What Is Autism?

Autism Spectrum Disorder (ASD) is a lifelong disorder that impairs an individual's understanding of what he or she sees, hears or otherwise senses. It is a disorder that is characterized by impaired development in communication, social interaction, and behavior. It is found in every country and region of the world, and in families of all racial, ethnic, religious, and economic backgrounds. Ongoing research around the world has still not unearthed a definitive conclusion on the causes of Autism. What is evident though is that Autism is neurological in origin and the genetic component factors in its occurrence.

The classification of autism occurred in 1943, when psychiatrist Dr. Leo Kanner who reported on 11 children with striking behavioural similarities, and introduced the label "early infantile autism". He pointed to "autistic aloneness" as one of its main features, which is a description of the mental isolation of an individual accompanied by an obsessive insistence on sameness. He suggested "autism" from the Greek avtoc, (autos), meaning 'self', to describe the fact that the children seemed to lack interest in other people' (in Frith, 1989, p.10-11).

Lorna Wing & Judith Gould (1979) gave the triad of impairment as the diagnostic criteria for autism Impaired ability to communicate
Impaired ability to socialize
Impaired imagination

Kellman defines autism as "a little understood disorder that appears to be either genetic in origin, or perhaps the result of damage during or before birth… a part of a long continuum that includes, at one extreme, severely retarded, mute individual, beset by numerous, compulsive, tic-like behaviours and at the other, highly articulate, single-minded geniuses with adequate social skills and a marked inability to take part in the mutual communicative aspects of social existence" (1999. pg.262).

Autism may have an onset in infancy yet not be recognized until some time later Retrospective parental reports suggest that many children with autism have had significant delays in the development of motor abilities, speech, verbal or non-verbal communication, reasoning and learning skills, social interactions and abnormal responses to sensations (Baron-Cohen, 1995; Frith, 1989; Hobson, 1993). According to Simon Baron-Cohen, the source of this disability lies in the fact that people with autism suffer from "mindblindness" hence are blind to their own and to other people's minds which is why they experience difficulty in communication, interaction and imagination (Baron-Cohen, 2000).

It is estimated to affect nearly 2 million individuals in India (T C Daley and Sigman, 2002). The incidence of ASD is said to be 2 to 6 in 1000 (CDC-USA), making it the third most prevalent developmental disorder in the world. The incidence of Autism is higher than disabilities like Cerebral Palsy or Down’s syndrome.

Cognitive Theories that have been used to explain thinking in autism spectrum disorders

Many attempts have been made to explain thinking styles among individuals with autism. The best researched among the theories are:

1) The Theory of Mind
2) Executive Dysfunction
3) Weak Central Coherence

Theory of Mind

The term “theory of mind” is attributed to Premack and Woodruff who used it in 1978 in reference to whether the mind of the chimpanzee works like the human mind, by making the implicit assumption that the behaviour of others is determined by their desires, attitudes and beliefs.

Over the years, alternatives for the term ‘theory of mind’, such as ‘ToM’, ‘mentalizing’ and ‘intentional stance’, have also come into use.

It refers to the ability to explain and predict behavior by hypothesizing on the thoughts, feelings and goals of partners in social interaction. Baron-Cohen and coauthors

(1985) suggested that theory of mind deficits were caused by a defective innate cognitive mechanism which makes it possible to imagine what goes on in the mind.

The roots of understanding the intentional or mentalistic nature of human action lie in infants’ strong interest in people as evident in their attention to human faces and language, and their ability to respond to affective expressions within the first few months of life.

Simon Baron-Cohen (Mind-blindness, MIT Press) postulated that there are four steps to mind-reading or achieving the theory of mind:

1) The Intentionality Detector (ID)
2) The Eye-Direction Detector (EDD)
3) Shared Attention Mechanism (SAM)
4) The Theory of Mind Mechanism (ToMM)

The Intentionality Detector is a perceptual device that interprets motion stimuli in terms of the primitive volitional mental states of goal and desire. ID reads anything with apparent self-caused motion or sound in terms of an agent’s goal and desire.

The Intentionality Detector is a perceptual device that interprets motion stimuli in terms of the primitive volitional mental states of goal and desire. ID reads anything with apparent self-caused motion or sound in terms of an agent’s goal and desire.

The Eye-Direction Detector computes whether there are eyes out there and if so whether those eyes are “looking at me” or “looking at not-me”. It involves detecting eyes, detecting the direction of eyes, interpreting gaze as seeing.

Shared Attention Mechanism is a triadic representation. SAM receives its information from EDD and also receives information from other perceptual modalities. Between 9 and 14 months of age children establish shared visual attention by gaze monitoring. Around the same time toddlers begin to use proto-declarative pointing gesture.

The Theory of Mind Mechanism infers a full range of mental states from behavior: pretending, thinking, believing, deceiving, dreaming and knowing.

Executive Dysfunction

Executive function is traditionally used as an umbrella term for functions such as planning, working memory, impulse control, inhibition, and shifting set, as well as the initiation and monitoring of action. These functions share the need to disengage from the immediate environment in order to guide actions. These are goal directed behaviours.

There are 3 separable but unified components of Executive Functions:

1) Attention control: selective attention and sustained attention.
2) Cognitive flexibility: working memory, attention shift, self-monitoring, and conceptual transfer.
3) Goal setting: initiating, planning and organization, difficulties generating and implementing strategies for problem solving, and strategic behaviour.

Executive functions are important for successful adaptation and performance in real-life situations. They allow people to initiate and complete tasks and to persevere in the face of challenges. Because the environment can be unpredictable, executive functions are vital to human ability to recognize the significance of unexpected situations and to make alternative plans quickly when unusual events arise and interfere with normal routines. In this way, executive function contributes to success in work and school and allows people to manage the stresses of daily life. Executive functions also enable people to inhibit inappropriate behaviours. People with poor executive functions often have problems interacting with other people since they may say or do things that are bizarre or offensive to others.

Weak Central Coherence

Central coherence is the ability to integrate individual components into a coherent whole. This can be related to the perceptual area or language ability.

One of the key theories that have been used to explain the core deficits of autism is the “weak central coherence” theory. This theory is said to account for the decreased ability in global processing and enhanced local processing in individuals with autism. One example of local processing is the autistic child’s tendency to draw a minor detail like the eye-balls first and then go on to complete the larger aspects of the face.