The role of inhibitory control in the cooperative play of high-functioning children with autism

Borbély, Tamás (2015) The role of inhibitory control in the cooperative play of high-functioning children with autism. Doctoral thesis (PhD), University of Sussex.

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This thesis contributes to the executive dysfunction account of autism by
demonstrating that impairments in inhibitory control, an aspect of executive
functioning, are partially responsible for deficits in the cooperative play of highfunctioning
children with autism (HFA).

As past research on whether inhibitory control is impaired in autism has been
inconclusive, a meta-analysis of 42 empirical studies (57 effect sizes, total n = 2,256)
was conducted, which provided clear evidence for impaired inhibition in HFA
children. It was also found that the degree of impairment shown does not vary across
measures of inhibition, which has important methodological implications for future

Two experimental studies were carried out to directly test the link between
inhibition and three components of cooperation: reciprocity, accepting the play
partner’s input, and fairness. In study one, HFA children in primary school and agematched
typically-developing (TD) peers were tested on engaging in joint attention,
theory of mind (ToM), measures of inhibition, and a cooperative drawing task. The
groups did not differ on first-order ToM and joint attention, but HFA participants
demonstrated poorer inhibitory control and less cooperative behaviour. Importantly,
the degree of impairment in inhibitory control predicted reciprocity and accepting the
play partner’s input in HFA children.

The second experimental study investigated whether poor inhibitory control
can explain the well-established discrepancy between moral reasoning and actual
sharing behaviour. A sample of HFA and TD children of primary school age
completed a moral reasoning interview, inhibitory control tasks, and a Dictator
Game. The results showed that while HFA children demonstrated age-typical levels
of moral reasoning and sharing, inhibitory control emerged as the most important predictor of sharing behaviour, lending support to the hypothesis that the ability to
suppress one’s own desires is a prerequisite of acting considerately.

The last study comprises a qualitative investigation of TD children’s
experience of engaging in cooperative play with their sibling who has a diagnosis of
HFA. Six children between the ages of 5 and 11 were interviewed, and their reports
analysed using interpretative phenomenological analysis (IPA). Five themes
emerged: poor emotion regulation, restricted interests, and no acceptance of the
playmate’s contributions reduced the hedonistic value of joint play for the
participants, but these were mitigated by appreciation for the HFA sibling’s
creativity and adjustment to the HFA sibling’s behavioural atypicalities. These
results can inform the development of support programmes for TD siblings and
social skills training for HFA children.

Overall, the results of the studies included in this thesis provide evidence that
deficits in inhibitory control moderate the relationship between relatively intact
social knowledge and impaired social competence in HFA children. This refinement
of the executive dysfunction account is a useful building block for an improved
multiple-deficit model of the autism phenotype.

Item Type: Thesis (Doctoral)
Schools and Departments: School of Psychology > Psychology
Subjects: R Medicine > RJ Pediatrics > RJ0370 Diseases of children and adolescents > RJ0499 Mental disorders of children and adolescents. Child psychiatry. Child mental health services
Depositing User: Library Cataloguing
Date Deposited: 14 Sep 2015 08:09
Last Modified: 14 Sep 2015 08:09

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