Maude Le Roux returns this week to discuss Theory of Mind: what it is, why it’s important, and how to foster its development in our children with developmental differences. Maude is an occupational therapist who runs a DIR clinic called A Total Approach in Glen Mills, PA and she is also a DIR Expert Training Leader who presents around the world on DIR/Floortime and other topics that she has advanced credentials in.
Theory of Mind with Maude Le Roux
It’s easier to test the cognitive part and some tests only do that. The beauty of the Developmental, Individual differences, Relationship-based (DIR) model is that it allows us to test the emotional part. Theory of mind is really and fully grasping that your mind is something different than my own and what you are experiencing, thinking, and feeling can be different from what I am experiencing.
Scenario
It has become a game where our son will walk up and smack Dada yelling “Aow!” in order to see this reaction from his father. He follows that up with a very playful, “Dada, are you ok? Are you happy, Dada?”
Maude had told us that our son is asking those questions because he wants Dad to participate in the game again, not because he understands that he hurt Dada and understands how Dad might feel. He is not being malicious or hurtful. He just likes to see the reaction, and he is noticing that it has an effect.
Maude had suggested that Dad say “Aow!” with a lot of affect and keep our son in that moment as long as possible, in order to foster our son’s recognition of the effect he’s having on his Dad, but Dad’s not comfortable doing that.
What Dad was comfortable doing was lay on the bed with a sad state on his face for an extended period of time, saying “You hurt me” in a calm, sad voice. This made our son quite uncomfortable and so he continued to hit to try to get a reaction out of Dad. It frustrated him that Dad didn’t get worked up.
Maude featured at Affect Autism
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Remediation versus Accommodation
We also previously discussed how our kids often need to practice and repeat something to figure it out. Maude says he is experimenting with what happens when he kicks his Dada, hits him, and does it harder or softer. So now what we’re doing to support his development is extending the moment so our son can be aware and can focus on that awareness, feeling what it feels like inside of his body to stay in that uncomfortable moment where Dada reacts differently and acts sad.
In that awareness comes that neurological firing of the brain of, “What do I do now? What do I do with this? Why is Dada doing this?” So now the cause and effect makes him negotiate something different. Challenging him in this way promotes his growth and development. Problem solving plays into this theory of mind piece as well. Maude says it’s important to practice this as a scaffolding ladder into theory of mind. Now he has to negotiate, “Let me try something… Let me try something. I’ll try what I tried before, but it’s not working anymore. Now what?“
Example
If parents keep with the behavioural model, they just find they have to do the same thing over and over because it doesn’t have meaning for the child.
In that moment when they aren’t understanding you and you’re scolding them, they will only be feeling, “I’m going to lose my mommy, my mommy’s mad, somehow I have something to do with it, and I don’t know what to do.” So first, you have to repair the Relationship. You can do the words later when they’re ready to hear that. The repair tells the child they are safe, and that is what’s so important. Maude recommends Dr. Shanker’s Self-Reg book that discusses the process of ‘learning to speak limbic’ when our children are under stress.
What I Did
Well, we weren’t fast enough and our son ran and knocked down the kids’ castle. The girl building it was so upset and started crying. Dada immediately firmly stated, “That’s it! We’re going!” grabbing his hand and pulling him away, but I said, “Wait! Wait! Wait!” I picked our son up like a baby and carried him over to where the girl was crying next to the collapsed castle and said calmly with great concern, “Oh no! Look what happened! The girl is so sad! She’s crying. She’s soooo upset. She worked so hard to build that tower!”
As I spoke slowly with a comforting tone, I continued, “You didn’t mean to make her sad but she’s so sad!” He was listening to everything I was saying. I think that part of it was going in and some of him was still unaware. He responded, “I knocked it down. I want to build it again!” I squeezed him and asked, “Is there anything you want to say to her?” (rather than directing him about what to say). He said, “Sorry, girl.”
Maude's response
In his experience, centralized on himself, that’s the most important thing. We’re taking that sense of self that he has accumulated and trying to turn it to what another person is thinking to invite empathy out. He has cognitive empathy. The girl is sad. But he may not feel it. It’s when you really understand it without talking that the true empathy happens. If I come back from this great vacation then I come in and you don’t look good, I can switch and change that emotion and say “Hey, what’s up?” to reach out, while suppressing my own need to share my excitement of my vacation.
Parents have the most power to create that intersubjective response–getting each other without having to talk. You’re sitting at a dinner party and someone says something and you can look at your partner with that knowing glance and know what each other is thinking. You feel and “get” each other. If anyone can put that message into the child’s mind, it’s the parent. We have this power as parents.
Theory of mind is a very crucial process in differentiating whether child has a diagnosis of Autism Spectrum Disorder or Sensory Processing Disorder, according to Maude. It starts to develop in the fourth functional emotional developmental capacity (FEDC) of the Developmental, Individual differences, Relationship-based (DIR) model. In the fourth FEDC, that awareness is what makes my son emerging. He’s staying and wondering what he’s feeling and wondering. You want that registration. It is an early step towards theory of mind.
Theory of mind is a process that can take a lot of time. The transition from FEDC 3 to 4 is the hard transition developmentally. With the third developmental capacity, you’re still working on that two-way communication, stretching it, using playful obstruction and simplistic problem-solving. Once you get into the fourth capacity you’re looking at abstract thinking, fantasy vs. reality, and early imaginary play. When there’s meaning behind it, that’s where level 4 is so robust. You start to abstract in 4, your ideation comes at 4, and you don’t master 4 until 60% of your ideas come from yourself.
You deepen the plot in the fifth functional emotional developmental capacity (FEDC 5). In the 4th capacity, you have all of this emotion. You have to be able to ideate about what it is you might be feeling in order to respond to that at the fourth capacity. Autistic kids have a phenomenal way of trying to figure out how to get what they want, so the parents think, “Well he is so smart, he should be able to understand” when they get frustrated about inappropriate behaviours.
You can ask things like “Hmm, I wonder why he’s mad?” which gets at the cognitive part of characters. Keep doing that. But more important is having the moments and doing it in the emotional moment. It’s the moment you have to seize. If the child is going through something tough, we naturally nurture. That’s the moment Maude asks us as parents to hold back a little bit and allow our children to feel it, rather than jumping in with a lot of “You’re ok“. Allow them to feel the pain so they can really understand what happened in that moment. Then you can go in and do your nurturing. Emotions are never really easy to work through.
Until next time, here’s to affecting autism through playful interactions!