Anticipatory Skills in Children With Autism

Anticipatory Skills:
Children with autism have difficulty with predictability and anticipation. This lack of anticipation is influenced by several factors commonly associated with ASD.

1. Poor Theory of Mind (Tom): "refers to one's ability to understand that other people have thought, beliefs, and feelings that are seperate and different from one's own" (Miller-Kuhaneck, 2004). Poor Tom causes an individual with ASD to have difficulty understanding what other people know, want, feel, and believe. This creates a challenge for those with ASD to anticipate what others will do and say in a situation.


2. Weak Central Coherence: or a local to global processing tendency, causes this population to focus on the details of a stimuli instead of striving for the higher "gestalt" or meaning (Pellicano et al, 2004). Weak central coherence makes it difficult for one to integrate incoming information.


3. Deficits in Executive Function: Executive function looks at goal-directed abilities such as planning, sequencing, cognitive flexibility, working memory, and monitoring and ceasing inappropriate behaviors (Miller-Kuhaneck, 2004). Deficits in these areas have been associated with repetitive behaviors and inflexibility to novel situations (Pellicano, et al, 2004).


4. Sensory Processing Differences: This population has difficulty modulating sensory input, often demonstrating sensitivity to sound, touch, lights, and odors while demonstrating poor body awareness, underresponsiveness to pain, and underresponsiveness to other forms of sensory input.


5. Diminished Facial Processing and Poor Eye Contact: This population has been found to demonstrate a decreased preference for faces and a tendency to focus on the parts, primarily the mouth and not the eyes when engaged in conversation or play.


6. Decreased Response to Perception of Biological Motion: According to Frietag, et al, 2008, these children perceive motion effectively but take longer to respond to movement.


7. Decreased Anticipation for Motor Planning: Children with autism make postural adjustments in response to stimuli rather than in anticipation of the required movements (Schmitz, et al, 2003). Poor processing of sensory input to create needed "motor mapping" may cause the child to simply react to each motor activity as if it were new versus anticipating it and generalizing it from prior learned motor movements.



Lack of Anticipation's Impact of Function

Lack of anticipation influenced by poor theory of mind, weak central coherence, deficits in executive functions, sensory processing differences, facial processing, decreased eye contact, decreased response to perception of biological motion, and decreased anticipation for effective motor planning can negatively impact the child with autism's ability to communicate and function in daily occupations of work, play, and self-help development.

The following link is a good example of social interaction and bonding between babies and parents based on the child's anticipation to daddy's voice.


http://www.all4humor.com/videos/funny-videos/laughing-babies.html



Other examples of how decreased anticipation affect daily occupations include:

a) Failure to Respond to, Initiate, or Sustain Conversation: if one is unable to understand the perspective of others, it will be very challenging to anticipate what the other person is thinking in order to respond and sustain communication appropriately.


b) Stereotyped or Idiosyncratic Language: individuals with autism often demonstrate "stocked phrases", and echolalia with decreased spontaneity. According to Frith, the ability to use spontaneous communication requires the ability to guess and anticipate what the listener may wish to hear at that precise moment.


Individuals with autism may also use obscure words and phrases which may have meaning to them but not to the listener. For example, a child who says "french toast" may be indicating "happy". The autistic speaker is not taking into account the work required of the listener to make this inference.


c) Abnormal Tonal Quality: Individuals with autism often have a "sing song" or monotone quality to their voice. Normally, a speaker will place emphasis on specific words to convey meaning. Lacking insight into the listeners perspective, the autistic speaker may not realize the need to emphasize words to portray his/her meaning. Similarly, the child with ASD will not likely comprehend the speakers intent when emphasizing particular words. Instead, they may be attending to the loudness of the word and miss out on what was being said.


d) Nonverbal Communication: To realize one's own and other's state of mind, one needs to be able to effectively interpret expressive gestures and other nonverbal means of communication. This skill is difficult for those on the autism spectrum and again, interferes in the ASD child's anticipation of where the conversation is leading.

e) Reliance on Routines: This creates challenges for adapting to new environments and situations. Resistance to complexity, demonstrated by increased rigidity and an increase in stereotypical behaviors, is often apparent as a result of poor anticipatory skills. Without gradual, consistent introduction of novelty, these children will experience a high level of anxiety with transitions like moving from one grade to the next, going out into the community, and transitioning into adulthood roles.


f) Conforming to Social Behavior: If one is unable to read the nonverbal cues of others and interpret inferences, they will have difficulty anticipating and conforming to rules of social behavior. This will interfere in play skills with peers and siblings as well as relationships with parents, teachers, and employers.



g) Difficulty engaging in nonpreferred topics: because of their desire for sameness, the child with autism will have a difficult time participating in conversations outside their area of interest and undoubtedly have difficulty anticipating the thoughts and feelings of others as it relates to an unfamiliar topic. They will also have limited play skills which will hinder cognitive growth and social interactions with peers.


h) Difficulty feeling empathy toward another: Not only do these children have a difficult time understanding the feelings of others, they will have difficulty anticipating how their comments could potentially hurt someone's feelings. Decreased awareness of emotions will negatively influence relationships with peers and adults.



i) Decreased Perception to Biological Motion: An increase in response time to biological motion suggests that children with ASD will have a harder time anticipating and making inferences from rapid changes in eye gaze, gestures, etc. It also suggests that these kids would have a difficult time participating in games and sporting events that require well timed motor movements like those needed to catch a ball or to swing a bat to hit a ball.



j) Dyspraxia: Motor planning difficulties can hinder almost every aspect of life. Some examples include: effectively navigating the classroom, performing self-help skills like putting toothpaste on a toothbrush or dressing, and effectively participating in games or playing on the playground with peers.



k) Sensory Processing: The tendency to be overaroused by a complex environment while demonstrating signs of underarousal (poor eye contact, appearing not to hear, poor awareness of position in space, decreased body awareness, etc.) can hinder one's ability to see beyond their own bombardment of sensations to effectively interact and anticipate the actions of others as well as prepare for changes in routine.





Resources:

Frietag et al, (2008). Perception of biological motion in autism spectrum disorders. Nauropsycholgia, 46: 1480-1494.

Frith, A new look at language and communication in autism. British Journal of Disorders of Communication. 24. 123-150.


Frith & Leslie, 1990. Prospects for a cognitive neurophysiology of autism: hobson's choice. Psychological Review. 97(1) 122-131.


Miller-Kuhaneck, 2004. Autism a comprehensive occupational therapy approach, 2nd edition.

Pellicano, et al, 2004. Central coherence in typically developing preschoolers: does it cohere or does it relate to mind reading and executive control? Journal of child psychology and and psychiaty. 46(5) 533-547.