ASSESSMENT AND TRAINING OF METACOGNITION IN AUTISM SPECTRUM DISORDER

Abstract

Cognitive differences, including deficits in executive functioning and detail-focused processing, are common in high functioning individuals with Autism Spectrum Disorder (ASD). There is also growing evidence that self-awareness is an area of particular difficulty for those with ASD; this is problematic as self-awareness is important for self-advocacy, daily functioning, and treatment outcomes. Despite its importance, there are no assessment tools for self-awareness in ASD, nor is self-awareness targeted for intervention. This dissertation involved three studies. The first two studies were undertaken to develop a measure that assessed metacognition in ASD (i.e., Awareness of Cognitions Questionnaire). The third study involved the development, piloting, and assessment of a metacognitive training program for adolescents with ASD. Study 1, an exploratory factor analysis of the ACQ, found the questionnaire to have four factors and satisfactory internal reliability. In Study 2 youth with ASD and typically developing (TD) participants, and a parent for each, completed the ACQ. Parents of ASD youth reported more cognitive biases in their children than parents in the TD group. Youth with ASD reported fewer biases than their parents attributed to them, whereas TD participants and their parents showed the opposite results. Results provided preliminary validation of the ACQ and demonstrated deficits in self-awareness of cognitive differences in ASD participants. Study 3 included the development and evaluation of a metacognitive training (MCT) program. Two groups of four males with ASD completed the seven-week MCT program, as well as program evaluation measures administered in a time series design. Both visual inspection of data and thematic analysis were used. Overall, both participants and their parents rated MCT favourably. Post-MCT, many of the youth were able to articulate what they had learned in the group and why the information is important for self-advocacy. There were no systematic changes (positive or negative) on quantitative measures of self-esteem, depression, or metacognition. The positive appraisal of the intervention and lack of adverse effects suggest further investigation of MCT is warranted. Overall, these data highlight the deficits in metacognition in youth with ASD and the potential benefits of a novel intervention to target these deficits.