Theory of Mind limitations

Theory of Mind Limitations

Children and young people with an ASD have difficulties understanding the beliefs, knowledge and thoughts of others, and therefore have limited ability to keep track of why others behave as they do. This inhibits ability to monitor, ascribe motive to, and predict others’ behaviour.

There are difficulties also with understanding/ predicting the impact of own behaviour on others.

Savannah has problems with Theory of Mind (ToM). Her lack of appropriate interaction during the more unstructured sport activity showed this. She often can only see things from her point of view so when her teacher does not respond immediately to her expectation she cannot understand the reasoning behind this or see the impact her behaviour is having on her teacher or the rest of the class.

Again because of ToM limitations, Savannah does not understand that another’s authority would have any consequence for her so she uses resistance or other distracting behaviours at the outset. She has found that this tactic will often get her the leeway to disengage from the anxiety provoking activity.

This is why set routines and structure are so important for Savannah. Knowing in advance what she will be doing on any set day for example will obviate the need for discussion, anxiety and inappropriate behaviour hence the emphasis on structure, routine, predictability and acceptable choice making. Allowing Savannah to feel that she has some measure of control within set parameters is important as it gives her security.

Social Stories – developed by Carol Gray are visual supports for expected behaviour in situations which are recognised to be likely triggers. Reading and revisiting what is going to happen prior to these events reduces anxiety. Experience at school showed that Savannah responded very well to Social Stories.

Social Stories for non-routine situations which need practice and are identified as a potential trigger: Social Stories can be constructed using photos and scripts for atypical events of which Savannah needs prior knowledge/forewarning – the camp, excursions, fire drills, gala day sport, transitioning to a new class, moving house again etc. See example on resources left at school for a Board Maker example. Using photos which include Savannah (she is part of the picture) will have far more impact – she can also be involved in creating the script.

A social journal will help Savannah identify her triggers for her frustrations and identify solutions to them for herself. This will also provide Savannah with strategies to increase her ability to generalise from one situation to another similar one.

E.g. l ‘Rule No xx What to do when there is a replacement teacher rule.’ She can look back to when this happened before and look at the strategy she used then and talk this through or adapt it to the new situation

Social journaling or scripting for response to events which have happened and are not predicted as triggers: When explaining specific behaviours and any issues that arise for Savannah, it is important to be very explicit. Write down (instead of only verbally discussing) the issue so that Savannah can have issue and resolution clarified in concrete/visual format. This will better suit her learning style. This strategy reduces verbal input and should help to reduce anxiety. Keep as a journal so a diary can be kept of behaviours. As new behaviours arise always refer back to similar previous behaviours. Encourage use of similar strategies to provide Savannah with continuity and predictability. This technique can be used at school and home. The social journal can move between home and school and the ‘rules’ built up as each behaviour is addressed.

Description of incident – student’s words Description of impact on others Visual representation of solution – right and wrong E.g. (an example from another child)

Ideally this process will be undertaken and relevant scenarios reviewed with Savannah regularly - perhaps before starting class (either at home or at school). This will help to visually remind Savannah of what has been discussed in the journal and what skills she will practise each day. This social journal could effectively help with the management of Savannah in ‘other’ subjects and in other situations such as doing her homework. She has to come up with a workable solution/rule for each ‘problem’.

Savannah needs to see a link between positive behaviour and positive consequences – the positive consequences should outweigh the negative benefits she is getting from her current behaviour patterns (avoidance of ‘worrying’ tasks). Any negative action towards her might result in an equally negative reaction –increasing resistance.

A reward system for “Savannah’s Goals” could be put in place to try and focus her on

‘positive behaviour = positive consequence’

A reward system like Brilliant Behaviour (see below) could be put in place to make achievement of points immediate. Any teacher will sign/give a sticker (Happy Clouds?) in each box whenever a goal is achieved.

The goals can be written out or visually represented on a separate sheet. They must be simple, direct, concrete, clear and achievable.

Achievement can be extended/delayed through a tick system - but initially, as the system is taught, starting with fewer ‘boxes’ will ensure success and motivation.

Brilliant Behaviour…..leading to a reward at home and or class rewards

The communication book between school and home could be used to monitor this. The Brilliant Behaviour sheet could be pasted in when completed and signed at home and rewarded. The book goes back and forth in Savannah’s bag.

Transitional times (even small movements from floor to desk – or from game to discussion activity) are difficult for Savannah. Currently Savannah often hangs back and watches until the class settles into the next activity. This is a good self-taught strategy.

Having a specified spot to sit in, established social story routines for events like entering the class in the morning, a visual timetable in close proximity as well as having a Task Sheet will help with uncertainty around what is happening next and what to do.

Giving Savannah a task to do at transition times is an alternative strategy. (“please find me the orange sheet…). Being a Messenger or having a class ‘job’ is a good way for this to be ‘normalised’. These sorts of tasks need to be single focussed and concrete. (Giving out the (boxes of pastels) for art for example as a regular ‘job’ might motivate Savannah to take part more)

Rewarding Savannah for managing to take part fully in all aspects of the lessons could be one of the goals for her Brilliant Behaviour card.