This paper reflects the research and thoughts of a student at the time the paper was written for a course at Bryn Mawr College. Like other materials on Serendip, it is not intended to be "authoritative" but rather to help others further develop their own explorations. Web links were active as of the time the paper was posted but are not updated.
2003 First Web Paper
In the words of Uta Frith, a proclaimed expert on autism, autistic persons lack the underpinning "special feature of the human mind: the ability to reflect on itself." ((3)) And according to our recent discussions in class, the ability to reflect on one's internal state is the job of a specific entity in the brain known as the I-function. Could it be that autism is a disease of this part of the mind, a damage or destruction to these specialized groups of neurons which make up the process we perceive as conscious thought? And if this is so, what are the implications? Are autistic persons inhuman? Which part of their brain is so different from "normal" people, and how did the difference arise?
The specific array of symptoms used to diagnose an individual as autistic do not appear as straightforward as Frith's simple statement. It seems hard to fathom that they could all arise from one similar defect in a certain part of the brains of all autistics. Examples of these symptoms include a preference for sameness and routine, stereotypic and/or repetitive motor movements, echolalia, an inability to pretend or understand humor ((3)), "bizarre" behavior((4)) and use of objects ((2)), lack of spontaneity, excellent rote memory ((2)), folded, square-shaped ears ((3)), lack of facial expression, oversensitivity, lack of sensitivity, mental retardation, and savant abilities.
Obviously not all autistics exhibit all of these characteristics. Psychologists, however, often believe certain symptoms to be more indicative of the disease than others. The world autism stems from a Greek word meaning, roughly, "selfism." Autistics are described as very self-absorbed, and some academics refer to a short list of three characteristics to diagnose them. These are impairment of social interaction, impairment of communication without gestures, and restrictive and repetitive interests. ((3)) Tests have also been designed in attempt to diagnose the disease decisively. One of these is the Sally-Anne test, in which autistic children usually show an inability to understand the perception of another child in a scenario or to understand that she could believe something false. ((4)) Another test involves two flashing lights. Autistic children will look at a light if it flashes, but other children will show a tendency to move their eyes toward a new light while autistic children will not. ((3))
Observation of the behavior of autistics makes it clear that they do interact with their world and understand certain aspects of it to a degree. However they often appear intensely focused on one perception or sensory experience and are unable to integrate multiple factors of emotion, intention, or personality in the way most people do. As a result of this inability to perceive order in all of the circumstances of their environment, they often find themselves in a world that seems very chaotic and random.
Jennifer Kuhn hypothesizes that many of the symptoms of autism are defense mechanisms stemming from a feeling of helplessness to control a situation. ((3)) Rats, when they are forced to jump at one of two doors that are randomly chosen to open unto food or stay closed and hurt the rat, will always pick the same door. (Lashley and Maier, 1934) Thus the repetitive behavior of autistics, their insistence on routine, and their echolalia can all be explained as attempts to calm themselves by achieving an inner order. They are effectively forsaking experimentation in an attempt to avoid failure. This might be evidence for damage to an I-function, as we have discussed that observation and experimentation are innate behaviors of humans, and that they require personal reflection.
However, many autistics do not exhibit behaviors such as echolalia all the time but rather more frequently when they are in an unfamiliar environment. ((1)) And I have observed in myself a tendency to get a nervous repetitive motion in my foot in certain situations or even a rhythmic movement of my head when I am concentrating very intensely, but I am still confident of my ability to reflect on my own thoughts.
One of the most obvious ways to find out if autistics share a collective brain abnormality that causes their unique array of characteristic behaviors is to look into the structure of the brain itself. In studies of autistic brains use scanning images as well as autopsies, scientists have generally not been able to agree on a single consistent abnormality. Some observations have been that the neurons in the limbic systems of the autistic subjects are often smaller and more densely packed than those of other individuals. Monkeys whose limbic systems were removed in experiments showed weaknesses in social interaction, memory, as well as exhibiting locomotor stereotypes similar to those of autistics. ((2))
Another area that often exhibits abnormality in autistic brains is the cerebellum, especially in the CA1 and CA4 cells were there are less dendritic arbors and less Purkinje and granule cells. ((2)) Purkinje cells are responsible for cell death, and in where they are in small number cells may be allowed to crowd each other and not develop networks properly. This could account for autistics' tendency to be overwhelmed by stimulation. The cerebellum is also responsible for muscle movement, and other studies have found significantly fewer numbers of facial neurons (400 as compared to 9,000 in a control brain), which could also account for absence of facial expression. ((3)) Other areas of the brain which some studies have argued are abnormal in autistic brains are the left hemisphere which controls language ((5)), ((6)) the temporal lobes which control memory((2)), and the brain stem((3)).
However, many of these findings are still considered controversial or inconclusive and may not only be attributed to autism but to many people with developmental disorders. And even if these observations are accurate there is still no explanation for why these differences in brain structure occur simultaneously.
One very convincing hypothesis to explain these occurrences has been proposed by Patricia M. Rodier. Inspired by the fact that relatives of autistics are much more likely than the natural population to be diagnosed with the disease, Rodier became convinced that there must be some definite genetic factor contributing to it. However there was still the fact that an identical twin with an autistic sibling will only contract autism about 60% of the time, which makes an argument for environmental influence as well.
She then came upon a study of children whose mothers were exposed to a drug called thalidomide during their pregnancy, and found that a full 5% of their children were diagnosed as autistic. By combining information about the drug with other birth defects in the ears and faces of the children, she was able to guess that autism began 20 to 24 days after conception, when the ears and the first neurons in the brain stem are starting to grow. When she began to examine the brains of previously autopsied autistics, she noticed they showed evidence of particular short brain stems and often they also had a small or even absent facial nucleus and superior olive.
This information suggests that the genetic factor which causes these abnormalities in the primitive brain could then go on to cause the secondary abnormalities in the various other more sophisticated parts of the brain already mentioned. And Rodier has identified a gene known as Hoxa1 which is present in 40% of autistics but only 20% of non-autistics. It is found more often in relatives who are autistic than those who are not. Although this is by no means a conclusive argument that autism is genetic, there could be other variants of that allele which contribute to autism or certain genes which decrease the risk of it which haven't yet been discovered but could account more strongly for genetic determination. ((3))
So could there be specific genes which actually code for the I-function? This is possible, but there is still certain evidence for environmental factors causing some of the symptoms of autism. In-utero exposure to not only thalidomide but also rubella, ethanol, and valproic acid have been liked to the disease. And there is a significant population of people who believe that the elimination of glutens and luteins found in milk, apple juice, wheat, and other products relieves the build up of certain chemicals in the brain and makes autistics more able to fit in with society. ((8)) A recent study of abused children has also claimed that the left hemisphere of the brain, specifically areas dealing with memory and expressing language in the limbic system, can be overexcited and damaged as a result of intense sexual or physical abuse. ((5)) Perhaps all of these environmental factors do additional damage to the different sectors the I-function.
What does all of this say about autistic people? Do the characteristic differences in their brains necessarily indicate that they are lacking this "I-function" or awareness part of the mind that makes someone human? I do not think so. The fact that rats and monkeys can show similar symptoms when these areas of their brains are damaged destroys this argument. The self-awareness or I-function does not appear to be limited to humans. And it may just be that the I-function operates differently or is damaged in the minds of autistics. There are huge degrees of severity in what are called the "autism spectrum diseases." These can be defined to include dyslexia, ADHD, Asperger's syndrome, pervasive developmental disorder, and more, with autism being the most severe. And any person can have symptoms of autism without being fully "autistic." But even severe changes in the I-function system should not necessarily be considered defects.
It is entirely possible that autistic people have thoughts and self-reflections which they cannot communicate through language or in society's "normal" modes of expression. While they do seem do have a diminished capacity to reflect on as much as other people do of the world at once, it may be that what they do reflect on could be just as much or more meaningful. Autistic savants, for example, show an amazing ability in one area such as music, art, or calculation which often surpasses what it seems a "normal" person could ever achieve. And these creations are not just byproducts of the rote memory and habit that some scholars insist is all that exists in autistics. It is my personal opinion after viewing the art of an autistic savant, Richard Wawro ((9)), that the work and the artist are infused with at least as much emotion and unique perspective as any "normal person."
Frith also argues that autistics are "...not living in a rich inner world but instead are victims of a biological defect that makes their minds very different from those of normal individuals." ((4)) But who is it that has the authority to decide what a "normal" individual is? The defense mechanisms that autistics display are evidence that they do experience distress and anxiety, but Freud argued that non-autistic or what Frith would call "normal" individuals also display a number of common defense mechanisms as a result of the anxieties in their lives, and this view is still widely accepted. Just because these may appear more normal or subtle to us does not mean they are not important.
In a society of autistics, we might feel a great deal of incoherence at how they might organize their world, and we might found ourselves the ones unable to communicate. In the movie "Molly," which concerns a fictional autistic woman who becomes normal and reflects on her experiences, there is a speech that illustrates this point beautifully. "In your world, almost everything is controlled....I think that is what I find most strange about this world, that nobody ever says how they feel. They hurt, but they don't cry out. They're happy, but they don't dance or jump around. And they're angry, but they hardly ever scream because they'd feel ashamed and nothing is worse than that. So we all walk around with our heads looking down, but never look up and see how beautiful the sky is." ((10)) If autistic people can possibly use their minds to see a beauty we cannot imagine, who are we to call them the abnormal victims? If they can only see the world in a sincere way and not understand irony or humor, is that necessarily a bad thing? We cannot truly know what autistics are aware of internally unless we have experienced their world.