Neurocognitive disorders affect cognitive abilities (e.g., learning, memory, perception, and problem solving). The DSM-5 defines six key domains of cognitive function: social cognition, perceptual-motor function, learning and memory, language, executive function, and complex attention.
Mind-blindness, the opposite of empathy, is a cognitive disorder in which the child with Asperger’s (AS) or High-Functioning Autism (HFA) is unable to predict the mental states of others (i.e., their thoughts, beliefs, emotions, desires, behaviors, intentions, and so on). It’s not necessarily caused by an inability to imagine an answer, but is often due to an inability to gather enough information to decipher which of the many possible answers is correct. This is referred to as an empathetic cognitive deficit.
Empathy is usually divided into two major components: (1) cognitive empathy is the ability to understand another's perspective or mental state, and (2) affective empathy is the ability to respond with an appropriate emotion to another's mental states. Cognitive and affective empathy are also independent from one another (e.g., you may not be very good at understanding another person’s perspective, but you may be very good at empathizing with others). Children on the autism spectrum have deficits in both cognitive and affective empathy.
Cognitive empathy can be subdivided into three categories: (1) tactical or strategic empathy, which is the deliberate use of perspective-taking to achieve certain desired ends; (2) perspective-taking, which is the tendency to spontaneously adopt another person’s psychological perspectives; and (3) fantasy, which is the tendency to identify with fictional characters.
Affective empathy can be subdivided into two categories: (1) personal distress, which is possessing feelings of discomfort and anxiety in response to another's suffering; and (2) empathic concern, which is having compassion for others in response to their suffering.
Mind-blindness is a state where the ability to make automatic interpretations of events taking into consideration the mental states of people, their desires and beliefs has not been developed or lost in the AS or HFA child. Imagine living with a disorder in which you can’t perceive or interpret the behavior of others – the needs, desires, feelings, beliefs, goals, purposes, and reasons of other people are a total mystery for you. No wonder why a child on the autism spectrum often views the world as a very confusing and frightening place.
The social and cognitive impairments seen in AS and HFA children can be attributed to mind-blindness. The abnormal behavior of these young people includes a lack of reciprocity, difficulty empathizing with others, being totally withdrawn from social settings, not being able to make eye contact, and having no desire to interact with other people (i.e., social detachment).
Behavioral manifestations that can occur in children with AS and HFA due to mind-blindness include the following:
- lack of empathy for others and their emotions
- difficulty with inferential thinking and problem solving (e.g., completing a multi-step task that is novel)
- impaired reading comprehension (e.g., difficulty understanding characters in stories, why they do or do not do something)
- lack of awareness that they can say something that will hurt someone's feelings or that an apology would make the person feel better
- lack of awareness that others have intentions or viewpoints different from their own
- when engaging in off-topic conversation, they don’t realize the listener is having great difficulty following the conversation
- lack of awareness that others have thoughts, beliefs, and desires that influence their behavior
- preference for factual reading materials rather than fiction
- tendency to view the world in black-and-white terms
Children without an Autism Spectrum Disorder (i.e., neurotypicals) naturally have the ability to make automatic interpretations of events taking into consideration the mental states of people, their desires and beliefs. This is called mentalizing. Neurotypical kids can explain and predict others' behavior in terms of their presumed thoughts and feelings.
For example, you may observe me in my woodshop bent over a tool chest pulling out and putting back tools. You would make sense of this behavior by mentalizing (i.e., automatically recognizing that I am looking for a particular tool that I believe is in one of the drawers of my tool chest). Without mentalizing, you may come up with an odd interpretation of what I was doing (e.g., perhaps sorting my tools by size, weight or color – or enjoying the sound of clanking tools, etc.).
Mind-blindness theory suggests that the milestones of the normal development of mentalizing are absent in kids on the spectrum. Specifically, they fail to understand make-believe play, fail to point at or show objects of interest (both signs of shared attention), and fail to follow another person's gaze.
To simplify, think of mind-blindness as a condition in which you can’t imagine what another person may be thinking of feeling. Possibly, the most difficult aspect of AS and HFA is this subtle but devastating deficit in human social insight.
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