The effectiveness of Dosa method on theory of mind in high-functioning autistic children

Dissertation for Master's Degree in Clinical Psychology

Abstract

The purpose of this research is to investigate the effectiveness of the Dosa method on the theory of mind of high-functioning autistic children. The current research is a quasi-experimental type and the design used is a single-group pre-test-post-test design with follow-up and without the use of random selection. Theory of mind scale and autism spectrum disorder screening questionnaire were used to collect data. For this purpose, 6 high-functioning autistic boys in the age range of 6 to 10 years, with an autism severity level of 50 to 100 in the controlled questionnaire, were selected and were receiving interventions at the autistic training and rehabilitation center in Ara. Then, the subjects received the interventions individually during 8 sessions of 45 minutes to one hour. After 2 weeks of treatment sessions, the theory of mind post-test was taken from the sample.

The results of the research showed that the Dosa psycho-motor rehabilitation method was effective on the first and second level of the theory of mind of children with high functioning autism (p=0.01). Also, the results of the follow-up test showed that the effects of the intervention continued after one month of the post-test in the first and second levels of the theory of mind (p=0.01).  It should be noted that at the third level of the theory of mind, the results obtained from the implementation of the post-test and the follow-up test indicated that the intervention was not meaningful. Therefore, interventions based on strengthening movement may be effective on people's basic cognition, but to achieve higher levels of theory of mind, more comprehensive and long-term interventions are needed.

Keywords: theory of mind, high-functioning autism disorder, Dosa method

1-1- Introduction

The history of evolutionary psychology has always witnessed the emergence and evolution of scientific models and theories about how behavioral changes occur. It has been cognitive, emotional and social. The goal of the scientific effort of thinkers is to describe and better understand the evolution of man throughout his life and to discover its basic processes and mechanisms. So far, various theories have been presented in the field of developmental psychology, each of which has caused scientific progress and has included important changes in the theoretical and practical fields of education and psychology (Damon and Lerner [1], 2004; quoted by Amin Yazdi, 2013). One of the important issues in interpersonal and intrapersonal relationships that has an important place in evolutionary psychology is social cognition [2]. Social cognition includes all the skills a child needs to understand the desires, emotions, and feelings of other children and adults (Sebola and Wishart [3], 2008). Social cognition refers to the ability to understand the thoughts and feelings of others. This knowledge includes the perception of feelings and emotions from the way they speak and the words that others use and from their faces and the way they stand and their body movements. More complex social cognition skills include the ability to justify and analyze mental states, empathy and humor (Yukerman et al. [4], 2010).

Social cognition has 3 structures, which are: a) personal perception b) role acceptance skills c) theory of mind (Grady et al. [5], 2002). The theory of mind approach is the latest trend in research on the development of children's social cognition, which began in the 1980s and is currently the dominant field of research in this field (Flavel[6] 1998; quoted by Mokhtari, 2019). The evolution of social cognition or a better understanding of human psychology is determined by the changes that occur in the content and level of organization of the theory of mind in children;  In other words, social cognition and successful social relations require having a special mechanism to understand the internal states of others and process their mental states, and the theory of mind, having this specific ability, plays a vital role in the development of social cognition (Raza and Blair [7], 2009).

The theory of mind has also been proposed under titles such as mind reading [8], belief9 and mentalization[9] and they consider it the basis of a person's perception of the social world (Slaughter and Rapacoli[10], 2003). Most daily life behaviors require "cognition"; In the sense that a person must have some kind of cognitive evaluation of "social position" and be able to consider his relationship with another in its context or social context (Harris [11], 2008).  This theory includes the concept of the ability to recognize human perceptions; As intentional beings, each of them individually has different beliefs, desires and cognitive goals and a different perception of the outside world.  This theory includes the concept of the ability to recognize human perceptions; As intentional beings who each have different beliefs, desires and cognitive goals and have a different perception of the outside world, social cognition is a key ability that is necessary for success in social interactions in daily life (Newman, Wegley and Xing [12], 2008). The term theory of mind was first used by Primack [13] and Wodorf [14] in 1978 to investigate whether chimpanzees have mind-reading skills (Call and Tomasello [15], 2008). Theory of mind is the ability to attribute mental states such as beliefs, desires, emotions, and goals to oneself and others and use this information to predict and interpret behaviors (Ferguson et al. Austin [16], 2010), in other words, the ability to understand that others have mental states that can be different from the individual's own mental states or reality and that humans are motivated by internal mental states such as beliefs, desires or intentions (Lakenro et al. [17], 2010). Theory of mind is necessary to understand how people in a similar situation, with similar experience, can have different mental states (Dahlgren et al. [18], 2010). Defects in theory of mind lead to a lot of damage in establishing relationships and other areas of life, which is unfortunately one of the most fundamental basic defects in one of the autism spectrum disorders with a high prevalence called autism. These disorders are a group of mental disorders in which there is a deterioration in social interaction skills, language development and a range of behavioral reserves. In this disorder, the child shows significant deterioration in social interaction and repetitive stereotyped behavior patterns, along with a delay in language development (Struck [19], 2008; cited by Koch and Hasbrouck [20], 2013). Autistic children show defects in several aspects of their communication with peers and problems in participating in two-way conversations and non-verbal communication in social exchanges and lack of empathy, lack of joint attention and also problems in understanding the thoughts of others and as a result the inability to predict the behavior of others and respond appropriately. Autistic children who show significant problems in the ability to imagine and understand the thoughts of others, despite these problems, it seems that there are still many questions in this area that can be investigated, such as whether it is possible to improve the theory of mind in these people by applying different treatment, education and rehabilitation methods for these children or not? Currently, various researches have investigated the teaching of theory of mind on autistic children and other exceptional groups; Among these studies, we can refer to Fisher and Hape [21] (2005); Atwood [22] (2005; adapted from Nejati et al., 2012); Nasayan (1389); Huafeng, Shuling and Guendlen [23] (2008); Bakhshi (1390); Biger [24] et al. (2011), Mokhtari (2019) and Nejati et al. (2012) pointed out that most of these studies have concluded that interventions in raising the understanding of autistic and mentally retarded children in the theory of mind have been successful, although the effectiveness has not been confirmed in some studies. However, most researches have paid attention to the effectiveness of educational methods and less to rehabilitation methods, including psychomotor rehabilitation methods, while the role of movement on cognition has long been the focus of developmental psychologists.  Therefore, in the current research, the effectiveness of the psycho-motor rehabilitation method (Dusaho) on the theory of mind of high-functioning autistic children is examined. 1-2- Statement of the problem Theory of mind [25] (TOM) is one of the main components of social cognition, which broadly refers to the ability to understand emotions, motivations, thoughts, and subsequently understand the behaviors of others (Grisham [26] et al., 2010).

    The defect in the theory of mind that leads to a lot of damage in establishing relationships and other areas of life is one of the most fundamental defects in autism spectrum disorders, which has increased the prevalence of this disorder in the last decade all over the world. In epidemiological studies conducted in 1960, the prevalence rate of autism spectrum disorders was reported to be 4 in 10,000. This prevalence rate has changed with the change in diagnostic criteria and the greater awareness of experts and parents about developmental problems, and has been on an increasing trend. The etiology of this phenomenon and how it contributes to the symptoms of the disease is disputed. These disagreements are mainly reflected in the field of neuroscience.