Detecting Time Concept Competence in Children with Autism Spectrum and Attention Disorders

Abstract

The importance of time concept in human existence is "ancient history" celebrated in the biblical book Ecclesiastes. Indeed, our time-sensitive mechanisms are literally carved into our biology and neurology on a molecular level, gifting us with neural clocks. However, time in human consciousness is not the time indicated by physical clocks: time is a subjective reality in our psychological makeup due to the nature of the temporal neural mechanisms and unique properties of physical time. Nonetheless, subjective time requires anchoring to physical time which permeates our language, endeavors, and entire existence, a process hinging on time-related skills such as estimates and measures of passage and duration of time. Moreover, accurate time reading, a critical adaptive life-skill, is imperative for effective function in all societal activities. Because it embodies the complexity of the time construct, it is central to instruction of time concept in primary education. It is often measured in children by clock drawings, a cognitive integrative skill with errors pointing to neuroanatomical differences impacting the integrity of executive function. Time competence in children with atypical neurobiological development and high prevalence, as in autism spectrum disorders (ASD), and attention disorders (ADHD), is often compromised, calling for investigation of its function. This thematic review article aims to: 1) discuss the complexity of time concept and its underlying bio-neurological mechanisms, 2) elucidate difficulties children with ASD and those with ADHD exhibit in temporal development, and 3) demonstrate the use of a set of clinical tools in uncovering temporal competence and ecological executive function in two children with ASD, and a child with ADHD, using a clock drawing task and error analyses; children's time knowledge questionnaire; a behavior rating parent questionnaire examining ecological executive function, and parent open-ended questions related to their children's time difficulties. A discussion, directions, and a take-home message round out the article.

Keywords: ADHD; ASD; clinical tools; intervention; time competence detection.

Figure 1

ASD-Y DAC drawing with qualitative errors: Size: Macrographic (larger than 12.7 cm). Graphomotor: wobbly circle, duplicated lines and, numbers (a repetitive behaviour), some tilted, and an oversized minute hand. Spatial planning: all numbers present but crowded to right; uneven spaces with noted gaps bottom center and left. Conceptualization: all numbers present in correct sequence but 12–6 and 9–3 not opposed shows lacks understanding these as traditional orienting points on a clock to facilitate time reading.

Figure 2

ASD-J DAC with qualitative errors: Size: Acceptable; Graphomotor: slightly wobbly circle, 9 darkened as are the hands (a repetitive behavior). Numbers well-formed, legible; Spatial planning: numbers crowded to right; hands off-center; uneven spaces at lower and left quadrant; Conceptualization: all numbers present in correct sequence but incorrectly placed: 11–6 and 9–1 opposed instead of 12–6 and 9–3; Note: while darkening the hands (the hour hand is 4 mms long, the minute hand is 6 mms), he was asked the time he wanted to show, he said, 2:00 o’clock but here 12:10 is set– shows weak knowledge of clock time setting, and features.

Figure 3

ADHD-L DAC drawing with qualitative Errors: Size: Macrographic error (15 cm). Graphomotor: oval instead of circular shape, line wobbly, 9 is reversed; some numbers tilted. Spatial Planning: numbers are well spaced, equal size, 12–6 opposed at an angle, 9- opposed to 2 instead of 3. Conceptualization: hand missing.