your relationship. This will give them the support and confidence they need to develop a strong sense of self. This sense of self will help them explore their worlds and experience emotions.
Be aware of how the home environment affects your child. Aim to keep the home one that feels safe, calm and welcoming. Establishing some routines may also assist in focusing your child, as they are able to predict what is coming next in their daily schedule.
Recognise and acknowledge your child’s emotions - “I see you are sad”
Help your child develop their language and vocabulary around their emotions – “it looks like you are feeling angry”
Praise good behaviour – “I liked the way you came to talk to me when you got upset”
Help your child to separate feelings from behaviour – “I know you are feeling angry but we do not hurt others”
Guide your child to understand how their behaviour can impact other people’s feelings – “I know you are happy with those toys, but you are making your sister feel sad”
Encourage your child to use gestures and expressions that are meaningful – “your face shows me you are feeling happy”.
Encourage your child to share feelings with you and their peers, both good and bad – “Tom I did not feel happy about how you pushed in front of me”
Set limitations for inappropriate expression of emotion e.g. tantrums and aggression. Encourage them to have a range of emotions, but also guide them to see the boundaries in what is appropriate and inappropriate. This feedback will help them to regulate their emotions and behaviour.
Be a good emotional role model for your child – “I just spilled my drink all over the floor! I am feeling very annoyed and frustrated. I think I am going to take a few minutes to calm down before I clean it up”.
Plan for strong feelings: Help your child cope with strong feelings by developing coping strategies. These may include:
- A safe and quite space for them to calm down in
- A stress ball or trampoline to release excess emotion
- Encourage you child to use words or write about how they are feeling at this time
- Develop a sentence that your child can say when they are feeling overwhelmed. This sentence should include a polite way to excuse themselves, regain control, and then return to the situation -“Excuse me, I need some time to think”.
- Make sure that when these strategies are used there is an importance placed on making it a positive situation. Praise your child when they are successful and gently remind them what to do if they are not successful. Remember that every child is different they learn differently and there is always a lot developing and changing in their little minds.

Try these activities:

Incorporate identifying emotions into everyday routines – “I am feeling happy because I get to spend time with you”

Read books and identifying how the characters are feeling. You can begin to work on identifying feelings and later talk about what may have been the cause of those feelings. Draw your child’s attention to what it is about that person’s body and face that shows that feeling. “Look at their mouth, see how it’s a straight line?” “Look at their eyes, see how they are all red” “Look at how tightly closed his fists are”

Choose an emotion for the day and encourage your child to talk about situations that make them feel that way. You can also discuss what makes other people in your family feel that emotion.

Look in the mirror with your child, work through some feelings and what those faces look like. Ask your child to copy you and you can model their faces back to them.

Cut out a series of different faces with different emotions (typically start with angry, sad and happy). Write down angry, sad and happy with some emoticon faces next to the word. Identify and talk about each emotion with your child and get them to think about what makes them feel that way and what their face looks like. Model those expressions and get your child to model those expressions back to you. Sort the faces you have cut out with child into the right emotion category. Encourage the identification of facial features that indicate that feeling.

Download the feelings book from Our website for free and work through it with your child.

ASD: Think and feel

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