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Autism Spectrum Disorder (ASD)

Aspergers / Autism Spectrum Disorder (ASD) & empathy
The term Aspergers has recently been officially dropped, so people previously diagnosed as such are now considered to be on the high-functioning end of the autism "spectrum".
But I (& many others) prefer the term "Aspies" to high-functioning ASD, because although I do have some deficiencies (disorders), I also have different abilities to "neuro-typical" (NT) people, which I consider gift (I could equally, for example, label much of the NT population as having a 'disorder' for often communicating dishonestly and for not having the same "special powers" in pattern-recognition & problem-solving skills as me!).

Here are two relevant online tests - notice that one is to estimate your Autism Quotient (i.e. to see where you might be "on the spectrum"), whilst the other measures empathy - which is not the same thing:
It is a common misconception to believe that people with autism lack empathy; on the contrary, in many ways we feel too much.  The reality is more complex and requires an understanding of the different types of empathy.
This link provides a good explanation of the different types of empathy and how it relates to Aspies.  This is my modified version of it:

There are 3 main types of empathy:
  1. Empathic Concern (sympathy, or caring about others)
  2. Affective Empathy (feeling the pain, sorrow, love etc. of others)
  3. Cognitive Empathy (being aware of the thoughts, perspectives and motivations of others)
Aspies only have problems with cognitive empathy, which is the ability to perceive what another person is thinking (especially not intuitively & quickly like neuro-typical people can, although we can work it out logically with a bit more time).
In fact, Aspies can be overly good at affective empathy, which is the ability to sense what another person is emotionally experiencing (through the activation of "mirror neurons", which are not broken, they're too sensitive).  They may quickly pick up on the "emotional vibes" in a room, and sometimes they may even be able to tell others how they are feeling before the other person even knows themself (but not why, because of their deficiency in cognitive empathy).  This high sensitivity to other's emotions (or the plight of others in the community/world) makes Aspies very caring people, but if it is too intense it can also lead to anxiety, confusion and, potentially - if the reverberating emotions between people escalate out of control - conflict.
The reason an Aspie may sometimes seem to show less empathy and sympathy is because their intense emotions may become jumbled, which, along with poor cognitive empathy, makes it hard to demonstrate empathy through communication (which is not the same as not sensing or caring about other people's emotions).  When an Aspie can sense that their partner is upset, but not understand what they're thinking, they may assume their partner is upset with them and then try to "pick their brains" by badgering & pestering them with questions to try to understand (which may just annoy them).
Aspies tend to be very logical/analytical (& good at problem-solving by identifying inconsistencies & patterns by "joining up dots"), which, along with their poor cognitive empathy, makes them more direct & bluntly honest in their communication than neuro-typical people (not realising quickly enough what others are thinking and how they may interpret & react to what they say), and this gets misinterpreted as not caring or a general lack of "empathy".
Aspies are very capable of love, sympathy, compassion etc. (traits psycho/sociopaths are incapable of feeling), and because of their poor cognitive empathy, most Aspies have great difficulty lying (or detecting lies) and are completely incapable of manipulating people.  But Aspies assume others will behave the same, and sadly this trusting naivety means "they are far more likely to be victims than offenders" in abusive relationships.

Autism = brain sensitivity
Besides sensitivity to feelings, people "on the spectrum" often also have extreme neuro-sensitivity to other stimuli, including light, sound, physical/touch, spatial/balance, taste/smell (depending on the person), which, as with emotional sensitivity, can cause them to feel totally overwhelmed & stressed (and in severe cases, have a "meltdown").  I think it's this brain sensitivity that is responsible for all or most of the other commonly recognised autism traits (see also this academic paper).  However, the sensitivity of autistic people to stimuli was barely recognised by professionals for many years, and is still not a core requirement of current autism diagnostic guidelines (although it is now part of the many traits included in a full assessment), which are based on someone showing qualitative impairments in all three areas of:
  1. Social interaction - such as lack of eye contact, relationships, sharing or emotional reciprocity
  2. Communication - delayed (not Aspies), impaired or idiosyncratic language
  3. Rigid thinking - preoccupation with a restricted range of (often unusual) interests, inflexible adherence to routines, repetitive physical mannerisms.
There's no medical "test" to determine whether someone is autistic, so diagnosis of being "on the spectrum" is basically determined by how many boxes you tick out of a wide range of characteristics/behaviours ("traits") that are commonly observed in autistic people.  But there is no underlying explanation for impaired social communication & rigid thinking, nor do the above "triad of impairments" explain or include sensitivity to stimuli (possibly because they were developed by NT people).

A variety of theories to explain autism (sourced from this free online course) have been proposed (& it's not caused by vaccines!), many of which relate to a strongly systematic/logical, or "extreme male" brain (which has many benefits, besides the problems of rigid thinking), along with an empathic deficiency related to a delayed & not fully developed "Theory of Mind" (ToM - the ability of humans to recognise that other people may have different thoughts & feelings to themselves, which most children rapidly develop as a highly intuitive skill between the ages of 3 & 4).  However, a deficient ToM does not obviously explain the systematic features, or vice versa (unless one considers these to be somewhat opposing characteristics at either end of a continuum).  Moreover, the proponent of the concept that autism's "core deficit" is an impaired ToM (Baron-Cohen, 1985) still found that 20% of autistic children between the ages of 6-16 passed "false belief" ToM tests, indicating that it is a typical but not universally defining condition of autism.
In my opinion, the current autism theory that is closest to the mark is that of "monotropism" (Murray et al., 2005), which is the tendency to focus on narrow interests to the exclusion of broader ones.  However, this theory still doesn't really explain why that tendency exists in autistic people.

Not surprisingly, there is still much debate about the "defining features" and root cause of autism.  Complicating the matter is the apparent paradox of autistic people also displaying hypo-sensitivity (low sensitivity), even for the same type of stimuli for which they are hyper-sensitive.  For example, I am very sensitive to certain kinds of sudden sounds or loud voices (making me twitch!) and struggle to filter a conversation from background noise in a crowded room (or lyrics from music instruments), yet when I am concentrating on a task, people may have to say my name many times before I notice (to which one person remarked, "It's as if you've got headphones on!").  This paradox of hypo-sensitivity may be explained as a response to hyper-sensitivity, due to the brain shutting down neural pathways to muffle the impact of otherwise overwhelming senses (when the brain isn't able to do this, an autistic person will try to physically avoid the excessive stimulation, e.g. by covering their ears). Essentially, the brain turns inwards to protect itself from excessive external stimulation, thus reinforcing the underlying condition of fast-growing, hyperconnected, highly sensitive and highly active neurons (typically self-firing, as an introvert). Based on my personal history, I suspect this muffling commences soon after birth, in reaction to the overwhelming sensory experience of a new, "noisy" world (which is why autistic babies are often extremely difficult ones, especially at night, when their brain may still be hyper-active and every little sound or other sensation is a scary unknown in the dark!).

Starting from this basic proposition and applying some speculative imagination, the following table is my explanation for how brain sensitivity produces a wide range of other common autistic "traits":

Common ASD characteristics (“traits”)

Explanation based on brain sensitivities

·         Intense, focussed thinking & attention to detail, creative

·         Introverted, “in their own world”

·         Rigid interests & routines

·         Sleep problems, migraines

·         “Stimming”
e.g. twitches, 
flapping or jigging (like Elvis' left leg), teeth grinding

 

 

 

 

·         Fundamental trait caused by highly-sensitive brain - neurons are more easily triggered by external stimuli but also by other neurons, thus reinforcing intense self-fired thinking activity (introverted) & generating new ideas (creative).

·         Brain reacts to excess stimulation from external sources by muffling/avoiding the relevant neural pathways; instead turning in on itself & reinforcing introverted thinking.

·         Intense thinking rapidly creates strong neural pathways (brain plasticity) that reinforce interests & routines, before the brain can be distracted by new stimuli & interests.

·         Constant intense brain activity affects sleep & can cause migraines.

·         Stimming releases excess “nervous energy” in an intense, sensitive brain.

·         “Intelligence”, especially identifying patterns, inconsistencies & memory recall

·         Highly systematic/logical/“extreme male” brain

·         Obsessive about order/neatness and dislike of changes, inconsistencies, lies & logical contradictions (it must be “right”)

·         Literal, trusting/naive

 

 

·         Highly sensitive neurons are better at detecting patterns, as long as they are not overwhelmed by too much stimuli.

o       Intense firing of sensitive neurons rapidly produces strong neural pathways for better recall (e.g. for facts or music).

·         The logical part of the brain (in all people) compares one or more inputs, producing an output “error” signal based on their difference.  It then computes (thinks) to find a solution to the problem that reduces this error signal to an acceptable level.

o       A highly sensitive brain produces stronger error signals that increase the motivation to keep solving a problem (which reduces brain inconsistencies).  As Einstein said,
It’s not that I’m smarter than other people, I just stick with problems longer.

·         Disorder, logical contradictions & lies create a strong error signal in the logical brain (internal brain conflict), and in an intense, sensitive brain this creates stress – so we act to avoid this stress (e.g. by ordering things & not lying).

·         Habitual honesty (& perhaps poor “theory of mind”) means we assume others also tell the truth & mean what they say (literally).

·         High emotional sensitivity

o       easily upset

o       squeamish

o       repressed

·         Caring, conscientious, loyal partner/friend

·         Emotional sensitivity is a fundamental trait of sensitive neurons & intense brain activity.

o       The brain may repress emotions if they are too intense.

·         High “affective/mirror empathy” means we are more strongly affected by other’s emotions and hence more motivated to care.

o       Logical brain also reinforces a strong sense of ‘right’ vs ‘wrong’ (sometimes to the exclusion of other more nuanced perspectives).

o       Loyalty may also serve need to avoid change.

Impaired communication skills:

·         Eye contact

·         Aphantasia (no “mind’s eye”)

·         Non-verbal communication
(hand gestures, facial expressions, Theory of Mind)

·         Direct / blunt

·         “Non verbal”

·         Dyslexia

·         Preference for text over verbal communication & tendency to “zone out”.

·         The emotional intensity of eye contact is overwhelming, especially if trying to listen simultaneously - hence we may look away to listen better, but at the expense of missing and not learning non-verbal communication such as facial expressions & hand gestures.

o       Delays / impairs ability to understand other’s thoughts, i.e. Theory of Mind.

o       May lead to aphantasia – difficulty recalling images, especially faces.

·         Theory of Mind also impaired by:

o       Overwhelmed/“jumbled” brain due to intense combination of own thoughts, feelings & affective empathy, hampering ability to calmly contemplate & understand other’s thoughts (like it becomes impossible to hear sounds properly when the input to a high-gain amplifier is so high that the output becomes distorted - capped by the maximum amplifier output).

o       Brain may shut down neural pathways used for cognitive empathy, in order to reduce total brain intensity.

·         Impaired ToM capability plus intense focus on one’s own thinking, along with an inherent “logical” & direct communication style may lead to blunt speaking that appears to lack empathy.

·         “Non verbal” – unable to communicate if sensory overload makes brain so jumbled it's impossible to even think clearly, let alone speak and articulate what's going on in the mind

·         Dyslexia may also be caused by a jumbled brain
- overwhelmed by too much text &/or other simultaneous stimuli?

·         Difficulty concentrating on people talking as the flow of information is slower than reading & the speed at which an intense brain operates.  Also distracting background thoughts are easily generated by sensitive neurons, which may cause us to “zone out” – disappearing into our own world.

Taste, smell & physical sensitivities:

·         Touch, hugs, extreme pain reactions

·         Bedwetting

·         Fussy eaters

Can be highly sensitive to the taste, smell & texture of foods, being touched &/or the feel of some surfaces, & other body sensations.

·         Human touches & hugs may also be affected by emotional sensitivity.

·         Extreme reactions to minor injuries (especially children)

·         Hypo-sensitivity (feelings suppressed in response to hyper-sensitivity) may prevent children detecting the need to go to the toilet.

·         Sensitivities may also affect sex

Spatial/balance:

·         Travel sickness

·         Vertigo, inversion fear

·         Sense of direction

·         Unusual/awkward gait

·         Coordination skills - throwing, balance, etc.

·         High sensitivity to inner-ear sensations may lead to travel sickness, dizziness from heights & being upside down (& dislike of roller coasters).

·         Poor sense of direction may be caused by confusion from overwhelmed spatial signals or from brain “muffling” (hypo-sensitivity) of these signals, and would also be affected by aphantasia.

·         Hyper &/or hypo-sensitivity to the body’s sense of position & balance would also impair movements such as walking (gait) and more complex athletic skills.




People with autism are stereotypically (but not always) very intelligent in terms of logical/analytical & scientific thinking, and there are so many famous high-achievers who are suspected of being Aspies (with Newton & Einstein probably being the most notable), one wonders what a poorer state the world might be in without them.
Autistic people can also be very creative & artistic - here's a drawing I did at my second ever art class (of the lovely lady Eleanor):



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