Sunday, December 20, 2009

Autism as a dual disorder

Autism is a complex neurological disorder of varying degrees of severity. Among its characteristics is a difficulty in social interaction and in reading the minds and intentions of others.

But social interaction involves at least two people, and in thinking about autism I wonder whether we should not also consider the way in which apparently normal people are also “impaired” in interacting with frankly autistic people.

I was very frustrated over a year ago when dealing with a lady who seemed remarkably ill equipped at social interaction, and seemed to lack all intuition. Communication with her was very difficult and other, apparently normal, individuals who came into contact with her shared my experience. I wondered, as did others, whether she is autistic.

It gradually dawned on me that the difficulty was two-way, that I in return was very ill-equipped to communicate with her, because I had no mental representation of a person from whom one could elicit no anger, or sadness, or joy or approval, or disapproval, or indeed any emotion, whatever one said or did.

Hence I suggest that, if we consider autism spectrum disorder to be, in part at least, a social disorder, we must envisage the possibility that the “disorder” is shared and that it is partly also a "disorder" in the individual with whom the interaction is occurring, and who has no mental framework to deal with this apparent difficulty of reading the mind of an autistic individual or interacting with them. It may be worth considering whether, in dealing with autism, we should not also try to generate rules that will make our interaction with autistic individuals more easy. This may even have the beneficial effect of easing their problems.

It is of course possible to argue that we would be able to learn how to deal with this lack of social interaction more readily than individuals with an autistic spectrum disorder. My experience with this lady has taught me otherwise. I found it very difficult to read into her mind and thus interact with her constructively even in spite of the long time during which I had to interact with her.

Hence I think that autism spectrum disorder should not be considered as confined to individuals but to social interactions in which both sides, the autistic and the apparently normal, are deficient in communicative skills, with each side lacking the mental representation of how to interact with the other.

At any rate, this is something worth thinking about.

10 comments:

Leonardo Caire said...

I believe that this deficience of communication skills by normal means of communication is one of the reasons that might lead some artists to really communicate with their art. Included are many examples of great introspective artists that were not the best (word)speakers of their time.

Greetings from Brazil, prof Zeki!

katherine lee reece said...

I know very little,
but maybe the next time you are in California you can head down to the LA area to see Paul Zak...the director of the Center for Neuroeconomics Studies at Claremont Graduate University. He is doing a study with oxytocin. That might take the edge off the communication frustration.
I have read in the American Journal of Psychiatry a study that found folks with autism have a larger brain size but less corpus callosum.
Having less corpus callosum might be making the information exchange between right and left brain activity more difficult or complex so maybe if we chill out with oxytocin we would be able to perceive their intelligence and intent better...maybe .

Fred McVittie said...

There is an excellent video on Youtube by a person with an autistic condition that expresses very well what you are saying here.

http://www.youtube.com/watch?v=JnylM1hI2jc

Professor Zeki said...

Thanks, Fred, for your input. SZ

Liben said...

According to pre-speech Triad Syntax (visio-audio-kinetic) as the noun-interjection-verb natural perception, Autism is mainly the triad syntax processing disorder. This idea blends well with your study on processing art. Please, check the last paper here http://vip.db.dk/signs/Articles.htm

Professor Zeki said...

Thanks for your post. Interesting. SZ

Bhismadev Chakrabarti said...

greetings, professor!

you raise an interesting point, but couldn't you extend this argument to nearly every brain disorder? e.g. the schizophrenic person's perception of themselves, and us, is quite different from our perception of the schizophrenic person, and ourselves. why should this 'duality' be singled out in autism? if it is just because we do not have an adequate mental model of 'what-it-is-like-to-be-autistic', then that should extend to nearly every other brain disorder - or, for that matter, all the blue that mary sees (and that we'll never know how she sees).

hope you are well,
best regards,
bhisma

Professor Zeki said...

Greetings Bhisma...my apologies for the long delay in responding.

You have generalised the point I made, and I am in agreement with you. Indeed one could generalize it yet further to conditions in which one individual must remain an outsider because the pronouncements of his or her community are - as the late Krishna Menon, Indian ambassador to the United Nations, used to say - "not cast in the mould of my thinking". One can turn the argument around and imagine a society made up of schizophrenics or those with autism spectrum disorder who understand the rules that govern the behaviour of similar individuals but have no understanding of the rules governing the behaviour of non-schizophrenic individuals. Who would then be the outsider?

The critical point is whether there is any rule or rules by which we can judge the behaviour and intention of such individuals. If there are, and if we can learn them, perhaps they would be less isolated than at present.

Thank you for your thoughts.

Regards, SZ

Lourdes said...

I was scanning your previously posted columns and found this one quite interesting.

I was a high school art teacher for 8 years and often had students with various levels of autism. So many times I had to rethink the ways I communicated. I often thought that if I wasn't reaching a child, it was because I wasn't creative in my expression or word usage. I didn't see it as "just their problem."

I'm so glad to see you write about communication being a two-way street. For instance, non-spoken facial clues can be as ineffective a tool to communicate with as it would be to use facial clues to a student with a visual impairment.

Thank you

S.Z. said...

Thanks for your interesting and informed contribution to this debate