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Impaired Theory of Mind in Autistic Individuals: The Cultural Construction of Disability A Three-field Anthropological Assessment Robin Freeman October 22, 2007 Integrating Essay Anthropology Department The George Washington University Two characteristics define what it means to be human: our theory of mind and capacity for language, yet, we still retain the same body and brain plan as the great apes from which we diverged 5-8 million years ago. Our similar set of cognitive skills includes the capacity to remember ‘what’ is ‘where’ in a local environment and categorize objects based on perceptual similarities. Additionally, both human and non-human primates recognize conspecifics, even distinguishing hierarchical and affiliative relationships. These social cognitive abilities allow all primates to engage in some type of social learning and cooperation, to varying degrees of complexity and abstraction. Yet, no one would argue that humans and primates are the same; we are different. Unique brain adaptations, according to many scientists and scholars, permit humans to attribute mental states such as beliefs, intentions, memories and aspirations to oneself and others. Known as “theory of mind,” it allows humans to exploit these attributions to understand and predict the behaviors of others (Shaked 2006) in ways that are far more abstract, conceptual and complex than other non-human primate species. One method used to detect and test human beings’ theory of mind is to study children in whom theory of mind appears to be impaired, namely individuals diagnosed with autism spectrum disorders, in comparison with typically developing children. This paper assumes theory of mind to be a uniquely human capacity, a physiological cognitive substrate, upon which human evolves and culture is built. I first trace the evolution of theory of mind in non-human and human primates. Then, I explore some of the implications of an impaired theory of mind, as observed in autistic children. From this foundation, I next focus on how theory of mind articulates with human linguistic practices by comparing ‘normal’ and autistic individuals. Lastly, I assess how cultural perceptions and normative practices ‘construct’ disability, again through theory of mind deficits in autistic children. Freeman Integrating Essay – Fall 2007 Page 1 The literature and research on autism has mushroomed in the past twenty years, from newspaper articles and talk shows to brain-imaging studies and academic reports. Given the scope of this paper, a comprehensive review of this broad array is impossible. In addition, specifically anthropological literature about autism is scarce. Therefore, I will use anthropological concepts to evaluate the idea of theory of mind across three-fields of anthropology, focusing on its relevance to autism. Some background on autism is needed to position and contextualize the illness in a broader framework. “The cluster of symptoms we now know as autism has probably been around for a long time, but no one really know for sure” (Grinker, 2007:52), although ‘retroactive’ diagnoses have gone back to accounts from the Middle Ages (ibid). However, autism was not distilled into a cohesive diagnostic suite of abnormalities until Kanner described it in 1943 (Grinker, 2007:64). The Diagnostic and Statistical Manual of Mental Disorders defines autism on the basis of observable symptoms in three behavioral domains: distinctly impaired or abnormal developments in social interaction; impaired communication; and a markedly restricted repertoire of activity and interests (DSM-IV). Regardless of geographic location or cultural milieu, developmental impairments in theory of mind have been strongly implicated as pivotal causes in the pervasive expression of disabilities in these three domains. As humans diverged from the great apes, the most dramatic changes occurred in the brain and muscoskeletal structure. A three-fold increase in brain volume is believed to have occurred sometime in the past 2 million years, along with a disproportionate increase in the prefrontal cortex of humans from apes, to 24% from 14% respectively (Povinelli and Preuss, 1995:419). Povinelli and Preuss assert that the expanded prefrontal region may be related to the evolution of a specialized neural system that underlies distinctive human cognitive capacities, in which the Freeman Integrating Essay – Fall 2007 Page 2 ‘normal’ ontogenic development subsumes theory of mind. Their studies of autistic individuals bolster the hypothesis for ‘locating’ theory of mind. Additionally, they attest that the lack of insight and introspection found in autistic individuals “is reminiscent of deficits that result from frontal lesions” (1995:419) observed in individuals with other brain injuries. The authors additionally posit that theory of mind “is a recent evolutionary innovation” (1995:418), and claim that this unique advance – in concert with a specific neural organization -- enables humans to attribute mental states. Similarly, Baron-Cohen calls the type of impaired theory of mind observed in autistic individuals ‘mindblindness’ and notes its essential role in the formation of human culture. “Without it,” Baron-Cohen asserts, “human society as we know it simply would not exist. It would either be rigid (like that of ants or bees) or limited to physical interactions and observable signs of social status and alliances (as in many species of monkeys and apes)” (1997). In contrast, Hare does not draw such sharp distinctions between humans and chimpanzees. He notes that chimps share the ability to recognize the emotional states of others and that they “not only take into account others’ perceptual states but also recognize the intentions behind other individuals’ behavior” (2007:60). However, Hare asserts a critical distinction: that chimps do not have the capacity to “flexibly read social cues in cooperativecommunicative contexts” (2007:61) which “seems to have evolved after the hominid split, and thus may play a role in explaining the unusual behavioral flexibility observed in humans” (ibid). Understanding intentionality and recognizing others as intentional agents is a critical cognitive milestone in children that facilitates linguistic acquisition and competence, with eventual full membership in a given culture (barring other obstacles). In particular, specific joint attention behaviors, such as gaze following and social referencing, are observable displays of an Freeman Integrating Essay – Fall 2007 Page 3 underlying awareness of intentionality, and by extension, theory of mind. In contrast, studies indicate that no non-human primate species possess this capacity to the same degree (Povinelli and Preuss, 1995; Tomasello, 1999; Gibson, 2000; Aitchison, 2000) . Baron-Cohen reiterates how entwined theory of mind is with human biological and cultural developments. “The ability to make inferences about what other people believe to be the case in a given situation allows one to predict what they will do” (Baron-Cohen et al, 1985:3). Baron-Cohen and colleagues argue this ability leads to the human capacity to form second-order representations, which “is clearly a crucial component of social skills” (1985:39). Tomasello similarly asserts that “for typically developing children, the ontogeny of these social cognitive skills begins at the end of the first year of life” (1999:513). Nevertheless, the vast majority of children diagnosed with autism lack the vital social cognitive skills to fully engage with cultural artifacts and participate in conventional social practices around them. This is believed to result from deficits in theory of mind, which is often tested by assessing ‘false belief’ competency, a particular aspect of theory of mind that usually develops by a child’s second year of life (Tomasello, 1999). False belief requires individuals to ‘walk in someone else’s shoes’ -- to understand how another person would act if it were known they had different information (i.e. a ‘false belief’) about a given situation. In Baron-Cohen’s 1985 study, the researchers asked autistic and normally developing children ‘belief questions’ regarding where a doll, ‘Sally’, might look for a marble that was moved after she ‘left’ the room. 16 of 20 autistic children failed the belief question, repeatedly pointing to the actual location of a marble, even though ‘Sally’ would have no way of knowing the marble’s location had been changed. Their findings strongly support the hypothesis that autistic children, as a group, “fail to employ a theory of mind” (Baron-Cohen et al, 1985). Freeman Integrating Essay – Fall 2007 Page 4 Accepting theory of mind as a critical component of human cognitive development, what provoked this crucial change? Based on evidence of accumulated modifications to human cultural artifacts and traditions over time, Tomasello claims that humans do not operate as isolated individual cultures. Rather humans pool their cognitive resources to construct collective products in ever-more complex ways, continually scaffolding upon prior innovations and insights (Tomasello, 1999). He argues that “the amazing suite of cognitive skills and products… is the result of some sort of species-unique mode or modes of cultural transmission” (1999:4), and concludes that this innately biological mechanism triggered the dramatic changes in the last 250,000 years of Homo sapiens evolution (Foley and Lahr, 1997; Klien, 1989; Stringer and McKie, 1996 in Tomasello, 1999:4). Schuman writes that “what society values has an impact on how the brain appraises certain stimuli, and that appraisal determines how the brain acquires and processes certain information. The brain, in turn, allows societal institutions to work” (2000:3). There exists a feedback system between brain processing functions and collectivized societal values that gives humans the ability to read and exploit social cues, particularly in communicative and cooperative interactions (Tomasello et al, 2003 in Hare, 2007:60). Theory of mind is believed to be a vital capacity that “paves the way for language, symbolic play, and the acquisition of a number of other cultural activities and skills during the second year of life” (Hare, 2004:488). Many scholars, including anthropologists, attest that language is a primary linking and mediating force between human cognitive capabilities and culture. Aitchison notes that language is a defining feature of human beings and that it is an “extraordinary system [that] allows us to communicate about anything whatsoever, whether it is present, absent, or even non-existent” (Aitchison, 1996:3). A smoothly functioning system requires theory of mind, manifested by, and Freeman Integrating Essay – Fall 2007 Page 5 through, language and is, in fact, “so closely coupled with the development of communication and language that we often do not recognize their interdependence” (Miller, 2006:142). As Bakhtin writes, “language enters life through concrete utterances (which manifest language) and life enters language through concrete utterances as well” (1987:63). Yet, studies indicate that for autistic individuals, an impaired theory of mind is tightly aligned with linguistic and communication defects, a key diagnostic criterion for autism (DSMIV). This broad category includes faulty semantic processing and impeded pragmatic processing, which has been identified as a specific, universal characteristic among autistics (Järvinen-Pasley, 2007). It should be foregrounded that the diagnosis of autism, or any illness for that matter, is entrenched in culturally agreed upon, discursively communicated, conventions of what constitutes ‘normal’ and ‘abnormal’ (Grinker, 2007; Mehan, 1998; Mehan, 1996; Ochs, 2005; Wisniewski et al, 1992). The underlying assumption equates linguistic competency, social aptitude, and selfawareness with normalcy, as the price of full-admission to a given society. What are the implications for autistic individuals whose deficits in language capacities and cognitive competencies are legendary? Throughout history, autistic individuals have been institutionalized, abandoned, or believed to be possessed (Grinker, 2007). Among ultraorthodox Jews in Israel, mothers of autistic children believe it is some kind of signal from God, often distinguishing “between the children’s damaged brain and their soul” (Shaked and Bilu, 2006:14). To understand how entangled language is with cognition, let us revisit the basic progression of language. Language starts with letters, arbitrary symbolic representations of potential sounds, which combine to form phonemes, are then united into words, and finally into Freeman Integrating Essay – Fall 2007 Page 6 sentences (Culler, 1986). Earlier stages are inextricable from later ones in constructing a linguistic system in which each layer simultaneously indexes multiple meanings. Silverstein asserts that the “linguistic – and dependent cultural – texts project (index) the metaphorically ‘surrounding’ contexts in which they by degrees ‘appropriately’ occur, as well as project (index) the contexts that, by their occurrence, they have ‘effectively’ brought into being” (1988:73). Consequently, for an individual to comprehend the full meaning and intention of an utterance, she/he must be both linguistically and culturally competent. And in order to attain that competency, one must understand the concept of intentionality and that others are intentional agents. Bakhtin opines that successful communication means “real and integral understanding” (1987:69) predicated on active interplay between speaker and listener. The speaker must convey the meanings and intentions of their utterances; likewise the listener must perceive and understand these various, and often hierarchically embedded, meanings (Bakhtin, 1987). As “mental states are unobservable” (Miller, 2006:145), the crucial role theory of mind in developing linguistic competence is again reinforced. The ‘what’ and ‘how’ of an utterance can be classified into two domains, the segmental and suprasegmental (Paul et al, 2005:861). The segmental focuses on word sequence, merging Saussure’s distinct conceptions of the syntagmatic and paradigmatic, whereby the ‘horizontal’ and ‘vertical’ selection of words both determines and constrains successive choices and meanings. In regards to theory of mind, participants engaged in a communicative moment must be aware of multiple potentially different perspectival and semantic intentions and connotations. For example, there are numerous ways to convey the same thought: “I broke the bat” versus “The bat was splintered.” Choosing one word, tense or sequencing rather than another indicates Freeman Integrating Essay – Fall 2007 Page 7 ability to reason, and the capacity to unify knowledge about situational context, (self)awareness of desired outcome, and understanding about other participants (Grinker, 2007; Tomasello, 1999; Culler, 1986). In contrast, suprasegmental “refers to all other aspects of the speech signal that modulate meaning and give each speaker unique identity” (Paul et al, 2005:861). Among individuals with autism, it is usually their atypical vocal and expressive communication behaviors that “most immediately creates an impression of oddness” (ibid). Their striking speech patterns primarily include prosodic distortions and irregularites, vocal quality (too loud/too soft), perseveration, and echolalia (Järvinen-Pasley et al, 2007; Paul et al, 2005; Ochs and Solomon, 2005; Constantino et al, 2006; Stiegler, 2007). Paul’s study indicates that prosodic processing is ‘somewhat’ independent of semantics and syntax (Paul et al, 2005), yet the erratic prosody of autistic individuals creates very real obstacles for full cultural integration. Language does far more than convey information. It describes, defines and constitutes disability, plus function as a discursive platform to talk about disabilities through concepts like ideology and genre. Heath defines ideology as the “self-evident ideas and objectives a group holds concerning roles of language in the social experiences of members as s/he contribute to the expression of the group” (Heath, 1989:53 in Woolard, 1998). In discursive practices, language is an expression of normative standards based on stages of biological development and the cultural views of individuals who do not measure up to them – linguistically creating disability. The underlying cultural paradigms equate societal aptitude and membership with language competency. As such, the language used to describe disability, regardless of cause, automatically positions that individual outside normative societal boundaries; a proverbial ‘abnormal Them’ in opposition to a ‘normative Us’. Freeman Integrating Essay – Fall 2007 Page 8 McDermott and Varenne note that “disabilities are less the property of persons than they are moments in a cultural focus” and that “their definition, their ascription, and their ties to social structure raise ultimate questions about cultural life” (McDermott et al, 1995:326). Utterances act as gatekeepers, through which both language and culture must be channeled. Consequently, language becomes one of the fundamental mechanisms that create culture, while simultaneously revealing it. Accordingly, speech genres become an ‘architectural’ framework that guides the organization and interpretation from the “interplay between systems of social value, linguistic convention, and the world portrayed” (Hanks, 1987:671). While the dominant cultural group operationalizes linguistic ideologies and genres through a discourse of disability, the disabled themselves or those associated with disabled individuals must also exploit the same tools of language and communication to express ideologies from their perspective. For individuals with autism, the developmental and cognitive impairments associated with a defective theory of mind make it extraordinarily difficult for them to communicate their own mental states (Grinker, 2007; Tomasello, 1999; Beth Zivic, special education teacher, personal communication). Another essential function of language is to socialize members into conventional cultural practices. Ochs and Schieffelin emphasize that “the process of becoming a competent member of society is realized to a large extent through language, by acquiring knowledge of its functions, social distribution, and interpretations in and across socially defined situations” (Ochs et al, 1984:264). Thus schools are principal “institutions of socialization” whose mandate is to “tighten the fit” between metadiscourse and textual practice (Silverstein et al, 1996: 10). In the socialization of autistic children, language is simultaneously an instrument by which mainstream cultural norms and beliefs are conveyed, and a mechanism that compels adherence to them (Ochs and Solomon, 2005; Noens et al, 2005; Hale and Tager-Flusberg, 2005; Grinker, 2007). For Freeman Integrating Essay – Fall 2007 Page 9 example, a special education teacher often articulates specific behavioral rules regarding ‘personal space’ when people converse. Language is also used to try to teach theory of mind – for instance, when an autistic child ‘memorizes’ the ‘rule’ that friends play gently and do not hit each other. At minimum, these types of lessons may provide a cognitive ‘template’ on which they rely in myriad real-life situations in their struggle to make sense of and adhere to normative values when interacting with the ‘wider world’ (Grinker, 2007; Ochs and Solomon, 2005; Constantino, 2006). By attaining linguistic competency, individuals with autism can potentially increase their level of independent functioning, which is why “developing competence in different generic frameworks is a major focus of educational systems.” (Bauman and Briggs, 1992:161). Culture is defined by most contemporary anthropologists as a “socially constructed, learned communicative code based on a shared system of meaningful signs” (Marshall, 1996:249). To learn one’s respective culture and achieve competency, people rely primarily on aural and oral capacities. Marshall contends that around the world, humans perceive anything that interferes with “the development or maintenance of normal speech is threatening because it inhibits or even prevents cultural transmission” (1996:249). He describes these individuals as “without culture” and “genuinely disabled” (ibid). Autistic individuals clearly fit this category. The cultural construction of a disability is usually accomplished through the application of labels to those judged impaired. Wisniewski and Sedlak assert that handicaps are identified as such when an individual is faced with an “environmental demand” beyond their capabilities or which their peers can normally perform. In specific situations that demand communicative and linguistic competency, and comprehension, people who do not reach an arbitrary normative Freeman Integrating Essay – Fall 2007 Page 10 standard established by the dominant group are marked as “learning disabled” (Wisniewski et al, 1992). McDermott and Varenne advance three models of how culture shapes disability. Their deprivation approach recognizes that people in various groups adhere to different measurable milestones tied to biologically-grounded stages of development. Cultural norms are mapped onto these physiological steps. Individuals that ‘lag’ are deprived of benefits because they cannot demonstrate proficiency. Over a lifetime, advantages or disadvantages accumulate that directly index the individual’s positionality and status within a given society. The second, or difference approach, tracks Boas’ theory of cultural relativity, stating that people invariably develop in ways that are highly attuned to their own culture. Therefore, disabled individuals cannot be judged by a ‘universal’ standard. Their third paradigm, culture-as-disability, is a spin on Bourdieu’s concept of habitus (1977), positing that people create idealizations of what their cultural members should be and systems of measuring those who fall short. It is a collectively produced system that “marks off those who are to be noticed, handled, mistreated and remediated for falling short” (McDermott et al, 1995:336). In a two decade psychiatric study, Higgins and colleagues used an ethnographic approach emphasizing emic perspectives to understand and describe their participants’ self-acceptance of being labeled ‘learning disabled’. Participants almost uniformly partitioned “the day-to-day technical problems of the disability from the stigma attached to it by their culture” (Higgins et al, 2002:7). They outline five stages of ‘acceptance’ as participants came to terms with the “social/emotional impact of being labeled” (ibid, 8): a) awareness of their ‘differentness’; b) the labeling event; c) understanding their limitations and negotiating with service providers; d) compartmentalizing their learning disability; and e) transforming their negative attitude into Freeman Integrating Essay – Fall 2007 Page 11 appreciation. The study’s participants had the self-awareness and cognitive capacities to recognize differences between themselves and their fellow students. The stages documented in this study may not be cognized as readily, or at all, by autistic individuals themselves, but may be applicable to parents and siblings of autistic children. Another key finding from Higgins’ research is the necessary adjustment of cultural expectations for future achievements of those with disabilities. While culture may be a system of learned, shared beliefs and behaviors, it is “not so much a product of sharing as a product of people hammering each other into shape” (McDermott and Varenne, 1995:326). The image of ‘hammering’ someone into culturally constructed pigeonholes leaves little room to maneuver. Clearly “autism, like all disorders, does not exist outside of culture. It is culture that sees something as abnormal or wrong, names it, and does something about it” (Grinker, 2007:11-12). A brief inventory of vocabulary used in the cultural construction of disability proves the point: disabled, abnormal, atypical, impaired, irregular, defective, deficient …and the list continues. This language concurrently buttresses a culture’s normative standards and reinforces the exclusion of a disabled person from the group. All the participants in Higgins’ study were profoundly impacted by these negative and damaging labels. Likewise, one has to wonder whether and how labeling process impacts the emotional and intellectual well-being of autistic individuals. Of note here is that labels index cultural assumptions and bind associated practices to these assumptions. Grinker optimistically challenges that although “autism is a terrible, lifelong disorder … it’s a better time than ever to be autistic … since there is much less stigma attached to autism than there once was” (Grinker, 2007:6). Furthermore, it is a disability to be “accommodated” as a “variation of human existence” (ibid). In this paper, I first outlined the development of theory Freeman Integrating Essay – Fall 2007 Page 12 of mind in human and non-human primates. Through a selection of literature on autism and theory of mind deficits, I then demonstrated how theory of mind (impaired or normal), linguistic practices, and cultural norms intersect. Lastly, I have explored the implications of how discourse and normative cultural values simultaneously create and construct disability, specifically in regards to autism. Freeman Integrating Essay – Fall 2007 Page 13 References Cited: Aitchison, Jean. 1996 The Seeds of Speech: Language Origin and Evolution. New York, NY. Cambridge University Press. Bakhtin, Mikhail. 1987 The Problem of Speech Genres in Speech Genres and Other Late Essays. Austin, Texas. University of Texas Press. Baron-Cohen, Simon, Alan M. Leslie, and Uta Frith. 1985 Does the Autistic Child Have a “Theory of Mind”? Cognition 21:37-46. Baron-Cohen, Simon. 1997 Mindblind. Natural History 106(7): Bauman, Richard, and Charles L. Briggs. 1992 Genre, Intertextuality, and Social Power. Journal of Linguistic Anthropology. 2(2):131-172. Bourdieu, Pierre. 1977 Structures and the habitus in Outline of a Theory of Practice. New York, NY. Cambridge University Press. Boyer, Pascal. 1999 Cognitive Tracks of Cultural Inheritance: How Evolved Intuitive Ontology Governs Cultureal Transmission. American Anthropologist. 100(4):876-889. Call, Josep, Brian Hare, Malinda Carpenter and Michael Tomasello. 2004 ‘Unwilling’ Versus ‘Unable’: Chimpanzees’ Understanding of Human Intentional Action. Developmental Science 7(4):488-498. Culler, Jonathan. 1986 Ferdinand de Saussure, Revised Edition. Ithaca, NY. Cornell University Press. Gibson, Kathleen R. 2000 Evolution. Journal of Linguistic Anthropology. 9(1-2):69-71. Grinker, Roy Richard. 2007 Unstrange Minds: Remapping the World of Autism. New York, NY. Basic Books. Hanks, William F. 1987 Discourse Genres in a Theory of Practice. American Ethnologist. 14(4):668-692. Hare, Brian. 2007 From Nonhuman to Human Mind: What Changed and Why? Current Directions in Pshyological Science 16(2):60-64. Freeman Integrating Essay – Fall 2007 Page 14 Higgins, Eleanor L, Marshall H. Raskind, Roberta J. Goldberg, Kenneth L. Herman. 2002 Stages of Acceptance of a Learning Disability: The Impact of Labeling. Learning Disability Quarterly. 25(1):3-18. Järvinen-Pasley, Anna, John Pasley and Pamela Heaton. 2007 Is the Linguistic Content of Speech Less Salient than its Perceptual Features in Autism? Journal of Autism Development Disorders. Springer Science + Business Media, LLC Marshall, Mac. 1996 Problematizing Impairment: Cultural Competence in the Carolines. Ethnology. 35(4):249-263. McDermott, Ray and Hervé Varenne. 1995 Culture "as" Disability. Anthropology & Education Quarterly. 26(3): 324-348. Mehan, Hugh. 1998 Educational Handicaps as a Cultural Meaning System. Ethos. 16(1):73-91. Miller, Carol A. 2006 Developmental Relationships Between Language and Theory of Mind. American Journal of Speech-Language Pathology 15(2):142-154. Ochs, Eleanor and Bambi B. Sheifflin. 1984 Language acquisition and socialization: Three developmental stories. in Culture Theory: Essays on Mind, Self and Emotion. R. Shweder & R. LeVine, editors. 276-320. New York: Cambridge University Press. Paul, Rhea, Lawrence D. Shriberg, Jane McSweene, Domenic Cicchetti, Ami Klin and Fred Volkmar. 2005 Brief Report: Relations between Prosodic Performance and Communication and Socialization Ratings in High Functioning Speakers with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders. 35(6):861-869. Perner, Josef, Uta Frith, Alan M. Leslie and Susan R. Leekam. 1989 Exploration of the Autistic Child’s Theory of Mind: Knowledge, Belief and Communication. Child Development 60:689-700. Povinelle, Daniel J. and Todd M. Preuss. 1995 Theory of Mind: Evolutionary History of a Cognitive Specialization. Trends in Neuroscience 18:418-424. Schumann, John H. 2000 Brain. Journal of Linguistic Anthropology 9(1-2):20-23. Shaked, Michal, Ifat Gamliel and Nurit Yirmiya. 2006 Theory of Mind Abilities in Young Siblings of Children with Autism. SAGE Publications and The National Autistic Society 10(2):173-187. Freeman Integrating Essay – Fall 2007 Page 15 Shaked, Michal and Yoram Bilu. 2006 Grappling with Affliction: Autism in the Jewish Ultraorthodox Community in Israel. Culture, Medicine and Psychiatry. 30:1-27. Silverstein, Michael. 1998 Functions in Language Ideologies: Practice and Theory (Oxford Studies in Anthropological Linguistics, No. 16. Oxford University Press. New York, NY. Silverstein, Michael and Greg Urban. 1996. Introduction in The Natural History of Discourse, pgs. 1 – 17. Michael Silverstein and Greg Urban, eds. The University of Chicago Press, Chicago, IL. Tomasello, Michael. 1999 The Cultural Origins of Human Cognition. Cambridge, Massachusetts. Harvard University Press. Tomasello, Michael. 1999 The Human Adaptation for Culture. Annual Review of Anthropology 28:509-529. Wisniewski, L., Sedlak, R. 1992 Assistive Devices for Students with Disabilities. The Elementary School Journal, 92(3):297-314. Special Issue: Integrating Learners with Disabilities in Regular Education Programs. Woolard, Kathryn A. 1998 Introduction: Language Ideology as a Field of Inquiry, in Language Ideologies: Practice and Theory (Oxford Studies in Anthropological Linguistics, No. 16. New York, NY. Oxford University Press. Freeman Integrating Essay – Fall 2007 Page 16 Bibliography (sources not specifically cited): Constantino, John N., Dan Yang, Teddi L. Gray, Maggie M. Gross, Anna M. Abbacchi, Sarah C. Smith, Catherine E. Kohn and Patricia K. Kuhl. 2006 Clarifying the Associations Between Language and Social Development in Autism: A Study of Non-native Phoneme Recognition. Journal of Communication Disorders. 37:1256-1263. Crossley, Rosemary. 1997 Speechless: Facilitating Communication for People without Voices. Dutton Books. New York, NY. Hale, Courtney M. and Helen Tager-Flusberg. 2005 Social Communication in Children with Autism: The Relationship between Theory of Mind and Discourse Development. SAGE Publications and The National Autistic Society. 9(2):157-178. Hazell, Gillian, Carroll-Few, L, Cockerill, H., compilers. 2001. “Experiences of Children and Families Who Use Augmentative and Alternative Communication,” in Communicating Without Speech: Practical Augmentative and Alternative Communication. Cockerill, H., Carroll-Few, L, eds. London, UK: Cambridge University Press. Landsman, G.H. 1998 Reconstructing Motherhood in the Age of “Perfect” Babies: Mothers of Infants and Toddlers with Disabilities. Signs, 24(1):69-99. Mehan, Hugh. 1996 “The Construction of an LD Student: A Case Study in the Politics of Representation,” in The Natural History of Discourse, pgs. 253 - 276. Michael Silverstein and Greg Urba,n, eds. The University of Chicago Press, Chicago, IL. Müller, Eve, and Adriana Schuler. 2006 Verbal Marking of Affect by Children with Asperger Syndrome and High Functioning Autism during Spontaneous Interactions with Family Members. Journal of Communication Disorders. 36:1089-1100. Noens, Ilse L.J., Ina A. van Berckelaer-Onnes. 2005 Captured by Details: Sense-making, Language and Communication in Autism. Journal of Communication Disorders. 38:123-141. Ochs, Elinor and Olga Solomon. 2005 Limitations and transformations of habitus in Child-Directed Communication. Discourse Studies. 7(4-5):547-583. Roberts, Jenny A., Mabel L. Rice, and Helen Tager-Flusberg. 2004 Tense Marking in Children with Autism. Applied Psycholinguistics. 25:429-448. Stiegler, Lillian N. 2007 Discovering Communicative Competencies in a Nonspeaking Child with Autism. Language, Speech, and Hearing Services in Schools. 38:400-413. Freeman Integrating Essay – Fall 2007 Page 17