Mind blindness. Walking in someone else's shoes. Theory of mind. There are a lot of different ways to describe the challenges that many individuals with autism have conceptualizing, understanding, or predicting the emotional states in other people. These difficulties for individuals with ASD can lead to troublesome situations, like this one:

Meet Curt, a boy with Autism

Several years ago I had the opportunity to work with a boy with autism named Curt. Curt was a middle school student in regular education classes and doing quite well academically. But he was having a lot of difficulties in public – especially at the grocery store. One of Curt's narrow interests was health and nutrition. He always made sure he was eating healthy and keeping his snacking to a minimum. This was great because Curt was in great shape. Problems arose when Curt started to become concerned about other people's eating habits.

One of Curt's favorite activities was to go grocery shopping. He loved researching health foods and then going to purchase them. But, while at the grocery store, he started noticing that there were overweight people with unhealthy foods in their cart. And every time he spotted someone he would go up to them and give them a lecture. He would even try to take food out of their carts and replace it with healthier options. Imagine grocery shopping and a stranger comes up and starts critiquing your food choices! Needless to say, his parents were extremely embarrassed and would get into a lot of arguments with Curt over his behavior.

So during one of our sessions I sat down with Curt to talk about these issues. I said, “Curt, I am so glad you are always thinking about your health. I love that you try to eat healthy foods all the time. And I know that you are concerned with other people's health as well. How do you think the people at the grocery store feel when you tell them they are buying unhealthy food?” Curt sat for a few seconds in thought and then got a big smile on his face. “Great!,” he said. “I bet they feel great. They are going to lose weight, have more energy, and live longer!” Though Curt had great intentions, he was not at all able to accurately predict the reaction of the people in the grocery store. He thought he was doing them a favor, when in fact he was making them feel ashamed and upset.

Creating Visuals for Behavioral Learning

So I created a visual to help Curt better understand the effect his actions were having on the people at the grocery store. Here it is:

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The visual helped get Curt to start thinking about other people's reactions. I created the “Shopping Facts” visual to look like a Nutrition Facts label because Curt was very interested in them. We reviewed the visual right before a trip to the grocery store, and we had him carry the “Shopping Facts” visual in his wallet. We had him check it a few times during the trip when it seemed like he was frustrated because he wanted to make comments about someone's cart. We directed him to the “Substitutions” part of the visual and he responded well. Over the next several weeks his trips to the store improved immensely. We still had a long way to go to generalize the concept of theory of mind – but that's for another blog post!

When an individual with autism is saying rude, hurtful, or inappropriate things they probably do not have a great understanding of how their words and actions are affecting those around them. Try to use visuals, like the one I used for Curt, to help explain the difficult concept of theory of mind. If you can teach it within the context of something the individual enjoys, like Curt and the grocery store, we will often see more compliance and success. And as always – contact InfiniTeach with any questions or ideas you have about teaching theory of mind!

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