Tag Archives: Theory of Mind

Psychological Evaluation

Last week, I would’ve had my ten year Aspieversary/autiversary or the anniversary of my autism diagnosis. I did realize this and even started writing a blog post about it, but it didn’t feel right to celebrate an anniversary of something that no longer is. After all, I’m no longer diagnosed as autistic. I was also quite shocked when it dawned upon me that I’d been institutionalized for almost the entirety of these ten years. I then started thinking about the ten years before that and how much longer they seemed to have taken. Time flies when you’re getting old(er).

I then started writing a post on the psychological evaluation that I had the day before my would-be-Aspieversary. That was hard too – both the evaluation and writing about it. For the first time that I had a psycholoigical assessment, the personality testing was in fact the easiest – or least difficult – part. I just can’t get past the fact that I did rather poorly on some of the neuropsychological tests and didn’t seem to score as great on the intelligence test.

The neuropsych testing consisted of a couple of memory tests. Most went okay, but with one, I kept losing focus. Then there was a test for semantics, the way words and their meanings are formed and articulated. I had to name as may words starting with a given letter or in a given category (animals, occupations) in one minute as possible. In the animals category, I started blurting out donkey, squirrel and Brazilian wandering spider, which are three words I use repetitively, and then I got stuck. I don’t know what the average score is of course, but some of my staff tried this one and did much better than I did. Of course, they weren’t in an actual test setting.

Then I got what I think is the verbal part of the Wechsler Adult Intelligence Scale. Older versions of this intelligence test consist of a verbal and a non-verbal (performance) part, but the performance part isn’t possible for me because I’m blind. The current version does not provide a verbal or performance IQ score, but it still consists of verbal and non-verbal tasks. I did okay and still seemed to have the same strengths (similarities, arithmetic) and weaknesses (compreheension) as when I last had an intelligence test twelve years ago. I don’t think I scored as mind-blowingly high as my parents would want me to though. When I told my mother so, she said I just don’t want to know that I’m gifted. I don’t know whether she meant that I didn’t try my best or that I underestimated my actual performance.

I also got some tests that seem to be specific to autism. One of them was a kind of weird test that seemed to measure theory of mind. I heard these little stories and then had to say whether a character had said something inappropriate. Then there were follow-up questions abou thow each character would feel, whether they could know that what they said was inappropriate, etc. I got rather frustrated with this test.

Some of the questionnaires also seemed to be relevant to my possible autism. One was some kind of systemizing/empathizing test. I once took a similar (or the same) test online and scored below-average on both scales. I mean, I am interested in systemizing, but I can’t actually do it right in daily life. For example, I can’t balance a checkbook, but I do take an interest in random strings of information, such as share prices (yes, I did at one point perseverate on that). There was also this test that asked about the ability to read one’s own feelings. This was a rather weird one to me, but that may be because I barely understand how anyone would be able to tell the difference between for example feelign excited and feeling enthusiastic.

Lastly, I got a coping sytles questionnaire and several personality tests. I scored high on avoidance twelve years ago when I got the same coping styles questionnaire and I think that has only gotten worse. After all, all I’ve learned in the mental hospital is to distract or take a tranquilizer. This is the worst coping style according to my college psychology professor. I did okay on the personality tests. I mean, it’s likely I have at least some personality disorder traits, but that’d show in my behavior too anyway.

A week has gone by since the psychological evaluation. My husband had to fill out another questionnaire about me again over the week-end. It was some kind of executive functioning questionnaire and I felt rather awkward at how many boxes my husband ticked. I also got a call from the student doing the evaluation on Monday with one more questionnaire. It seemed to be the other half of the systemizing/empathizing thing. I got to do that over the phone. The student also asked for my E-mail address, so that the psychologist could contact me regarding some questions and concerns I had written down and taken to the assessment.

I have mixed feelings about the possible outcomes of the assessment. I mean, I don’t even know whether I want to be autistic after all. Of course, you’d think, most people wouldn’t choose to be autistic over neurotypical. That’s not what’s at stake here though, since I won’t change neurotype if the psychologist diagnoses me one way or the other. I still think I need the validation that my impairments are real. Realizing these impairments makes me feel a little inferior to the people I love, and in that sense, it’d be great if I made them all up. Of course, that may be internalized ableism.

On Appearing Autistic: Theory of Mind

Tonight, I was discussing with a nurse an autism support meeting I went to last week. We got to talking about how autistic the participants appeared, and the nurse mentioned that she had a family member who works at one of the country’s largest autism facilities, which happens to be in my town. The nurse talked about how the autistics who go there are much more obviously autistic than I am.

I have been diagnosed with autism by three different diagnosticians in three different evaluations between early 2007 and late 2010. The last two, who did the most extensive evaluations, both had their reservations about the diagnosis. There were roughly two reasons for this: 1. that I appear to have good theory of mind, and 2. that they weren’t sure which of my oddities were due to autism and which were due to blindness or other factors. I want to talk about the first now.

I am pretty sure I mentioned this before, but theory of mind is not the same as prosocial behavior. People who are antisocial, except for maybe the worst of psychopaths, have good theory of mind and use it to their advantage. I honestly have pretty bad theory of mind, to the point where I fail the more compliciated versions of the Sally and Anne test. Theory of mind is the ability to shift your focus from your own cognitions and emotions onto anoother person’s. In the Sally and Anne test, Anne has a toy in her basket. She leaves the room and Sally moves the toy to her own basket. Then Anne returns and the person being assessed is asked to say where Anne would be looking for the toy. The correct answer would be Anne’s own basket because it was here when she left, but people with poor theory of mind who have seen Sally move the toy, will say Anne will look into Sally’s basket. Note that the Sally and Anne test in this version is passed by most typically-developing four-year-olds, and real-life theory of mind is much more complex.

I, for one, appear to have good theory of mind, because I am generally pretty sociable and also because I exhibit a good deal of prosocial behavior. I was told by my former therapist that I had good theory of mind because I apologized in about every E-mail I wrote to her in case she didn’t want to receive E-mails from me. This, however, is not theory of mind. I have no clue when it is and isn’t appropriate to write your therapist out of session and so apologize just in case. Inndeed, when I am rude, I pretty often forget to apologize if I even realize I am rude. Because I don’t talk out of turn and say rude things 99% of the time, doesn’t mean I know when it’s appropriate to talk and what to say.

In addition, I have above-average verbal intelligence, which allows me to reason through social situations pretty well. I used to make my own Social Stories in high school, but still was seen as quite a rude person. Now that I’m in my twenties, I’ve learned to adapt and become less in your face unless I’m agitated. While this could connote a better theory of mind – after all, I can reason through social situations to some extent -, it is not nearly enough for what is required in everyday social interactions.

I at one point read an article by I believe Tony Attwood on Asperger’s in females, in which it was said that Asperger’s is often not recognized in females because male Aspies tend to be active but odd, ie. talking out of turn, talking on and on about one subject, etc. while female Aspies are often passive, ie. only interacting when encouraged to. I reckon that more passive Aspies tend to aslo be more cautious about their social interactions. This could easily lead to them not appearing as Aspie because they aren’t saying inappropriate things.

Please remember that autism is not a behavior disorder. It’s a neurodevelopmental disorder that impacts on various aspects of functioning, theory of mind being just one. Even if a person has relatively good theory of mind, that doesn’t mean they don’t have the processing dyfunction that is thought to cause autism.