Clinical Utility of the Rorschach Inkblot Method: Reframing the Debate

 

Phase		Period
1	1921- 1950s	The unbridled optimism period	This period was marked by widespread interest in the RIM, aided in part by these seminal publications of Schafer (1954)
2	1960s	Increasing skepticism period	widespread misuse of the test by clinicians (typically involving biased, impressionistic interpretation.
3	1974 onwards	The psychometrization period	Comprehensive System (CS) for RIM scoring and interpretation (subsequently revised and refined in 1986, and again in 1993). With the publication of Exner’s CS, a single overarching framework was adoptedby most (although not all) RIM users. The empirical foundation of the RIM was strengthened, and the test achieved a degree of respectability that it had not enjoyed for some time (see Meyer, 1999; Weiner, 1995, 2000a)
4	1996 onwards	Backlash period	began with Wood, Nezworski, and Stejskal’s (1996) critique of the RIM in general, and the CS in particular. Wood et al.’s challenge led to Exner’s (1996) published response in Psychological Science, and several interrelated dialogues ensued, with RIM proponents and critics exchanging sharply opposing views (e.g., Hunsley & Bailey, 1999; Viglione, 1999).   In the midst of these debates, two prominent journals published point–counterpoint exchanges specifically devoted to the RIM: the special series on “The Utility of the Rorschach for Clinical Assessment” in Psychological Assessment (Meyer, 1999), and the special section on “The Rorschach Test in Clinical Diagnosis” in the Journal of Clinical Psychology (Garfield 1947/2000; Weiner, 2000b).

Source: Clinical Utility of the Rorschach Inkblot Method: Reframing the Debate: Journal of Personality Assessment: Vol 77, No 1 (tandfonline.com)

TOM as the theoretical Framework

 

TOM, weak central coherence and executive functioning difficulties are underlying cognitive features associated with Autism. These cognitive features effect the way students or children process in the environment including:

1.      Impairments recognizing the mental states (TOM) of others can result in difficulty understanding social interactions, relating to their peers and knowing what to do to fitting in.

2.    Hyper focus on the details of a lesson, piece of work or social situation (Weak central coherence) can result in difficulty understanding the big picture and coping when things change.

3.      Problems organizing and coordinating multiple tasks (Poor executive functioning) can lead to difficulty coping with the workload, prioritising and displaying flexibility in problem solving.

Tony Attwood

Source: http://www.tonyattwood.com.au/index.php?option=com_content&view=article&id=79:the-discovery-of-aspie-criteria

The Definition and Prevalence of Autism

The results of the studies of the prevalence of autism are summarised in Tables I to S. Each is identified by the name of the area in which it was carried out. The authors of the papers, the full names of the areas studied, and the abbreviations of these names used in the tables are listed below, in the order in which they appear in the tables:
- Lotter (1966; 1967a; 1967b) Middlesex, England (Midx)
- Brask (1972) Aarhus, Denmark (Aarh)
- Wing & Gould (1979) Camberwell, London, England (Camb)
- Hoshino et al.(1982) Fukushima-ken, Japan(Fuma)
- Bohman et al. (1983) Västerbotten, Sweden(Väst)
- Cialdella & Mamelle (1989) Rhône, France(Rhôn)
- Matsuishi et al. (1987) Kurume, Japan (Kuru)
- Tanoue et al. (1988) Ibaraki, Japan (Ibar)
- Sugiyania & Abe (1989) Nagoya, Japan (Nago)
- Burd et al. (1987) North Dakota, USA (NDak)
- Ritvo et al. (1989) Utah, USA (Utah)
- Gillberg (1984) Göteborg region, Sweden (Göt1)
- Steffenburg & Gillberg (1986) Göteborg city, Sweden (Göt 2)
- Bryson et al. (1988) Nova Scotia, Canada (NoSc)
- Gillberg et al. (1991) Göteborg city, Sweden (Göt 3)
- Ishii & Takahashi (1983) Toyota, Japan (Toyo)
For the studies in Fukushima, the Rhône, and Utah, the authors gave reasons for considering that the rates found for particular age groups within the total range studied were the most accurate. The findings for these age groups are given in Tables 1 and 2. For the second and third studies in Göteborg the authors also gave rates separately for rural Bohuslän, but only the findings for city Göteborg are quoted in Tables 1 and 2. However, for all these studies, the data in Table 5 refer to all the children finally diagnosed as autistic because, for some of the papers, this was the only information given.

Source: http://www.mugsy.org/wing.htm

Role of Language in Theory of Mind evelopment

Many writers have made a convincing case for a causal role of language in the development of a mature ToM (Astington & Baird, 2005). However, there are at least three distinct arguments for why language should matter and good empirical evidence for each one.

1. Content of ToM-Even with respect to children developing an understanding of their own feelings or desires or thoughts, it seems necessary to hear language used about them in order to learn how to express those concepts in our culture. We learn the words that label such private events by hearing others talk about and interpret our inner worlds, but we begin to bring these together into causal webs that constitute our first primitive psychological theories (Dunn & Brophy, 2005; Nelson, 2005). This approach to ToM development, therefore, focuses on the importance of learning words as labels for mental states that may not be directly observable in behavior.

2. Role of language in ToM development concerns the information that conversation itself contains (Appleton & Reddy, 1996; Harris, 2005; Peterson & Siegal, 1999; Wellman & Peterson, 2013b). Beyond the content of discussions about the mind and behavior, every conversation, even a mundane one about breakfast, is a window into the beliefs and desires of other people.  Language exposes people’s knowledge or ignorance, our beliefs, our attitudes, and our differences, even when they are implicit and not directly expressed. Therefore, probable that the information about minds conveyed through conversation is richer than that conveyed through behavior, eye gaze, or gestural expression of feelings and desires.

 3. A third class of theories emphasizes the role played by the child’s own language mastery rather than the information contained in the input language or conversational interaction (Astington & Jenkins, 1999; de Villiers & de Villiers, 2009; Milligan, Astington, & Dack, 2007).A child with the capacity to express someone’s mistaken belief can then use that representation to reason about what the other person might do next, or why the person had that belief.



The evidence that language development is closely intertwined with ToM development is strong, and the connections are multidirectional (de Villiers, 2007). The earliest stages of communication depend on the infant’s interest in and engagement with other social beings with minds, and it is through these interactions that children begin to learn words and meanings.It is through this greater comprehension, and the parallel development in metalinguistic skills, that children become capable of really understanding, and using, nonliteral language, such as jokes, metaphors, irony, sarcasm, and lies (de Villiers, de Villiers, ColesWhite, & Carpenter, 2009; Happe, 1995; ´ Tager-Flusberg, 2000). A mature ToM thus feeds into these later pragmatic language developments.

Cognitive deficit or Cognitive style?

Autism is a devastating development disorder affecting at least one in a hundred of children and adults. Although with a strong biological genetic component, diagnosis of autism is still made by behavioral criteria: qualitative impairments in social and communicative development, with restricted and repetitive activities and interests. It is not difficult to find things that people with autism have difficulty with, most autistic people also have general learning difficulties and low IQ. However, we should explore on what autistic people are good at. Thus, we could make use of their unique cognitive style to discover the unrevealed talent or to develop the specific skills.

Much progress has been made in the last 15 years to understand the preserved and impaired abilities in autism, including nature of social and communicative handicaps in autism. Primary in this is the notion of the Theory of mind. Theory of Mind is the ability to attribute mental states, beliefs, desires, emotions, knowledge to oneself , and to others. In another term, mentalization. Autistic children have such difficulty to understand deception, pretend play and even telling lies. A hypothesis was tested using Wimmer and Perner's puppet play paradigm by Uta Frith, the result shows that even though the mental age of the autistic children was higher that those with Down's syndrome, they
failed to impute beliefs to others. Hence, it is proven that this dysfunction is independent of mental retardation and specific to autism.

Besides, autistic