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Theory of Mind and Teachable Moments

By Elizabeth Graham, September 2017
Autism Waiver Service Coordinator, The Arc of Prince George’s County
Woman with Asperger’s Syndrome

In a previous article I wrote about Teachable Moments (available at

http://marshall.academia.edu/ElizabethGraham). In this article I am going to tie teachable
moments with theory of mind (ToM). ToM is a term to describe a person’s ability to understand
what others might be thinking; it is a social skill. Temple Grandin, PhD is a professor of Animal
Science; she was diagnosed with autism when she was young and did not start learning to speak
until around the age of four years. She is the focus of the 2010 Emmy-winning film “Temple
Grandin”; she has authored several books and has given numerous conference presentations on
autism. According to Grandin (2015):

“In its most elementary form, [theory of mind] is the ability to understand that different
people have different thoughts. Involved with ToM is perspective taking, being able to
think about and understand an event or a situation ‘through the eyes of another.’ These
are all social thinking skills that develop without formal instruction in neurotypical
individuals, starting at a very early age. These are also skills that most people, including
educators, assume exist in all people, to a greater or lesser degree of development. This is
not the case within the autism population” (Grandin, 2015, p. 201).
(Neurotypical is a term used in the autism community to refer to someone who may not be on
the autism spectrum.)

Stephen M. Edelson, Ph.D., Executive Director of the Autism Research Institute, says,
“Theory of mind appears to be independent of intelligence even though people with
Asperger’s syndrome exhibit this problem to a lesser degree. Interestingly, people with
autism have difficulty comprehending when others don’t know something.…It is quite
common, especially for those with savant abilities, to become upset when asking a
question of a person to which the person does not know the answer. By not understanding
that other people think differently than themselves, many [individuals with autism] may
have problems relating socially and communicating to other people. That is, they may not
be able to anticipate what others will say or do in various situations. In addition, they may
have difficulty understanding that their peers or classmates even have thoughts and
emotions, and may thus appear to be self-centered, eccentric, or uncaring. Although this
is an egocentric view of the world, there is nothing in the theory of mind to imply that
[individuals with autism] feel superior to others” (Edelson).

Grandin mentions an example when her mom used a visual example to help her understand how
a person feels. When Dr. Grandin was about eight years of age, she ate with her mouth open and
her mom kept telling her to keep it closed during eating; she did not understand why she needed
to keep her mouth closed when chewing. She writes, “Then one day I came home from school
and I told mother that watching Billy eat with his mouth open made me gag, that it looked like
the inside of a garbage truck. Mother quietly replied, ‘Your mouth looks like the inside of a
garbage truck when it is open and it makes me want to gag’” (Grandin, 2015, p. 203). This was a
visual example that helped Dr. Grandin realize that her mom was experiencing a very similar
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response to seeing someone else chew with their mouth open. Grandin says, “For children who
are less visual learners and respond well to verbal language, it may work to tell them that the rule
is to chew with their mouth closed” (Grandin, 2015, p. 203).

From 1995 until graduation in 2008, I attended The Lab School of Washington, an independent
school in Washington, DC for students with learning differences. The school has its own staff of
occupational therapists, speech-language therapists, and licensed clinical psychologists. Around
my sophomore and junior years of high school I was officially diagnosed with Asperger’s
Syndrome, a high-functioning form of autism. (Due to normal speech development, the diagnosis
of Asperger’s often was diagnosed once social demands become more intricate and signs became
more visible.) My mom, until she succumbed to skin cancer in 2004 at the age of 54 years, used
a lot of teachable moments to help me learn polite and respectful behavior. Looking back, I feel
it’s safe to say my parents realized I learn best through experiential/visual examples. Here are
some examples of teachable moments that helped me learn ToM.

In the summer of 2000, I was attending a tennis day camp. During a break I was speaking to the
other kids and I was talking about a movie and one of them asked me what I was talking about; I
continued to talk about that movie, assuming they had already seen it. When my mom picked me
up at the end of the day, one of the tennis coaches talked about this with her. The moment we got
into the car, my mom told me it is important to ask people if they know what I am talking about
and to listen carefully to their answer.

One Christmas prior to 2000, one of my mom’s piano students sent a Christmas card that she
made in art class in school. My mom had told me that her piano student said the art on the card
was created a certain way. Later that night, my dad was videotaping me looking at the Christmas
tree and the cards on the fireplace mantel. I began talking about the different cards and when I
came to the card I just mentioned, I spoke to the camera as if someone else would already know
what I was told about the card; I said, “It is sure amazing how she made this card.” I did not
explain why it was amazing. Later both of my parents were watching the tape with me. My dad
asked me what I meant and I said “Well, you know, what mom said about how she made the
acard.” My parents told me that it is important to give other people background information.
“They won’t know what you know,” my dad said. My parents taught me an example of ToM
using a visual example with myself with the use of the videotape.

When I was in fifth or sixth grade, my classmates and I were learning about the Industrial
Revolution and the famous industrialists (such as J.P. Morgan, Henry Ford, and John D.
Rockefeller). We learned a bit about the stock market, too. We then took a field trip to the
financial company Merrill Lynch to their office on K Street in Washington, DC. The visit was
not as interesting as our teacher said he hoped. The financial advisors that met with us spoke to
us as if we were in an upper-level college finance class. All I remembered from the visit was that
a client would come to them if she or he wanted to invest in a stock of a company. That night,
while eating dinner, I told my parents about the boring visit we had. My parents reiterated the
importance of taking into consideration who your audience is and how much they know or don’t
know about what you are talking about. They pointed out that I sometimes speak to other people
without giving them the important details or background information and others may feel the
way I did.
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Beginning around junior high, I was beginning to grasp the concept that others might have a
different level of knowledge on a certain topic than me. I was good at providing more
information; however, sometimes it was too much information to the extent of boredom.
Sometimes I would give too much detail that the main point would be lost. So I had to learn to
gauge the amount of information I would give so the listener would not become bored or
overwhelmed.

Over time and with all of these concrete teachable moments, I was able to learn that not
everybody would know what I know and that I would have to give them some background
information when talking to people. When teaching people with autism a concept or a skill, it is
important to teach in multiple settings, over and over again; if you only teach it once and in only
one situation, the person you are teaching most likely will think what they learned only applies to
that setting or situation. Teaching across multiple settings and multiple times will help the child
generalize the task or concept. In order for many with autism to understand a concept, many
concrete examples first have to be gathered and put into their “mental file cabinets”.

Pictured: Elizabeth Graham (left) with Temple Grandin, Ph.D. at the Future Horizons Autism and Asperger’s Syndrome Conference
in Baltimore, Maryland in September 2016. Dr. Grandin is Professor of Animal Science at Colorado State University and a recent
inductee to the National Women’s Hall of Fame.

About Elizabeth Graham

Elizabeth Graham, a Washington, DC area native, works at The Arc of Prince George’s County where she is a
Service Coordinator for the Maryland Home and Community Based Services Waiver for Children with Autism Spectrum
Disorder. Administered by the Maryland State Department of Education, this Medicaid waiver provides direct support
services to children with severe autism to develop skills to live in their homes and their communities. Prior to working at
The Arc of Prince George’s County, upon college graduation she worked two years as a direct support professional in
Montgomery County, Maryland, providing community-based residential support to adults with
developmental/intellectual differences.
Elizabeth has her B.A. in Psychology with a minor in Counseling from Marshall University in Huntington,
West Virginia. Her academic area of focus was bereavement in people with autism; this was influenced by her Mom’s
death to melanoma at age 54 years in December 2004 and her later diagnosis of Asperger’s. During college, she
volunteered with hospice and bereavement camps for families and children. She has presented on the topics of autism
and bereavement at various conferences and events. In the summer of 2007, she attended the Georgetown University
School of Continuing Studies College Preparatory Program. She is a 2008 alumna of The Lab School of Washington in
Washington, DC and a 2009 post-graduate alumna of The Perkiomen School in Pennsburg, PA. She has been published
by The Arc of the United States Autism Now blog.
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References

Edelson, S.M. Autism Research Institute¸”Theory of Mind”.

autism.com/understanding_theoryofmind

Grandin, T. (2015). The way I see it: a personal look at Autism & Asperger’s. Arlington, TX:
Future Horizons.

Helpful Resources (not in any particular order)

Sally-Anne task of theory of mind

https://www.youtube.com/watch?v=41jSdOQQpv0

Autism Jargon: Theory of Mind

https://www.youtube.com/watch?v=IhnE1FCD2uo

Theory of Mind Test

https://www.youtube.com/watch?v=YGSj2zY2OEM

Do People With Autism Lack Theory of Mind? University of Virginia class

https://www.youtube.com/watch?v=r7C3-70YyuE

Brain Games Theory of Mind

https://www.youtube.com/watch?v=FTCWLUjoF10&t=1s

Autism and Theory of Mind TED Youth talk

https://www.youtube.com/watch?v=Svts046kIFY

Autism and theory of mind by Simon Baron-Cohen

http://docs.autismresearchcentre.com/papers/2000_BC_theoryofmind.pdf