Autism As Context Blindness

I like the approach that Peter Vermeulen, Ph,D., takes in his book regarding “context blindness”.  The book,originally published in Dutch in 2009, has recently been translated into English and is now available through AAPC.  It appears that at the same time, a gentleman by the name of Joe Griffin came up with a similar idea and coined the phrase “Caetextia”.  Using the word blindness grabs your attention.  It used to be that use of the word blindness for anything other blindness in a medico-legal sense of reduced best corrected visual acuity, or loss in peripheral vision was frowned upon.  With the advent of terms such as change blindness, the word has been more liberally applied to phenomena of the mind that escape detection.

Here is a sign that appears on one of the side streets in Point Pleasant Beach.  It is a caution to drivers that a child with autism may be lacking in “theory of mind” to judge whether it is safe to do something as basic as cross the street.  If a car is approaching, will the child understand the rate of approach?  Will the child be able to gauge what the driver is thinking?  If the child is immersed in playing with a toy, and that toy rolls out in the street, will he or she understand the an approaching care can’t be counted on to stop short?  These are part of the fundamentals of autism, the concept that the emphasis on thoughts and actions are within the self.  The ability to anticipate the actions of others, to empathize, to share joint attention – are all benchmarks of the social mind of a child who is on the autistic spectrum (ASD).

Here is where Vermeulen is at his best – in pointing out the limitations of social and other training programs for autism:  they lack real-world context.  One of the most challenging aspects that all clinicians have in working with patients who are ASD is in being able to generalize context.  Patients with ASD tend to be systemizers, bound by black and white, perplexed by shades of gray, and prone to rigidities that make it challenging to use information learned in one setting and apply it to other settings.  Activities that work well in the office may not be reproducible outside of the office.  It matters little whether this is OT, PT, VT. Speech, or Psychology – the same challenges apply.


One thought on “Autism As Context Blindness

  1. All the more reason for the OD VT practitioner to become more involved with the ASD child in his/her environment outside of the office. This includes school, home and extra curricular activities.

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