Inside Autism

1. Is autism on the rise?

2. Nature and nurture, but not vaccines

3. The system-making mind

4. Lighting up the brain

Roll over the eyes after you've guessed which emotion they express. On average, men score lower on tests like this than women. Individuals with autism score lower than both men and women. Test images courtesy Simon Baron-Cohen, Autism Research Centre

Many want support and respect for their difference, but do not want to be cured...

Meet Austin.
After a normal pregnancy and delivery, the baby weighed a healthy 8 pounds. He was alert and appeared normal in every respect. A year later, he began to pound his fists against his ears at loud noises and cry for no apparent reason. At 18 months, he spoke only a few words -- and soon after, not at all.

"He would go to the refrigerator if he wanted something to drink. Or if he wanted a toy, he would walk to the toy and just stand there. You just had to read his mind," Austin's father wrote (anonymously) in the Journal of the American Medical Association seven years later (See "An 8-year-old boy with autism" in the bibliography).

Like many autistic children, Austin was diagnosed as a toddler. Parents and doctors often first notice the signs when a child develops some language and then loses it.

eyes "My experience indicates that language regression is the harbinger of autism in 90 percent of toddlers," Rapin wrote in a commentary on Austin's case.

No one knows what, exactly, causes the language setbacks in autism. But many researchers agree that autistic people, to varying degrees, lack a "theory of mind." In other words, autistic people have trouble understanding, and talking about, their own needs. More obviously, they struggle to understand others.

The world in pieces
When healthy people watch a film of moving triangles and a circle, they often imagine that the objects have social relationships ("The big triangle is helping the little triangle out of the square."). When people with autism look at the same clip, they see independent objects. ("The small triangle and the large triangle are moving to the right. The square isn't moving.").

eyesPeople with autism also have trouble interpreting faces, which comes so naturally for most people that it's hard to imagine not being able to do it. Researchers at Yale University have found that when people with autism interact with other people, they spend most of the time looking at the other person's mouth. Non-autistic people will gaze at the other person's eyes.

Understanding concepts can present as big a challenge for many autistic people as understanding faces (although this is usually not true for those with high-functioning autism or Asperger syndrome). Autistic people often have a remarkable memory for facts but can't always place them in context. They see the trees, but not the forest.

Reading people isn't always easy
eyesBut for a person with autism, it can be very difficult. In tests asking people to assign emotions to pictures of faces showing even the most basic emotions -- fear, surprise, pain -- autistic individuals score lower than others. Even individuals with high-functioning autism and Asperger Syndrome -- who often participate fully in society and can have productive, happy lives -- often have trouble in these areas. In fact, one new kind of treatment for individuals with autism spectrum disorders is software that teaches, in a systematic way, how to read faces.

In the late 1980s, Uta Frith of University College London proposed the "weak central coherence" theory -- that autistic people think about things in the smallest possible parts. The theory explains how some autistic people show remarkable ability in subjects like math and engineering -- but still have trouble with language and still appear to live in a disjointed social world. eyes

"The idea is that people with autism may notice details at the expense of the larger picture," explains Simon Baron-Cohen, director of the Autism Research Centre at Cambridge University. "That they are not able to integrate information from the local level to the global level. Where this theory runs into problems is where it is clear that someone with high-functioning autism or Asperger syndrome might be able to do physics or engineering or computer science or maths, where they eventually come to understand a whole -- global -- system."

Frith admits that her theory "does not fully explain autism. It explains, however, a particular cognitive strength in autism: being able to focus on details and not being biased by context or prior knowledge." In Frith's view, an autistic person can understand a whole system. eyesThe idea is that there is "a preference in information processing for the bottom-up (from one local detail to another) rather than the top-down (from concept to small detail) approach to building and understanding of knowledge," she wrote in an email to The Why Files.

Nevertheless, Baron-Cohen and his colleagues are testing a provocative new theory based on an old idea proposed by German physician Hans Asperger.

The extreme male brain
We never wanted to go there. But to hear Baron-Cohen tell it, it's a pretty interesting place. His theory builds on some nuggets from basic psychology:

Women, on average, are better at identifying and responding to the thoughts and actions of other people. In lay language and psychology, this is called empathizing.

Men, on average, are better at building systems from parts, and at understanding these systems. In this context, a "system" is anything with inputs and outputs that is governed by rules, like a car engine or weather pattern. Baron-Cohen calls this ability "systematizing."

Baron-Cohen applies this framework to autism, arguing that autism is an extreme version of the normal male brain. In other words, the autistic mind systematizes to a fault, which comes at the expense of empathy.

Two graphs depicting the results of tests designed to test a person's ability to empathize.
In tests designed to test a person's ability to empathize, men usually score lower than women. Autistic individuals, on average, score lower than men. The opposite is true for systematizing. Researchers are using psychological tests like these to support the "extreme male brain" theory of autism. Information from The Essential Difference, by Simon Baron-Cohen (see bibliography)

Empathizing, after all, is "a leap in the dark, in the absence of much data (thoughts like 'Maybe she didn't phone me because she was feeling hurt by my comment' )," Baron-Cohen wrote in 2002. "Systemising is our most powerful way of understanding and predicting the law-governed inanimate universe. Empathizing is our most powerful way of understanding and predicting the social world. And ultimately, empathizing and systemizing are likely to depend on independent regions in the human brain" (See "The extreme male brain theory of autism" in the bibliography).

eyes All this begs the question: Is there an extreme female brain? Baron-Cohen speculates that there probably is, but that this kind of personality is not stigmatized the same way. There are engineers to build cities and there is Mapquest to get us from point A to point B. But there is no guide to explain the message in the eyes of a mother, partner, or co-worker.

Despite the social costs of autism, Baron-Cohen suspects that society has overlooked the contributions made by people on the autistic spectrum. Some have speculated that historic geniuses like Einstein and Newton had autism spectrum disorders -- probably high-functioning autism or Asperger syndrome. In very rare instances, even those with classic autism can have extraordinary abilities.

eyes"I am putting a lot of effort into testing the empathizing-systemizing theory, as I think this captures not just the deficits but also the strengths in this set of conditions," Baron-Cohen told The Why Files. "It is clear that of the individuals with 'high functioning' autism or Asperger syndrome, many want support and respect for their difference, but do not want to be cured... The E-S theory would predict that any attempt at curing autism spectrum conditions risks not only improving their empathy but reducing their systemizing skills, and this might be at a cost to the individual as well as to our society."

The extreme male brain idea is "an interesting theory," says Frith. But is it any good? "Time will tell."

Getting a closer look.

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