Central Coherence: DetailFocused Cognitive Style in ASD

1
Central Coherence Detail-Focused Cognitive
Style in ASD

• Francesca Happé, Institute of Psychiatry, Kings
  College London f.happe_at_iop.kcl.ac.uk
• Overview
• Autism spectrum disorders time to give up on a
  single account?
• The central coherence account
• Sentence completion test
• Typical developmental trajectory
• ASD versus ability-matched controls
• Role of EF? ASD versus ADHD
• The central coherence account genetic and neural
  bases?
• Conclusions

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Triad of impairments
Social Impairments
Triad co-occurs above chance One cause?
Communication impairments
Restricted Repetitive Behaviours Interests
3
Exploring the coherence of the triad general
population twin study

• TEDS data collected at age 8
• Ngt3400 twin pairs (born Jan94-Aug95, includes
  some ASD)
• Parent report (Childhood Asperger Syndrome Test
  CAST, Scott et al., 2002)
• ASD triad traits only correlate .2-.4,
  genetically distinct

Ronald, Happé Plomin (2005) Devl Science (in
press) JAACAP
4
The triad No single cognitive explanation
Social impairments
Theory of mind
Executive functions
Problems recognising thoughts and feelings?
Problems generating, planning, monitoring?
Communication impairments
Restricted/ Repetitive Behaviours Interests
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The puzzle of superior performance in autism

• ToM and EF deficits may explain problems in
  autism
• But people with autism also show superior
  performance
• savant skills in music, maths, art...
• excellent memory for facts...
• jigsaw puzzle and other spatial skills...
• noticing tiny changes, perfect pitch...
• Current deficit accounts (ToM, EF) cant explain
  these

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The puzzle of autistic talent
The puzzle of ASD talent
Drawings by Nadia, a 3-year-old with severe
autism
Drawing by Gilles Trehin
Drawing by Nadia, 3yrs
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Cognitive style in autism

• Central coherence (CC) refers to normal
  tendency to integrate information in context for
  meaning, often at the expense of surface form
• People with autism process details well at
  expense of global configuration and meaning
• This detail-focus has been called weak
  coherence (Frith89)
• Weak coherence a style not deficit
• leads to assets as well as difficulties
• bias that can be overcome

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Embedded Figures Test
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Sentence Completion task example of a CC
test   1. I was given a pen and ... 2. The
sea tastes of salt and ... 3. Hens lay eggs
and ... 4. The woman took the cup and ...
5. You can get burnt by the sun and
... 6. You can feed a child bread and ...
7. Little boys grow up to be men and
... 8. In the sea there are fish and ...
9. In a cave lived a bat and ... 10. You
can go hunting with a knife and 11. You can
swallow apple ... 12. The old shoe-maker
mended the shoes and ... 13. The fireman
carried the bucket and ... 14. A vet cares for
cats and 15. The night was black and
...   Filler items
You can go hunting with a knife and ...  Weak
coherence ? .......fork  Strong coherence ?
......catch a bear
Record number of local completions that are
globally incoherent
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Central Coherence as Cognitive Style
Area of autism risk?
weak------------------Central
Coherence-----------------strong e.g. good
proof reading e.g. good gist
recall A continuum of cognitive style from
weak to strong coherence? Both extremes have
costs and benefits? Possible sex differences?
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Results of Typical Development study of Sentence
Completion
Age effects 8-10 11-13 gt 17-25 Correlation
significant in males only (r -.25) NO
relationship with IQ (r .02)
Significant main effect of gender (F(1,191)
4.30, p 0.04) males make more globally
incorrect completions (mean 0.79, s.d. 1.25)
than females (mean 0.54, s.d. 0.74).
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Performance of ASD group and matched controls,
relative to TD Males performance
N local completions
ASD group make significantly more local
completions than matched Control group
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Relation between CC and EF?

• Executive Functions (EF) ability to maintain a
  context-appropriate set for attainment of future
  goals
• EF deficits found in ASD
• EF interpretations of CC findings are possible
• E.g. inhibitory failure in sentence completion
  task?
• Can EF and CC be disentangled?
• Test ADHD group shows inhibitory problems
• do they show weak coherence?

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Performance of ASD and ADHD groups, relative to
TD Males performance
N local completions

• Impulsive errors on a Go-NoGo task do not
  correlate with local completions
• WCC findings not a function of EF problems in ASD

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Brain basis of cognitive style?

• Right Hemisphere traditional role in integrative
  functions
• Dorsal stream/magnocellular pathway, thought to
  be specialised for low spatial frequency
  information
• Evidence of larger head/brain size in ASD
• Increasing interest in functional connectivity in
  autism

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Conclusions

• Although a devastating disorder, autism is
  notable for strengths as well as weaknesses
• Part of autism may be a cognitive style, not
  deficit
• There may be distinct genetic contributions to
  this part of autism (vs. social impairment)
• Studying cognitive style in ASD should
• raise awareness of positive aspects of ASD
• increase appreciation of the potential of
  individuals with ASD
• inform educational approaches working to
  strengths not just weaknesses