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Laurent Mottron is professor of psychiatry and holds the Marcel & Rolande Gosselin Research Chair in Cognitive Neuroscience of Autism at the University of Montreal. He is also director of the autism programme at the Hospital Rivière-des-Prairies, 7070 boul. Perras, Montreal H1E 1A4, Quebec, Canada.,
The discussion in this issue of Nature about the potential advantage of autistic spectrum traits reminds me of the old debates about whether schizophrenia was simply extreme creativity. Most people with autistic spectrum disorders (ASD) suffer from the effects the disorder has on their social abilities. Since their social skills are affected, their neighbours, friends, relatives, spouses and children also suffer.
Some have speculated that problems with empathy can make people with ASD more prone to commit crimes (1). But ASD covers a lot of territory including a full range of intellectual abilities and disabilities. We have argued that pre-labeling people?s abilities only on the basis of a diagnosis of ASD, is prejudiced and wrong. While the symptoms of ASD can cause a people to be ?asocial?, it does not mean they are necessarily ?anti-social? (2).
Researchers in the field of ASD must clearly define which part of the spectrum(s) they are investigating. They should also avoid confusing causal explanations with correlations. Scientists need to remember that words and labels can hurt, especially for people with ASD. We need to be careful not to confuse the hypothesized etiologies of ASD with the current concatenated symptom clusters of ASD or pronouncements about whether people with ASD are ?better? or ?worse? because of the diagnosis. Lets all agree that ASD deserves unbiased scientific research since the results will both inform and reflect on us all.
J. Paul Fedoroff, M.D. Forensic Research Director University Ottawa Institute of Mental Health Researh
1. Fedoroff, JP. Sadism, Sadomasochism, sex and violence. Canadian Journal of Psychiatry, 53, 637-646, 2008.
2. Fedoroff, JP., Richards, DA. Sexual disorders and intellectual disabilities In: Handbook of Clinical Sexuality for Mental Health Professionals Stephen B. Levine (ed) Routledge New York, Chapter 25, 451-468, 2010.
pituti pituti
Nice article, pitty that the the world is made by and for social people, including science.
Mary Livingston
AHHHH... The WORLD is not made by social people; oceans, mountains, trees, clouds, rain, snow, etc. couldn't care less what PEOPLE are doing. Expanding your viewpoint might help you to enjoy the world a bit more. As for the SOCIAL community, it may be wise to limit close connections to the quality few. Quantity is rarely the gem it is advertised as.
I found this youtube clip on www.youtube.com about a boy named Jason McElwain who has autism. It is shown in the video that McElwain excels in basketball. Also, it is extremely nice to see other team mates cheering for him, showing that autism is not "anti- social disease".
Peter Gibson
Laurent Mottron comment on autism (Nature 479, 3 Nov 2011 pp. 33-35) appears to be an over interpretation of the problem. Autism may be, in spite of what Mottron says, due to slower reaction times in speech and hearing. All other behavioural difficulties that accompany it, rage in particular, are likely to result from this. Slowing may be due to a neocortical wiring problem such as too many or few connections and so on. As a result there appear to be a filing difficulty – a problem in locating words. An similar problem may be severe stuttering where a person cannot find appropriate words. The same problem may be motor spasticity. That is, connections are unable to be made in the correct order. Speech depends on neo-cortex motor and sensory function. The cortex is made up of basic repeated architectonic units. Muscular coordination in, say, walking appears to be more complex than that of speech. Speech in contrast to walking is evolutionarily recent – there is no speech organ. Regions of the primate brain adapted to foraging in woods became redundant when hominids moved to other environments. The regions were pre-adapted to language. The muscles used in speech are essentially identical to those used in eating. Language is an ad hoc. Compared to many other animals with long evolutionary pedigrees, say the lyre bird, human speech and language are crude and ambiguous. Word assemblage in sentences is grossly redundant and sentence construction is repetitive and clichéd. There would appear to be no such thing as non-autistic and autistic people since autism is a continuum. The suggestion that people with severe autism have compensatory ability sounds like condescension. ?Poor things are handicapped in expressing themselves but they are good map readers?. Autistic people are unlikely to be any better at visualisation the most people. The visual cortex is a separate system to that used by language although it involves a degree of cortical correlation. Following blindness other regions of the brain can learn to ?see?. Recognition of shapes (places, maps and faces) involves correlation and is not impaired in autism. Other correlative problems such as dyslexia may be a form of autism. Dyslexia is a positive advantage in undergraduates. They fall over themselves to register as dyslexic. Autism will be next. There is a possibility that autism has a selective evolutionary advantage. It is likely to be a defence against exploitation. Language, contrary to popular belief, probably evolved as a means of exploiting others. It is the basis of trade and involves securing advantageous deals and involves deceit (see Stuart West in Nature 478, 20 Oct 2011, pp. 314-315). Those who are slow to react may be at an advantage.
Dr Peter Gibson – University of Edinburgh
Andromeda Luxenburg
I personally know a number of people who are diagnosed with Aspergers' Syndrome, and meet the qualifications in the DSM 4, who are primarily language-based in the way they deal with the world, and have difficulty with visual, spatial, and other nonverbal tasks. Are there then two types of autistics (or three, as Grandin asserts, who think in pictures, in patterns, or in "paragraphs"?
David Whitlock
As someone with Asperger's (but only a touch ;) and doing research in autism, I agree with essentially everything that Dr Mottron has said. My perspective is compatible with all the data in the literature that I have read.
First, communication is the Savant Skill of neurotypically developed individuals. It is a skill that non-neurotypically developed individuals (i.e. people with autism) cannot hope to match.
Second, the two uniquely and defining human traits; language with syntax and grammar, and tool making and tool using both require a large brain with considerable plasticity for learning and thinking across the lifespan.
Third, the infant brain is limited in size at birth by the size of the maternal pelvis. Even so, in the absence of medical C-section, there is ~1% fetal/maternal death per pregnancy due to cephalopelvic disproportion.
Presumably, much of human evolution has been devoted to trying to optimize brain function to maximize the functionality of the infant brain that can successfully be born alive. Brain substrate (neural stuff) optimized for one thing can't be optimized for something else. Optimization necessarily is a trade-off of different neuroanatomy to do different cognitive tasks.
Fourth, division of cognitive labor allows humans to learn and use the cognition of others. A tribe only needs one expert, one savant to make the conceptual leap, then the others can learn, use and extend it.
Presumably tribes with diverse cognitive abilities out competed tribes without diverse cognitive abilities. Because development of diverse neuroanatomy couldn't be directly coded for by the genes the tribe shared, that diversity must have come from increased sensitivity of those shared genes to environmental influences affecting neurodevelopmental outcomes.
Teratogens that cause autism (valproate, thalidomide, phenytoin) do so during the first trimester. That is also when the number of minicolumns in the brain is fixed. A larger number of minicolumns is a highly repeatable characteristic of individuals with autism.
What would a trade-off of communication ability for tool making and tool using ability look like? I think it would look a lot like the autism spectrum.
I have discussed some of these ideas in greater detail on my blog.
Andromedea, there are as many types of autism as there are individuals with autism. The neuroanatomy of each person's brain is unique and develops from a single cell in utero to ~10^11. Neurodevelopment is coupled to the in utero ?environment? at the level of noise via stochastic resonance. The myriad coupled non-linear interacting parameters are chaotic and produce an outcome sensitive to the butterfly effect at the level of Brownian motion.
Edward Schaefer
I am someone who possibly could be considered AS"D". For whatever reason, the AS"D" issue seems to be going down the male line in my family, and getting more pronounced over time. My father has a little of it, I have a little more, my brother could be considered Asberger's, and my son is so afflicted that he is non-verbal and very limited by it.
Is AS"D" advantageous? To be honest with you, that has to be decided on a case-by-case basis. For me, the added analytical ability has beed very helpful in my carrer in software engineering, and my father has had an even more successful career in electrical engineering. Then again, both myself and my father are very much able to function verbally, but socially we are less than adept and our ability to associate names and faces is impaired. So I see us an being different, but overall being neither advantaged or disadvantaged.
For my brother and son, there is no question that they are disadvantaged because of the severity of their ASD. Me and may father are very much at ease even with advanced mathematics, and I suspect that some of that is facilitated by the ASD. However, my brother has difficulty grasping even basic algebra, and my son has is just plain illiterate both in language and math. Career wise, my brother works in a mail room, and my son spends his days at a sheltered workshop. For them, pronounced ASD is a very limiting and (especially in the case of my son) debilitating condition.
So my reading of AS"D" is that a little can be helpful in some respects but sooner or later you hit a point of diminishing returns, and after that ASD quickly turns into the "devestating disorder" that most autism researchers consider it to be.
Overall, I call on researchers to be open-minded, and be aware that the conditions listed in the DSM IV are not diseases but instead are symdromes which in most cases have multiple possible causes. What unifies a DSM "diagnosis" is the region or regions of the brain which are being affected. However, effective treatment means identifying the causative factors. Also, as Dr. Mottron makes clean, appropriate treatement may mean acknowledging that mild AS"D" may be somewhat advantageous, meaning the for my brother and son the issue may be one of limiting the effects of this condition as opposed to elimintaing them.
I also strongly endorse Dr. Mottron's call for people to take advantage of the differences in learning styles created by AS"D" in the classroom. In some cases, this is a very useful condition, and we should be taking advantage of that.
Overall, I very much thank Dr. Mottron for this very thoughtful article.
Laurent Mottron
Pr Fedoroff, please refer to specific data when hypothesizing that there is a propension for autistics to commit more crimes. This is not confirmed by by clinical experience of more than a thousand of asessments of autistics I did, and the only studies i know testing this idea at a large scale (and not with individual cases reported, susceptible of a report bias) do not go in this direction
Laurent Mottron
to Edward Schaefer I think you confound in your comment, if you authorize me to say so, adaptation and intelligence. The disability aspect is not contested, but it does not cover the entire range of abilities. Even non verbal autistics present with some spared or superior cognitive abilities in a subtantial number of cases, despite having obvious adaptive issues in a larger extent that verbal individuals (and even my later statment should be modulated by the fact that having acess to language for autistics is not always beneficial). So employers could use this working power, in the same way that they do for motor disabilities, which despite their adaptive difficulties, represent a working force. I simply advocate for the fact that autism should be measured and treated as other disabilities, rather that represent an exception among disabilities in terms of social status. In the case of your son, there is always the issue of is it an actual intellectual disability, or a ''false'' one, resulting from an absence of speech? And in the latter case, was he provided the amount of information he was interested in, and does his current work involve this interest? My regret is that the amount of working force that autistic are believed to possess is always measured using a non-autistic measure, rather than for its own value.
Laurent Mottron
to Andromeda Luxenburg
You are right, some ASD people do not have visuospatial strengths, broadly overlaping the clinically defined Asperger subgroup, who display rather language-based strengths. In our group, we strictly separate ASD people with and without speech delay for our experiments. This way of operationalize the autism vs Asperger distinction seems to overlap at 90 % with having or not visuo-spatial and auditory perceptual peaks (see eg Bonnel et al, 2010, neuropsychologia)
Jasper van Haasteren
Having read this article I really feel the need to comment on it and also share my personal views.
A short overview of myself: Asperger, member of Mensa, 30 years of age, bachelor?s degree in neurobiology, a research subject in the autism research for more than 10 years, and a student of the human condition since the age of three.
In the article Mottron states some views that are of course so obvious that it is a shame most of your colleagues in science and psychiatry don't share these views. However, these views are only the beginning. They can be expanded to get a view that applies equally to autistics and non-autistics, or actually, to pretty much every individual.
I think I'll take the term normocentrism as a starting point. An interesting idea to give this a name, but this term clouds the readers from what for me is the underlying issue. The underlying issue in my view is that every individual has the tendency to experience his/her own way of feeling, seeing, hearing, and experiencing the world as being valid. This makes it a small step to view one?s own experience of life as the only one, or as the majority one. This also makes it hard to understand other ways to experience life, other ways of thinking, feeling, dealing with situations, etc. etc. If we were to start from the term normocentrism, Mottron uses this to differentiate between autistic and non-autistic people. If the term is truly intended to only point at this distinction, it should be neurotypical centrism. Make the term fit the limited distinction between autistic and neurotypical people.
And here is why I say so. Within Mensa I have a few friends who are also autistic. We have our own set of nonverbal communications, our own set of social "rules" and we have even tested them in a wider context. The most interesting observations happened when there was a large group of autistic people with only a couple of neurotypical people. In this setting the autistic way of communicating was used by almost everyone, and those who did not "speak" our social interaction were left out. This of course meant the most hardcore neurotypical people. They were unable to join conversations, they were unable to get any contact whatsoever, and in the end some of them just left the conference. If we apply the term normocentrism, in this setting it would mean that the autistic way of communicating was the norm and those who have not mastered the autistic way of interacting were socially inapt. I have also been to several meetings for aspergers, in that setting it is easy for all of us to join conversations, to engage in social contact, etc. etc. because we all speak the same social language.
It is merely that the neurotypical population far outnumbers the autistic population which causes the neurotypical ways of social conduct prevails. It is this outnumbering that is the root cause for every problem that is experienced by people that fall outside the ways of doing and being of the majority. Be it autistic, be it extremely intelligent, be it a more complex worldview, be it left handiness, be it sexual orientation, it doesn't matter how an individual differs. To differ means there's a gap both sides have to overcome.
To apply this on the individual level: Every person has a certain way of interacting with others that is natural for that individual. Also each person has a certain range with whom she/he can interact. Of course the range varies from person to person. But if the natural ways of communicating between two people are far enough apart, having a huge range can still mean the two of them have trouble communicating, or are even unable to communicate. Both will interpret the reactions and behavior of the other in ways that is comprehensible to themselves. And this is by definition limited, and does not always include the way the one giving the reaction will interpret it. If the natural way of being between individuals differs only slightly, communication is much more fluent. This is so simple and obvious that hardly anyone seems to realize this to be at the root of communication between people. Communication difficulties as well as success depend on the differences between the natural ways and the range both can reach. Just to make the most obvious point so far: if the group is autistic, the differences are small, and thus even a small range is more than sufficient. The same goes if the group is neurotypical, or extremely intelligent, intuitive, non-verbal or any way of being that anyone can think of.
The mistake made by the majority is that they impose their way of communicating upon others. Their values, their ideals, their ways of communication, everything gets imposed upon the minority. And those who do not fit the profile set by the majority get labeled as being defective. And from the viewpoint that to differ is to be defective, this is correct. Viewed from science to differ means just that, to differ. But since the neurotypical way of being has the tendency to give emotional value to everything, the neurotypical way of being has difficulties using objective language and thought. And thus it sees defects. And defects usually require a fix. It is the view of me and my fellow Aspergers that this is a shortcoming in the neurotypical way of being. Some Aspergers view this shortcoming with the same judgmental normocentrism that many of neurotypical people view the autistic way of being.
Another basic flaw in how autism is being described and tested has to do with the concept of empathy. This concept is viewed from the perspective of the neurotypical way of being, with all of its neurotypical centric applications. When we let go of neurotypical centric and any other kind of centric view the result would be the following: The range of being an individual can communicate with also entails a range of being with which this individual can empathize with. This range is usually limited to what the individual trying to understand how another might feel, would feel himself in the situation the other is in. This of course has the basic flaw that the variation of ways to experience a situation is much larger than the range of feelings any single individual will experience within that situation. The solution is to try to understand the way the other individual?s way of being works, and to do this in the terms the other uses, letting go of all your own experiences for that situation. For the neurotypical way of being this is almost impossible. The neurotypical way of being starts out with how it itself would feel in any situation and then ascribe those feelings to others. This works for all other neurotypical individuals and this is a successful strategy in those situations. However, this strategy utterly fails when trying to empathize with someone outside the neurotypical range, for example an autistic person. For most autistic individuals, their range does not include the neurotypical way of experiencing life. And since the autistic way is a minority, autistic people have to work very hard on increasing their range to reach the neurotypical way of experiencing life. On the other hand, neurotypical centrism states that it is perfectly healthy that the range of neurotypical individuals does not include the autistic way of experiencing life. For autistic people, the capability to process large amounts of raw data is a solution most high intelligent autistic people adopt. They collect an almost insane amount of data on the neurotypical way of being and after a decade or two of study they can enter some simple neurotypical social settings. After this long study, the range of people who have traveled this path is much larger, even though it might still not include the neurotypical way of being. The interesting thing is that neurotypical centrism keeps saying that autistic individuals can?t empathize with people very well. While the neurotypical scientists only mean that the neurotypical way of being is not within the range of the autistic people who are tested.
Another thought: I believe the reason why autism is viewed in such negative terms has a historical reason. It was first described from the perspective of psychiatry instead of the perspective of psychology. Psychiatry feels it needs to fix while psychology is mainly interested in the fact that humans differ from each other. In a way, psychiatry is much more normocentric than psychology is.
I think this covers what I wanted to say for now, I am quite interested in any response.
Jasper.
Laurent Mottron
to Peter Gibson There are numerous sets of data which do not fit with your model, at least as expressed here. For exemple, most ERP studies involving auditory information (Like Gomot and Ceponiene's papers) show that the ERP latency to auditory information is faster in autistics. In the visual modality, Chawarka's recent Archives paper show that visual disengagement from faces are faster in autistics. So you cannot generalize to non social information the idea of a slower processing, and even for non social material, you have some big rocks in the way of such a straight forward model!
Jonathan Jones
Upon finding this article, I sent the following message to Dr Mottron:
Changing perception?s: The power of autism (Might I be autistic?)
I am a 33 year old male that presents symptoms of ADD, chronic depression, chronic sinus and GI ailments [I mentioned these ailments because some of my poking about around the subject suggests that autists often have a particular sensitivity to nutritional defficiencies – though I have not found much information about this], along with a myriad of behaviours commonly associated with autism [but hidden from public view to the best of my ability].
I am often perceived as being normal despite a deeply felt sense that most of my social responses are based on mimicry. One of the few indicators of autism that I lack is the common difficulty with interpersonal communication (disregarding a friend's pithy "That's what you think!" this morning). I am quite literal, but adept at deciphering when a conversation's participants are not effectively understanding one another, and can often intervene to assist in communication between seperate parties. I am not quite so adept at doing so in my own conversations.
Does my ability to navigate social interaction with some skill preclude a possible diagnosis of autism? If not... would you kindly offer a suggestion on what next step I should take to pursue a definitive answer to this inquiry?
Thank you for your time.
--------------------
This inquiry feels emberassing and clumsy in retrospect, especially in light of some of the truly noteworthy comments avove, but as the doctor was kind enough to reply and request that I post it here, I have done so.
roberto melgar jimeno
which kind of text, do you mean?
James Hillard
It is not at all clear to me what diagnostic criteria the authors are using. From the limited data provided, it seems extremely unlikely that the author meets DSM-IV criteria for autism. Perhaps he is a person with Asperger's Disorder, but not even that is clear from the data provided. The fact that these individuals who have self identified as being "autistic" trivializes the suffering of patients and their families who are actually dealing with the
Peter Gray
I am a family physician in Belleville, ON and I read the paper with interest. I have an autistic son and probably have mild autistic / Aspergers tendencies myself, although it hasn't stopped me from qualifying as a family physician and raising a family, so I have a more than passing interest in the subject.
I have spent some time thinking about the question "what are autistic people for?" and I've come up with a theory which didn't appear in the article but I'd be interested to hear people's comments. Most "normal" people have a desire to fit in with the society in which they live. However, one of the hallmarks of autism is social dysfunction. This is usually a disadvantage, but could be an advantage in a socially dysfunctional society, where the autistic person may feel less peer pressure to follow dysfunctional social norms, and thus act in a more "normal" way. So, for example, an autistic person living in the Enlightenment era might be less likely to support the Spanish Inquisition's earth-centric theory of the universe, and an autistic person living in Nazi Germany might be less likely to believe in Hitler's "master race" theory. So maybe they are one of Nature's ways of ensuring societal progress.
Geke Schrijver
to Jasper van Haasteren. This comment does not directly have so much to do with the article. But I read that you have been to asperger meetings. I am interested in that because I have been diagnosed with Asperger-syndrome myself. Your name sounds very Dutch, were the meetings you attended in Holland? If so, could you tell me please where you attended them and how I could attend a meeting myself? Thanks in advance. I would very much like to meet other Aspergers.
Silvia Baetti
Dear Dr: Im pleased to read your article, Im a medical doctor in Argentina. I coordinate the autism treatments in" Hospital Italiano de Buenos Aires". I have the same experience as you with my little autistic patients and our educational sistem is not preapared to give them what they really need. I suffer with their pearents because we cant give them the opportunities they deserve to be happy. Im convinced that they have a different brain and this is my speech in the hospital, and this, causes me a lot of trouble with my collegues. This is the reason why Im so pleased and grateful to you. I can refered them to your article as you are an important researcher..THANK YOU!!!! I ask you for permission to translate it into spanish to make the reading easier to not english speakers. Ill be waiting for your answer. Congratulatinos for your work!!!! Dra. Silvia Baetti. www.adluminare.org.arwww.silviabaetti.com.ar
Jasper van Haasteren
To Geke: (Dutch mode) Ja ik ben inderdaad een Nederlander. De gevraagde info gaat wel erg off-topic, mail me maar op " mijnsp4m at gmail dot com" . Dan mail ik je wel terug vanaf mijn eigen adres.
Elliott de Launay
Very insightful, I look forward to future developments regarding learning and developmental strategies.
?Everyone is a genius. But if you judge a fish on its ability to climb a tree, it will live its whole life believing that it is stupid.? ?	 A. Einstein
Robin Schaaf
Laurent, thanks for the insightful and much-needed article. I really feel we need to rethink "curing" autism and work more on awareness and acceptance. I am a mother of 5 year old child with high functioning autism. From talking to other moms, it seems that higher functioning children who are mainstreamed and are open with classmates about autism (and the differences in brain structure) don't have as much trouble fitting in. Other children can be very accommodating and understanding of differences. But we need more awareness that autism is a "difference" and not necessarily a "disability".
"ASD characteristics" run in my family (mostly through the male lines but now me and my sister). We've all had successful careers in the sciences / technology. So I share a similar perspective of ASD – after my son was diagnosed I was probably the only mom who didn't cry!
My son is very smart – not savant – but I pay attention to the differences and advantages that he has over other children. He's amazing visually – he puts puzzles together without referring to the picture – and in very little time. He builds incredibly intricate buildings, he has beautiful attention to colors when painting. I started him at 14 months into therapy to help him along with language, motor skills, sensory issues and developing play skills, although no behavioral therapy. The therapy is amazing – he's in full days mainstream schooling – and has friends. (although I shouldn't get started on how difficult it was to get the diagnosis – again a need for awareness!)
Anyway – with his amazingly detailed visual perception I think someday he might be an exceptionally talented architect – just like his great-grandfather!
Mary Smith
I could wax eloquent on this topic, but I will stay with simple terms instead. I have been wondering when someone would point out Autistic capabilities of this nature. Temple Grandin told the world about thinking in pictures, and then society thought this summed it all up, along with the better-known savant qualities that come along every so often. Not so.
I have Asperger Syndrome, formally diagnosed. I was once a hyperlexic 3 yr. old in love with letters and numbers. I was voraciously hungry for information. I tested off the charts in elementary school IQ tests. I went on to earn a graduate degree. Along the way, I learned that I have several uncommon skills. I see patterns in all of that infromation, continually, where other people do not. It leaps out at me. And, I can pick out discrepancies at ten paces. Discrepancies are a breach in logic, and I find this jarring. No one else seems to notice such breaches. I am astonished that they do not. Once I pick out all that information, I connect it with any and all other information I carry mentally, rather like a connect-the-dot game. And memory is like a third hand to me. I use it with aplomb. Further, I learn by reading....seeing information in print. If I hear a lecture, or anything else, given verbally, I am likely to have gaps in my understanding. Give me high-quality printed information on my topics of interest (and I have hundreds of them), allowing me to focus, and I am in heaven.
So what can I do with these skills? I am a researcher by profession. I can find and retain and analyze great bodies of information. I do this exceedingly well. And in fact, in my personal life, I worked for many years to untangle the family genetic disorder that conferred the Autism. It is very rare, and all but unknown. I worked my pattern-finding and connecting magic so that my family now has answers which eluded docotrs for over fifty years. But you know what? Doctors are very unhappy about this state of affairs.....a medical layperson has beat them at their own game, and I have been very rudely "put in my place". It was not the answers per se that they were after; it was the opportunity to remain on their pedestals. I found that shocking. I can make the right connections, and I don't play the power games -- they don't know what to make of someone like me.
At any rate, though I have my Asperger Syndrome struggles, when it comes to pattern recognition and making connections and noting logical gaps, there are few who can outshine me. It comes in very handy in analytical work of any nature. However, I cringe to think of the long history of low-level jobs I went through, even with my excellent formal education, until I was given a real opportunity. I worked under managers who were barely literate, but knew how to shmooze. Life, of course, is rarely fair.
From my perspective, Autism Spectrum Disorders can have both great advantages, as well as strong disabilities. I would not claim either one side or the other as the whole truth.
Tirtza Toren Gal
Fascinating article! It's a pretty difficult task to raise a child, but it's a lot harder and more challenging to raise children with special needs. Daily activities are more challenging, but can be inspiring, too. Research shows that children with autism, dyslexia, ADD etc. can remember and memorize pictures more easily than text. Pictures are their first loves. Almost 80% of kids have some special talent that supersedes educational talents.
Having a child is a blessing, no matter what the circumstances are! I believe that there is a blessing in every situation, if we take the time to look for it.
Laura Martin
I found this article extremely refreshing with a positive consideration of autistic traits and the valuable contribution that autistic people can make to society. Your colleague Michelle Dawson is a fine example of someone who has been given the opportunity to show her value and to find her rightful place in this world. I hope that this article will contribute to a change in the societal perception of autism and that more people on the autistic spectrum will be valued as they deserve to be.
Edward Schaefer
Dr. Mottron – You make some interesting points in your response to me. Even so, I do not think that I am confounding adaptation and intelligence. You are correct about my son's intelligence. He definitely has just as much raw brain power as anyone else in the family, including his younger sister who is now a junior in college and double-majoring in math and computer science. However, he is very much unable to use it in certain essential ways. Therein lies the source of the disability.
Perhaps the central issue if whether autism = pathology. In terms of combating that, you are on the right track. It is indeed ironic this in some respects autism is adaptive in the modern world. However, you can still have too much of a good thing, and that is the issue for my brother and my son.
Beyond that, I truly applaud your work. Some of what has gome wrong for my son is our not knowing how to reach him and show him how to operate with and through his condition. In his childhood, that may have made a huge difference. Then again, in my family there is a love of learning that extends throughout our lives. So my son may yet be reachable if only we can figure out how and what to teach and/or show him.
Laurent Mottron
To Mary Smith. Hyperlexia, or the various abilities which demonstrate a superior ability to detect a similarity between two isomorphic structures, even only imperfectly matched (like verbal and written code) seems me rich of educational possibilities. There is probably a difference between autistic hyperlexia, associated with speech delay, and Asperger hyperlexia where this not the case, but in both sides it indicates that the written code, and through it pattern perception, has a special importance in autism. In the Montréal Group, we attempted at modeling this ability (shared with other savant capacities) as veridical mapping (Mottron, L., Soulières, I., Dawson, M. Enhanced perception in savant syndrome: patterns, structure and creativity (2009). Proc Trans Royal Soc London, biological sciences B, 364 (1522) 1385-1391 ). We are now piloting ways to use this in early education, and replace techniques and theories which are mouse-based, obsolete, normocentric like ABA.
Laurent Mottron
To Jonathan Jones Considering the public nature of this forum, I can just try to answer on a general basis. In my clinical practice I see now and then people corresponding to this description. To summarize, these are people with an early, intimate profound feeling of difference, which arrive to the clinic with a previous diagnosis of axis 2 personality disorders like schizoid, narcissic or avoidant personality, and/or ADHD. They describe a voluntary, deliberated and old history of mimicry (sometime in front of the mirror) of typical social strategies. The absence of apparent benefit (of the material type), as well as the apparent sincerity and earliness of these behaviours suggest and sub threshold Asperger, despite an absence of adaptation problem, and an invisibility of the difference from outside. As there is neither a gold standard for these types of diagnoses, nor reliable biological markers, these diagnoses (or discarding them, possibly erroneously) relies entirely on clinical expertise. And DSM 5 will probably kick them out of the spectrum. So this is a difficult issue. I usually rely on my judgment on how similar (and not text-book like) are these introspective description with that of prototypical Asperger people, in order to detect and discard self proclaimed autistics....
alan spector
I am impressed both with your research and Michele's abilities but more impressed with your sense of empathy and humanity without which she would remain an alien force. It was your recognition and sensitivity that rescued her from the prevailing prejudiced, dominate outlook. Perceiving autism merely as a disability rather than as a potential real mental asset skews the debate away from truly understanding and helping the autistic to the perspective of finding weaknesses. My son is 16 and autistic. At the time of his birth little was know and understood about his condition so I had to rely on my own observations and experiences. I had come to your same conclusions many years ago and have been militating many times against the prevailing shortsightedness of doctors and care providers who merely perceive his condition as a liability. Unfortunately day- to-day practical concerns often override whatever small injustices he may suffer in order to survive. He neither speaks nor cleans himself, so as you've pointed out, he performs badly on conventional IQ tests. Yet his visual and auditory abilities, I can attest, are above what I understand as being normal. He has a real inner life that must be respected and accounted for. Often Dr. Mottron's intuitive, probing sensitivity is lacking in some highly trained specialists who should be more open. My main problem and concern though, is not taking care of him per say but rather making sure his care with others is both humane and positive in terms of his abilities. The school he currently attends is more concerned with order, proscribed behavior and strong. pacifying medications than with adaptive education. I fear lack of insight and understanding might cause my son undue suffering and missed learning opportunities. Your understanding, research and humanity will go a long way in educating everyone to the notion that autistics' are valuable, with a heart and minds that need to be understood and respected not as a side show but as struggling, full fledged contributing members of society. Alan Spector
JEAN MICHEL ANTOINE
Dear Laurent, > > I really enjoyed reading your comment in Nature nov 3rd. I love looking > the other way round ! > > I was wondering whether some autistic scientists have considered > anatomo-pathology as an area where their skills will be more than > appreciated: > It is a non-verbal science, it is about picking some specific structure > among a lot of details, it is about remembering figures, images, and it is > about making a diagnostic from facts. > > Do you know if there are already some autistic anatomo-pathologists, or > how can we suggest anatomo-pathologists to be interested in autistic > students for future jobs. > > I have no interest in the field, but my wife is practicing > anatomo-pathology in a french hospital.
Mini K.T.
Dear Sir I am from India. My daughter is 10 years old, and is autistic. I read your article with great interest and hope. My daughter is really good in English, even writes short poems very well and has good vocabulary. She even writes in her mother tongue, even though we never taught her to do so. She can do mathematical calculations such as percentage, time, basic geometry and trigonometry without teaching. But she cannot control her behaviour and emotions. This is the biggest challenge in front of us. The schools here do not give much importance to formal education for autistic children. I wish you would give us guidance in the future because we are in a dilemma on what to do. I greatly anticipate a reply from you. Thanking you Mini.K.T.
Luisa Di Biagio
Good evening Professor. I read with great interest your article "The strength of Autism" (the title in Italian). I am writing to thank you. I am an autistic person. I have a lot of difficulties. I am not be recognized as a person but as sick. In half of the world would grant me a visa, even in Canada, I had a proposal for collaboration with a fellow psychologist, but I can not live in Canada, or USA, or Australia or New Zealand. Thank you for your words.
I enclose an article I wrote, is the only one of which I have an English translation. I hope you like it.
Dr. Luisa Di Biagio
Thomas Owren
A question to Jasper van Haasteren (and perhaps others reading this):
I am a norwegian neurotypical master's student of community work. I'm doing my master's thesis on the theme of neurotypical ("normal") social and communication habits viewed through the lens of autistic experience – especially focusing on which aspects of such habits that may be understood as disabling barriers for autistic citizens. My starting point is autism/asperger viewed as a difference (not deficit), the neurodiversity movement, and a social justice majority/minority perspective. This made me take notice of your comment of 2011-11-08 07:22 on this page, especially your eloquently stated observations on the subject on empathy.
My question: May I include your comment as part of my data collection? I cannot promise that I'll cite you directly in my thesis. But in case I do, I need to know how you would like to be cited, or whether you wish to remain anonymous. You may of course withdraw your permission at any time. My email address is thomas@steinkjelleren.no
* and there I also issue a general invitation to persons who consider themselves autistic and have written blogs, comments to blogs or comments in open internet forums that touch on my theme, to send me an email describing what they've written, where I can find it, and if I may use the content in my masters? thesis.
Laurent Mottron
As long as one publish something, it falls in the public domain. So I am not in the position to limit in any extent what you do with this paper or with the messages posted on this forum., I would just suggest you consult autistic people, the most than you can. Even if I dedicate my research life to bring back autistic in th communauty, I remain a non autistic person, with the risk of representing only myself
Diane Whiteley
A friend forwarded your article to me and I was so pleased to receive it. I have never thought of my son's autism as a disability but only as a 'difability'. He has high intelligence, he is extremely good a sport and is a great and wise philosopher. He is 14 years old. I always get a feeling of great sorrow when I read that parents are 'devestated' by a diagnosis of autism. I know that some cases are compounded by physical difficulties but as far as social integration is concerned I think that most people can experience difficulties in this area. I know that my son will be able to use his abilities to achieve whatever he wants to in life. He has high self esteem, is active and sporty, fit and healthy, well nourished and, most importantly, loved and supported. My son has participated in many research projects and I have found that they are limited in their scope. Also, the education system tries to bang square pegs into round holes, although it is slowly changing. I support my son to be who he is and help him to understand why society is the way it is and how to use it to get where he wants to go. Thank you for your article. I will print it out and show his teachers. Diane
Laurent Mottron
This post was submitted by: Janet Chippindale <jntchipp@aol.com>
Dear Laurent Mottron,
Re: Changing perceptions: The power of autism 10.1038/479033a
I have a 21 year old daughter, Helen, who was diagnosed as having Asperger's Syndrome earlier this year. Her boyfriend , David is also AS but not formally diagnosed. Helen has just returned to university to start a maths degree. She dropped out half way through a degree course in Plant Science because of depression due to complete social isolation and stress about doing the dissertation. David has a first class honours degree in History. he has been unemployed since (18 months). I have now read fairly widely about AS and see it everywhere. All those poor peculiar people one meets through life and thoughtlessly got irritated by and cross with. Helen and David are both bright and capable. They have enormous powers of concentration and when engaged, will carry on tirelessly for hours. They are good-natured and kind. Helen has never criticised any-one, she says nothing rather than something nasty. They get on like a house on fire with each other but have social difficulty with normals. Their small group of friends are also along the spectrum and ,again, are at ease with each other. I worry for them. There seems to be no agency to help employ adult ASs. There is huge amount of help and interest for children and adolescents. When we saw a psychiatrist for Helly's depression she admitted she knew nothing about Asperger's and suddenly wondered about what happens to all the children diagnosed when they become adults. The answer is that they sink to the lowest jobs, get made miserable by bullying , change jobs frequently and finally languish amongst the unemployed. Quiet and unassuming they disappear from sight. I really , really, really don't want this fate for Helly and David, but I think it is inevitable. They are simple souls and have a much greater capacity for happiness than competetive, grasping, judgemental normals. They only need someone to see their potential and offer a degree of protection and they will be very happy. What can I do? Janet Chippindale
mirjana golusin
I have found you e-mail address on your article "The power of autism", posted me by my friend, prof Lior, University of Pennsylvania. I do not know how he have found your article...
My name is Mirjana Golusin (43), I have an autistic boy (15).
Everything what you wrote in your article is right. You are a psychiatrists (scientist, as I am), and you know a lot about autism. I am just a mother who straggles to create the better future for her son. I want he to be independent and happy as possible.
Picture of you and your autistic assistant reminds me on my son in details. Position of assistant`s arms is the same!
When he was 2 years old, doctors told me – there is no chances for him ever to be anything than an object. After so many years of teaching and training, when he was 8, he was able even to visit a dentist and to be quiet during dental intervention... When he was 5 he first time look at me and told me Mummy, he felt fear, shame, all spectre of emotions, now he is very sensitive boy. He always likes physical contact, furthermore, he demands it. He understands when he needs to wait, he can be alone, he is totally independent regarding hygiene and basic home skills since he was 2 years old.
He was exposed to various social situation, he travels with us (he has a brother), he visits every public places, restaurants, he swims, ski, makes big puzzles when he was 2, likes nice music, he is visually excellent, he developed significant language skills, he likes horses, he rides. He also developed a significant social skills, but his professional life concerns me a lot. I know he has abilities, but I have no instruments and I am not familiar with modern techniques how to assess them. I want to find out what he knows and, according to that, what kind of future is best for him. I pass a long and hard journey with him so far and I will never give up. I know he is right now in stage of doing nothing, and that is something what you underlined as bad in your article. I know he is able to do something, but I do not know what?
Regardless all historical problems, here in Serbia we have a proper schools, and god staff, but we have no possibilities to find out more than what is going on at the surface. Our scientists study only autistic deficits, not positive sides. I do not like that. Science needs to offer a solutions, not just a review of problems. Now I have only list with problems described. My son deserves more.
I would like to know what is in his head? Is that possible?
L L
While I agree with you that autism can be an advantage and, I believe, will be an advantage for my kids, I am deeply disturbed by your statement that "despite these caveats, Dawson and other autistic individuals have convinced me that, in many instances, people with autism need opportunities and support more than they need treatment".
Why does it have to be "either or"? Why can't they have opportunities support AND treatment?
My children are succeeding because, in addition to opportunities and support, they are getting a lot of treatment that is helping them communicate with others, establish relationships, learn to share their gifts and overcome their challenges. My formerly non-verbal younger son is now ahead of his peers in speech and the more engaged he becomes with others, the more he interacts with his very verbal brother, the bigger the advances he makes in his verbal communication. His older brother, who has always been very gifted verbally, still can't eat solid food but is slowly learning to smell, touch, lick, and bite food without gagging and throwing up. He is a good reader and writer with very original imagination but he is on a special liquid diet and not completely toilet trained. Before we did intesive ABA with my older son his frequent meltdowns did not let him enjoy his time at school and learn to his potential, his teachers let him do whatever he wanted, so he won't be disruptive to the rest of the class. Now he is in a mainstream classroom and has a great rapport with his teacher who enjoys his quirky sense of humor and wild imagination. He still has meltdowns but they are not as frequent and he can calm himself down much more quickly so that he can "tune back in" much faster to what's going on in the class and get back to his work.
Would you in your lab employ autistic people who are not toilet trained, who throw up at the smell and sight of food, who throw loud tantrums if something is not up to their exacting standards? Would you be able to work with them even if they had superior IQ? Would you employ a non-verbal individual?
Many of your arguments against treatment are the same as the ones given by our insurance company against paying for treatments for my sons: "we need the same level of evidence as drug trials", "too expensive", "not proven". But do all behavioral treatments (not only those for autism) go through the same type of clinical trials as pharmaceuticals? What about OT and speech therapy? And what is more expensive--early intensive intervention or lifetime on disability? I know that in the case of my children early intervention has played a significant role in their progress. I wonder how much early intensive treatment the autistic people working in your lab received. Since they are adults, they might not have had much in the way of treatment 15+ years ago. What would have happened if they would have received that treament? Maybe your collaborator Dawson would have been a scientist with a research lab and a Chair of her own?
One of the advantages of autism that you cite is that autistic people "tend not to get bogged down by the career politics that can sidetrack even the best scientists. They prefer not to seek popularity, promotions or vast numbers of papers; they may post their best ideas on the web rather than publish them". Maybe some neurotypical scientists won't take advantage of their autistic peers but there seems to be a lot of potential for abuse. I notice that you state that your collaborator Dawson deserves a PhD. Is she on the track of getting it? Are you helping her get it? Will she be able to advance in her field without it?
I am disturbed about the way you write about your collaborator. You praise her for her work and for her abilities, she is useful to you in your work. But what do you know about her life outside work? Does she have family and friends? As a parent, I want my children to have work that they enjoy and are passionate about. But I also want them to have families and friends of their own, somebody that they love and who love them, to be more than just useful tools or pet projects in a research lab. And yes, I want them to have careers and promotions and recognition for their work that they deserve.
Have you ever considered adopting an autistic child?
clarice Kloezeman Thornton
Dear Laurent Mottron,
Re: Changing perceptions: The power of autism 10.1038/479033a
I also read with great interest your article on the power of autism. I have a 20 year old daughter with Aspergers. She is, for her age and education, absolutely brilliant in the areas of science such as evolutionary biology, animal behaviour and genetics. She did graduate from high school, but her Aspergers has interfered with her post secondary dreams. Actually, she has dreamt of being a scientist from early childhood. It would be an ideal fit but for one thing – she has extreme difficulty with math and only made it through grade 10 math after 3 attempts. Her difficulty isn't so much with the math as it is with the context – unless she can make the math real and related to her interests, it has no meaning. Sadly, we are unable to find anyone who can teach math this way.In January my daughter will be attending a
program at a college that helps young adults with any kind of mental illness/disability learn the social and life skills necessary for independently navigating a post secondary education. She needs this, but it will not help her to succeed within the field of her passion.Michelle Dawson was incredibly lucky to have found you. I
would like my daughter to be able to find someone she could be mentored by. How can we manufacture the kind of connection you have with Ms. Dawson?
Laurent Mottron
Now, some answers to the bitter post of LL. I try to help families distinguishing opportunistic and eclectic support, which I would consider as helpful, but modest in their ambition, and recognising that autism is here to stay ?from treatments, who pretend to modify the course of the condition, (make autistics indistinguishable from their peers). There are no data showing that early intervention result in the changes these methods pretend to obtain. I agree that this is also the case of speech therapy. But what seems me to justify more the later that the former is that their cost, demands, and level of pressure is without comparison with ABA, that the later adapt to the child need and current state, and that their purpose are not normalisation but communication, whatever vehicle is successful. And no, we would not employ autistic people who are not toilet trained, who throw up at the smell and sight of food, who throw loud tantrums if something is not up to their exacting standards?; but I am just not convinced that behavioural methods, as they stands, are the efficient ingredients within rehabilitation package that are actually responsible for improvement at this level. When you say I know that in the case of my children early intervention has played a significant role in their progress how can you, just by the power of your own judgment and own beliefs, be sure you can avoid the replicated over-estimation of treatment effects by people personally involved in the application of these treatments? Last, I did not consider adopting an autistic child. Regarding the intimate frontier between selfishness and altruism that anyone has to draw in his own life, I decided to dedicate my professional time and energy to autistics, while I adopted a typically developing child. There is no ethical justification for that. And I wonder from which ethical framework you could authorise yourself to have a scornful judgment on this aspect of my personal life.
Stephan Lloyd Watkins
I have Aspergers syndrome, but was diagnosed with attention deficit initially. I have seen this a couple times, and even seen aspergers children made to take ritalin in the 1980's. Basically, the visual aspects are what stand out for my self, although patterns and other aspects here and there also seem like common themes. Lifelong I have been trying to be a scientist. By this, I mean at age 6 my physicist grandfather introduced me to science, and I decided then to become a scientist, as I was obsessed with chemistry, biology and physics. Mostly I focused on Biochemistry, and settled on structural biology when introduced to it in the 1990's. My main problems are inter-personal.
For instance;Ideally, autistic individuals would have mediators who could help settle situations that trigger anxiety in them. Typically anything unscheduled or hostile, such as changes to an existing plan, computer problems or things being out of order, when there already organized chaotically. As I entered University life, I have found people akin to this knowledge will sit back and drive you insane using such things. I dont know why it is always funny to make fun of a small behavioral quirk, but this is what people do from hgih school all the way to the top. University life being as competitive as it has become now for many reasons, this tends to go on extensivly. Usually it's mundane, such as killing a single enzyme or replacing some solution with water, which ends up making you spend weeks going insane, diagnosing things and causing a stress I can not explain. It kinda makes you want to start smashing windows or just breaking things, but initially leaves you feeling unable to concentrate, followed by the "freak out feelings". It has some pain aspect to it, but it is more of a mental pain. I have hung out with autistic children in my past, and can see something much more heightened than I feel. In the end, after 20 minutes or the feeling disipates, it usually is such a remedial or mundane thing you end up feeling stupid. This in itself is only a normal side effect of things such as this, and one can easily cope with the later feeling. This being said, and people knowing you can be made to snap (in appearance to anyone else) easy use it as a tactic, especially in situations such as academia in which this can lead to further problems as it is a connection based system of operations. Without the proper set of contacts, no one advances in science.
In any case, I have finished 2 bachelors, one in biology and one in Chinese History, as I have a half Chinese daughter from High school I wanted to educate her about her ancestors history. I also have a masters degree in Molecular biology from the University of Bern, Switzerland and am now attempting for the 3rd time a PhD. My first attempt was in the Netherlands, the second and current here in Switzerland. The 2nd one was stopped before it started as funding was canceled. I wrote however, as your article struck a nerve. It is nice to see such a thought as integration, or more appropriate integration of different personality and neurological behavioral types into social settings of benefit to humanity. I often feel the only people utilizing Autistic and Aspergers folks are intelligence agents, or governments or other parasitic organizations. Usually these are one sided, ie an idea generator sends off 3 agents with fresh, novel Nobel prize ideas to infiltrate some place over seas. In turn, the idea generators usually end up at a gas station, homeless, or dead. Im almost 38 now, and still a student, but I try. I now realize any academic career is gone, but fashion ideas about collaborative work from home, considering computational advancements, and the cheapness of equipment these days. Which brings up another point, about the man you mentioned whom can memorize areal landscapes. It is something I grew up with, and thought was normal, ie universal to everyone before I graduated High school. Basically, I was in some sort of bubble land, and spent most of my time in some abstract visualization or analysis of media which helped me to cope with society at large. By normal I mean being able to replay your memories like a video tape. This, and detailed image recall. I found if you mention to people you can do such things, especially in academia, they tend to all the sudden decide you are arrogant. This, and you tend to get "chumped" much more in the scientific community, or the community in general. This is a downside of things, the "idiot geniuses", or someone whom can do quantum physics but gets suckered into buying something they didnt even want. In any case, I'm glad you are making an attempt to change the ideologies involved with such things. I feel people have a number of different gifts, and utilizing the good while making sure the bad aspects of our nature and neurological programming are kept from hindering things will help advance things much more quickly. There's a good resource out there in the form of people which should not be wasted, kept from the limelight or used in ways which prevent a persons freedom and individuality from being exerted.
Thank you,Sincerely,
Stephan Lloyd Watkins
winnie dunn
Dr. Mottron, Thank you so much for writing this commentary and thanks to NATURE for publishing it! The discussion posts are so lively; clearly the time has come for this discussion.
I am an occupational therapist and researcher; I study sensory processing and its impact on everyday life. I have studied people who have autism; they talk a lot about how sensory experiences affect how they construct their own daily life routines and activities. Their intense experiences with various sensations made it easy to see relationships between sensory processing and daily life in the early years of my research.
As I have continued to study the impact of sensory processing patterns on daily life, I have come to understand that all of us have sensory patterns that affect our reactions, our daily routines, and the choices we make about work, recreation and rest (1-3). Just as you describe, it became increasingly clear to me that saying something was wrong with someone because they had a different experience was shortsighted. Some people without particular conditions also have intense sensory experiences. The important factor for living becomes having insight about our own, our family and friends?, our colleagues? sensory patterns, so we appreciate their behaviors rather than judge them.
Autistics are on the same continuum with all of us; you don?t have to have autism to be bothered by a particular kind of sock, or to be a picky eater, or to shy away from crowds because of the noise, the movement or the bumping. And you don?t have to be bothered by these things if you are autistic. When we embrace the concept that there is a continuum on most human variables, a host of additional sources of knowledge become available to us; all the people who have a particular kind of intense reaction can provide ideas for managing that particular situation. When we consider everyone, people look more alike than different; this perspective affords us many more options for solving everyday life challenges.
There is a growing body of literature illustrating different patterns of sensory processing in various conditions. But there is also a growing body of literature about neurotypicals which demonstrates there is a continuum. For example, researchers have shown that there is a relationship between sensory patterns and anxiety, pain catastrophizing, sleep and the need for routinization (4-7) in neurotypical children and adults. With our continued focus on finding the pathology, we may be missing opportunities to find the ways people are adapting to create a satisfying life based on THEIR OWN criteria.
As colleagues like you speak, you provide a stronger scaffold upon which to build a case for taking a strengths perspective. I am so grateful. In fact, don?t we all build our lives based on our interests and strengths? Don?t we all rely on our families, colleagues and friends to support us? Perhaps the question we need to be asking everyone is ?what supports and adjustments to activities and environments do you need so you can do what you want and need to do?? rather than ?what is wrong with you and how can we fix it?? The former question suggests the challenges reside in the spaces between the person and their context; the latter question suggests the challenges reside in the person. The former question invites us to consider the infinite possibilities for a satisfying life; the latter suggests there is a limited view of what a satisfying life can be.
Winnie Dunn PhD OTR FAOTA Professor and Chair Department of Occupational Therapy Education University of Kansas Medical Center
1. Dunn, W. (2001). "The sensations of everyday life: theoretical, conceptual and pragmatic considerations." American Journal of Occupational Therapy 55(6): 608-620. 	 2. Dunn, W. (2008). Living Sensationally understanding your senses. London, Jessica Kingsley Publications. 	 3. Dunn, W. (2011). Sensory Processing: Tools for Supporting Young Children in Everyday Life. Early childhood intervention: Shaping the future for children with special needs and their families, three volumes. S. Maude. Santa Barbara, CA: ABC-CLIO, Praeger Santa Barbara. 2. 	 4. Engel-Yeger, B. and W. Dunn (2011). "Exploring the relationship between affect and sensory processing patterns in adults." British Journal of Occupational Therapy 74(10): 456-464. 	 5. Engel-Yeger, B. and W. Dunn (2011). "The relationship between sensory processing difficulties and anxiety level of healthy adults." British Journal of Occupational Therapy 74(5): 210-216. 	 6. Reich, J. and J. Williams (2003). "Exploring the properties of habits and routines in daily life." Occupational Therapy Journal of Research 23(2): 48. 	 7. Shochat, T., O. Tzischinsky, et al. (2009). "Sensory hypersensitivity as a contributing facrot in the relation between sleep and behavioral disorders in normal schoolchildren." Behavioral Sleep Medicine 7(1): 53-62. 	
Sven Pattyn
Thank you, Dr. Mottron, for sharing your interesting ideas on autism and how it is and should be viewed in society, science, and clinical practice. My son (5) was recently diagnosed with autism, and, as far as I can tell, he best fits the 'active, but odd' subtype of PDD-NOS. As he strongly resembles me, I guess I might have PDD-NOS myself (although I'm more of a 'passive' type). Although we're both fairly to highly intelligent (I've almost finished my PhD in social psychology) other people often misjudge our capabilities, as we are both socially and communicatively impaired. We just don't give that good of a first impression. Even my teachers have always thought that my strengths lied in studying things by heart, while in reality, I've never studied that much (even at university), things just tend to stick once I understand them (which I often do faster and better than others). My son, then, seems to have the same qualities. He's very good with numbers and letters (making sums, reading numbers up to 999,999, already reading simple words). Just to say that I recognize what you say about the hidden strengths of some autists.
Furthermore, I share your aversion to the over-treatment of autists, just to make them 'as normal as possible'. Of course, many severely impaired autists may need help to improve social, behavioral or communicative skills, but others do not. I, for one, have always been a very happy person, both as a kid and now as happily married father of three, working at the university. I've settled in my role of the odd, non-conformist (which, I believe, can also be a strength of autists). I do not feel any pressure to pursue a career just because of the social prestige. I can just do what I really want to do (actually, I've really had it with desk work, so, once I've finished my PhD, I'm becoming a train driver). By the way, I've never had any therapy whatsoever, as I've never been diagnosed. Back to my son, then. The team that has diagnosed him immediately proposed to put him in day-care at the hospital to improve his skills or to sent him to a special education class. However, we've decided to keep him at home. We've already sent him to school for one week when he was three. He just stopped eating. He was truly miserable, it took about 9 months before he was the quirky little person again we used to know and love. Of course they very actively tried to persuade us to act differently, but we couldn't stand to lose our happy little fellow again, and we really had the impression they wanted to change completely who he is. We just want to let him be himself and let him accept himself as he is. As school is no option, we're going to homeschool him (successfully this far, as he's cognitively already far ahead on his peers), as only at home he can truly be himself. For socialization, we (will) stimulate him in doing social hobbies (if needed, we'll accompany him) and he has a brother and sister with which he gets along very well (except for the characteristic outbursts now and then). Up-to-now, he's still making progress socially and communicatively, especially when interacting with adults (other children are still a big problem). However, if we ever find his skills to stop developing or even regressing, we'll not hesitate to call for help. But only to aid him with that specific skill, not to treat him entirely. He's different, he's special, he's happy, let him be and don't expect him to be just like everybody else (or make him think he should be).
tim fab
Dr. Mottron, This was a nice article. If you want to emphasize the role of pattern identification as a strength in the autistic community, then you may want to consider looking at autism from a signal processing perspective. It can be a useful approach. For example, the calendar counting phenomenon that you have investigated and pondered about fits together with language problems like a hand in a glove. But, you can really only appreciate that tight link from a signal processing point of view. Tom Fabricius, MD
Mike Alexander
Just to remind people how diverse the manifestations of ASD can be, my 4.5-year-old son has a diagnosis of ASD, and though he is considered to be high-functioning, he has difficulty with pattern recognition and matching. A standardised Ed. Psych. assessment identified some specific visual processing difficulties, such as an inability to replicate simple patterns with blocks, an inability to select matching pictures from a set of four, and a tendency to focus on details at the expense of the bigger picture (part:whole integration problems).
We're glad we had these tests done because so many support professionals just assume that ASD kids will have strong visual skills, and so suggest using visual timelines etc. Our child's strengths seem to be auditory/verbal – he has a good vocabulary and a superb memory for word and number sequences (in a test for recalling number sequences forwards and backwards he scored on the 98th centile).
christopher jensen
My observations of my "autistic" children lead me to believe that "autism" is only categorized as a disorder because of how we as, evolving humanoids,currently perceive and "grade/score" human intelligence. Our children, are part of an evolutionary process. We have reached the point where our kids are expressing noticeable changes in societal functioning. Language,verbal speech will become obsolete. Our children are categorized as having a disorder when in fact they are more "advanced" then we are. Our form of communication and social relations will be conceived as primitive, in the future. These kids have "over activated" parts of the brain because these are the centers of the brain that are going to more activated in the future. Verbal speech, linguistics,are primitive. Mathematics and maybe even mental telepathy will be the language of the future.
Peter Gibson
I wish to return to the problem of autism discussed by Mottron and commented on by me (above). My suggestion that part of the problem is due to slowed reaction was rejected. However, autism is associated with a complex of similar ill defined conditions which produce a cascade of problems that cannot be disentangled. The descriptions for these are shaky at best since many factors are involved. Even finding a ?gene for? would not help for the same argument applies since genes do not work alone and have knock on effects. A general explanation is needed which can be refined to cover the various conditions. The lack of an obvious physical component is perhaps an over simplification since when the condition affects, for example, speech this can be slow and confused. The overall condition may be due to by hypertrophy: there may be too many neuronal connections. In childhood these are pruned which possibly allows for developmental flexibility which compensates for problems produced at birth such as anoxia. A result of pruning is probably to produce an optimum number of connections. A popular assumption is that this optimum depends on environmental demands. Enriching the environment however may simply increase a wish to please parents. Autism, dyslexia, schizophrenia and so on, then, may be a consequence of hypertrophy which is linked to intelligence. Variation in intelligence appears to depend on the numbers of neuronal connections uses to correlate information. Language, for example, appears to have evolved as a result of an increase in brain size and in particular the neocortex (Nature, 486, 481-482, 28 June 2012). The adaptive advantage of language is it is a means by which individuals can manipulate one another for gain. This ability appears to be strikingly lacking in autism unless the condition is simple a cry for attention. Too many connections may be as much of a problem as too few. Over wiring becomes a burden and could produce various conditions. Since intelligence is inherited the parents of autistic children may be brighter than those of other children. The autistic child therefore has a greater chance of inheriting a debilitating excess of connections. Intelligence always returns to the norm over generations as presumably does autism. If one is looking for a genetic explanation for autism then one might do worse than look for a faulty ?connection-pruning? gene.
Peter Gibson
So called learning difficulties are normally split into specific groupings as they are not seen as a continuum produced by a common or similar cause. This may be more than a matter of classification especially since the criteria for the different conditions are imprecise. The slits are based on a general tendency for lumping or splitting. For lumpers a continuum exists. The clinical groups merge and contain striking similarities with so called normal behaviour. They are in effect exaggerated aspects of normal behaviour. This suggests that autistics are unlikely to have any special abilities that are not found in most people. Their apparent special abilities simply contrast with the rest of their disability. The condition appeals to some people who wish to either justify their attraction to the idea or imagine a heightened ability. The argument applies to conditions such as dyslexia, bipolar depression or even schizophrenia. The temptation for the lumper is to find an explanation that fits the panoply of conditions. Although challenged by Mottron a feature of autism is a slow response. In many situations this is complete by a failure to understand. We all have this in common to a lesser extent. The message appears to get lost. This is not a global cerebral phenomenon but appears to be restricted to some regions of the brain and is most noticeably in the associative area. If one region of the brain was always involved one would be expect this to be reflected in consistent behaviour which is not the case. In learning difficulties many different areas appear to be affected which appear to merger into one another. Where these overlap in one area, say the languages centre, then the condition may be severe. By mapping that overlaps a comprehensive picture might emerge. The desire to absorb various conditions into a spectrum of normal behaviour may be seen in an evolutionary approach. An example is ADHD. Environmental stress appears to be part this condition. It appears to be labile and modulates other conditions through the neurotransmitter serotonin. In humans and other primates diet may be a factor. Over evolutionary time human diet has shifted from a largely protein, hunter gatherer, to a cereal, agrarian, and now contains a high levels of preservatives and colouring. These changes may have behavioural knock on effects. The serotonin system in the brain is thought to modulate of other synaptic systems involved in behaviour. Peculiarities in behaviour might be account by difference in synapse distribution and number. The evolutionary increase in the size of the in the human brain has been in part due to neoteny. The ancestral juvenile brain has been retained in the adult and accounts to a larger number of synapses than are found in other primates. In humans the process may have led to language, which is the means by which individuals manipulate one another for personal advantage and requires an increase in associative areas. Increased brain size has also resulted in the brain becoming labile. Serotonin maintains the balance needed for a greater repertoire of behaviour. It is a modulator necessary for hunting in early hominids. Bipedalism led to a greater protein consumption and serotonin levels and is associated to specified types of behaviour such as dominance. The introduction of farming, depended on cereals, reduced the need for protein. Lower serotonin levels produced greater tolerance. The switch in diet accompanying farming led to sociality. The aftermath of this switch might account for the problems in learning difficulties.
Learning difficulties may be explained by neurotransmitter systems. The suggestion is not new. At birth and in early childhood synapses in the brain are reduced and these may belong to the serotonin system. The extent of pruning or even a failure to prune may produce the variety of similar conditions. If pruning was small this may result in slowing of association and other cerebral processes: too many connections. The reverse may be seen in Alzheimer?s disease. A controlled loss and modulation may be required for so called normal behaviour.
Paul Fedoroff
The discussion in this issue of Nature about the potential advantage of autistic spectrum traits reminds me of the old debates about whether schizophrenia was simply extreme creativity. Most people with autistic spectrum disorders (ASD) suffer from the effects the disorder has on their social abilities. Since their social skills are affected, their neighbours, friends, relatives, spouses and children also suffer.
Some have speculated that problems with empathy can make people with ASD more prone to commit crimes (1). But ASD covers a lot of territory including a full range of intellectual abilities and disabilities. We have argued that pre-labeling people?s abilities only on the basis of a diagnosis of ASD, is prejudiced and wrong. While the symptoms of ASD can cause a people to be ?asocial?, it does not mean they are necessarily ?anti-social? (2).
Researchers in the field of ASD must clearly define which part of the spectrum(s) they are investigating. They should also avoid confusing causal explanations with correlations. Scientists need to remember that words and labels can hurt, especially for people with ASD. We need to be careful not to confuse the hypothesized etiologies of ASD with the current concatenated symptom clusters of ASD or pronouncements about whether people with ASD are ?better? or ?worse? because of the diagnosis. Lets all agree that ASD deserves unbiased scientific research since the results will both inform and reflect on us all.
J. Paul Fedoroff, M.D.
Forensic Research Director
University Ottawa
Institute of Mental Health Researh
1. Fedoroff, JP. Sadism, Sadomasochism, sex and violence. Canadian Journal of Psychiatry, 53, 637-646, 2008.
2. Fedoroff, JP., Richards, DA. Sexual disorders and intellectual disabilities In: Handbook of Clinical Sexuality for Mental Health Professionals Stephen B. Levine (ed) Routledge New York, Chapter 25, 451-468, 2010.
pituti pituti
Nice article, pitty that the the world is made by and for social people, including science.
Mary Livingston
AHHHH... The WORLD is not made by social people; oceans, mountains, trees, clouds, rain, snow, etc. couldn't care less what PEOPLE are doing. Expanding your viewpoint might help you to enjoy the world a bit more. As for the SOCIAL community, it may be wise to limit close connections to the quality few. Quantity is rarely the gem it is advertised as.
Castielle Chun
http://www.youtube.com/watc...
I found this youtube clip on www.youtube.com about a boy named Jason McElwain who has autism. It is shown in the video that McElwain excels in basketball. Also, it is extremely nice to see other team mates cheering for him, showing that autism is not "anti- social disease".
Peter Gibson
Laurent Mottron comment on autism (Nature 479, 3 Nov 2011 pp. 33-35) appears to be an over interpretation of the problem. Autism may be, in spite of what Mottron says, due to slower reaction times in speech and hearing. All other behavioural difficulties that accompany it, rage in particular, are likely to result from this. Slowing may be due to a neocortical wiring problem such as too many or few connections and so on. As a result there appear to be a filing difficulty – a problem in locating words. An similar problem may be severe stuttering where a person cannot find appropriate words. The same problem may be motor spasticity. That is, connections are unable to be made in the correct order.
Speech depends on neo-cortex motor and sensory function. The cortex is made up of basic repeated architectonic units. Muscular coordination in, say, walking appears to be more complex than that of speech. Speech in contrast to walking is evolutionarily recent – there is no speech organ. Regions of the primate brain adapted to foraging in woods became redundant when hominids moved to other environments. The regions were pre-adapted to language. The muscles used in speech are essentially identical to those used in eating. Language is an ad hoc. Compared to many other animals with long evolutionary pedigrees, say the lyre bird, human speech and language are crude and ambiguous. Word assemblage in sentences is grossly redundant and sentence construction is repetitive and clichéd.
There would appear to be no such thing as non-autistic and autistic people since autism is a continuum. The suggestion that people with severe autism have compensatory ability sounds like
condescension. ?Poor things are handicapped in expressing themselves but they are good map readers?. Autistic people are unlikely to be any better at visualisation the most people. The visual cortex is a separate system to that used by language although it involves a degree of cortical correlation. Following blindness other regions of the brain can learn to ?see?. Recognition of shapes (places, maps and faces) involves correlation and is not impaired in autism. Other correlative problems such as dyslexia may be a form of autism. Dyslexia is a positive advantage in undergraduates. They fall over themselves to register as dyslexic. Autism will be next.
There is a possibility that autism has a selective evolutionary advantage. It is likely to be a defence against exploitation. Language, contrary to popular belief, probably evolved as a means of exploiting others. It is the basis of trade and involves securing advantageous deals and involves deceit (see Stuart West in Nature 478, 20 Oct 2011, pp. 314-315). Those who are slow to react may be at an advantage.
Dr Peter Gibson – University of Edinburgh
Andromeda Luxenburg
I personally know a number of people who are diagnosed with Aspergers' Syndrome, and meet the qualifications in the DSM 4, who are primarily language-based in the way they deal with the world, and have difficulty with visual, spatial, and other nonverbal tasks. Are there then two types of autistics (or three, as Grandin asserts, who think in pictures, in patterns, or in "paragraphs"?
David Whitlock
As someone with Asperger's (but only a touch ;) and doing research in autism, I agree with essentially everything that Dr Mottron has said. My perspective is compatible with all the data in the literature that I have read.
First, communication is the Savant Skill of neurotypically developed individuals. It is a skill that non-neurotypically developed individuals (i.e. people with autism) cannot hope to match.
Second, the two uniquely and defining human traits; language with syntax and grammar, and tool making and tool using both require a large brain with considerable plasticity for learning and thinking across the lifespan.
Third, the infant brain is limited in size at birth by the size of the maternal pelvis. Even so, in the absence of medical C-section, there is ~1% fetal/maternal death per pregnancy due to cephalopelvic disproportion.
Presumably, much of human evolution has been devoted to trying to optimize brain function to maximize the functionality of the infant brain that can successfully be born alive. Brain substrate (neural stuff) optimized for one thing can't be optimized for something else. Optimization necessarily is a trade-off of different neuroanatomy to do different cognitive tasks.
Fourth, division of cognitive labor allows humans to learn and use the cognition of others. A tribe only needs one expert, one savant to make the conceptual leap, then the others can learn, use and extend it.
Presumably tribes with diverse cognitive abilities out competed tribes without diverse cognitive abilities. Because development of diverse neuroanatomy couldn't be directly coded for by the genes the tribe shared, that diversity must have come from increased sensitivity of those shared genes to environmental influences affecting neurodevelopmental outcomes.
Teratogens that cause autism (valproate, thalidomide, phenytoin) do so during the first trimester. That is also when the number of minicolumns in the brain is fixed. A larger number of minicolumns is a highly repeatable characteristic of individuals with autism.
What would a trade-off of communication ability for tool making and tool using ability look like? I think it would look a lot like the autism spectrum.
I have discussed some of these ideas in greater detail on my blog.
http://daedalus2u.blogspot....
Andromedea, there are as many types of autism as there are individuals with autism. The neuroanatomy of each person's brain is unique and develops from a single cell in utero to ~10^11. Neurodevelopment is coupled to the in utero ?environment? at the level of noise via stochastic resonance. The myriad coupled non-linear interacting parameters are chaotic and produce an outcome sensitive to the butterfly effect at the level of Brownian motion.
Edward Schaefer
I am someone who possibly could be considered AS"D". For whatever reason, the AS"D" issue seems to be going down the male line in my family, and getting more pronounced over time. My father has a little of it, I have a little more, my brother could be considered Asberger's, and my son is so afflicted that he is non-verbal and very limited by it.
Is AS"D" advantageous? To be honest with you, that has to be decided on a case-by-case basis. For me, the added analytical ability has beed very helpful in my carrer in software engineering, and my father has had an even more successful career in electrical engineering. Then again, both myself and my father are very much able to function verbally, but socially we are less than adept and our ability to associate names and faces is impaired. So I see us an being different, but overall being neither advantaged or disadvantaged.
For my brother and son, there is no question that they are disadvantaged because of the severity of their ASD. Me and may father are very much at ease even with advanced mathematics, and I suspect that some of that is facilitated by the ASD. However, my brother has difficulty grasping even basic algebra, and my son has is just plain illiterate both in language and math. Career wise, my brother works in a mail room, and my son spends his days at a sheltered workshop. For them, pronounced ASD is a very limiting and (especially in the case of my son) debilitating condition.
So my reading of AS"D" is that a little can be helpful in some respects but sooner or later you hit a point of diminishing returns, and after that ASD quickly turns into the "devestating disorder" that most autism researchers consider it to be.
Overall, I call on researchers to be open-minded, and be aware that the conditions listed in the DSM IV are not diseases but instead are symdromes which in most cases have multiple possible causes. What unifies a DSM "diagnosis" is the region or regions of the brain which are being affected. However, effective treatment means identifying the causative factors. Also, as Dr. Mottron makes clean, appropriate treatement may mean acknowledging that mild AS"D" may be somewhat advantageous, meaning the for my brother and son the issue may be one of limiting the effects of this condition as opposed to elimintaing them.
I also strongly endorse Dr. Mottron's call for people to take advantage of the differences in learning styles created by AS"D" in the classroom. In some cases, this is a very useful condition, and we should be taking advantage of that.
Overall, I very much thank Dr. Mottron for this very thoughtful article.
Laurent Mottron
Pr Fedoroff, please refer to specific data when hypothesizing that there is a propension for autistics to commit more crimes. This is not confirmed by by clinical experience of more than a thousand of asessments of autistics I did, and the only studies i know testing this idea at a large scale (and not with individual cases reported, susceptible of a report bias) do not go in this direction
Laurent Mottron
to Edward Schaefer
I think you confound in your comment, if you authorize me to say so, adaptation and intelligence. The disability aspect is not contested, but it does not cover the entire range of abilities. Even non verbal autistics present with some spared or superior cognitive abilities in a subtantial number of cases, despite having obvious adaptive issues in a larger extent that verbal individuals (and even my later statment should be modulated by the fact that having acess to language for autistics is not always beneficial). So employers could use this working power, in the same way that they do for motor disabilities, which despite their adaptive difficulties, represent a working force. I simply advocate for the fact that autism should be measured and treated as other disabilities, rather that represent an exception among disabilities in terms of social status. In the case of your son, there is always the issue of is it an actual intellectual disability, or a ''false'' one, resulting from an absence of speech? And in the latter case, was he provided the amount of information he was interested in, and does his current work involve this interest? My regret is that the amount of working force that autistic are believed to possess is always measured using a non-autistic measure, rather than for its own value.
Laurent Mottron
to Andromeda Luxenburg
You are right, some ASD people do not have visuospatial strengths, broadly overlaping the clinically defined Asperger subgroup, who display rather language-based strengths. In our group, we strictly separate ASD people with and without speech delay for our experiments. This way of operationalize the autism vs Asperger distinction seems to overlap at 90 % with having or not visuo-spatial and auditory perceptual peaks (see eg Bonnel et al, 2010, neuropsychologia)
Jasper van Haasteren
Having read this article I really feel the need to comment on it and also share my personal views.
A short overview of myself: Asperger, member of Mensa, 30 years of age, bachelor?s degree in neurobiology, a research subject in the autism research for more than 10 years, and a student of the human condition since the age of three.
In the article Mottron states some views that are of course so obvious that it is a shame most of your colleagues in science and psychiatry don't share these views. However, these views are only the beginning. They can be expanded to get a view that applies equally to autistics and non-autistics, or actually, to pretty much every individual.
I think I'll take the term normocentrism as a starting point. An interesting idea to give this a name, but this term clouds the readers from what for me is the underlying issue. The underlying issue in my view is that every individual has the tendency to experience his/her own way of feeling, seeing, hearing, and experiencing the world as being valid. This makes it a small step to view one?s own experience of life as the only one, or as the majority one. This also makes it hard to understand other ways to experience life, other ways of thinking, feeling, dealing with situations, etc. etc.
If we were to start from the term normocentrism, Mottron uses this to differentiate between autistic and non-autistic people. If the term is truly intended to only point at this distinction, it should be neurotypical centrism. Make the term fit the limited distinction between autistic and neurotypical people.
And here is why I say so. Within Mensa I have a few friends who are also autistic. We have our own set of nonverbal communications, our own set of social "rules" and we have even tested them in a wider context. The most interesting observations happened when there was a large group of autistic people with only a couple of neurotypical people. In this setting the autistic way of communicating was used by almost everyone, and those who did not "speak" our social interaction were left out. This of course meant the most hardcore neurotypical people. They were unable to join conversations, they were unable to get any contact whatsoever, and in the end some of them just left the conference. If we apply the term normocentrism, in this setting it would mean that the autistic way of communicating was the norm and those who have not mastered the autistic way of interacting were socially inapt.
I have also been to several meetings for aspergers, in that setting it is easy for all of us to join conversations, to engage in social contact, etc. etc. because we all speak the same social language.
It is merely that the neurotypical population far outnumbers the autistic population which causes the neurotypical ways of social conduct prevails. It is this outnumbering that is the root cause for every problem that is experienced by people that fall outside the ways of doing and being of the majority. Be it autistic, be it extremely intelligent, be it a more complex worldview, be it left handiness, be it sexual orientation, it doesn't matter how an individual differs. To differ means there's a gap both sides have to overcome.
To apply this on the individual level: Every person has a certain way of interacting with others that is natural for that individual. Also each person has a certain range with whom she/he can interact. Of course the range varies from person to person. But if the natural ways of communicating between two people are far enough apart, having a huge range can still mean the two of them have trouble communicating, or are even unable to communicate. Both will interpret the reactions and behavior of the other in ways that is comprehensible to themselves. And this is by definition limited, and does not always include the way the one giving the reaction will interpret it.
If the natural way of being between individuals differs only slightly, communication is much more fluent. This is so simple and obvious that hardly anyone seems to realize this to be at the root of communication between people. Communication difficulties as well as success depend on the differences between the natural ways and the range both can reach.
Just to make the most obvious point so far: if the group is autistic, the differences are small, and thus even a small range is more than sufficient. The same goes if the group is neurotypical, or extremely intelligent, intuitive, non-verbal or any way of being that anyone can think of.
The mistake made by the majority is that they impose their way of communicating upon others. Their values, their ideals, their ways of communication, everything gets imposed upon the minority. And those who do not fit the profile set by the majority get labeled as being defective. And from the viewpoint that to differ is to be defective, this is correct.
Viewed from science to differ means just that, to differ. But since the neurotypical way of being has the tendency to give emotional value to everything, the neurotypical way of being has difficulties using objective language and thought. And thus it sees defects. And defects usually require a fix.
It is the view of me and my fellow Aspergers that this is a shortcoming in the neurotypical way of being. Some Aspergers view this shortcoming with the same judgmental normocentrism that many of neurotypical people view the autistic way of being.
Another basic flaw in how autism is being described and tested has to do with the concept of empathy. This concept is viewed from the perspective of the neurotypical way of being, with all of its neurotypical centric applications.
When we let go of neurotypical centric and any other kind of centric view the result would be the following: The range of being an individual can communicate with also entails a range of being with which this individual can empathize with. This range is usually limited to what the individual trying to understand how another might feel, would feel himself in the situation the other is in. This of course has the basic flaw that the variation of ways to experience a situation is much larger than the range of feelings any single individual will experience within that situation.
The solution is to try to understand the way the other individual?s way of being works, and to do this in the terms the other uses, letting go of all your own experiences for that situation.
For the neurotypical way of being this is almost impossible. The neurotypical way of being starts out with how it itself would feel in any situation and then ascribe those feelings to others. This works for all other neurotypical individuals and this is a successful strategy in those situations. However, this strategy utterly fails when trying to empathize with someone outside the neurotypical range, for example an autistic person.
For most autistic individuals, their range does not include the neurotypical way of experiencing life. And since the autistic way is a minority, autistic people have to work very hard on increasing their range to reach the neurotypical way of experiencing life. On the other hand, neurotypical centrism states that it is perfectly healthy that the range of neurotypical individuals does not include the autistic way of experiencing life.
For autistic people, the capability to process large amounts of raw data is a solution most high intelligent autistic people adopt. They collect an almost insane amount of data on the neurotypical way of being and after a decade or two of study they can enter some simple neurotypical social settings.
After this long study, the range of people who have traveled this path is much larger, even though it might still not include the neurotypical way of being. The interesting thing is that neurotypical centrism keeps saying that autistic individuals can?t empathize with people very well. While the neurotypical scientists only mean that the neurotypical way of being is not within the range of the autistic people who are tested.
Another thought: I believe the reason why autism is viewed in such negative terms has a historical reason. It was first described from the perspective of psychiatry instead of the perspective of psychology. Psychiatry feels it needs to fix while psychology is mainly interested in the fact that humans differ from each other. In a way, psychiatry is much more normocentric than psychology is.
I think this covers what I wanted to say for now, I am quite interested in any response.
Jasper.
Laurent Mottron
to Peter Gibson
There are numerous sets of data which do not fit with your model, at least as expressed here. For exemple, most ERP studies involving auditory information (Like Gomot and Ceponiene's papers) show that the ERP latency to auditory information is faster in autistics. In the visual modality, Chawarka's recent Archives paper show that visual disengagement from faces are faster in autistics. So you cannot generalize to non social information the idea of a slower processing, and even for non social material, you have some big rocks in the way of such a straight forward model!
Jonathan Jones
Upon finding this article, I sent the following message to Dr Mottron:
Changing perception?s: The power of autism (Might I be autistic?)
I am a 33 year old male that presents symptoms of ADD, chronic depression, chronic sinus and GI ailments [I mentioned these ailments because some of my poking about around the subject suggests that autists often have a particular sensitivity to nutritional defficiencies – though I have not found much information about this], along with a myriad of behaviours commonly associated with autism [but hidden from public view to the best of my ability].
I am often perceived as being normal despite a deeply felt sense that most of my social responses are based on mimicry. One of the few indicators of autism that I lack is the common difficulty with interpersonal communication (disregarding a friend's pithy "That's what you think!" this morning). I am quite literal, but adept at deciphering when a conversation's participants are not effectively understanding one another, and can often intervene to assist in communication between seperate parties. I am not quite so adept at doing so in my own conversations.
Does my ability to navigate social interaction with some skill preclude a possible diagnosis of autism? If not... would you kindly offer a suggestion on what next step I should take to pursue a definitive answer to this inquiry?
Thank you for your time.
--------------------
This inquiry feels emberassing and clumsy in retrospect, especially in light of some of the truly noteworthy comments avove, but as the doctor was kind enough to reply and request that I post it here, I have done so.
roberto melgar jimeno
which kind of text, do you mean?
James Hillard
It is not at all clear to me what diagnostic criteria the authors are using. From the limited data provided, it seems extremely unlikely that the author meets DSM-IV criteria for autism. Perhaps he is a person with Asperger's Disorder, but not even that is clear from the data provided. The fact that these individuals who have self identified as being "autistic" trivializes the suffering of patients and their families who are actually dealing with the
Peter Gray
I am a family physician in Belleville, ON and I read the paper with interest. I have an autistic son and probably have mild autistic / Aspergers tendencies myself, although it hasn't stopped me from qualifying as a family physician and raising a family, so I have a more than passing interest in the subject.
I have spent some time thinking about the question "what are autistic people for?" and I've come up with a theory which didn't appear in the article but I'd be interested to hear people's comments. Most "normal" people have a desire to fit in with the society in which they live. However, one of the hallmarks of autism is social dysfunction. This is usually a disadvantage, but could be an advantage in a socially dysfunctional society, where the autistic person may feel less peer pressure to follow dysfunctional social norms, and thus act in a more "normal" way. So, for example, an autistic person living in the Enlightenment era might be less likely to support the Spanish Inquisition's earth-centric theory of the universe, and an autistic person living in Nazi Germany might be less likely to believe in Hitler's "master race" theory. So maybe they are one of Nature's ways of ensuring societal progress.
Geke Schrijver
to Jasper van Haasteren. This comment does not directly have so much to do with the article. But I read that you have been to asperger meetings. I am interested in that because I have been diagnosed with Asperger-syndrome myself. Your name sounds very Dutch, were the meetings you attended in Holland? If so, could you tell me please where you attended them and how I could attend a meeting myself? Thanks in advance. I would very much like to meet other Aspergers.
Silvia Baetti
Dear Dr: Im pleased to read your article, Im a medical doctor in
Argentina. I coordinate the autism treatments in" Hospital Italiano de
Buenos Aires". I have the same experience as you with my little
autistic patients and our educational sistem is not preapared to give
them what they really need. I suffer with their pearents because we
cant give them the opportunities they deserve to be happy. Im
convinced that they have a different brain and this is my speech in
the hospital, and this, causes me a lot of trouble with my collegues.
This is the reason why Im so pleased and grateful to you. I can
refered them to your article as you are an important
researcher..THANK YOU!!!! I ask you for permission to translate it
into spanish to make the reading easier to not english speakers. Ill
be waiting for your answer. Congratulatinos for your work!!!! Dra.
Silvia Baetti. www.adluminare.org.ar www.silviabaetti.com.ar
Jasper van Haasteren
To Geke:
(Dutch mode)
Ja ik ben inderdaad een Nederlander. De gevraagde info gaat wel erg off-topic, mail me maar op " mijnsp4m at gmail dot com" . Dan mail ik je wel terug vanaf mijn eigen adres.
Elliott de Launay
Very insightful, I look forward to future developments regarding learning and developmental strategies.
?Everyone is a genius. But if you judge a fish on its ability to climb a tree, it will live its whole life believing that it is stupid.?
?	 A. Einstein
Robin Schaaf
Laurent, thanks for the insightful and much-needed article. I really feel we need to rethink "curing" autism and work more on awareness and acceptance. I am a mother of 5 year old child with high functioning autism. From talking to other moms, it seems that higher functioning children who are mainstreamed and are open with classmates about autism (and the differences in brain structure) don't have as much trouble fitting in. Other children can be very accommodating and understanding of differences. But we need more awareness that autism is a "difference" and not necessarily a "disability".
"ASD characteristics" run in my family (mostly through the male lines but now me and my sister). We've all had successful careers in the sciences / technology. So I share a similar perspective of ASD – after my son was diagnosed I was probably the only mom who didn't cry!
My son is very smart – not savant – but I pay attention to the differences and advantages that he has over other children. He's amazing visually – he puts puzzles together without referring to the picture – and in very little time. He builds incredibly intricate buildings, he has beautiful attention to colors when painting. I started him at 14 months into therapy to help him along with language, motor skills, sensory issues and developing play skills, although no behavioral therapy. The therapy is amazing – he's in full days mainstream schooling – and has friends. (although I shouldn't get started on how difficult it was to get the diagnosis – again a need for awareness!)
Anyway – with his amazingly detailed visual perception I think someday he might be an exceptionally talented architect – just like his great-grandfather!
Mary Smith
I could wax eloquent on this topic, but I will stay with simple terms instead. I have been wondering when someone would point out Autistic capabilities of this nature. Temple Grandin told the world about thinking in pictures, and then society thought this summed it all up, along with the better-known savant qualities that come along every so often. Not so.
I have Asperger Syndrome, formally diagnosed. I was once a hyperlexic 3 yr. old in love with letters and numbers. I was voraciously hungry for information. I tested off the charts in elementary school IQ tests. I went on to earn a graduate degree. Along the way, I learned that I have several uncommon skills. I see patterns in all of that infromation, continually, where other people do not. It leaps out at me. And, I can pick out discrepancies at ten paces. Discrepancies are a breach in logic, and I find this jarring. No one else seems to notice such breaches. I am astonished that they do not. Once I pick out all that information, I connect it with any and all other information I carry mentally, rather like a connect-the-dot game. And memory is like a third hand to me. I use it with aplomb. Further, I learn by reading....seeing information in print. If I hear a lecture, or anything else, given verbally, I am likely to have gaps in my understanding. Give me high-quality printed information on my topics of interest (and I have hundreds of them), allowing me to focus, and I am in heaven.
So what can I do with these skills? I am a researcher by profession. I can find and retain and analyze great bodies of information. I do this exceedingly well. And in fact, in my personal life, I worked for many years to untangle the family genetic disorder that conferred the Autism. It is very rare, and all but unknown. I worked my pattern-finding and connecting magic so that my family now has answers which eluded docotrs for over fifty years. But you know what? Doctors are very unhappy about this state of affairs.....a medical layperson has beat them at their own game, and I have been very rudely "put in my place". It was not the answers per se that they were after; it was the opportunity to remain on their pedestals. I found that shocking. I can make the right connections, and I don't play the power games -- they don't know what to make of someone like me.
At any rate, though I have my Asperger Syndrome struggles, when it comes to pattern recognition and making connections and noting logical gaps, there are few who can outshine me. It comes in very handy in analytical work of any nature. However, I cringe to think of the long history of low-level jobs I went through, even with my excellent formal education, until I was given a real opportunity. I worked under managers who were barely literate, but knew how to shmooze. Life, of course, is rarely fair.
From my perspective, Autism Spectrum Disorders can have both great advantages, as well as strong disabilities. I would not claim either one side or the other as the whole truth.
Tirtza Toren Gal
Fascinating article! It's a pretty difficult task to raise a child, but it's a lot harder and more challenging to raise children with special needs. Daily activities are more challenging, but can be inspiring, too. Research shows that children with autism, dyslexia, ADD etc. can remember and memorize pictures more easily than text. Pictures are their first loves. Almost 80% of kids have some special talent that supersedes educational talents.
Having a child is a blessing, no matter what the circumstances are! I believe that there is a blessing in every situation, if we take the time to look for it.
Laura Martin
I found this article extremely refreshing with a positive consideration of autistic traits and the valuable contribution that autistic people can make to society. Your colleague Michelle Dawson is a fine example of someone who has been given the opportunity to show her value and to find her rightful place in this world. I hope that this article will contribute to a change in the societal perception of autism and that more people on the autistic spectrum will be valued as they deserve to be.
Edward Schaefer
Dr. Mottron – You make some interesting points in your response to me. Even so, I do not think that I am confounding adaptation and intelligence. You are correct about my son's intelligence. He definitely has just as much raw brain power as anyone else in the family, including his younger sister who is now a junior in college and double-majoring in math and computer science. However, he is very much unable to use it in certain essential ways. Therein lies the source of the disability.
Perhaps the central issue if whether autism = pathology. In terms of combating that, you are on the right track. It is indeed ironic this in some respects autism is adaptive in the modern world. However, you can still have too much of a good thing, and that is the issue for my brother and my son.
Beyond that, I truly applaud your work. Some of what has gome wrong for my son is our not knowing how to reach him and show him how to operate with and through his condition. In his childhood, that may have made a huge difference. Then again, in my family there is a love of learning that extends throughout our lives. So my son may yet be reachable if only we can figure out how and what to teach and/or show him.
Laurent Mottron
To Mary Smith.
Hyperlexia, or the various abilities which demonstrate a superior ability to detect a similarity between two isomorphic structures, even only imperfectly matched (like verbal and written code) seems me rich of educational possibilities. There is probably a difference between autistic hyperlexia, associated with speech delay, and Asperger hyperlexia where this not the case, but in both sides it indicates that the written code, and through it pattern perception, has a special importance in autism. In the Montréal Group, we attempted at modeling this ability (shared with other savant capacities) as veridical mapping (Mottron, L., Soulières, I., Dawson, M. Enhanced perception in savant syndrome: patterns, structure and creativity (2009). Proc Trans Royal Soc London, biological sciences B, 364 (1522) 1385-1391 ). We are now piloting ways to use this in early education, and replace techniques and theories which are mouse-based, obsolete, normocentric like ABA.
Laurent Mottron
To Jonathan Jones
Considering the public nature of this forum, I can just try to answer on a general basis. In my clinical practice I see now and then people corresponding to this description. To summarize, these are people with an early, intimate profound feeling of difference, which arrive to the clinic with a previous diagnosis of axis 2 personality disorders like schizoid, narcissic or avoidant personality, and/or ADHD. They describe a voluntary, deliberated and old history of mimicry (sometime in front of the mirror) of typical social strategies. The absence of apparent benefit (of the material type), as well as the apparent sincerity and earliness of these behaviours suggest and sub threshold Asperger, despite an absence of adaptation problem, and an invisibility of the difference from outside. As there is neither a gold standard for these types of diagnoses, nor reliable biological markers, these diagnoses (or discarding them, possibly erroneously) relies entirely on clinical expertise. And DSM 5 will probably kick them out of the spectrum. So this is a difficult issue. I usually rely on my judgment on how similar (and not text-book like) are these introspective description with that of prototypical Asperger people, in order to detect and discard self proclaimed autistics....
alan spector
I am impressed both with your research and Michele's abilities but more impressed with your sense of empathy and humanity without which she would remain an alien force. It was your recognition and sensitivity that rescued her from the prevailing prejudiced, dominate outlook. Perceiving autism merely as a disability rather than as a potential real mental asset skews the debate away from truly understanding and helping the autistic to the perspective of finding weaknesses. My son is 16 and autistic. At the time of his birth little was know and understood about his condition so I had to rely on my own observations and experiences. I had come to your same conclusions many years ago and have been militating many times against the prevailing shortsightedness of doctors and care providers who merely perceive his condition as a liability. Unfortunately day- to-day practical concerns often override whatever small injustices he may suffer in order to survive. He neither speaks nor cleans himself, so as you've pointed out, he performs badly on conventional IQ tests. Yet his visual and auditory abilities, I can attest, are above what I understand as being normal. He has a real inner life that must be respected and accounted for. Often Dr. Mottron's intuitive, probing sensitivity is lacking in some highly trained specialists who should be more open. My main problem and concern though, is not taking care of him per say but rather making sure his care with others is both humane and positive in terms of his abilities. The school he currently attends is more concerned with order, proscribed behavior and strong. pacifying medications than with adaptive education. I fear lack of insight and understanding might cause my son undue suffering and missed learning opportunities. Your understanding, research and humanity will go a long way in educating everyone to the notion that autistics' are valuable, with a heart and minds that need to be understood and respected not as a side show but as struggling, full fledged contributing members of society. Alan Spector
JEAN MICHEL ANTOINE
Dear Laurent,
>
> I really enjoyed reading your comment in Nature nov 3rd. I love looking
> the other way round !
>
> I was wondering whether some autistic scientists have considered
> anatomo-pathology as an area where their skills will be more than
> appreciated:
> It is a non-verbal science, it is about picking some specific structure
> among a lot of details, it is about remembering figures, images, and it is
> about making a diagnostic from facts.
>
> Do you know if there are already some autistic anatomo-pathologists, or
> how can we suggest anatomo-pathologists to be interested in autistic
> students for future jobs.
>
> I have no interest in the field, but my wife is practicing
> anatomo-pathology in a french hospital.
Mini K.T.
Dear Sir
I am from India. My daughter is 10 years old, and is autistic. I read your article with great interest and hope. My daughter is really good in English, even writes short poems very well and has good vocabulary. She even writes in her mother tongue, even though we never taught her to do so. She can do mathematical calculations such as percentage, time, basic geometry and trigonometry without teaching. But she cannot control her behaviour and emotions. This is the biggest challenge in front of us. The schools here do not give much importance to formal education for autistic children. I wish you would give us guidance in the future because we are in a dilemma on what to do. I greatly anticipate a reply from you.
Thanking you
Mini.K.T.
Luisa Di Biagio
Good evening Professor.
I read with great interest your article "The strength of Autism" (the title in Italian).
I am writing to thank you.
I am an autistic person.
I have a lot of difficulties. I am not be recognized as a person but as sick.
In half of the world would grant me a visa, even in Canada, I had a proposal for collaboration with a fellow psychologist, but I can not live in Canada, or USA, or Australia or New Zealand.
Thank you for your words.
I enclose an article I wrote, is the only one of which I have an English translation. I hope you like it.
Dr. Luisa Di Biagio
Thomas Owren
A question to Jasper van Haasteren (and perhaps others reading this):
I am a norwegian neurotypical master's student of community work. I'm doing my master's thesis on the theme of neurotypical ("normal") social and communication habits viewed through the lens of autistic experience – especially focusing on which aspects of such habits that may be understood as disabling barriers for autistic citizens. My starting point is autism/asperger viewed as a difference (not deficit), the neurodiversity movement, and a social justice majority/minority perspective. This made me take notice of your comment of 2011-11-08 07:22 on this page, especially your eloquently stated observations on the subject on empathy.
My question: May I include your comment as part of my data collection? I cannot promise that I'll cite you directly in my thesis. But in case I do, I need to know how you would like to be cited, or whether you wish to remain anonymous. You may of course withdraw your permission at any time. My email address is thomas@steinkjelleren.no
I present my study in a little more detail on this web page -
http://www.steinkjelleren.n...
* and there I also issue a general invitation to persons who consider themselves autistic and have written blogs, comments to blogs or comments in open internet forums that touch on my theme, to send me an email describing what they've written, where I can find it, and if I may use the content in my masters? thesis.
Laurent Mottron
As long as one publish something, it falls in the public domain. So I am not in the position to limit in any extent what you do with this paper or with the messages posted on this forum., I would just suggest you consult autistic people, the most than you can. Even if I dedicate my research life to bring back autistic in th communauty, I remain a non autistic person, with the risk of representing only myself
Diane Whiteley
A friend forwarded your article to me and I was so pleased to receive it. I have never thought of my son's autism as a disability but only as a 'difability'. He has high intelligence, he is extremely good a sport and is a great and wise philosopher. He is 14 years old. I always get a feeling of great sorrow when I read that parents are 'devestated' by a diagnosis of autism. I know that some cases are compounded by physical difficulties but as far as social integration is concerned I think that most people can experience difficulties in this area. I know that my son will be able to use his abilities to achieve whatever he wants to in life. He has high self esteem, is active and sporty, fit and healthy, well nourished and, most importantly, loved and supported. My son has participated in many research projects and I have found that they are limited in their scope. Also, the education system tries to bang square pegs into round holes, although it is slowly changing. I support my son to be who he is and help him to understand why society is the way it is and how to use it to get where he wants to go. Thank you for your article. I will print it out and show his teachers. Diane
Laurent Mottron
This post was submitted by: Janet Chippindale <jntchipp@aol.com>
Dear Laurent Mottron,
Re: Changing perceptions: The power of autism
10.1038/479033a
I have a 21 year old daughter, Helen, who was diagnosed as having Asperger's Syndrome earlier this year. Her boyfriend , David is also AS but not formally diagnosed. Helen has just returned to university to start a maths degree. She dropped out half way through a degree course in Plant Science because of depression due to complete social isolation and stress about doing the dissertation. David has a first class honours degree in History. he has been unemployed since (18 months). I have now read fairly widely about AS and see it everywhere. All those poor peculiar people one meets through life and thoughtlessly got irritated by and cross with. Helen and David are both bright and capable. They have enormous powers of concentration and when engaged, will carry on tirelessly for hours. They are good-natured and kind. Helen has never criticised any-one, she says nothing rather than something nasty. They get on like a house on fire with each other but have social difficulty with normals. Their small group of friends are also along the spectrum and ,again, are at ease with each other. I worry for them. There seems to be no agency to help employ adult ASs. There is huge amount of help and interest for children and adolescents. When we saw a psychiatrist for Helly's depression she admitted she knew nothing about Asperger's and suddenly wondered about what happens to all the children diagnosed when they become adults. The answer is that they sink to the lowest jobs, get made miserable by bullying , change jobs frequently and finally languish amongst the unemployed. Quiet and unassuming they disappear from sight. I really , really, really don't want this fate for Helly and David, but I think it is inevitable. They are simple souls and have a much greater capacity for happiness than competetive, grasping, judgemental normals. They only need someone to see their potential and offer a degree of protection and they will be very happy. What can I do? Janet Chippindale
mirjana golusin
I have found you e-mail address on your article "The power of autism",
posted me by my friend, prof Lior, University of Pennsylvania. I do not
know how he have found your article...
My name is Mirjana Golusin (43), I have an autistic boy (15).
Everything what you wrote in your article is right. You are a psychiatrists
(scientist, as I am), and you know a lot about autism. I am just a mother
who straggles to create the better future for her son. I want he to be
independent and happy as possible.
Picture of you and your autistic assistant reminds me on my son in details.
Position of assistant`s arms is the same!
When he was 2 years old, doctors told me – there is no chances for him ever
to be anything than an object. After so many years of teaching and
training, when he was 8, he was able even to visit a dentist and to be
quiet during dental intervention...
When he was 5 he first time look at me and told me Mummy, he felt fear,
shame, all spectre of emotions, now he is very sensitive boy. He always
likes physical contact, furthermore, he demands it. He understands when he
needs to wait, he can be alone, he is totally independent regarding hygiene
and basic home skills since he was 2 years old.
He was exposed to various social situation, he travels with us (he has a
brother), he visits every public places, restaurants, he swims, ski, makes
big puzzles when he was 2, likes nice music, he is visually excellent, he
developed significant language skills, he likes horses, he rides. He also
developed a significant social skills, but his professional life concerns
me a lot.
I know he has abilities, but I have no instruments and I am not familiar
with modern techniques how to assess them. I want to find out what he knows
and, according to that, what kind of future is best for him.
I pass a long and hard journey with him so far and I will never give up. I
know he is right now in stage of doing nothing, and that is something what
you underlined as bad in your article. I know he is able to do something,
but I do not know what?
Regardless all historical problems, here in Serbia we have a proper
schools, and god staff, but we have no possibilities to find out more than
what is going on at the surface. Our scientists study only autistic
deficits, not positive sides. I do not like that. Science needs to offer a
solutions, not just a review of problems. Now I have only list with
problems described. My son deserves more.
I would like to know what is in his head? Is that possible?
L L
While I agree with you that autism can be an advantage and, I believe, will be an advantage for my kids, I am deeply disturbed by your statement that "despite these caveats, Dawson and other autistic individuals have convinced me that, in many instances, people with autism need opportunities and support more than they need treatment".
Why does it have to be "either or"? Why can't they have opportunities support AND treatment?
My children are succeeding because, in addition to opportunities and support, they are getting a lot of treatment that is helping them communicate with others, establish relationships, learn to share their gifts and overcome their challenges. My formerly non-verbal younger son is now ahead of his peers in speech and the more engaged he becomes with others, the more he interacts with his very verbal brother, the bigger the advances he makes in his verbal communication. His older brother, who has always been very gifted verbally, still can't eat solid food but is slowly learning to smell, touch, lick, and bite food without gagging and throwing up. He is a good reader and writer with very original imagination but he is on a special liquid diet and not completely toilet trained. Before we did intesive ABA with my older son his frequent meltdowns did not let him enjoy his time at school and learn to his potential, his teachers let him do whatever he wanted, so he won't be disruptive to the rest of the class. Now he is in a mainstream classroom and has a great rapport with his teacher who enjoys his quirky sense of humor and wild imagination. He still has meltdowns but they are not as frequent and he can calm himself down much more quickly so that he can "tune back in" much faster to what's going on in the class and get back to his work.
Would you in your lab employ autistic people who are not toilet trained, who throw up at the smell and sight of food, who throw loud tantrums if something is not up to their exacting standards? Would you be able to work with them even if they had superior IQ? Would you employ a non-verbal individual?
Many of your arguments against treatment are the same as the ones given by our insurance company against paying for treatments for my sons: "we need the same level of evidence as drug trials", "too expensive", "not proven". But do all behavioral treatments (not only those for autism) go through the same type of clinical trials as pharmaceuticals? What about OT and speech therapy? And what is more expensive--early intensive intervention or lifetime on disability? I know that in the case of my children early intervention has played a significant role in their progress. I wonder how much early intensive treatment the autistic people working in your lab received. Since they are adults, they might not have had much in the way of treatment 15+ years ago. What would have happened if they would have received that treament? Maybe your collaborator Dawson would have been a scientist with a research lab and a Chair of her own?
One of the advantages of autism that you cite is that autistic people "tend not to get bogged down by the career politics that can sidetrack even the best scientists. They prefer not to seek popularity, promotions or vast numbers of papers; they may post their best ideas on the web rather than publish them". Maybe some neurotypical scientists won't take advantage of their autistic peers but there seems to be a lot of potential for abuse. I notice that you state that your collaborator Dawson deserves a PhD. Is she on the track of getting it? Are you helping her get it? Will she be able to advance in her field without it?
I am disturbed about the way you write about your collaborator. You praise her for her work and for her abilities, she is useful to you in your work. But what do you know about her life outside work? Does she have family and friends? As a parent, I want my children to have work that they enjoy and are passionate about. But I also want them to have families and friends of their own, somebody that they love and who love them, to be more than just useful tools or pet projects in a research lab. And yes, I want them to have careers and promotions and recognition for their work that they deserve.
Have you ever considered adopting an autistic child?
clarice Kloezeman Thornton
Dear Laurent Mottron,
Re: Changing perceptions: The power of autism
10.1038/479033a
I also read with great interest your article on the power of autism.
I have a 20 year old daughter with Aspergers. She is, for her age and
education, absolutely brilliant in the areas of science such as
evolutionary biology, animal behaviour and genetics. She did graduate
from high school, but her Aspergers has interfered with her post
secondary dreams. Actually, she has dreamt of being a scientist from
early childhood. It would be an ideal fit but for one thing – she has
extreme difficulty with math and only made it through grade 10 math
after 3 attempts. Her difficulty isn't so much with the math as it is
with the context – unless she can make the math real and related to
her interests, it has no meaning. Sadly, we are unable to find anyone
who can teach math this way.In January my daughter will be attending a
program at a college that helps young adults with any kind of mental
illness/disability learn the social and life skills necessary for
independently navigating a post secondary education. She needs this,
but it will not help her to succeed within the field of her
passion.Michelle Dawson was incredibly lucky to have found you. I
would like my daughter to be able to find someone she could be
mentored by. How can we manufacture the kind of connection you have
with Ms. Dawson?
Laurent Mottron
Now, some answers to the bitter post of LL.
I try to help families distinguishing opportunistic and eclectic support, which I would consider as helpful, but modest in their ambition, and recognising that autism is here to stay ?from treatments, who pretend to modify the course of the condition, (make autistics indistinguishable from their peers). There are no data showing that early intervention result in the changes these methods pretend to obtain. I agree that this is also the case of speech therapy. But what seems me to justify more the later that the former is that their cost, demands, and level of pressure is without comparison with ABA, that the later adapt to the child need and current state, and that their purpose are not normalisation but communication, whatever vehicle is successful.
And no, we would not employ autistic people who are not toilet trained, who throw up at the smell and sight of food, who throw loud tantrums if something is not up to their exacting standards?; but I am just not convinced that behavioural methods, as they stands, are the efficient ingredients within rehabilitation package that are actually responsible for improvement at this level. When you say I know that in the case of my children early intervention has played a significant role in their progress how can you, just by the power of your own judgment and own beliefs, be sure you can avoid the replicated over-estimation of treatment effects by people personally involved in the application of these treatments?
Last, I did not consider adopting an autistic child. Regarding the intimate frontier between selfishness and altruism that anyone has to draw in his own life, I decided to dedicate my professional time and energy to autistics, while I adopted a typically developing child. There is no ethical justification for that. And I wonder from which ethical framework you could authorise yourself to have a scornful judgment on this aspect of my personal life.
Stephan Lloyd Watkins
I have Aspergers syndrome, but was diagnosed with attention deficit initially. I have seen this a couple times, and even seen aspergers children made to take ritalin in the 1980's. Basically, the visual aspects are what stand out for my self, although patterns and other aspects here and there also seem like common themes. Lifelong I have been trying to be a scientist. By this, I mean at age 6 my physicist grandfather introduced me to science, and I decided then to become a scientist, as I was obsessed with chemistry, biology and physics. Mostly I focused on Biochemistry, and settled on structural biology when introduced to it in the 1990's. My main problems are inter-personal.
For instance;Ideally, autistic individuals would have mediators who could help settle
situations that trigger anxiety in them. Typically anything unscheduled or hostile, such as changes to an existing plan, computer problems or things being out of order, when there already organized chaotically. As I entered University life, I have found people akin to this knowledge will sit back and drive you insane using such things. I dont know why it is always funny to make fun of a small behavioral quirk, but this is what people do from hgih school all the way to the top. University life being as competitive as it has become now for many reasons, this tends to go on extensivly. Usually it's mundane, such as killing a single enzyme or replacing some solution with water, which ends up making you spend weeks going insane, diagnosing things and causing a stress I can not explain. It kinda makes you want to start smashing windows or just breaking things, but initially leaves you feeling unable to concentrate, followed by the "freak out feelings". It has some pain aspect to it, but it is more of a mental pain. I have hung out with autistic children in my past, and can see something much more heightened than I feel. In the end, after 20 minutes or the feeling disipates, it usually is such a remedial or mundane thing you end up feeling stupid. This in itself is only a normal side effect of things such as this, and one can easily cope with the later feeling. This being said, and people knowing you can be made to snap (in appearance to anyone else) easy use it as a tactic, especially in situations such as academia in which this can lead to further problems as it is a connection based system of operations. Without the proper set of contacts, no one advances in science.
In any case, I have finished 2 bachelors, one in biology and one in Chinese History, as I have a half Chinese daughter from High school I wanted to educate her about her ancestors history. I also have a masters degree in Molecular biology from the University of Bern, Switzerland and am now attempting for the 3rd time a PhD. My first attempt was in the Netherlands, the second and current here in Switzerland. The 2nd one was stopped before it started as funding was canceled. I wrote however, as your article struck a nerve. It is nice to see such a thought as integration, or more appropriate integration of different personality and neurological behavioral types into social settings of benefit to humanity. I often feel the only people utilizing Autistic and Aspergers folks are intelligence agents, or governments or other parasitic organizations. Usually these are one sided, ie an idea generator sends off 3 agents with fresh, novel Nobel prize ideas to infiltrate some place over seas. In turn, the idea generators usually end up at a gas station, homeless, or dead. Im almost 38 now, and still a student, but I try. I now realize any academic career is gone, but fashion ideas about collaborative work from home, considering computational advancements, and the cheapness of equipment these days. Which brings up another point, about the man you mentioned whom can memorize areal landscapes. It is something I grew up with, and thought was normal, ie universal to everyone before I
graduated High school. Basically, I was in some sort of bubble land, and spent most of my time in some abstract visualization or analysis of media which helped me to cope with society at large. By normal I mean being able to replay your memories like a video tape. This, and detailed image recall. I found if you mention to people you can do such things, especially in academia, they tend to all the sudden decide you are arrogant. This, and you tend to get "chumped" much more in the scientific community, or the community in general. This is a downside of things, the "idiot geniuses", or someone whom can do quantum physics but gets suckered into buying something they didnt even want. In any case, I'm glad you are making an attempt to change the ideologies involved with such things. I feel people have a number of different gifts, and utilizing the good while making sure the bad aspects of our nature and neurological programming are kept from hindering things will help advance things much more quickly. There's a good resource out there in the form of people which should not be wasted, kept from the limelight or used in ways which prevent a persons freedom and individuality from being exerted.
Thank
you,Sincerely,
Stephan Lloyd Watkins
winnie dunn
Dr. Mottron,
Thank you so much for writing this commentary and thanks to NATURE for publishing it! The discussion posts are so lively; clearly the time has come for this discussion.
I am an occupational therapist and researcher; I study sensory processing and its impact on everyday life. I have studied people who have autism; they talk a lot about how sensory experiences affect how they construct their own daily life routines and activities. Their intense experiences with various sensations made it easy to see relationships between sensory processing and daily life in the early years of my research.
As I have continued to study the impact of sensory processing patterns on daily life, I have come to understand that all of us have sensory patterns that affect our reactions, our daily routines, and the choices we make about work, recreation and rest (1-3). Just as you describe, it became increasingly clear to me that saying something was wrong with someone because they had a different experience was shortsighted. Some people without particular conditions also have intense sensory experiences. The important factor for living becomes having insight about our own, our family and friends?, our colleagues? sensory patterns, so we appreciate their behaviors rather than judge them.
Autistics are on the same continuum with all of us; you don?t have to have autism to be bothered by a particular kind of sock, or to be a picky eater, or to shy away from crowds because of the noise, the movement or the bumping. And you don?t have to be bothered by these things if you are autistic. When we embrace the concept that there is a continuum on most human variables, a host of additional sources of knowledge become available to us; all the people who have a particular kind of intense reaction can provide ideas for managing that particular situation. When we consider everyone, people look more alike than different; this perspective affords us many more options for solving everyday life challenges.
There is a growing body of literature illustrating different patterns of sensory processing in various conditions. But there is also a growing body of literature about neurotypicals which demonstrates there is a continuum. For example, researchers have shown that there is a relationship between sensory patterns and anxiety, pain catastrophizing, sleep and the need for routinization (4-7) in neurotypical children and adults. With our continued focus on finding the pathology, we may be missing opportunities to find the ways people are adapting to create a satisfying life based on THEIR OWN criteria.
As colleagues like you speak, you provide a stronger scaffold upon which to build a case for taking a strengths perspective. I am so grateful. In fact, don?t we all build our lives based on our interests and strengths? Don?t we all rely on our families, colleagues and friends to support us? Perhaps the question we need to be asking everyone is ?what supports and adjustments to activities and environments do you need so you can do what you want and need to do?? rather than ?what is wrong with you and how can we fix it?? The former question suggests the challenges reside in the spaces between the person and their context; the latter question suggests the challenges reside in the person. The former question invites us to consider the infinite possibilities for a satisfying life; the latter suggests there is a limited view of what a satisfying life can be.
Winnie Dunn PhD OTR FAOTA
Professor and Chair
Department of Occupational Therapy Education
University of Kansas Medical Center
1. Dunn, W. (2001). "The sensations of everyday life: theoretical, conceptual and pragmatic considerations." American Journal of Occupational Therapy 55(6): 608-620.
	
2. Dunn, W. (2008). Living Sensationally understanding your senses. London, Jessica Kingsley Publications.
	
3. Dunn, W. (2011). Sensory Processing: Tools for Supporting Young Children in Everyday Life. Early childhood intervention: Shaping the future for children with special needs and their families, three volumes. S. Maude. Santa Barbara, CA: ABC-CLIO, Praeger Santa Barbara. 2.
	
4. Engel-Yeger, B. and W. Dunn (2011). "Exploring the relationship between affect and sensory processing patterns in adults." British Journal of Occupational Therapy 74(10): 456-464.
	
5. Engel-Yeger, B. and W. Dunn (2011). "The relationship between sensory processing difficulties and anxiety level of healthy adults." British Journal of Occupational Therapy 74(5): 210-216.
	
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Sven Pattyn
Thank you, Dr. Mottron, for sharing your interesting ideas on autism and how it is and should be viewed in society, science, and clinical practice.
My son (5) was recently diagnosed with autism, and, as far as I can tell, he best fits the 'active, but odd' subtype of PDD-NOS. As he strongly resembles me, I guess I might have PDD-NOS myself (although I'm more of a 'passive' type). Although we're both fairly to highly intelligent (I've almost finished my PhD in social psychology) other people often misjudge our capabilities, as we are both socially and communicatively impaired. We just don't give that good of a first impression. Even my teachers have always thought that my strengths lied in studying things by heart, while in reality, I've never studied that much (even at university), things just tend to stick once I understand them (which I often do faster and better than others). My son, then, seems to have the same qualities. He's very good with numbers and letters (making sums, reading numbers up to 999,999, already reading simple words). Just to say that I recognize what you say about the hidden strengths of some autists.
Furthermore, I share your aversion to the over-treatment of autists, just to make them 'as normal as possible'. Of course, many severely impaired autists may need help to improve social, behavioral or communicative skills, but others do not. I, for one, have always been a very happy person, both as a kid and now as happily married father of three, working at the university. I've settled in my role of the odd, non-conformist (which, I believe, can also be a strength of autists). I do not feel any pressure to pursue a career just because of the social prestige. I can just do what I really want to do (actually, I've really had it with desk work, so, once I've finished my PhD, I'm becoming a train driver). By the way, I've never had any therapy whatsoever, as I've never been diagnosed.
Back to my son, then. The team that has diagnosed him immediately proposed to put him in day-care at the hospital to improve his skills or to sent him to a special education class. However, we've decided to keep him at home. We've already sent him to school for one week when he was three. He just stopped eating. He was truly miserable, it took about 9 months before he was the quirky little person again we used to know and love. Of course they very actively tried to persuade us to act differently, but we couldn't stand to lose our happy little fellow again, and we really had the impression they wanted to change completely who he is. We just want to let him be himself and let him accept himself as he is. As school is no option, we're going to homeschool him (successfully this far, as he's cognitively already far ahead on his peers), as only at home he can truly be himself. For socialization, we (will) stimulate him in doing social hobbies (if needed, we'll accompany him) and he has a brother and sister with which he gets along very well (except for the characteristic outbursts now and then). Up-to-now, he's still making progress socially and communicatively, especially when interacting with adults (other children are still a big problem). However, if we ever find his skills to stop developing or even regressing, we'll not hesitate to call for help. But only to aid him with that specific skill, not to treat him entirely. He's different, he's special, he's happy, let him be and don't expect him to be just like everybody else (or make him think he should be).
tim fab
Dr. Mottron,
This was a nice article. If you want to emphasize the role of pattern identification as a strength in the autistic community, then you may want to consider looking at autism from a signal processing perspective.
It can be a useful approach. For example, the calendar counting phenomenon that you have investigated and pondered about fits together with language problems like a hand in a glove. But, you can really only appreciate that tight link from a signal processing point of view.
Tom Fabricius, MD
Mike Alexander
Just to remind people how diverse the manifestations of ASD can be, my 4.5-year-old son has a diagnosis of ASD, and though he is considered to be high-functioning, he has difficulty with pattern recognition and matching. A standardised Ed. Psych. assessment identified some specific visual processing difficulties, such as an inability to replicate simple patterns with blocks, an inability to select matching pictures from a set of four, and a tendency to focus on details at the expense of the bigger picture (part:whole integration problems).
We're glad we had these tests done because so many support professionals just assume that ASD kids will have strong visual skills, and so suggest using visual timelines etc. Our child's strengths seem to be auditory/verbal – he has a good vocabulary and a superb memory for word and number sequences (in a test for recalling number sequences forwards and backwards he scored on the 98th centile).
christopher jensen
My observations of my "autistic" children lead me to believe that "autism" is only categorized as a disorder because of how we as, evolving humanoids,currently perceive and "grade/score" human intelligence. Our children, are part of an evolutionary process. We have reached the point where our kids are expressing noticeable changes in societal functioning. Language,verbal speech will become obsolete. Our children are categorized as having a disorder when in fact they are more "advanced" then we are. Our form of communication and social relations will be conceived as primitive, in the future. These kids have "over activated" parts of the brain because these are the centers of the brain that are going to more activated in the future. Verbal speech, linguistics,are primitive. Mathematics and maybe even mental telepathy will be the language of the future.
Peter Gibson
I wish to return to the problem of autism discussed by Mottron and commented on by me (above). My suggestion that part of the problem is due to slowed reaction was rejected. However, autism is associated with a complex of similar ill defined conditions which produce a cascade of problems that cannot be disentangled. The descriptions for these are shaky at best since many factors are involved. Even finding a ?gene for? would not help for the same argument applies since genes do not work alone and have knock on effects. A general explanation is needed which can be refined to cover the various conditions.
The lack of an obvious physical component is perhaps an over simplification since when the condition affects, for example, speech this can be slow and confused. The overall condition may be due to by hypertrophy: there may be too many neuronal connections. In childhood these are pruned which possibly allows for developmental flexibility which compensates for problems produced at birth such as anoxia. A result of pruning is probably to produce an optimum number of connections. A popular assumption is that this optimum depends on environmental demands. Enriching the environment however may simply increase a wish to please parents.
Autism, dyslexia, schizophrenia and so on, then, may be a consequence of hypertrophy which is linked to intelligence. Variation in intelligence appears to depend on the numbers of neuronal connections uses to correlate information. Language, for example, appears to have evolved as a result of an increase in brain size and in particular the neocortex (Nature, 486, 481-482, 28 June 2012). The adaptive advantage of language is it is a means by which individuals can manipulate one another for gain. This ability appears to be strikingly lacking in autism unless the condition is simple a cry for attention.
Too many connections may be as much of a problem as too few. Over wiring becomes a burden and could produce various conditions. Since intelligence is inherited the parents of autistic children may be brighter than those of other children. The autistic child therefore has a greater chance of inheriting a debilitating excess of connections. Intelligence always returns to the norm over generations as presumably does autism. If one is looking for a genetic explanation for autism then one might do worse than look for a faulty ?connection-pruning? gene.
Peter Gibson
So called learning difficulties are normally split into specific groupings as they are not seen as a continuum produced by a common or similar cause. This may be more than a matter of classification especially since the criteria for the different conditions are imprecise. The slits are based on a general tendency for lumping or splitting. For lumpers a continuum exists. The clinical groups merge and contain striking similarities with so called normal behaviour. They are in effect exaggerated aspects of normal behaviour. This suggests that autistics are unlikely to have any special abilities that are not found in most people. Their apparent special abilities simply contrast with the rest of their disability. The condition appeals to some people who wish to either justify their attraction to the idea or imagine a heightened ability. The argument applies to conditions such as dyslexia, bipolar depression or even schizophrenia.
The temptation for the lumper is to find an explanation that fits the panoply of conditions. Although challenged by Mottron a feature of autism is a slow response. In many situations this is complete by a failure to understand. We all have this in common to a lesser extent. The message appears to get lost. This is not a global cerebral phenomenon but appears to be restricted to some regions of the brain and is most noticeably in the associative area. If one region of the brain was always involved one would be expect this to be reflected in consistent behaviour which is not the case. In learning difficulties many different areas appear to be affected which appear to merger into one another. Where these overlap in one area, say the languages centre, then the condition may be severe. By mapping that overlaps a comprehensive picture might emerge.
The desire to absorb various conditions into a spectrum of normal behaviour may be seen in an evolutionary approach. An example is ADHD. Environmental stress appears to be part this condition. It appears to be labile and modulates other conditions through the neurotransmitter serotonin. In humans and other primates diet may be a factor. Over evolutionary time human diet has shifted from a largely protein, hunter gatherer, to a cereal, agrarian, and now contains a high levels of preservatives and colouring. These changes may have behavioural knock on effects.
The serotonin system in the brain is thought to modulate of other synaptic systems involved in behaviour. Peculiarities in behaviour might be account by difference in synapse distribution and number. The evolutionary increase in the size of the in the human brain has been in part due to neoteny. The ancestral juvenile brain has been retained in the adult and accounts to a larger number of synapses than are found in other primates. In humans the process may have led to language, which is the means by which individuals manipulate one another for personal advantage and requires an increase in associative areas. Increased brain size has also resulted in the brain becoming labile. Serotonin maintains the balance needed for a greater repertoire of behaviour. It is a modulator necessary for hunting in early hominids. Bipedalism led to a greater protein consumption and serotonin levels and is associated to specified types of behaviour such as dominance. The introduction of farming, depended on cereals, reduced the need for protein. Lower serotonin levels produced greater tolerance. The switch in diet accompanying farming led to sociality. The aftermath of this switch might account for the problems in learning difficulties.
Learning difficulties may be explained by neurotransmitter systems. The suggestion is not new. At birth and in early childhood synapses in the brain are reduced and these may belong to the serotonin system. The extent of pruning or even a failure to prune may produce the variety of similar conditions. If pruning was small this may result in slowing of association and other cerebral processes: too many connections. The reverse may be seen in Alzheimer?s disease. A controlled loss and modulation may be required for so called normal behaviour.