Features of Cognition in Autism

Cognition is an exceptionally complex, essential feature of human consciousness, yet not all aspects of cognition are consciously experienced. Cognition is sometimes defined as the mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment. In simple terms, cognition means thinking. Cognitive psychology is the field of psychology dedicated to examining how people think. It attempts to explain how and why we think the way we do by studying the interactions among human thinking, emotion, creativity, language, and problem solving, in addition to other cognitive processes.

Research suggests that some people with autism have uneven cognitive profiles, with variation between verbal intellectual and nonverbal intellectual measures of cognitive functioning when compared to peers with and without disabilities (Coolican, Bryson, & Zwaigenbaum, 2008; Joseph, Tager-Flusberg, & Lord, 2002; Kuschner, Bennetto, & Yost, 2007).

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Some people on the autism spectrum have extremely good cognitive skils. For example, there are numerous individuals on the autism spectrum with very successful academic carers, such as Temple Grandin, a professor of animal husbandry at Colorado State University. However many people on the autism spectrum struggle with some cognitive tasks and this is not necessarily to do with intelligence. For example, some academically able people on the autism spectrum are unable to cross the road by themselves because they are unable to process all of the variables (such as the speed of traffic coming in different directions).

The cognitive patterns associated with autism include a tendency to interpret information in a fragmented manner, misperceive the perspectives of others, focus on details, and become “stuck” in one mode of thinking and behaving. These cognitive patterns can cause individuals with autism to misinterpret the meaning of experiences, which can lead to challenges with social reasoning and cognitive flexibility (i.e., the ability to shift between different thoughts or actions depending on situational demands and tasks; Geurts, Corbett, & Solomon, 2009). In addition, learning and social and communication skills may become self-directed and intensely ritualized (Bodfish, 2011). The cognitive challenges that people with autism face lie on a continuum, with severity measured as the degree to which each of these cognitive processes dominates thinking and behavior (Brunsdon & Happé, 2013).

Since it was first identified, autism has been explained by a number of hypotheses resting on cognitive, psychological, and behavioural theories. No singular explanation exists for all of the core features of autism. Some claims have been discredited, such as the “refrigerator mother” theory. Current theories that address the different aspects of autism can be thought of as “satisfactory working theories” (Happé & Ronald, 2008). In addition to providing cognitive explanations for behaviors associated with autism in the areas of attention, information processing, and social cognition, this section presents related major satisfactory working theories behind the features of autism: executive dysfunction, weak central coherence, and mindblindness. Although each of these theories improves our understanding of autism, none addresses the entire complexity of the spectrum.

In order to attend to others, it is necessary to feel comfortable, filter out distractions, and know what is relevant. An experience must be either interesting or meaningful to maintain some level of attention. Attention to a novel or confusing situation requires a degree of internal motivation and/or external reinforcement. The failure to attend to a social stimulus can reflect a lack of motivation and/or an understanding of its relevance. In the absence of motivation (i.e., internal or external reinforcement) and meaning (i.e., understanding the experience), interest and attention may be lost. The cognitive trait of attention falls under the broad umbrella of executive functioning, and the theory to explain problems with attention seen in autism is referred to as executive dysfunction.

Theory of executive dysfunction executive function is the term used to describe multiple cognitive processes that are crucial for planning and carrying out goal-directed behavior and problem solving in the face of distractions (Fisher & Happé, 2005). Executive function might be thought of as the chief executive officer of the brain. It organizes, controls, and directs all thinking and physical activity. Executive function allows for the regulation of attention, thoughts, and behaviors in all contexts (Carlson, 2009; Kenworthy, Yerys, Anthony, & Wallace, 2008). Executive function enables an individual to start (plan, initiate, and sequence), stop (inhibitory control and disengage attention), and switch (mental flexibility and shift focus of attention) while engaged in a task (Robinson, Goddard, Dritschel, Wisley, & Howlin, 2009). The theory of executive dysfunction explains challenges with a wide range of executive functioning skills. People with autism exhibit difficulties with all aspects of executive function, including initiation, regulating attention, attending to others, attending to multiple cues, and shifting attention (Corbett, Constantine, Hendren, Rocke, & Ozonoff, 2009; Geurts, Verté, Oosterlaan, Roeyers, & Sergeant, 2004; Liss et al., 2001; Rosenthal et al., 2013). Executive dysfunction in individuals with autism is exhibited as repetitive behaviors, cognitive inflexibility, and social communication challenges. These difficulties impact all areas of learning and behavior, particularly social competence. Particular attention challenges resulting from executive dysfunction include problems with social attention, overselective attention, and problems shifting attention.

One developmental theory suggests that early attention challenges deprive children with autism of essential social information, thus disrupting social and cognitive development (Mundy & Newell, 2007). Research indicates that people with autism experience differences in the way in which they attend to people and faces during social interaction (Hanley et al., 2014; Riby, Doherty-Sneddon, & Whittle, 2012). Some of the earliest signs of autism include impaired or absent social orienting, joint attention, and attention to the emotions of others (Dawson et al., 2004). Social orienting occurs when a person spontaneously turns toward naturally occurring social stimuli in the environment; for example, turning toward someone who has just said your name. Joint attention refers to coordinating attention between social partners and objects or events to share awareness and experiences. Joint attention is displayed by looking at where another person is pointing and then looking back at the person to share an emotion related to the shared experience. Attention to the emotions of others occurs when an individual simultaneously notices the saliency of another person’s emotion and can link the meaning of the emotional expression to the social context.

Retrospective studies of first birthday home videos have shown that infants later diagnosed with autism fail to orient to their names, demonstrate a lack of joint attention, and attend infrequently to others’ social and emotional messages (Osterling et al., 2002). Expressions of emotion have a communicatory function and convey specific information (Blair, 2003). The majority of studies focusing on attending to emotions has been centered on the face and basic emotions such as happiness, sadness, anger, surprise, fear, and disgust (Castelli, 2005; Tracy, Robins, Schriber, & Solomon, 2011). Research has revealed that attending to and recognizing emotions is challenging for individuals with autism, with difficulties most apparent in the recognition of more complex emotions (Golan, Baron-Cohen, & Golan, 2008; Nuske, Vivanti, & Dissanayake, 2013). Generally, complex emotions involve attributing a cognitive mental state to an emotion and are more dependent on context and culture. Examples of complex emotions are embarrassment, discomfort, shock, worry, temptation, relief, guilt, excitement, and loneliness. The following vignettes illustrate social attention challenges.

Jillian often engaged in solitary activity with a number of preferred items. During this activity, she was frequently unresponsive to those around her. Her mother would try to get Jillian’s attention before calling her name by interrupting her activity or placing her hands over Jillian’s item. This frequently caused Jillian to become agitated and further withdraw from interaction by trying to cover the items her mother was not holding. Subsequently, Jillian’s mother tried to draw the child’s attention by tapping Jillian’s hand lightly and then drawing her daughter’s finger toward her face. This strategy worked when Jillian was seated at the table, but not in other less structured settings. Jillian’s teacher recommended that her mother try snapping when calling Jillian’s name. Jillian was highly motivated by auditory input and found silly noises amusing. When her mother tried it, Jillian readily oriented to the noise. She reinforced Jillian for looking and, over time, faded the snapping. Tyler would focus on the fibers in the rug rather than on toys during play and leisure activities. His teacher tried prompting him to attend by telling him “Look,” coupled with a finger point. Tyler’s response was inconsistent, so his teacher began to play with the toy herself, rolling the car back and forth in front of Tyler while making animated engine noises. Tyler oriented to the noise. While she had Tyler’s attention, she rolled the car lightly over her foot and stopped it in front of him. Tyler looked at the car and then at the teacher. The teacher held her foot and puckered her lips to look like she was going to cry. Tyler did not respond to the emotion of the teacher. He does not gather information with his eyes to reference others’ emotions. He can identify emotions when shown photographs of people’s faces. He can even hold a mirror and illustrate different basic emotions, such as happy and sad, on his own face. He struggles, however, to distinguish among more complex emotions such as frustration, pride, or embarrassment.

Research reveals that people with autism demonstrate differences in their capacity for attention. One such difference is referred to as overselectivity, which is a restricted ability to simultaneously attend to multiple cues in order to make sense of incoming information (Broomfield, McHugh, & Reed, 2008; Leader, Loughnane, McMoreland, & Reed, 2009; Ploog, 2010). Overselective attention results in a tendency for some people with autism to process information one piece at a time. Material often is stored and remembered as a whole or gestalt rather than reorganized and integrated in a flexible manner. With overly selective attention, an individual may attend to a limited number of cues and have difficulty determining the most meaningful feature of a given stimulus, which can affect information processing in situations consisting of complex or multiple cues (Reed, Altweck, Broomfield, Simpson, & McHugh, 2012). Many times, the message or meaning is lost in the details or stops at the concrete level so that the person misses important abstract connections. With these challenges, a narrow and more restricted understanding of information emerges.

Individuals with autism may direct their focus on a single feature or be drawn to the same repetitive stimuli as a result of overselectivity. Thus, the tendency to engage in repetitive behavior may be viewed, in part, as a means to create order amid chaos. Firsthand accounts from people with autism often describe an overwhelming experience of feeling bombarded by sensory input. Some report that, at times, they engage in a defensive shutdown reaction and are only able to attend to a limited number of cues (Birch, 2003; Grandin, 2011; Miller, 2003; Sainsbury, 2000). Research has indicated that these hypersensitivities or atypical responses to sensory stimulation can affect individuals in areas such as attention (Baranek et al., 2013; Brock et al., 2012; Donkers et al., 2015). Sensory challenges can cause distractibility, disorganized thoughts, and discomfort in people with autism. The result is a tendency to hyperfocus on sensory experiences that are pleasurable, engage in repetitive behavior for sensory feedback, and ignore or avoid multisensory experiences that are uncomfortable or confusing. The following vignettes illustrate some of the sensory challenges associated with overselective attention.

Devon loves to sit and play on the beach in the sand for hours. He sifts the sand through his fingers and laughs. Although he enjoys this tactile experience, he has a high degree of auditory sensitivity. While he seeks tactile sensory input, he avoids auditory sensory input. He is able to watch videos only with the sound turned off; otherwise, he covers his ears and cries at the sound.

Eduardo engages well with a wide range of activities at home and will attend for extended periods of time. In his classroom, however, when there is a lot of sensory input, he engages in self-stimulatory flapping of his hands. The discrepancy between skills seen at home and at school appears linked to the number of cues or amount of stimulation in the environment. When he is overstimulated, he is unable to organize himself even during familiar activities.

Given that learning requires attention to multiple environmental features, difficulties with attention can markedly impede development, particularly in the social domain. For example, understanding the meaning of someone’s message requires attending simultaneously to the speaker’s words, facial expression, tone of voice, and body gestures as well as the social context. People with autism may have difficulty determining the most meaningful feature of a given stimulus and focus on less relevant cues (Berger, Aert, van Spaendonck, Cools, & Teunisse, 2003). If the person is preoccupied or attending to only one cue, such as someone’s gestures, he or she will be less likely to understand the full meaning of the social message. This attention to details often translates into misinterpreting the meaning of the situation. The following vignettes illustrate some of the challenges associated with attention to only one cue.

Ferdinand is having difficulty learning his numbers. He points to the correct answer only 50% of the time. Upon closer examination, it is discovered that he always selects the card that is in the location of the previous correct answer. He focuses on location, not meaning, in his effort to understand the task.

George is learning about money in math. When asked to tell the class what he would do with a nickel, he explains, “A nickel is gray or silver. A nickel is a circle, and a nickel has a man on it with a jacket. The quarter has a man with no jacket.” Henry recognizes the president’s attire on U.S. coins, but he has concentrated on details that are not socially relevant and does not appear to understand the purpose of money.

Sharing attention with others requires a person to rapidly shift his or her attention between different stimuli. Research demonstrates that people with autism can have problems with shifting attention between stimuli once attention has been engaged and with changing reactions in response to circumstances (Geurts et al., 2009; Gioia, Isquith, Kenworthy, & Barton, 2002; Hill, 2004; Reed et al., 2012). In autism, an impaired ability to flexibly shift attention is associated with executive dysfunction and can be linked to restriction of interests (South, Ozonoff, & McMahon, 2007; Yerys et al., 2009) and difficulties with language meaning and social interaction (Dawson et al., 2004; Landa & Goldberg, 2005). Shifting attention requires cognitive flexibility, and cognitive flexibility requires multiple attention processes, all challenges in autism (Corbett et al., 2009; Solomon, Ozonoff, Cummings, & Carter, 2008).

Studies of attention report that people with autism may be slow to shift attention between and within different sensory modalities; shift attention toward and away from people less; and struggle to attend to rapidly occurring sensory, language, and social events (Hutman, Chela, Gillespie-Lynch, & Sigman, 2012; Ibañez, Messinger, Newell, Lambert, & Sheskin, 2008; Nadig et al., 2007). For example, individuals with ASD may have trouble following the quick pace and complex features of social interaction (Mostert- Kerckhoffs, Staal, Houben, & de Jonge, 2015). Some people with ASD have a tendency toward repetitive behavior and an interest in restricted activities that do not change and may be unusual in intensity or focus (Boyd, Conroy, Mancil, Nakao, & Alter, 2007). This desire for repetition or rituals may be an attempt to have meaningful experiences amid confusing social stimuli. The following vignettes illustrate the characteristics and behaviors associated with difficulties shifting attention.

Imad lines up the pieces of a puzzle in order according to shapes. He also lines up objects within the classroom, including markers by color. At home, he lines up his mother’s shoes and his brother’s baseball cards. He can sustain attention while involved in meaningful solitary leisure activities, but he has difficulty in social interaction or classroom activities that require him to shift attention back and forth from his own activity to the activities of others.

Jacob’s attention varies during group time. He can maintain attention to the lesson if the teacher reads something from beginning to end without interruption or if the lesson is an area of special interest to him. If the teacher interrupts a lesson intermittently to ask questions, however, Jacob’s attention is lost, and he attempts to leave the classroom. He has difficulty during discussions that require him to shift attention back and forth from one thing to the next, especially if the teacher is asking him to shift his attention away from something in which he is especially interested.