Autism, Empathy and the Sally-Anne Test

I asked if he had brushed his teeth, knowing he hadn't gone into the bathroom, and he grinned at me, saying, "Yeah!" In the parallel universe of autism parenthood, I jumped for joy and called his therapist to share the good news.
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Click here to read an original op-ed from the TED speaker who inspired this post and watch the TEDTalk below.

Mid-tantrum, my 17-year-old son, Danny, will often turn to me, look right into my eyes, say, "I'm sorry, Mom," and then go right back to his tantrum.

Danny was diagnosed with Pervasive Developmental Disorder/Not Otherwise Specified (PDD/NOS), a form of mild autism, when he was three. One of the many horrifying facts I was told when he was given the diagnosis was that people with autism lack empathy. That is because, apparently, they lack what is called "Theory of Mind," the ability to understand that other people think and see things differently from the way they do.

This so-called "Mind Blindness" is usually diagnosed by a test similar to the one that Rebecca Saxe shows in her fascinating TEDTalk. The test given to people with autism is generally called the Sally-Anne Test. Simon Baron-Cohen, of the Autism Research Centre, did a famous study in which this test was used. A child is told the following story:

Sally puts a marble in a basket and leaves the room. While she is gone, Anne removes the marble from the basket and puts it in a box. Sally comes back into the room.

Then the child is asked, "Where will Sally look for her marble?"

People with autism, I am told, generally say or indicate, "In the box," because they don't realize that Sally does not know the marble has been moved.

I say, "I am told," because my son, like an enormous number of people with autism, does not have the attention span to pay attention to this story. He is extremely hyperactive, and would have a very difficult time concentrating on this exercise. However, if someone were to make him sit through it somehow, I have no doubt that he would answer, as most people with autism do, "In the box."

While I don't question the truth of the researchers' findings, I do question the conclusion that is so often drawn from the response to this story: That people with autism lack empathy. While autistic people may not quite understand what is going on, and may not realize what Sally does or does not know, this does not mean that they do not feel empathy and/or sympathy for the people they love. I'm basing this conclusion on my independent research as the mother of a child with autism. When I'm down, Danny will lay his head on my shoulder and say, "You're sad, Mom." When I was angry with him one day and gave only monosyllabic answers, Danny struggled terribly to come up with a way to get my attention and approval, finally saying, in sheer desperation, "I love your glasses, Mom." When he was ten, in a moment I will always treasure, he lied for the first time, a sure sign he understood I could be manipulated. I asked if he had brushed his teeth, knowing he hadn't gone into the bathroom, and he grinned at me, saying, "Yeah!" In the parallel universe of autism parenthood, I jumped for joy and called his therapist to share the good news.

I based a character on Danny in the novel I wrote, If I Could Tell You, about parents raising children with autism, and a number of readers who do not have relatives with autism were amazed that an autistic character would show so much concern for others. But my son can, and does.

We parents will never give up on our children, but some bureaucrats and teachers out there may be tempted to. -- Hannah Brown

Danny's responses show, as Saxe demonstrated in her talk, that the brain region that controls our judgments about other people's feelings can and does develop throughout the course of life. For a child like my son, clearly it develops differently and later than with others. But while this is obvious to me, it isn't at all clear to many who work with people with autism. Children with autism, and eventually, adults with autism, are labeled as people who feel no empathy. I've also been told Danny doesn't have imagination, and that he hugs people not out of affection but because he "craves sensory input."

All these conclusions -- so obviously false to people who know and love children with autism -- can be used to dehumanize these children. And when people are dehumanized, it is easier to give up on them. We parents will never give up on our children, but some bureaucrats and teachers out there may be tempted to.

So I would plead with researchers to take great care when labeling the conclusions of this kind of research. Because if the researchers don't keep in mind that people with autism may not understand the Sally-Anne story, or that autistic children may have different ways of expressing their empathy, it's the researchers who truly lack empathy -- and compassion.

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