What is Autism?
Every species on planet Earth has its own claim to fame -- a special skill or talent which helps it solve a difficult problem such as capturing a meal, finding a mate, or avoiding a predator. Bats evolved sonar in order in order to hunt insects in the dark, male bowerbirds decorate their nests with colorful objects to attract the female, and stick bugs developed such effective camouflage that they are practically invisible to all but the sharpest eye. Down to the lowliest dung beetle, each species has evolved its own inventive way to make its way in the world. This might cause you to wonder: what skill do humans possess that is special or unique? Of all the amazing things that humans do, the one that is most crucial to our survival as a species is cooperation. Humans work together in ways that no other species can even approximate. Indeed, cooperation is at the root of the emergence of modern humans.
It’s easy to see how cooperation could have had such a transformative effect on our species. While cooperation most likely emerged as a solution to a single problem that humans faced during our early evolution (possibly related to hunting and food storage), it doesn’t solve just one problem; it is a powerful system for solving all sorts of problems. In short, cooperation is an all-purpose strategy that has allowed humans to influence everything from the atom to the atmosphere. And when it comes to cooperation -- the more, the merrier. The evolutionary psychologist Robin Dunbar points to the size of human communities relative to our primate cousins. He argues that the natural size of human groups is 150 -- far larger than any other species. Dunbar makes the further point that group size correlates with the amount of neocortex that is present in the primate brain. The implication is that cooperation is the catalyst for the growth in size of cortex, the development of language, and the advent of tool use. It is the quintessential human characteristic and has given shape and definition to the wondrous rich world in which we live.
What does this tell us about Autism? Well, cooperation only works when individuals have (roughly) the same goal in mind. But in order to get on the same page, each participant must have some notion about what others are thinking. Getting into each other’s heads begins early in humans. Typically developing infants (also called “neurotypicals,” a term coined by Temple Grandin, who is autistic) begin trying to capture the attention of others when they encounter something new or interesting by looking at the caregiver and then at the object of interest. When two people are exploring something together, it’s called “shared attention.” This reflex that infants display, to loop someone else into the conversation, is the first step toward developing what philosopher Dan Dennett calls this the “intentional stance,” interpreting other people’s actions as if they are caused by their thoughts and beliefs -- mindreading, for short -- and is fundamental to understanding how humans coordinate behavior.
Now, imagine that your brain is different -- you don’t have that reflex to enter into a mind meld with others. In fact, the awareness that other people have thoughts and beliefs doesn’t occur to you. In much the same way that people born without the ability to see or hear are cut off from the visual or auditory worlds, you’re are not able to perceive the social world. Things happen around you, but you can’t figure out why -- there doesn’t seem to be any logic to it. Consequently, you become very dependent on patterns and routines to structure your existence, because otherwise it’s all chaos. Since you not are aware that others can help you get your needs met, you don’t really ask, and often just try and do things yourself. You find that there are lots of rules everywhere that are difficult to follow. Life is a big puzzle.
The collection of features that comprise Autism were first described in 1943 by Leo Kanner at John Hopkins Hospital, and then (independently) in 1944 by Hans Asperger at University of Vienna Hospital, who each noted that these children appeared to be trapped within themselves, unable to reach out to others. In addition, the children described in these initial studies were were noted to have strong need for sameness in their environment, characterized by repetitious patterns of behaviour such as dressing in the exact same order or reading the a book in the same particular way. They were also noted to have pronounced isolates of ability such as the a complete memorization of the train schedule or mapping the rooms and hallways of each floor of the hospital with surprising accuracy. The final core feature, language and communication, are either absent, delayed, or marked by odd intonation and vocabulary.
Initial theories about the cause of Autism placed responsibility on the parents for not interacting enough with their child (Kanner). That view was eventually rejected, as environment, culture, and experience were all ruled out as playing a causal role. Our current understanding is that autism is an organic form of “mind-blindness” that results from the selective impairment of the mental systems that facilitate shared attention and allow people to interpret the behaviour of others as intentional. Given that Autism appears to be associated with difficulty in accessing the social realm, the most promising lines of research are those that focus on the emergence of cooperation and communication in humans.
While all people Autism have some degree of mind-blindness, the severity varies along a spectrum. There is also variability in the associated skills and abilities they have. Most are able to acquire some functional language ability and learn about social conventions, although Temple Grandin describes the later process as that of “an anthropologist on Mars” -- learning through study with no help from intuition or instinct. Because people with Autism don’t develop a robust social awareness, they remain in a permanent state of immaturity. They have difficulty perceiving or understanding emotions in others, so are often unable to maintain relationships outside of their primary family. And because living in the big wide world is tricky enough even for most neurotypicals, you can imagine it would be enormously hard for someone with Autism to navigate. As a result, people with severe Autism are often unable to live independently as adults.
And as our understanding of Autism increases, so does the effectiveness of the strategies that we use to help children and adults with this puzzling condition. Early intervention including a speech-language pathologist, with primary focus is on communication, has been found to be especially helpful. In particular, implementing alternative modes of communication (such as sign language or a symbol system) has resulted in more positive outcomes than relying solely on spoken language. Much is yet to be learned, and research continues to identify precisely what is different in the brain of a person with Autism, and what can be done to increase the ability to recognize and understand intentions, and thus participate in that most human skill: cooperation.