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Parent-Child Interaction and Autism Spectrum Disorder ASD
Autism continuing education psychology CEUs

Section 12
Sharing Humor & Laughter in Autism

CEU Question 12 | CEU Test | Table of Contents | Autism
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs

Everyday humour and laughter can tell us about children's ability to engage with and understand others. A group of 19 pre-school children with autism and 16 pre-school children with Down's syndrome, matched on non-verbal mental age, participated in a cross-sectional study. Parental reports revealed no group differences in overall frequencies of laughter or laughter at tickling, peekaboo or slapstick. However, in the autism group, reported laughter was rare in response to events such as funny faces or socially inappropriate acts, but was common in strange or inexplicable situations. Reported responses to others' laughter also differed: children with autism rarely attempted to join in others' laughter and rarely attempted to re-elicit it through acts of clowning or teasing. Analysis of videotaped interactions also showed no group differences in frequencies of child or adult laughter. However, the children with autism showed higher frequencies of unshared laughter in interactive situations and lower frequencies of attention or smiles in response to others' laughter. Humour is an affective and cultural phenomenon involving the sharing of affect, attention and convention; children with autism show problems in some simple affective and mutual as well as joint attentional and cultural aspects of humorous engagement.

"The tragic (and the dramatic). . . are universal. The comic (is) ... bound to its time, society, cultural anthropology" (Umberto Eco, Travels in hyperreality, 1986)

Humour and laughter are fundamentally relational phenomena and can tell us a lot about the interpersonal, affective, socio-cognitive and cultural skills of young children. Despite their potential as developmental and diagnostic tools, however, we know little about their everyday occurrence in very early development and even less in atypical development. Humour and laughter in children with autism are of particular relevance because their difficulties centre specifically around relating to other people (Hobson, 1989), sharing cultural conventions (Lord, 1993; Loveland, 1991) and understanding others' emotional, attentional and intentional states (Baron-Cohen, 1989; Hobson, 1986a, b; Leslie, 1987; Mundy, 1995), and because the debate surrounding the nature of the primary deficit in autism is still unresolved. The present paper opens up a body of everyday phenomena for investigation in terms of interpersonal understanding and contributes to the debate about social understanding in autism with naturalistic data from children with autism and children with Down's syndrome.

Psychological theories of humour development in recent years have focused mainly on individual cognition, i.e. on the individual's processing of incongruity and its resolution, rather than on social, emotional or cultural processes. However, in older writings, humour and laughter are acknowledged as relational and social phenomena (Bergson, 1911; Freud, 1905; Johnson, 1978; Koestler, 1964; Lowenfield, 1935; Luquet, 1930; Wolfenstein, 1954/1978). A joke may be a joke when even one person laughs at it (Crawford, 1999), but one person's laughter is needed to make a joke funny. Whether humour and laughter could ever develop if they were never shared with another human being may be one of those questions that can only be indirectly answered. That humour exists between people rather than somehow in the joke itself, is also evident from the forms and topics of humour which do not travel well across cultures and contexts. Sharing humour may show a more complex acculturation than sharing tragedy, requiring subtle implicit reference to socio-cultural rules rather than their explicit acknowledgement (Eco, 1986). Sharing laughter with others reveals both cultural and emotional attunement with them, namely a mutuality of interest in the topic of the laughter and/or an interest in the laughter of the others as an affective state in its own right. It is well known that the presence of others facilitates laughter to humorous events in adults and in children (Chapman, 1976; Glenn, 1989) and that laughter itself can be contagious (Provine, 1992). Although no clear evidence exists regarding the onset of contagious or socially facilitated laughter in infancy, it may begin from the middle of the first year (Reddy, personal observation).

The primary focus on cognitive processes underlying humour has led to a dearth of information about humour early in development. The cognitive skills for the humorous appreciation of incongruity (absurdity or the juxtaposition of different frames of reference) are believed to develop after 18 months (McGhee, 1979), although primitive precursors to humour can be seen earlier in laughter in response to tickling, peekaboo and chasing (Shultz, 1976). Potentially humorous behaviour in infants younger than 18 months has consequently been rarely explored, and study of the production and use of humour in actual engagement has been neglected in favour of studies of responses to controlled humorous 'stimuli'.

Early humorous exchanges in typical development
Humorous exchanges are central to social interactions with infants as young as 3 months of age (Ambrose, 1963; Darwin, 1872; Washburn, 1929), and during the first year, developments in infant laughter at humorous events reveal an increase in non-reflexive laughter, an increasing appreciation of culturally inappropriate acts, and a grasp of playful intentions in others. In the middle of the first year, infants laugh mainly at events involving physical or intense sensory contact--especially tactile stimulation such as tickling -- but by 11 or 12 months of age, infants laugh more at distal events such as funny faces and sounds, or events involving socially inappropriate or incongruous acts such as mother waddling like a duck or sucking from the baby bottle (Sroufe & Wunsch, 1972). Laughter at increasingly more complex events may result from a tendency to respond most positively to challenges that are just at the edge of their capacities (Sroufe & Wunsch, 1972; Zigler, Levine, & Gould, 1966), and newly discovered patterns and norms are often violated and distorted in fun and exploration (Garvey, 1977; Groos, 1901/1976). Infant laughter at the violation of social expectancies (Sroufe & Wunsch, 1972) reveals the infant's grasp of the social conventions governing the use of objects and the performance of actions, and infant laughter at others' teasing and joking shows an understanding of playful versus serious intentions in others (Nakano & Kanaya, 1993; Trevarthen & Hubley, 1978).

From around 10 months of age, infants begin to be active humorists as well as appreciative respondents, laughing before rather than after the termination of humorous events (Sroufe & Wunsch, 1972), initiating key aspects of familiar playful sequences themselves (Bruner & Sherwood, 1976) and initiating novel games and humorous interactions as well as routine ones (Bates, Benigni, Bretherton, Camaioni, & Volterra, 1979; Reddy, 1991; Trevarthen & Hubley, 1978). Mischief begins at this age, specifically teasing and clowning, aimed at provoking laughter and other emotional reactions in others (Reddy, 1991). Clowning may involve the ritual violation of the sacred (Handelman, 1981), and the ability to accept intimacy (Lowenfield, 1935), but at its simplest level involves sensitivity to others' amusement and the repetition of, often exaggerated, acts that have previously elicited laughs. Teasing others requires some understanding of others' emotional attitudes, expectations and intentions (Dunn, 1988; Leekam, 1991; Nakano & Kanaya, 1993; Reddy, 1991; Stern, 1985) and the provocative violation of social understandings, conventions and agreements (Alford, 1983; Miller, 1986; Pawluk, 1989; Reddy, 1991). Clowning and teasing require two corresponding 'skills' in both the comic and their 'audience': one, an interest in others' emotional reactions and a desire to elicit them (or let them be elicited); and two, the ability to perceive (and respond to) causal links between one's actions and others' reactions. Teasing, in addition, requires a shared knowledge of social meanings, conventions and agreements that may then be playfully violated. Both clowning and teasing maybe precursors of joint attentional abilities (Bakeman & Adamson, 1984; Mundy, Sigman, & Kasari, 1993) as they involve the infant's active directing of others' attention to acts by the self before infants are able to direct attention to external targets (Reddy, Hay, Murray, & Trevarthen, 1997; Reddy, 1998, 1999).

Evidence of humour and laughter in autism
Evidence about humour in autism is sparse. Older writings and some anecdotal reports suggest that 'seeing the funny side of things' is a problem in autism, as is laughing in moderation or in balance with others (Asperger, 1952/1991; Lord, 1993). In typical development, humour is related to behaviours less evident in autism; playfulness, curiosity and disobedience (Barnett, 1991). Children with autism have deficits in 'showing-off' or drawing attention to themselves or to their acts (Dahlgren & Gillberg, 1989; Wetherby & Prutting, 1984), although it is unclear whether this extends to clowning. Although older autistic children are reported to tease, the nature of this teasing is unclear (Kanner, 1943; Lord, 1993), and while children with autism and Asperger's syndrome often get teased by peers, they are reported to have particular difficulty in responding to teasing with understanding, thus perhaps increasing the likelihood of being teased (Asperger, 1952/1991; Wing, 1991).

The very few recent studies on this topic suggest that children and adults with autism may not have a problem with humour per se, but only with humour involving complex cognitive skills. High functioning adults with autism produce a variety of forms of humour, including verbal and conceptual incongruities, multiple meanings and jocular acts of pretence with the functions of objects, and only show deficits in humour with high cognitive demands (Van Bourgondien & Mesibov, 1987). Parents of school-age children with autism do, however, report some problems in humour-related interactions, particularly in relation to clowning rather than to teasing (Briscall, 1995). In the only available exploration of humour and laughter in young school-age children with autism, St James and Tager-Flusberg (1994) suggest that the simpler forms of humorous interaction (which typically occur in the first year of infancy) may be unaffected. They observed parent-child interactions in the home for six children with autism and six children with Down's syndrome (DS) individually matched on language level with ages ranging from 3 to 7 years. Although there was a large variability within groups, they found more humour episodes overall in the DS group, but when total humour was a covariate, there was a significant difference between groups in only one category of humorous response -- non-verbal incongruity (i.e. humorous inappropriate acts with objects) -- with the children with DS producing (or responding to) relatively higher frequencies of such acts than the children with autism. In all other categories--tickling, familiar routines, silly/slapstick, funny sounds, teasing, verbal incongruity and riddles-there were no significant group differences, although jokes and riddles were completely absent in the autism group. The authors suggest that it may be only the cognitively more complex forms of humour that are affected in autism (incongruity and above), since the developmentally simpler, more affective, forms of humour such as tickling, familiar routines and slapstick show no apparent deficit in autism.

However, we cannot yet conclude that children with autism are 'above' the 12-month level of typically developing infants in terms of humour and laughter, or that there are no simple affective and relational problems in humorous exchanges in autism. This study involved very small and heterogeneous groups of school-age children, and the findings may not generalize to a larger sample or to pre-school children. Only episodes where laughter actually occurred were analysed, and there may have been critical failures to laugh or unsuccessful attempts by others to elicit laughter. In more private contexts, there may be other differences in the elicitors of laughter between the two groups of children that can be reported by the family. Furthermore, we do not yet know anything about children's interest in and responses to others' laughter or their own attempts to make others laugh, all of which are necessary before we can determine whether the affective aspects of humour and laughter are disrupted in children with autism.

Debates about the primary deficit in autism
Research on autism shows that deficits in young children with autism involve several aspects of social relations: affective engagement with others, the understanding of others' intentions, affective and attentional states and joint attention deficits. All of these skills are evident in the humorous interactions of typical infants before the end of their first year. However, there is considerable disagreement about the age of onset of the disorder and about the nature of the primary deficit. The mentality-specific conceptual deficit view (Baron-Cohen, 1989; Leslie, 1987; Perner, 1991) argues that the deficit appears at 18 months, following the failure of a critical cognitive representational mechanism. Affective disturbance views, however (Hobson, 1989; Trevarthen, Aitken, Papoudi, & Robarts, 1996), suggest an onset earlier in infancy, whose basis lies in disturbances in the ability to engage emotionally with others. Simple humorous exchanges involving emotional engagement may provide evidence to illuminate a part of the debate about autism. St James and Tager-Flusberg (1994), with their findings about the lack of group differences in simple humour, suggest support for a cognitive deficit view and conclude that the claim for an affective and interpersonal basis for the constellation of deficits in autism (Hobson, 1989) is weakened. However, even inappropriate acts with objects may require an affective and social basis. They need, for instance, an interest in what other people think of as appropriate actions (Williams, Costall, & Reddy, 1999; Williams, Reddy, & Costall 2001). More evidence is needed about other affective aspects of humour before we can resolve this issue.
- Reddy, Vasudevi, Williams, Emma & Amy Vaughan, Sharing humour and laughter in autism and down's syndrome, British Journal of Psychology, May 2002, Vol. 93, Issue 2.

Personal Reflection Exercise #5
The preceding section contained information about sharing humor and laughter in autism. Write three case study examples regarding how you might use the content of this section in your practice.

Peer-Reviewed Journal Article References:
Crown, N. J. (2021). Oh no! I see a pit: Making sense of the sensory on the autism spectrum. Psychoanalytic Psychology. Advance online publication.

Proff, I., Williams, G. L., Quadt, L., & Garfinkel, S. N. (2021). Sensory processing in autism across exteroceptive and interoceptive domains. Psychology & Neuroscience. Advance online publication.

Ungar, W. J., Tsiplova, K., Millar, N., & Smith, I. M. (2018). Development of the Resource Use Questionnaire (RUQ–P) for families with preschool children with neurodevelopmental disorders: Validation in children with autism spectrum disorder. Clinical Practice in Pediatric Psychology, 6(2), 164–178.

Online Continuing Education QUESTION 12
Why is humor and laughter in children with autism of particular relevance? Record the letter of the correct answer the CEU Test.

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