Category: science

In my last post, I wrote about how I had a very logical, rule-oriented mind from an early age. One of the things I’ve been thinking about for a while is how much that tendency has both influenced and been shaped by my faith in Christ.

I grew up in a Christian family, and I went to the same small, conservative Christian school from 1st-12th grade.  As with any environment, the one I was brought up in had both positive and negative aspects.  I was protected from many potential pitfalls, and at the same time I became more susceptible to others.

I’d like to write about examples of both on this site, partly to help me organize my own thoughts as I continue to learn more both about Asperger’s and about God– and partly in hopes of relating to other people who are interested in Asperger’s and religion.

I’ve seen many discussions about faith and religion on Aspie discussion sites, and one thing that I find fascinating is that, while it seems common for people to describe the experience of having Asperger’s as playing a role in how their beliefs developed, there seems to be just as much variation in religious beliefs among people with Asperger’s as there is in the population in general.

One person may say that her orderly way of thinking made the idea of a God who establishes absolute standards of right and wrong make sense.  Another may say that his concrete thinking leads him to search for natural explanations for the world and to treat the idea of God or the supernatural with skepticism.  Both may be surprised that a similar way of thinking has led the other to a vastly different conclusion; I’ve seen threads asking “Are most Aspies religious?” and threads asking “Are most Aspies atheists?” on the same discussion board!

(Incidentally, the same phenomenon seems to occur with politics; people with Asperger’s can be anywhere on the political spectrum.)

Overall, this makes sense to me, and I’m actually glad that being an Aspie doesn’t mean I am exactly the same as every other person with Asperger’s.  It’s really important to remember that a syndrome is just a useful label and every person is unique.  Even people who share similar experiences can end up very different from one another.

Well, I was originally going to try to cram a lot more into this post, but I think I’ll save that for later!


In my last post, I said that I think researchers have overlooked Asperger’s syndrome in females, and that’s the biggest problem I have with the “extreme male brain” theory of autism. I’m not the only one that thinks so. Recently I read a very interesting article online from the British Sunday paper The Observer:

Doctors are ‘failing to spot Asperger’s in girls’ by Amelia Hill, April 12, 2009.

The article quotes Dr. Judith Gould, director of the UK’s National Autistic Society.  In 1979, she and Lorna Wing co-wrote a paper that helped to begin the process of defining Asperger’s and the autism spectrum.  The British government is forming a strategy on dealing with autism, and Gould is pushing for an effort to pay attention to girls on the spectrum.

“We’re failing girls at the moment. We are doing many thousands of them a great disservice. They are either not being picked up in the first place, but if they ask for help they are being turned away. Even if they are referred for diagnosis, they are commonly rejected.”

One problem that you can run into in science is that forming a theory requires making assumptions, and if you’re not careful, those assumptions can be self-reinforcing.  If you go back to the posts about defining Asperger’s, you’ll remember that the syndrome is defined by a set of outward characteristics that seem to go together.

Most of the people diagnosed according to those characteristics are male, which leads to the expectation that most of the people who will be diagnosed will be male.  And because Asperger’s is still such a new diagnosis, even a lot of professionals don’t know a lot about what to look for.  I have read accounts of girls being told “You can’t have Asperger’s; you’re a girl,” even when they believe the traits of Asperger’s actually do describe them quite well.

In addition to that problem, what if the definition itself is biased because it is based on what Asperger’s typically looks like in a male?  Might it not be the case that the same cognitive condition might tend to have different outward signs in females than in males?  The differences in behavior between genders are not all due to physical differences in the brain.  There are a lot of societal and cultural differences in the things that boys and girls tend to do, and in the ways that they are expected to behave.  It seems quite reasonable to me that Asperger’s syndrome would tend to look a bit different in girls than in boys, and we won’t know what to look for until we pay attention and look for it.

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Okay; we’re up to our fourth cognitive theory of autism, a series of theories that attempt to explain the outward traits of autism by some difference in the brain or mind.

This theory is another one advanced by psychologist Simon Baron-Cohen, so it builds somewhat on his earlier ideas about theory of mind.  (He gives credit to much earlier researchers 60 years ago for first suggesting the “extreme male brain” idea, but it had not been considered for a long time.)  My feelings about the two theories are similar, meaning that I think Baron-Cohen has observed something real, but I’m not sure he has the whole picture right.  (And, to be fair, he doesn’t claim to– this is the way science works.  You create a scientific model based on observation and adjust it as new information comes in that works for or against it.)

Anyway, my material for this post largely comes from a 1999 paper by Baron-Cohen, accessible here in PDF format.  Baron-Cohen starts off by assessing the three cognitive theories of autism I’ve talked about on this blog, noting both strengths and weaknesses in each theory.  Then he cites a few findings from research:

  • Autism seems to be at least partly linked to genetics.  In the general population, autism seems to occur at a rate of somewhere between 0.05% and 0.1%.  But if a child is diagnosed with autism, there is a 3% chance that his or her sibling will also– a significantly higher number.  Also, among identical twins, there is a 60% chance that if one is diagnosed with autism, the other will be as well.  So while genetics may not be the only thing that determines whether you are autistic or not, there definitely seems to be a link.

    (I can personally attest that, while none of the other members of my family have been diagnosed with Asperger’s, we share a lot of the same personality traits.  Some of the material I read about the traits of Asperger’s made me say “This isn’t a disorder; this is my family!”)  🙂

  • Most of the people diagnosed with autism are male; the ratio is about 4 to 1.  If you only look at Asperger’s diagnoses (those with no delay in speech or cognitive development), the ratio is even more extreme, 9 to 1.

    It’s unclear why this is, though.  Some genetic conditions, like red-green colorblindness, much more commonly occur in males because the genes for them are on the X chromosome.  In order for a girl (with two X chromosomes) to be red-green colorblind, for example, she needs to receive the colorblindness gene from both her mother and her father.  A boy receives an X chromosome only from his mother (he gets a Y chromosome from his father), and if his one X chromosome has the colorblindness gene on it, he will be colorblind.  (I’m probably oversimplifying this example, but hopefully you understand what I mean.)

    But so far, at least, genetic research does not indicate that autism is linked to the X chromosome.  It seems to be tied to multiple genes on multiple chromosomes among the other 22 that humans have.  Researchers are trying to trace it to something they can identify (I think there was a recent article about a new finding in this area), but it’s really complicated.

Baron-Cohen then cites research noting that men and women tend to have different areas of cognitive strength.  Here are the strengths he lists for females:

  • Language tasks; girls tend to develop language skills faster than boys.
  • Tests of social judgment.
  • Measures of empathy and cooperation.
  • Perceptual speed; the ability to quickly identify matching items.
  • Ideational fluency; the example Baron-Cohen gives of this is quickly listing as many things as you can that are a specific color.
  • Fine motor coordination.
  • Mathematical calculation tests.
  • Pretend play in childhood.

Studies show that males tend to be weaker in the above areas but stronger in the following:

  • Mathematical reasoning; especially in areas like geometry, word problems, and higher-level math.
  • The embedded figure test; being able to find a shape in the middle of a jumble of distracting information.
  • Mentally rotating or folding an object and predicting what it will look like.
  • Some spatial skills.
  • Target-directed motor skills; guiding or intercepting projectiles.

If you know much about the traits of autism, a lot of these weaknesses and strengths probably sound pretty familiar.  Some of the descriptions of being excessively literal and concrete or socially clueless at times do sound similar to the kinds of things that people joke about as being a “guy thing” (and provide sitcom writers with plenty of material).  Could it be that an autistic brain is an “extreme” version of the male brain, with these weaknesses and strengths magnified even more?

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Okay; this is my third post about a specific cognitive theory of autism, a theory that attempts to explain the outward signs of autism as the results of something different about the autistic person’s brain or mind.

The weak central coherence theory was first advanced by German-born psychologist Uta Frith of University College London in the late 1980s.  She describes weak central coherence as “an information processing style” that tends to process “details at the expense of global meaning.”  Put another way, autistic people are very good at noticing details, but we struggle with seeing the “big picture”– we might see every tree but miss the forest.

Incidentally, here’s a link to a presentation by Frith on various Cognitive Theories of Autism.  It’s been one of my most helpful sources for this series of posts.

The funny thing is that, while the name of this theory of autism refers to a weakness, the most clear evidence of it is seen in a person’s strengths at tasks that depend on being detail oriented.

Frith’s video gives several examples of visual tests that seem to indicate that this focus on details is an area of strength in people with autism and Asperger’s.

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This is part of a series of posts I’m trying to do about the cognitive theories of autism that are prevalent today, which attempt to explain the outward signs of autism and Asperger’s syndrome by what is happening in the mind or brain.  I have heard of at least five such theories; how much I am able to tell you about them depends on how much I’m able to understand.

I’ve been doing a lot of reading about this first one, and it still has me pretty confused– not so much about what the theory says, but about whether and how it may apply to me.  I’m not sure that I agree with it, but I’m also not positive that I understand it properly.

At any rate, I’m looking at the view that autism is characterized by a difficulty or delay in developing a theory of mind.  One of the biggest proponents of this idea is Simon Baron-Cohen, a Cambridge psychology professor whose research of autism has gathered a lot of evidence that seems to show a connection.  (If his name sounds vaguely familiar to you, that may be because he has a famous cousin, actor Sacha Baron Cohen.  Yes, his cousin played Borat.)

So, anyway, what is a theory of mind?  Simon Baron-Cohen defines it as follows:

“A theory of mind is the ability to infer mental states (beliefs, desires, intentions, imagination, emotions, etc.).  We seem to do this an enormous amount, as a natural way of thinking about why people do what they do.”

Developing a theory of mind includes recognizing that other people have their own minds, with their own beliefs, desires, and awareness of the world; and that one’s own mind also has these properties; and that the perspectives, beliefs, and emotions of others can be different from one’s own.

This isn’t a simple concept.  What is a mind, after all?  You can’t see another person’s mind, or even your own.  You can’t directly hear another person’s thoughts or feel their feelings (unless you know how to do a Vulcan mind meld).  That’s why psychologists call it a theory of mind– the idea that each person has a mind is not directly observable, but like a scientific theory, it helps us to make sense of what we see– in this case, the behavior of people around us.  Baron-Cohen gives an example of how we regularly make use of the theory of mind, using italics to mark the words that refer to thoughts about what’s going on inside another person’s mind:

“For example, you might wonder why someone hasn’t phoned you in a while:  You speculate that maybe you’ve offended them in some way, or at least they think you have.  Or maybe they’re trying to avoid you because they feel the friendship is suffocating.  Or maybe they just want more space.  So you phone them up and they say that everything is fine.  You start wondering whether, when they say that, do they actually mean it?  Perhaps they’re intending to keep things polite but really wish the friendship was over?”

Now that I think about it, it’s amazing that we work all of this stuff out when we’re still very young, but we do.  Psychologists have studied how children tend to develop a theory of mind, and they can see signs of it developing between the ages of 1 and 4 for most children.

Simon Baron-Cohen gives several examples of signs that a child is developing a theory of mind:

  • Understanding the difference between mental and physical things.  If one child is holding a dog and another is thinking about a dog, which of them can pet the dog?
  • Being able to name some of the mental functions of the brain– understanding that the brain thinks, feels, dreams, etc.
  • Being able to pick out words that refer to things that happen in the mind (think, imagine, pretend) from a list that also contains words referring to physical things (jump, climb, run).
  • Using these words to describe things.
  • Playing make-believe.
  • Understanding that emotions can have mental causes (disappointment), not just physical causes (scraping your knee).
  • Being able to tell what a person is thinking about from clues about where they are looking– a person may stare at something they want or are interested in, or they may look up at nothing in particular if they are thinking hard.
  • Understanding that one’s intentions can be different from what actually happens.
  • Deception (whether that means lying or playing a game like hide-and-seek),
  • Understanding metaphor, sarcasm, and irony– non-literal speech.

These are all areas that autistic children tend to lag behind in learning, and Simon-Cohen believes that many of the traits of autism are related to difficulty developing a theory of mind.

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One of the many things I’ve enjoyed about starting this blog on WordPress is that it’s given me the chance to read what other people are posting about Asperger’s and autism– including other “Aspies”!  A blog I’ve really enjoyed reading is Soph’s An Ordered Mind.  Some of her posts have reminded me things that I tend to do that I had never realized could be connected to Asperger’s syndrome– but now that I think about it, it makes perfect sense.

Anyway, a recent post on that blog gave me the idea of doing a series of posts about theories of autism.  This is the next step in the scientific process after defining the characteristics of autism or Asperger’s syndrome.  It looks at the list of characteristics in the syndrome and asks the question “Okay, so what can explain all of these characteristics?”  Most of the current theories of autism are cognitive theories, meaning that they seek to explain the outward characteristics of the syndrome by something going on in the person’s mind or brain.  How does an autistic person’s thinking differ from a non-autistic person’s?  Is there something physically different in the brain that explains this difference?

Once again, autism can look very different in different people.  I already talked about how the autistic spectrum can range from what is considered severe mental impairment (such as never speaking) to what may be considered just a quirky personality (like ranking almost every video game you’ve played– it’s now a “top 80” list, in case you were interested).  And even the idea of “low-functioning” vs. “high-functioning” autism is a vast oversimplification.

I think most scientists would love to be able to trace all of the ways autism is manifested in different people back to one clear, simple cognitive trait.  (At least I would– I love simple answers.)  Not surprisingly, we haven’t been able to do that.  : )  That’s why there are many competing theories of autism.  They all seem to explain some of the common traits of autism pretty well, but none of them explains everything.

The theory you use to explain something naturally causes you to “fill in the blanks” according to what the theory predicts.  This needs to be done cautiously, though, with an understanding that it’s possible to be wrong.  The consequences of applying a theory that is wrong, especially when applying it to people, can be very bad.  In order to provide an example of this, I want to talk about what the predominant theory of autism in the United States used to be until some time in the 1970s, and I’m afraid it’s a very sad story.

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So far, I’ve talked about three of the criteria the DSM-IV uses to define Asperger’s syndrome:

  • Qualitative impairment in social interaction.
  • Repetitive, stereotyped patterns of behavior, interest and activities.
  • A clinically significant degree of impairment in social, occupational, or other areas of functioning.

The other three criteria seem to be mainly for the purpose of keeping the description of Asperger’s distinct from other categories described in the DSM-IV.  Here are the first two:

There is no clinically significant general delay in language (e.g., single words used by age  2 years, communicative phrases used by age 3 years).

There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.

These are the main things that distinguish Asperger’s syndrome from what is considered “classic autism.”  Some of the early signs of autism include a delay in language development or a delay in cognitive development.  Aside from that, many of the other traits of autism and Asperger’s can be the same, to the point that it is hard to say if Asperger’s is really something different from what is considered “high-functioning autism.”

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (or the DSM-V) is tentatively scheduled for publication in 2012.  Interestingly, according to Wikipedia, there has been some discussion about removing this distinction:

“A panel session at a 2008 diagnosis-related autism research planning conference noted problems with the classification of AS as a distinct subgroup of ASD, and two of three breakout groups recommended eliminating AS as a separate diagnosis in future versions of the Diagnostic and Statistical Manual of Mental Disorders.”

So it’s possible that within in a few years, the label for my brain will simply be “autism” rather than “Asperger’s syndrome.”

The last criterion for Asperger’s syndrome is also intended to keep it distinct from other diagnoses:

Criteria are not met for another specific Pervasive Development Disorder or Schizophrenia.

I don’t know much about the other Pervasive Development Disorders or about schizophrenia, so I don’t want to try to talk a lot about them here.  I have read that some people on the autistic spectrum were previously misdiagnosed with schizophrenia, so this may be partly in response to that.  At any rate, that takes care of all six criteria.

So now you know how complicated it is to make a useful label for the way the human brain works.

As I think about all this, I am thankful for the abilities God has given me– there are a lot of abilities that I often take for granted that are more difficult or impossible for others to do.

Even more so, I am thankful that God is with each of us in whatever struggles and weaknesses he allows into our lives.

Okay; we’re now on the third criterion from the DSM-IV for the diagnosis of Asperger’s syndrome.  This one has only one part:

The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.

On the face of it, it may seem like there’s not much to say about this criterion.  Maybe this is the criterion that separates those diagnosed with Asperger’s from those who are merely considered not very social and a bit obsessive in their interests.  Asperger’s is sometimes seen as a “trendy” diagnosis in recent years, so perhaps this is a measure to make sure that people don’t become preoccupied with getting a label if it’s not particularly useful.  After all, practically everyone can identify with at least some of the traits I’ve talked about so far at some point in their lives.

I think this criterion helps to highlight something interesting about the way the label is applied, though.  I learned about my Asperger’s because I sought help and answers after struggling with anxiety and depression during my time at grad school.  (Actually, these have been lifelong struggles for me, but the high-pressure environment of grad school made them much more apparent.)  Currently, the areas that I find most difficult in my life are the two that are mentioned here– social (forming relationships) and occupational (finding a career).  These are common struggles for “Aspies.”

However, I can easily imagine someone with virtually the same brain chemistry as me coping with life just fine without ever learning about Asperger’s or getting diagnosed with that label.  After all, I did fine for 26 years without knowing about it!  I can look back and realize now all of the ways that God provided for me throughout my life the strength and support I needed.  And I believe that my diagnosis and all of the things I am learning about myself now are yet more provisions from him.

It’s like I said before; Asperger’s is just a human label– God knows me better than I know myself, and I trust that he knows what he is doing.

I do think it’s important to take this criterion into account when you see statistics that say things like “People with Asperger’s are prone to anxiety and depression.”  While it’s useful to be aware of such a correlation, it’s possible that causation could go both ways.  Yes, perhaps people with Asperger’s are more likely to struggle with depression and anxiety; but at the same time, an “Aspie” who doesn’t struggle with something is not likely to be diagnosed in the first place!

Since Asperger’s was defined, there has been much speculation about famous historical figures that may have been on the autistic spectrum based on descriptions of their behavior.  (It’s really popular to mention Albert Einstein, but of course everyone wants to be like Einstein, so I’m not sure I believe that story.)

But the fact is, if autism works as a spectrum, then the line between having Asperger’s and not having it will necessarily be fuzzy.

Don’t worry; even though there are three more criteria in the diagnosis, I think I will be able to talk about them all in one post.  : )

If you ever get into a discussion with me about sports, it probably won’t take you long to learn that I am an avid Pittsburgh Steelers fan.  I was born in the Steel City, and my family have been Pittsburgh fans going back two generations.

So maybe you can imagine my reaction when a couple of weeks ago I got an e-mail from the Steelers’ long-time rival, the Cleveland Browns, that began “Dear Browns Fan,” asking me if I would answer a fan satisfaction survey.  How had they come to the conclusion that I was a Browns fan?  A note at the end of the e-mail explained:

You have received this email because you have identified yourself to be a Browns fan or have demonstrated an affinity for the Club through a purchase or purchases you have made through the NFL or one of the NFL’s participating business partners.

I realized what had happened.  In addition to being a Steelers fan, I also enjoy learning about pro football history in general, particularly the history of all four of the teams in the Steelers’ division.  (Their stories are interconnected in some interesting ways.)  A while ago, I had bought a book from about the great Cleveland Browns teams of the late 1940s and early 1950s, who played in ten consecutive league championship games, winning 6 of them.  It was a good book, even though I don’t agree with its conclusion that those Browns were the greatest team of all time– the 1970s Steelers–of course– hold that honor, in my opinion.  ; )

The Browns’ e-mail illustrates one of the difficulties of defining something that is internal (team allegiance) by a set of outward characteristics (book purchases)– while it seems reasonable to assume that the majority of people who bought that book are Browns fans, it’s not true in every case.  But since the Browns didn’t have a chance to ask me if I was really a fan before they sent the e-mail, they made the best guess they could.

I think that’s similar in some ways to the task of defining something like Asperger’s.  It requires working backwards.  At first, all you have to go by are the outward characteristics, like the things that Hans Asperger noticed about some of the children he saw as a pediatrician.  You begin writing down character traits that go together, that form a pattern– a “syndrome,” and watch for those in other people.  The more people you see, the more data you gather, the more information you have, and you can try to form theories about what cognitive differences can explain these characteristics, and you can try to look for physical differences in the brain that may explain the source of these differences in thinking.

But at the same time, you also find that the set of characteristics you wrote down isn’t exactly right– maybe you left something out, maybe you included something that doesn’t belong, or maybe you misinterpreted the reason that two characteristics seem to go along with each other.  So you have to be open to the possibility that the definition of the syndrome itself will change the more you learn about it.  Science is “messy” like that.

I wrote all of that stuff because I wanted to find a structure that would help me talk more specifically about the traits of Asperger’s syndrome, and for that I’ve decided to use the diagnostic criteria given in the 4th (and current) edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, or the DSM-IV for short.  The DSM-IV is widely used in the United States, and understandably, a lot of argument goes on about it every time it’s revised.

The 4th edition was published in 1994, and it was the first edition to attempt to provide diagnostic criteria for Asperger’s syndrome– it uses six such traits to define Asperger’s.  (Note that it doesn’t try to explain why these traits are associated with Asperger’s, or what causes Asperger’s, or what people with Asperger’s should do/not do.  These questions are all outside its scope.  It’s merely trying to give a list of characteristics to look for.)

Finally, I want to say that I’m not any sort of doctor, and I have never studied psychiatry, so please don’t treat me as an expert!  The only “Aspie” I’m an expert on is myself, and I wanted to share my observations about how I think some of the traits in the definition fit me, and how others don’t, and some pondering over why that might be.  There was a period before I was diagnosed when everything I read about Asperger’s seemed to make me change my mind about whether I fit the description or not, and even now there are times that I feel unsure.

Well, I originally meant to actually get to some of the criteria in this post, but instead I got all of that introductory disclaimer stuff out of the way.  So, a partial success!  More posts later!