Excerpts from Temple Grandin, The Autistic Brain, 2013, Houghton Mifflin Harcourt.
Autism, depression, and other disorders are on a continuum ranging from normal to abnormal. Too much of a trait causes severe disability, but a little bit can provide an advantage. If all genetic brain disorders were eliminated, people might be happier, but there would be a terrible price.
the core principle of every program—including the one that was used with me, Miss Reynolds’s Basement Speech-Therapy School Plus Nanny—is to engage with the kid one-on-one for hours every day, twenty to forty hours per week.
The paper presented the case histories of eleven children who, Kanner felt, shared a set of symptoms—ones that we would today recognize as consistent with autism: the need for solitude; the need for sameness. To be alone in a world that never varied.
“One other fact stands out prominently,” Kanner continued. “In the whole group, there are very few really warmhearted fathers and mothers. For the most part, the parents, grandparents, and collaterals are persons strongly preoccupied with abstractions of a scientific, literary, or artistic nature, and limited in genuine interest in people.” These observations of Kanner’s are not as damning about parents as they might sound. At this early point in his study of autism, Kanner wasn’t necessarily suggesting cause and effect. He wasn’t arguing that when the parents behaved this way, they caused their children to behave that way. Instead, he was noting similarities between the parents and his patients. The parents and their child, after all, belonged to the same gene pool. The behaviors of both generations could be due to the same biological hiccup.
But Kanner was also a product of his time, and his most productive years coincided with the rise of psychoanalytic thought in the United States. When Kanner looked at the effects of autism, he might have originally told himself that they were possibly biological in nature, but he nonetheless wound up seeking a psychological cause. And when he speculated on what villains might have inflicted the psychic injury, he rounded up psychoanalysis’s usual suspects: the parents (especially Mom).
In fact, Kanner had cause and effect backward. The child wasn’t behaving in a psychically isolated or physically destructive manner because the parents were emotionally distant. Instead, the parents were emotionally distant because the child was behaving in a psychically isolated or physically destructive manner. My mother is a case in point. She has written that when I wouldn’t return her hugs, she thought, If Temple doesn’t want me, I’ll keep my distance. The problem, though, wasn’t that I didn’t want her. It was that the sensory overload of a hug shorted out my nervous system.
Kanner’s backward logic found its greatest champion in Bruno Bettelheim, the influential director of the University of Chicago’s Orthogenic School for disturbed children. In 1967 he published The Empty Fortress: Infantile Autism and the Birth of the Self, a book that popularized Kanner’s notion of the refrigerator mother. Like Kanner, Bettelheim thought that autism was probably biological in nature. And like Kanner, his thinking on autism was nonetheless grounded in psychoanalytic principles. Bettelheim argued that an autistic child was not biologically predetermined to manifest the symptoms. Instead, the child was biologically predisposed toward those symptoms. The autism was latent—until poor parenting came along and breathed life into it.1
In 1973 David Rosenhan, a Stanford psychiatrist, published a paper recounting how he and several colleagues had posed as schizophrenics and fooled psychiatrists so thoroughly that the psychiatrists actually institutionalized them, keeping them in mental hospitals against their will. How scientifically credible can a medical specialization be if its practitioners can so easily make incorrect diagnoses—misdiagnoses, moreover, with potentially tragic consequences?
Even as Kanner was trying to define autism, Asperger was identifying a class of children who shared several distinct behaviors: “a lack of empathy, little ability to form friendships, one-sided conversations, intense absorption in a special interest, and clumsy movements.” He also noted that these children could talk endlessly about their favorite subjects; he dubbed them “little professors.”
I can see the effects of a heightened awareness of autism and Asperger’s just by looking at the audiences who come to my talks. When I started giving lectures on autism in the 1980s, most of the audience members with autism were on the severe, nonverbal end of the spectrum. And those people do still show up. But far more common now are kids who are extremely shy and have sweaty hands, and I think, Okay, they’re sort of like me—on the spectrum but at the high-functioning end. Would their parents have thought to have them tested for autism in the 1980s? Probably not. And then there are the geeky, nerdy kids I call Steve Jobs Juniors. I think back on kids I went to school with who were just like these kids but who didn’t get a label. Now they would.
a typographical error. Shocking but true. In the DSM-IV, the description of pervasive developmental disorder not otherwise specified that was supposed to appear in print was “a severe and pervasive impairment in social interaction and in verbal or nonverbal communication skills” (emphasis added). What actually appeared, however, was “a severe and pervasive impairment of reciprocal social interaction or verbal and nonverbal communication skills” (emphasis added). Instead of needing to meet both criteria to merit the diagnosis of PDD-NOS, a patient needed to meet either.
You know how when you’re cleaning out a closet, the mess reaches a point where it’s even greater than when you started? We’re at that point in the history of autism now. In some ways, our knowledge of autism has increased tremendously since the 1940s. But in other ways, we’re just as confused as ever.
“There’s a long tradition in medicine where the diseases start out in psychiatry and eventually they move into neurology”—epilepsy, for example. And now autism is joining that tradition. At long last, autism is yielding its secrets to the scrutiny of hard science, thanks to two new avenues of investigation that we’ll explore in the next two chapters.
Neuroimaging allows us to ask two fundamental questions about every part of the brain: What does it look like? What does it do? Magnetic resonance imaging, or MRI, uses a powerful magnet and a short blast from a specific radio frequency to get the naturally spinning nuclei of hydrogen atoms in the body to behave in a way that the machine can detect. Structural MRI has been around since the 1970s, and as the word structural suggests, it provides views of the anatomical structures inside the brain. Structural MRI helps answer the What does it look like? question. Functional MRI, which was introduced in 1991, shows the brain actually functioning in response to sensory stimuli (sight, sound, taste, touch, smell) or when a person is performing a task—problem-solving, listening to a story, pressing a button, and so on. By tracing the blood flow in the brain, fMRI presumably tracks neuron activity (because more activity requires more blood). The parts of the brain that light up while the brain responds to the stimuli or performs the assigned tasks, researchers assume, provide the answer to the What does it do? question.
neuroimaging can’t distinguish between cause and effect. Take one well-known example associated with autism: facial recognition. Neuroimaging studies over the decades have repeatedly indicated that the cortex of an autistic doesn’t respond to faces as animatedly as it does to objects. Does cortical activation in response to faces atrophy in autistics because of the reduced social engagement with other individuals? Or do autistics have reduced social engagement with other individuals because the connections in the cortex don’t register faces strongly? We don’t know.
I always tell my students, “If you want to figure out animal behavior, start at the brain and work your way out.” The parts of the brain we share with other mammals evolved first—the primal emotional areas that tell us when to fight and when to flee. They’re at the base of the brain, where it connects with the spinal cord. The areas that perform the functions that make us human evolved most recently—language, long-range planning, awareness of self. They’re at the front of the brain. But it’s the overall complex relationship between the various parts of the brain that make us each who we are.
When I talk about the brain, I often use the analogy of an office building. The employees in different parts of the building have their own areas of specialization, but they work together. Some departments work closer together than others. Some departments are more active than others, depending on what the task at hand is. But at the end of the day, they come together to produce a single product: a thought, an action, a response. At the top of the building sits the CEO, the prefrontal cortex—prefrontal because it resides in front of the frontal lobe, and cortex because it’s part of the cerebral cortex, the several layers of gray matter that make up the outer surface of the brain. The prefrontal cortex coordinates the information from the other parts of the cortex so that they can work together and perform executive functions: multitasking, strategizing, inhibiting impulses, considering multiple sources of information, consolidating several options into one solution.
Occupying the floors just below the CEO are the other sections of the cerebral cortex. Each of these sections is responsible for the part of the brain it covers. You can think of the relationship between these discrete patches of gray matter and their corresponding parts as similar to the relationship between corporate vice presidents and their respective departments. The frontal cortex VP is responsible for the frontal lobe—the part of the brain that handles reasoning, goals, emotions, judgment, and voluntary muscle movements. The parietal cortex VP is responsible for the parietal lobe—the part of the brain that receives and processes sensory information and manipulates numbers. The occipital cortex VP is responsible for the occipital lobe—the part of the brain that processes visual information. The temporal cortex VP is responsible for the temporal lobe—the auditory part of the brain that keeps track of time, rhythm, and language.
Below the VPs are the workers in these various divisions—the geeks, as I like to call them. They’re the areas of the brain that contribute to specialized functions, like math, art, music, and language. In the basement of the building are the manual laborers. They’re the ones dealing with the life-support systems, like breathing and nervous system arousal. Of course, all these departments and employees need to communicate with one another. So they have desktop computers, telephones, tablets, smartphones, and so on. When some folks want to talk to others face to face, they take the elevator or the stairs. All these means of access, connecting the workers in the various parts of the building in every way imaginable, are the white matter. Whereas the gray matter is the thin covering that controls discrete areas of the brain, the white matter—which makes up three-quarters of the brain—is a vast thicket of wiring that makes sure all the areas are communicating.
The imaging indicated that I am overconnected, meaning that my inferior fronto-occipital fasciculus (IFOF) and inferior longitudinal fasciculus (ILF)—two white-fiber tracts that snake through the brain—have way more connections than usual. When I got the results of that study, I realized at once that they backed up something I’d been saying for a long time—that I must have an Internet trunk line, a direct line—into the visual cortex to explain my visual memory. I had thought I was being metaphorical, but I realized at that point that this description was a close approximation of what was actually going on inside my head.
How did the two lateral ventricles become so different? One hypothesis is that when damage occurs early in the brain’s development, other areas of the brain try to compensate. In my case, the damage would have occurred in the white matter in the left hemisphere, and the left ventricle would have enlarged to fill the damaged area. At the same time, the white matter in the right hemisphere would have tried to compensate for the lost brain function in the left hemisphere, and that expansion in the right hemisphere would have squeezed the right ventricle’s growth.
Volume has nothing to do with the fear factor; the association with a possible threat does. Human voices are associated with a possible threat. New Age music isn’t associated with a possible threat. For that matter, neither is the sound of an airplane, so that sound doesn’t bother me, even when I’m in a hotel by an airport. A plane could land on the hotel and I wouldn’t wake up. But people talking in the next room? Forget it. I might as well turn on the light and read, because I know I’m not going to go to sleep until they go to sleep.
Preferring objects to faces? “These results are typical of individuals with autism,” the researchers who conducted the MRI study at Pittsburgh in 2006 later wrote me in a summary of their findings. “One thing that seems to be coming up repeatedly in these scanning studies with individuals with autism is the marked reduction in the cortical activation to faces.”
Nonetheless, some patterns are emerging. In addition to the variations in my own brain that seem consistent with those of many other autistics—enlarged amygdalae, macrocephaly, lack of cortical engagement when looking at faces—these widespread patterns include:
What a neurotypical person feels when someone won’t make eye contact might be what a person with autism feels when someone does make eye contact. And vice versa: What a neurotypical feels when someone does make eye contact might be what an autistic feels when someone doesn’t make eye contact. For a person with autism who is trying to navigate a social situation, welcoming cues from a neurotypical might be interpreted as aversive cues. Up is down, and down is up.
Personally, I like knowing that my high level of anxiety might be related to having an enlarged amygdala. That knowledge is important to me. It helps me keep the anxiety in perspective. I can remind myself that the problem isn’t out there—the students in the parking lot under my bedroom window. The problem is in here—the way I’m wired. I can medicate for the anxiety somewhat, but I can’t make it go away. So as long as I have to live with it, I can at least do so secure in the knowledge that the threat isn’t real. The feeling of the threat is real—and that’s a huge difference.
“The most obvious disability in autism is the disability of speech,” she said, regarding the rationale behind the experiment. “Our hypothesis was that at the first stage we could begin to see differences.” And they felt they did: Their measures of activity in that region could identify fourteen out of fifteen of the autistic subjects, a sensitivity rate of 92 percent.
The younger the subject, the earlier the possibility of intervention. The earlier the intervention, the greater the potential effect on the trajectory of an autistic person’s life.
“Just like there are 206 bones in your body, there are major cables in your brain,” Schneider says. “You can ask most anybody on the street to create a drawing of what a broken bone looks like, and they would be able to draw something somewhat sensible. If you ask them, ‘So what does a broken brain look like?’ most people—including researchers in the field—can’t give you the details.”
For years I’ve compared the circuitry of the brain to highways, and I’m hardly alone. But the high-definition part of HDFT technology has revealed just how apt the superhighways reference is.
As Schneider says, “One of my favorite lines of neuroscience is if you can think of five ways for the brain to do something, it does it in all ten. The five you’ve thought of, and the five you haven’t thought of yet.”
When a football player suffers a concussion or when a boxer takes multiple punches to the head, the effects of an injury might not be evident for years or decades. Not anymore. HDFT will show what the blows to the head have done to the brain, and I’m telling you, it’s not going to be pretty. You won’t need a medical degree to compare a concussed brain and a control brain and go, “Oh no.”
Between birth and the age of one, Schneider explained, infants engage in two activities that developmental researchers call verbal babbling and motor babbling. Verbal babbling refers to the familiar act of babies making noises to hear what they sound like. Similarly, motor babbling refers to actions such as waving a hand just to watch it move. During this period when babies are figuring out how to engage with the world, their brains are actually building connections to make that engagement possible.
Then between the ages of one and two, children reach a stage where they can say single words. What’s happening in the child’s brain at this point is that fibers are forming an interlink between those two fiber systems that were constructed during the verbal and motor babbling period. The brain is connecting “what you’re seeing” with “what you’re saying” until out pops Mama, Dada, ball, and so on.
In my case, Schneider hypothesized, something happened developmentally during the single-word phase so that the fibers didn’t form a connection between “what you’re seeing” and “what you’re saying.” This would be the tract that was 1 percent of the size of the control subject’s. To compensate, my brain sprouted new fibers, and they tried to go somewhere, anywhere. Where they wound up primarily was in the visual area rather than traditional language-production areas. That’s the tract that was 400 percent of the size of the control subject’s.
As an article in Science magazine said, “Using fMRI to spy on neurons is something like using Cold War–era satellites to spy on people: Only large-scale activity is visible.”
Researchers also can’t assume that if a patient is exhibiting abnormal behavior and the scientists find a lesion, they’ve found the source of the behavior. I remember sitting in a neurology lecture in graduate school and suspecting that linking a specific behavior with a specific lesion in the brain was wrong. I imagined myself opening the back of an old-fashioned television and starting to cut wires. If the picture went out, could I safely say I had found the “picture center”? No, because there were a lot of wires back there that I could cut that would make the TV screen go blank. I could cut the connection to the antenna, and the picture would disappear. Or I could cut the power supply, and the picture would disappear. Or I could simply pull the plug out of the wall! But would any of those parts of the television actually be the picture center? No, because the picture depends not on one specific cause but on a collection of causes, all interdependent. And this is precisely the conclusion that researchers in recent years have begun to reach about the brain—that a lot of functions depend on not just one specific source but large-scale networks.
In one common analogy, the earlier sequencing of the human genome by the Human Genome Project and by Craig Venter’s Celera Genomics in 2001 “was like getting a picture of Earth from space,” as one scientist told the Times, while Encode was like Google Maps: It told us “where the roads are,” “what traffic is like at what time of the day,” “where the good restaurants are, or the hospitals or the cities or the rivers.” The Human Genome Project told us what the genome was. Encode has begun to tell us what it does.
A strand of DNA completely unfurled would be about ten feet long. But it’s not unfurled. Instead, DNA is so tightly coiled that it fits inside the microscopic cell nucleus. By looking at DNA in its natural state, Encode researchers found, as the Times reported, “that small segments of dark-matter DNA are often quite close to genes they control.” Now that, I thought, is a mindblower. Until then, scientists had been thinking about DNA in its stretched-out form. But if you envision DNA as a tightly wound coil—and while I was standing in the airport, holding the Times in my hands, that’s exactly what my picture brain was doing—then a noncoding piece of DNA could be flipping switches on coding DNA that’s hundreds of thousands of base pairs away. In the stretched-out helix, they’re nowhere near each other; in the coiled-up helix, they’re adjacent to each other.
Because identical twins share the same DNA, these results strongly support the idea that the source of autism is genetic. But the influence of DNA is not absolute. If one identical twin has autism, the chance that the other one will have it too is very high. But it’s not 100 percent. Why not? Well, we could ask the same question about other subtle differences in identical twins. Their parents can always tell them apart, and in some cases the differences are obvious enough that anyone can tell them apart. One reason is that even when the genotype—the DNA at conception—is identical in both twins, the genes might work differently inside the cell. The other reason is that the genotypes might not be identical at birth, due to spontaneous mutations in the DNA of one or both of the twins. Both sets of genetic differences contribute to an individual’s phenotype—the person’s physical appearance, intellect, and personality.
Sperm cells divide every fifteen days, more or less, so the older a father is, the greater the number of mutations in his sperm. It’s like making a copy of a copy of a copy on a photocopier. And the greater the number of mutations, the higher the risk of a mutation that might contribute to autism.
For me, the multiple-hit hypothesis is supported by observations that I’ve made again and again when I’ve met with families over the past twenty years. I’ve noticed that in a lot of cases, a kid with autism has at least one parent who exhibits a mild form of autistic behavior. A kid with severe autism often has two parents who exhibit this behavior. If both parents are contributing copy number variations of a kind that pose a higher risk for autism, then the incidence of autism in the children in those families is naturally going to go up. The more you load the dice on both sides of the family, the likelier you are to have a kid with a problem.
I myself have often wondered if the increase in prescription-drug use over the past few decades has contributed to an increase in the incidence of autism.
But here’s the thing. I think Prozac is a fabulous drug. I have friends who would be in really bad shape if they weren’t on Prozac, Lexapro, or some other selective serotonin reuptake inhibitor. I know people who have been saved by these drugs. I myself wouldn’t be functional without them. They can transform a life merely being lived into a life worth living. So women who are pregnant or are thinking about becoming pregnant and who take antidepressants should consult a doctor and weigh the risks and benefits.
An observed correlation—two events happening around the same time—might just be coincidence. Let’s use the now infamous vaccination controversy as a way to look at the logical complexity of a causation-versus-coincidence argument. The story goes like this. Parents routinely have their children vaccinated around age eighteen months. Some parents note that their children begin exhibiting signs of autism around age eighteen months—withdrawing into themselves, reversing the gains they’d made in learning language, engaging in repetitive behaviors. Is the correlation between certain vaccines and the onset of autism an example of coincidence or causation? Along comes a study in the British journal The Lancet in 1998 that offers the answer: causation. Parental outrage ensues,4 as does a widespread grassroots movement to persuade parents not to have their children vaccinated. Yet numerous follow-up investigations can’t replicate the results of the 1998 study, and in 2010, following an investigation by the UK General Medical Council that determines the research was misleading and incorrect, The Lancet retracts the study.
Today I know that if I had been able to pop balloons myself, poking a small balloon with a pen and producing a soft sound, then working my way up to bigger and bigger balloons and louder and louder pops, I might have been able to tolerate balloons. I’ve heard a lot of people with autism say that if they can initiate the sound, they’re more likely to be able to tolerate it. The same is true if they know the sound is coming; fireworks set off at random by kids down the block are shocking, but fireworks set off at the city park as part of a holiday program are acceptable.
Our five senses are how each of us understands everything that isn’t us. Sight, sound, smell, taste, and touch are the five ways—the only five ways—that the universe can communicate with us.
After all, our senses have evolved to capture a common reality—to allow us to receive and interpret, as reliably as possible, the information we need in order to survive.
Over the decades, I’ve seen hundreds if not thousands of research papers on whether autistics have theory of mind—the ability to imagine oneself looking at the world from someone else’s point of view and have an appropriate emotional response. But I’ve seen far, far fewer studies on sensory problems—probably because they would require researchers to imagine themselves looking at the world through an autistic person’s jumble of neuron misfires. You could say they lack theory of brain.
I suspect that they simply don’t understand the urgency of the problem. They can’t imagine a world where scratchy clothes make you feel as if you’re on fire, or where a siren sounds “like someone is drilling a hole into my skull,” as one autistic person described it. Most researchers can’t imagine living a life in which every novel situation, threatening or not, is fueled by an adrenaline rush, as one study indicates is the case in many people with autism. Because most researchers are normal human beings, they’re social creatures, so from their point of view, worrying about how to socialize autistics makes sense. Which it does, up to a point. But how can you socialize people who can’t tolerate the environment where they’re supposed to be social—who can’t practice recognizing the emotional meanings of facial expressions in social settings because they can’t go into a restaurant?
If researchers want to know what it’s like to be one of the many, many people who live in an alternate sensory reality, they’re going to have to ask them. Researchers routinely disparage self-reports, saying they’re not open to scientific verification because they’re subjective. But that’s the point. Objective observation of behaviors can provide important information. But the person suffering from sensory overload is the only one who can tell us what it’s really like.
The problem in eliciting self-reports from this population is obvious. If a sensory problem totally disorganizes a person’s way of thinking, then he’ll have trouble describing the problem. If a person is nonverbal, then another means of expression, like typing or pointing, has to be used. In the most extreme cases, however, even that goal would be unrealistic.
unfortunately, wrist-supported writing produces unreliable information; the facilitator might be moving the hand without realizing it, as one would with the planchette on a Ouija board.
I’m hoping that some of the new technologies might allow for a higher incidence of self-reporting. Tablets, for example, have a tremendous advantage over plain old computers, even laptops: You don’t have to take your eyes off the screen. Usually typing is a two-step process. First you look at the keyboard, then you look at the screen to see what you’ve typed. That could be one step too many for someone with severe cognitive problems. Before tablets, a therapist would have to mount the keyboard of a desktop computer on a box so that it was right below where the print was appearing on the screen. In tablets, however, the keyboard is actually part of the screen, so eye movement from keyboard to the letter being typed is minimal. Cause and effect have a much clearer correlation. That difference could well be meaningful in terms of allowing people with extreme sensory problems to tell us what it’s like to be them.
In his book How Can I Talk If My Lips Don’t Move? Inside My Autistic Mind, Tito Rajarshi Mukhopadhyay describes his liberation from a locked-in autistic existence. It came in the form of a board filled with numbers and letters that his mother provided for him before he was four years old, in the early 1990s. With her help, he learned math and spelling. Eventually his mother tied a pen to his hand so that he could communicate through writing. Over the years Tito has published several books that describe how he experiences his reality in two parts: an “acting self” and a “thinking self.”
What I had witnessed, I realize now, is Tito’s acting self in action, the self that the outside world sees: a spinning, flailing, flapping boy. Which is also the self that Tito sees. In his book, he described his acting self as “weird and full of actions.” He saw himself as pieces, “as a hand or as a leg,” and he said the reason he spun himself in circles was so that he could “assemble his parts to the whole.” He recalled staring at himself in a mirror, trying to force his mouth to move. “All his image did was stare back,” Tito wrote, adopting a third-person point of view that only underscored the disconnect between his acting self and his thinking self. That self, his thinking self, is “filled with learnings and feelings.” And frustrations. He recalled a doctor telling his parents that Tito couldn’t understand what was happening around him, and he remembered his thinking self’s unspoken response: “‘I understand very well,’ said the spirit in the boy.”
The acting self runs around a library flapping his arms. The thinking self observes the acting self running around a library flapping his arms.
For me that is a different case altogether. The woman who brushes along our table leaves an overpowering scent of perfume and my focus moves. Then the conversation over my left shoulder from the table behind us comes into play. The rough side on my left sleeve cuff rubs up and down on my body. That starts to get my attention, as the whoosh and whistle of the coffee maker blends into different sounds all around me. The visual of the door opening and shutting in the front of the store completely consumes me. I have lost the conversation, missing most of what the person in front of me is talking about. . . . I find myself only hearing the odd word.
These self-reports reinforce my longstanding hypothesis that some nonverbal autistics might be far more engaged in the world than they seem to be. They just happen to be living in such an extraordinary jumble of sensations that they have no way of productively experiencing the outside world, let alone expressing their relationship to it. But these self-reports also demonstrate that Tito and Carly observe their own behaviors as closely as a parent or caregiver or researcher. Unlike those outside observers, however, they can tell us what their behaviors actually mean. The difference between the observer’s view and the subject’s experience—between the acting self and the thinking self—is the difference between what sensory problems look like and what they feel like.
I asked myself about my own experience with hearing difficulties as a child, when I would try to make sense out of the babble of adult voices talking too fast for me to follow. My hearing had two settings: Off, and Let All the Stimulation In. Sometimes I would shut down and block out all the stimuli. Sometimes I would throw a tantrum. Two behaviors, one feeling.
“Your eyes try to go to every movement they perceive. That is part of what destroys your eye contact and makes you seem very inattentive.”
Isn’t our whole approach to autism a result of what the experience looks like from the outside (the acting self) rather than what the experience feels like from the inside (the thinking self)? Yes. Which is why I believe the time has come to rethink the autistic brain.
Now it all made sense! I couldn’t keep my skis together without falling because— Because what? Because I’m autistic? Or because I have a small cerebellum? Both answers are correct. Which, however, is more useful? That depends on what you want to know. If you’re looking for a label, something that will help you understand who I am in a general sense, then “because I’m autistic” is probably good enough. But if you’re looking for how I got that way specifically—if you’re looking for the biological source of the symptom—then the better answer is definitely “because I have a small cerebellum.” The difference is important. It’s the difference between a diagnosis and a cause.
1477 Everything in the brain, everything in genetics—they’re all one big continuum.
Half the employees at Silicon Valley tech companies would be diagnosed with Asperger’s if they allowed themselves to be diagnosed, which they avoid like the proverbial plague. I’ve been to their offices; I’ve seen the work force up close. Many of the hits on my home page come from Silicon Valley and other areas with a high concentration of tech industries. A generation ago, a lot of these people would have been seen simply as gifted. Now that there’s a diagnosis, however, they’ll do anything to avoid being ghettoized.
“One of the curses in this field,” a study on vision in autism concluded, “is the size of the error bars, which always seem to be at least twice as large in the ASD data compared to the controls.” Error bars twice as large as the controls’ error bars? Right there, that should tell you that you have a huge variation in the sample—that you have subgroups in the population that need to be identified and separated out.
The same is true for studies that conclude that some solutions to sensory problems, like weighted vests or Irlen glasses, don’t work for people with autism. I used to read these studies, and I would tell myself, But I’ve seen weighted vests work, again and again! The problem with the research, I’ve realized, is that autistic people don’t all have the same sensory problems. If you have twenty people with autism, shaded glasses or weighted vests will help maybe three or four. So researchers say, “Well, look—these devices work on only 15 or 20 percent of the autistic population!” So what? That result doesn’t mean that colored glasses don’t work for autism; it means that colored glasses do work for autistics with certain specific visual problems. They work on a subgroup of the autistic population.
In the DSM-IV, a diagnosis of autism depended on three criteria, called the triad model. Those criteria were: Impairment in social interaction. Impairment in social communication. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. The first two might sound similar to each other in that they both involve issues of socializing. In fact, that’s the official justification for collapsing them into one criterion for the DSM-5. In a 2010 presentation before the federal Interagency Autism Coordinating Committee, the chair of the DSM-5 Neurodevelopmental Workgroup said, “Deficits in communication are intimately related to social deficits. The two are ‘manifestations’ of a single set of symptoms that are often present in differing contexts.” As a result, the DSM-5 uses a two-criteria, or dyad, model: Persistent deficits in social communication and social interaction. Restricted, repetitive patterns of behavior, interests, or activities.
What isn’t scientific about the DSM-5’s handling of the diagnostic criteria, however, is its collapsing together social interaction and social communication. Social interaction covers nonverbal behavior that involves being with another person—making eye contact, smiling, and so on. Social communication covers the verbal or nonverbal ability to converse—share ideas and interests, for example.
Do impairments in social communication and impairments in social interaction actually belong to one single domain? Does an inability to get words out and master grammar and syntax (known as specific language impairment or syntactic-semantic disorder) really come from the same place in the brain as a tendency to speak with abnormal intonation and give conversational responses that are socially inappropriate (known as pragmatic language impairment or semantic-pragmatic disorder)? Are language mechanics and social awareness closely related, neurologically speaking? I doubt it—and I’m not alone in that doubt.
(To my way of thinking, social impairments are the very core of autism—more so than the repetitive behaviors.)
these diagnoses overlook the gifted but frustrated—the typical Aspie or high-functioning autistic who is laboring in a nonsympathetic environment. Consider the oppositional defiant disorder diagnosis: “The disturbance in behavior causes clinically significant impairment in social, educational, or vocational activities.” I guarantee you that if you take a third-grader who can read high-school math texts and make him do baby-math drills over and over and over, he will turn oppositional defiant—because he’s bored out of his mind. How do I know? Because I’ve seen these cases—kids who are considered to have severe behavior problems at school until you give them math lessons that meet them where their brains are. Then their behavior normalizes, and they become productive and engaged—maybe even model students.
Instead of talking about sets of symptoms in an attempt to assign them a label, we can begin to talk about one particular symptom and attempt to determine its source. We’ve reached a point in our research that we can match symptoms and biology.
Thanks to advances in neuroscience and genetics, we can begin phase three in the history of autism, an era that returns to the phase-one search for a cause, but this time with three big differences. One, the search for the cause involves not the mind but the brain—not some phantom refrigerator mom but observable neurological and genetic evidence. Two, because we realize how extraordinarily complex the brain is, we know this search will lead not to a cause but to causes. Three, we need to be looking for a cause or multiple causes not of autism but of each symptom along the whole spectrum.
The results were striking. Dawson found that the measure of intelligence in the autistic population depended on the type of test. On the Wechsler, one-third of the test subjects with autism qualified as “low functioning.” On the Raven’s, however, only 5 percent did so—and one-third qualified as having “high intelligence.” On the Wechsler, the autistic subjects on the whole scored far below the population average, while on the Raven’s they scored in the normal range. I myself have scored really well on the Raven’s Coloured Progressive Matrices. Why such a wide disparity in responses to the two tests? Perhaps because answering many of the Wechsler questions correctly depends on the social ability to acquire skills and information from others, whereas the Raven’s is purely visual. “We conclude,” the Montreal group wrote in their groundbreaking study published in Psychological Science in 2007, “that intelligence has been underestimated in autistics.”
I also want to be clear that when I say strengths, I’m not talking about savant skills like those of Stephen Wiltshire, who needs only one helicopter tour of a portion of a city, like London or Rome, in order to draw the entire landscape down to the last window ledge, or Leslie Lemke, who needs to hear a piece of music only once—any style, including complex classical compositions—in order to re-create it on the piano. Only about 10 percent of autistics belong in the savant category (though most savants are autistic).
1707 People with autism are really good at seeing details.
Traditionally researchers have characterized this trait as “weak central coherence”—a deficit. Weak central coherence is at the heart of the impairments in social communication and social interactions that have long been part of the official diagnosis of autism. More informally, you can say that autistic people have trouble putting together the big picture, or that they can’t see the forest for the trees.
Think about Tito and his encounter with the door. He saw the door as a series of properties—its physical features (hinges), its shape (rectangular), its function (allowing him to enter the room). Only when he’d collected enough details did he know what he was seeing. When I met him at a medical library, I asked him to describe the room.
A landmark study in 1978, “Recognition of Faces: An Approach to the Study of Autism,” brought the social implications of this trait to the forefront of research. Subjects were shown only the lower parts of a series of faces of people they knew and asked to identify the people. The autistic population performed better than the controls. The same was true when both groups were shown inverted images. The people with autism were better at figuring out what the image was when it was upside down. The researcher who performed the study, Tim Langdell, posited that people with autism were better at seeing “pure pattern” rather than “social pattern.”
This interpretation would be consistent with results from biological motion tests. You know motion-capture technology in filmmaking, where an actor wears a bunch of white dots that map his movements in a computer? That’s biological motion. On a computer screen, biological motion is nothing more than dots moving, but the dots are arrayed in such a way that they suggest an action a living person or animal would perform, like running. Studies have repeatedly shown that people with autism can identify biological motion, but they don’t do so with the same ease as neurotypicals. Nor do they attach emotions and feelings to the motions. What’s more, they use different parts of the brain than neurotypicals do. Neurotypicals show a lot of activation in both hemispheres, while autistics show less activation overall. The way the autistic brain engages with biological motion is reminiscent of Tito’s description of focusing on a door at the expense of seeing the room, or a description by Donna Williams I once read, of her being entranced by individual motes of dust.
These are important findings. But there can be a flip side to a deficit in social pattern recognition: a strength in pure pattern recognition—being really good at seeing the trees. Studies have repeatedly shown that people with autism perform better than neurotypicals on embedded-figure tests—a variation on the old something’s-hidden-in-the-picture game. Several years ago I took a test where I had to look at large letters that were composed of smaller, different letters—for instance, a giant letter H that was built out of tiny Fs. I then had to identify either the big letter or the little letter. I was faster at identifying the little letters, a result that’s far more common among autistics than neurotypicals. Research has also shown that when performing language tasks, the autistic subject relies on the visual and spatial areas of the brain more heavily than the neurotypical subject does, perhaps to compensate for a lack of the kind of semantic knowledge that comes with social interaction. An fMRI study in 2008 showed that when the neurotypical brain conducted a visual search, most of the activity was confined to one region of the brain (the occipitotemporal, which is associated with visual processing), while what lit up in the autistic brain was just about everything. Perhaps this is why I can immediately spot the paper cup or hanging chain that’s going to spook the cattle, while the neurotypicals all around me don’t even notice it. Researchers have a lovely term for that tendency to see the trees before recognizing the forest: local bias.
Consider Michelle Dawson, the researcher who thought to look for references to autistic strengths that are buried in the literature. She’s autistic. I can’t say she made her conceptual leap because she’s autistic, but I think she was more likely to make it because she herself possessed a fine attention to details. “Dawson’s keen viewpoint keeps the lab focused on the most important aspect of science: data,” Mottron wrote in a 2011 article in Nature. “She has a bottom-up heuristic, in which ideas come from the available facts, and from them only.”
Dawson had always approached her research with the same received wisdom, making the same unthinking assumption, as her mentors and peers—that studying autism means studying deficits. But that assumption was the result of what Mottron identified in himself as a “top-down approach: I grasp and manipulate general ideas from fewer sources.” Only when he’s come up with a hypothesis does he “go back to facts.” Dawson found it easier to free herself of the preconceptions inherent in top-down thinking because she was able to see the details dispassionately and in isolation. When other researchers look at her data about autistic strengths and say, “It’s so good to see something positive!” she answers that she doesn’t see it as positive or negative: “I see it as accurate.”
I completely identify with this attitude. For my undergraduate honors thesis, I wanted to explore the subject of sensory interaction. How does a stimulus to one sense, such as hearing, affect the sensitivity of other senses? I gathered more than one hundred journal papers. Because my thinking is totally nonsequential, I had to develop a way to make sense of the research. First, I numbered each journal article. Next, I typed the major findings of each study on separate slips of paper. Some studies yielded only one or two strips of paper. Review articles prompted more than a dozen. Then I put all the strips in a box. I’d hung a huge bulletin board in my dorm room—maybe four feet by six feet. I drew the first strip out of the box and I pinned it just anywhere on the board. Then I pulled out the next strip. Let’s say the first strip was about the sense of vision, and the second was about the sense of hearing. So the second strip went on a different part of the board, because now I had the beginnings of two categories. I made labels for those two categories and pinned them to the top of the board so that they headed two columns. I continued to take strips of paper out of the box, one at a time, like drawing lots. I’d pick one, put it with the other strips in a category, create a new category, or throw out all the old categories and rearrange all the strips of paper. In the end, after I had finished sorting all the strips of paper into different categories of information, I began to see how the categories of information fit together to form larger concepts.
This feeling of certainty is probably what has fed the reputation among mathematicians and scientists who have Asperger’s or are high-functioning autistics as being rigid and unswerving. Once they arrive at a proof, their attitude toward it becomes inflexible, because they have experienced the piece-by-piece, painstaking logic that went into creating it. Mathematicians and scientists even speak of the beauty of an equation or proof.
For a top-down thinker, however, that certainty is not necessarily earned—not without a lot of supporting evidence. I had one client who insisted that he could build a meatpacking plant in three months. Well, no. That’s absolutely not going to work. But he couldn’t be persuaded otherwise. He knew he was right, and all the deadlines the contractor missed because they were impossible to meet, all the unforeseen delays that normally get padded into the schedule in advance, meant nothing. In the end, his was a twenty-million-dollar screwup.
For a bottom-up thinker like me, however, getting a detail wrong when I’m trying to solve a problem doesn’t have implications for the whole solution, because I haven’t reached the whole solution yet. If someone shows me a part of a project where I did something wrong, I say, “Change it.”
I’ve often said that my brain works like a search engine. If you ask me to think about a certain topic, my brain will generate a lot of hits. It can also easily make connections that will get off the original topic pretty fast and go pretty far. The similarity between my brain and a search engine, though, shouldn’t come as too much of a surprise. Who do you think designed the original search engines? Very likely it was people whose brains work like mine—people with brains that have trouble with linear thought, brains that ramble, brains that have weak short-term memory.
I recently read a definition of creativity in the journal Science that really made an impression on me: “a sudden, unexpected recognition of concepts or facts in a new relation not previously seen.” That’s what happened when Michelle Dawson challenged the whole history of autism research based on identifying deficits. She had the same concepts and facts as everyone else, but she saw them in a “new relation not previously seen.”
A few years ago I went to a reunion at Franklin Pierce and I saw Mr. Burns, who was by then retired. “You asked some questions that were really deep,” he told me. They didn’t seem deep to me. They seemed like common sense. But now I understand I wouldn’t have been able to make the association between Mendel’s genetics and crossbred dogs if I didn’t already have enough crossbred dogs in my database. In fact, when I confronted Mr. Burns, I had in mind a particular Border collie and springer spaniel that I had known back when I was in high school. They were the parents of a litter of puppies. I could still see the mom and dad in my mind, and I could see the puppies, and I could see what the dogs looked like when they grew up. I like to look at the usual materials for any project and imagine a potential application or construction that wouldn’t occur to most other people.
I think that bottom-up, details-first thinkers like myself are more likely to have creative breakthroughs just because we don’t know where we’re going. We accumulate details without knowing what they mean and without necessarily attaching emotional significance to them. We seek connections among them without knowing where they’re taking us. We hope those associations will lead us to the big picture—the forest—but we don’t know where we will be until we arrive there. We expect surprises.
The neurotypical response to his insight was to dismiss it. But Robison could hear what other people missed. Actually, he could see it: “I saw the whole thing as a great mental puzzle—adding the waves from different instruments in my head, and figuring out what the result would look like.” He was, he learned, working in a kind of waveform mathematics, even though he didn’t think of his work as math. Seeing waves, adding them in his head—that sounded like visual thinking, as in “thinking in pictures.”
We can reconceive the autistic brain as a repository for certain strengths—the ability to pick out details, maintain a large database of memories, make associations. But of course, autistic brains don’t all see the world the same way—despite what I once thought. Autistic brains might tend to have these strengths in common, but how each individual uses them varies. What kinds of details? What kinds of memories? What kinds of associations?
After the boy had presented me with his gift, he hurried away, but I noticed that his parents were still standing nearby. I asked them about their son, and they said he was gifted in math. Which made sense. It certainly took a mathematical mind to engineer such a complicated structure. But didn’t such a subtle and beautiful work of art have to be the product of a visual mind too? Maybe, I thought one day, putting the origami back on the windowsill, people who are really good at math think in patterns.
Once I realized that thinking in patterns might be a third category, alongside thinking in pictures and thinking in words, I started seeing examples everywhere.
After I gave a talk at one high-tech firm in Silicon Valley, I asked some of the folks there how they wrote code. They said they actually visualized the whole programming tree, and then they just typed in the code on each branch in their minds. And I thought, Pattern thinkers. I recalled my autistic friend Sara R. S. Miller, a computer programmer, telling me that she could look at a coding pattern and spot an irregularity in the pattern.
Crossword puzzles involve words, of course, while sudoku involves numbers. But what they have in common is pattern thinking. In the 2006 documentary Wordplay, a movie about crossword puzzles, the people who created the best puzzles were mathematicians and musicians.
Then I read an article on origami in Discover magazine that just about blew my mind. I learned that for hundreds of years, the most complex origami patterns needed only about twenty steps, but in recent years, competitors in extreme origami had used software programs to design patterns requiring one hundred steps. And I read this amazing passage: The reigning champion of intricate origami is a 23-year-old Japanese savant named Satoshi Kamiya. Unaided by software, he recently produced what is considered the pinnacle of the field, an eight-inch-tall Eastern dragon with eyes, teeth, a curly tongue, sinuous whiskers, a barbed tail, and a thousand overlapping scales. The folding alone took 40 hours, spread out over several months.
In 2004, Daniel Tammet came to my, and a lot of other people’s, attention when he set a European record for reciting the highest number of digits of pi ever: 22,514. And he did so in five hours. That’s an average of 75 digits a minute—more than one per second. Demonstrations of other abilities followed: He became fluent in Icelandic in only a week; he could tell you what day of the week a distant date would fall on. In interviews, he said that he had been diagnosed with Asperger’s syndrome. When he published his book Born on a Blue Day, I naturally couldn’t wait to read it. He explained the title on page 1: He was born on January 31, 1979, a Wednesday—and Wednesdays, in his mind, were always blue. As I read on, I learned that he thought of numbers as unique, each having its own personality. He said that he had an emotional response to every number up to 10,000. He described seeing numbers as shapes, colors, textures, and motions. He explained that he could instantly multiply two large numbers—53 × 131, for example—not by performing the math but by “seeing” how the shapes of the numbers merged into a new shape, which he recognized as the number 6,943. Patterns.
Now, I’m certainly not the first person to notice that patterns are part of how humans think. Mathematicians, for instance, have studied the patterns in music for thousands of years. They have found that geometry can describe chords, rhythms, scales, octave shifts, and other musical features. In recent studies, researchers have discovered that if they map out the relationships between these features, the resulting diagrams assume Möbius strip–like shapes.
Even the seemingly random splashes of paint that Jackson Pollock dripped onto his canvases show that he had an intuitive sense of patterns in nature. In the 1990s, an Australian physicist, Richard Taylor, found that the paintings followed the mathematics of fractal geometry—a series of identical patterns at different scales, like nesting Russian dolls. The paintings date from the 1940s and 1950s. Fractal geometry dates from the 1970s. That same physicist discovered that he could even tell the difference between a genuine Pollock and a forgery by examining the work for fractal patterns. “Art sometimes precedes scientific analysis,” one of the van Gogh researchers said. Chopin wrote the music he wrote, and van Gogh and Pollock painted the images they painted, because something just felt right. And it just felt right because, in a sense, it was right. On some deep, intuitive level, these geniuses understood the patterns in nature.
In 2011, participants in an online video puzzle game called Foldit solved the mystery of the crystal structure of a particular monomeric retroviral protease. The configuration of the enzyme had long eluded scientists, and the solution was so significant that it actually merited publication in a scientific journal. What made the achievement especially remarkable, though, was that the players were not biochemists. But they sure were pattern thinkers.
Mathematicians distinguish subsets of thinkers: algebra thinkers and geometry thinkers. Algebra thinkers look at the world in terms of numbers and variables. Geometry thinkers look at the world in terms of shapes.
And then there’s chess. There’s always chess. For a century now, chess has been the petri dish of choice for cognitive scientists—researchers who think about thinking. Skill at chess can easily be measured, which is why rankings can be so precise, and it can be observed in an environment as controlled as any laboratory’s—the tournament hall. What makes a chess master a chess master? Definitely not words. But not pictures, either, which is what you might think. When a chess master looks at the board, she doesn’t see every game she’s ever played and then find the move that matches the move from a game she played three or five or twenty years earlier. (That’s probably what I would try to do.) A chess master doesn’t “see” a board from a nineteenth-century chess match that she’s studied closely. So what does a chess master see, if not pictures? By now you can probably guess: patterns. The stereotype of a chess grand master is someone who can think many moves ahead. And certainly, many chess players do strategize that way. Magnus Carlsen, a Norwegian prodigy who became a grand master in 2004 at the age of thirteen, calculates twenty moves ahead and routinely makes moves that other grand masters haven’t even contemplated. Most grand masters can see many moves ahead, even while playing dozens of games simultaneously, walking from board to board in an exhibition space.
But a clue to how they’re thinking comes from José Raúl Capablanca, a Cuban grand master. In 1909, he participated in an exhibition in which he played twenty-eight games at once, and he won all twenty-eight. His strategy, though, was the opposite of Magnus Carlsen’s. “I see only one move ahead,” Capablanca reportedly said, “but it is always the correct one.” Cognitive scientists don’t see a contradiction between these two approaches. Whether a chess player immediately sees a move in the context of twenty moves ahead or immediately sees a move in the context of one move ahead, the point is that he sees the move immediately. The grand masters see it immediately not because they have better memories than regular players. They don’t, according to studies that tested their memories. Nor do masters and grand masters see the next move immediately because their memories carry more possibilities from which they can choose. Their memories do carry more possibilities, because top-tier players have played longer than other players. But they retrieve from their memories not more possibilities but better possibilities. It’s not just the quantity that grows over time. It’s the quality.
The reason is that they are better at recognizing and retaining patterns—or what cognitive scientists call chunks. A chunk is a collection of familiar information. The letter b is a chunk, as is the letter e, as is the letter d. The ordering of those letters as bed is also a chunk, as is the phrase going to bed. The average person’s short-term memory can retain only about four to six chunks. When superior chess players and novices were presented with pieces on nonsensical boards and then asked to re-create the positions of the pieces from memory, members of both groups were able to recall the locations of four to six pieces. When they were presented with pieces on actual chessboards, however, the superior chess players could recall the positions of the pieces across the board, while the novices were stuck at the four-to-six-pieces level. The real-life chessboards contained familiar patterns of pieces, and for a superior player, each pattern represented a chunk. To the expert eye at a glance, a board of twenty-five pieces might have four or six chunks—and the master or grand master knows upward of fifty thousand chunks, which is to say upward of fifty thousand patterns.
Michael Shermer, a psychologist, historian of science, and professional skeptic (he founded Skeptic magazine), called this property of the human mind patternicity. He defined patternicity as “the tendency to find meaningful patterns in both meaningful and meaningless data.” Why would we need to find patterns even when they’re not there? “We can’t help it,” he wrote in his book The Believing Brain. “Our brains evolved to connect the dots of our world into meaningful patterns that explain why things happen.” In fact, we might make bad decisions because our brains themselves feed us bad information. Our brains “want” to see patterns, and as a result, they might identify patterns that aren’t there. In one experiment, for instance, researchers found that when subjects were shown randomly pointing lines on a computer screen and were asked which way, on average, the lines were pointing, they consistently tended to think the lines were pointing in either a more horizontal or a more vertical way than they actually were. The researchers hypothesized that our brains “want” to see horizontal or vertical, because that’s what we need to see in nature. The horizon tells us where we’re headed; the vertical tells us there’s an upright person coming our way.
About a decade ago, a college dropout named Jason Padgett survived a vicious mugging outside a karaoke bar in Tacoma, Washington. He was struck in the back of the head, just above the primary visual cortex, and he suffered a concussion. Then a day or two later, he began seeing the world as a mathematical formula. “I see bits and pieces of the Pythagorean theorem everywhere,” he said. “Every single little curve, every single spiral, every tree is part of that equation.” He found himself compelled to draw what he was seeing, over and over and over, year after year. All the resulting artwork turned out to be fractals that were mathematically precise—even though he had had no math training and previously had exhibited no talent for art. It’s as if the fractals were in his brain, just waiting to be freed.
Cowan hypothesized that because hallucinations moved independently of the eye, the source of the image was not on the retina but in the visual cortex itself. “What that told me,” he said, “was that if you see geometric patterns, the architecture of your brain must be reflecting those patterns and therefore must itself be geometric.” Cowan and other researchers have continued to pursue that idea over the past three decades, and today they accept, as a 2010 review article in Frontiers in Physiology phrased it, “the prevalence of fractals at all levels of the nervous system.” You could say that the whole universe is fractal. Look at the weblike structure of neuronal cells in the brain, the network that transmits chemical and electrical signals. Then look at the large-scale structure of the universe, the galaxy clusters and superclusters that make up what astronomers call the cosmic web. If you squint, you can’t tell them apart.
I quickly began searching for more papers by the same author, and I found a few. But when I went to the citation index—the list of other papers that cited these papers—the trail went cold. This small cluster of papers was it: a new branch of research, one that was finding empirical evidence to support my anecdotal hunch.
She dug a little deeper into the data. And she noticed that while the visual thinkers’ group average on the spatial tests was about the same as the verbal thinkers’ group average, the visual thinkers’ individual scores diverged along two extremes. Some scored very well. Some scored very poorly. They were all visual thinkers, yet some could easily manipulate objects in space, and some could not. “It was clearly a bimodal distribution,” she told me. “Clearly. It was so obvious from the statistical data that you had two types of people who report themselves as highly visual. One group had very high spatial ability, and the other group had very low. And I had the idea: Maybe the two groups are just different.”
Still, my score of 17 was “VERY high,” said Kozhevnikov. For visual artists, the mean is 11.75. For scientists and architects, she added, the mean is less than 9. Now, that was pretty interesting to me. Twice I had scored in the same range as visual artists, and not in the same range as scientists. But I am a scientist. Then again, those were object imagery tests, and objects—pictures—are first nature to me. What would the spatial-relations tests show?
I have done a lot of thinking about the spatial relations test, I wrote to Kozhevnikov. I can do well in certain types of visual spatial tests. I explained that I could rotate a two-dimensional object—a flat drawing—in my mind. You show me the outline of Texas upside down and ask me what it is, and I won’t hesitate: “That’s Texas.” But in my work, I actually don’t have to rotate an object. When I visualize a large cattle handling facility in my mind, I wrote in my e-mail, I move my mind’s eye around it.
He tried again. He said that he’d recently seen on television a design for a bridge between Hong Kong and China. In Hong Kong, cars drive on the left side of the road (because it’s a former British colony), and in mainland China, cars drive on the right side. How would I design such a bridge? The switchover bridge does what it says. © NL Architects; Flipper Bridge, switching lanes between mainland China and Hong Kong “I’m seeing roadways crossing,”
Kozhevnikov wrote back that in imagining the scene from the roof, I’m not manipulating an object in space. I’m manipulating me in space. I’m visualizing an object from a new perspective, but I’m still visualizing an object. I’m still thinking in pictures. When I’m drawing a blueprint, remodeling a plant, or designing a project, my thinking starts with an image of an object. Even the movies in my head start with a still image. Which is why I scored the way I did on the tests. On the object imagery tests, I had scored high—as high as visual artists, and even higher. On the spatial imagery tests, I had scored low—as low as visual artists, and even lower. I am a visual thinker, and in both sets of tests my scores were remarkably similar to those of visual artists. But how to account for the fact that I’m a scientist, yet where I scored high, scientists scored low, and vice versa?
Richard took the tests too. He scored perfectly on the spatial tests—the paper folding, the mental rotation, the stand-at-the-flower-and-face-the-house-and-point-at-the-stop-sign. But the grain test presented problems for him; he got eleven right out of twenty. Not bad, but not in the category of pulling up images of two objects and comparing them, the way I do. Because he’s a writer, he identifies himself as a verbal thinker. The visual tests showed that he also has superior spatial abilities, similar to a scientist’s. Is it any wonder, then, that even though he’s not a scientist, he specializes in writing about science?
Still, I understood what Richard was saying. Another person might have an emotional attachment to his mother’s sewing basket, an object he remembers fondly from his childhood. And in fact, Kozhevnikov’s research showed that in describing the two paintings, artists used emotional terms—crash, breakthrough, extreme tension. I see like an artist, I realized, but I don’t feel like an artist. Instead, my emotions work like a scientist’s. When scientists described the paintings, they used unemotional words—squares, stains, crystals, sharp edges, and swatches. I’m not saying that scientists and engineers don’t feel emotions; I’m sure most scientists and engineers would feel some sort of sentiment about their mothers’ sewing baskets. But the scientists in this study didn’t see a mother’s sewing basket, or any other object. They saw geometrical shapes. They saw what was literally there, and what was literally there wasn’t the kind of image that would elicit an emotional response. Artists, on the other hand, saw what was figuratively there, and what was figuratively there was indeed the kind of image that would elicit an emotional response. I saw what was figuratively there too—only those images did not produce an emotional response in me.
Like Michelle Dawson, who described autistic traits not as positive or negative but as accurate, I don’t attach an emotional response to concrete objects. So I am able to handle them objectively—literally as objects, and only as objects. I can’t manipulate them in space. I can’t subject them to spatial reasoning. But I can sure design a cattle chute that works.
During the Japanese tsunami catastrophe of 2011, the Fukushima nuclear power plants melted down because the tidal wave that came over the seawall flooded not only the main generator but its backup. And where was the backup located? In the basement—the basement of a nuclear power plant that is located next to the sea. As I read many descriptions of the accident, I could see the water flowing into the plant, and I could see the emergency generators disappearing under the water. (This is partly what I do as a consultant: I see accidents before they happen.)
So my test results were consistent after all. The correlation between how the tests predicted I would think and how I actually do think was simple, direct, clear—once I factored autism into the equation: high object imagery plus autism equals scientific mind, at least in my case.
In recent years, the relationship between nature and nurture has been getting a lot of attention in the popular press. In particular, the 10,000-hour rule seems to have captured the public imagination. New Yorker writer Malcolm Gladwell didn’t invent the rule, but he did popularize it through his best-selling book Outliers. The principle actually dates to a 1993 study, though in that paper the authors called it the 10-year rule. Whatever name it goes under, the rule essentially says that in order to become an expert in any field, you need to work for at least x amount of time.
But was he born with a brain for business—a brain that would lend itself to number-crunching and risk-taking and opportunity-identifying and all the other skills that go into becoming the leading investor of his generation? I say yes.
By putting such an emphasis on practice, practice, practice at the expense of natural gifts, the Fortune interpretation of the 10,000-hour rule does a tremendous disservice to the naturally gifted. But wait. It gets worse. Some interpretations of the 10,000-hour rule leave talent out of the equation altogether.
Let’s go to Gladwell’s example of Bill Gates. In the late 1960s, when Gates was still in high school, he had access to a Teletype terminal, and his math teacher excused him from class so that he could write code. Computer code became something of an obsession with Gates, and ten thousand hours later—well, you know the story. Now let me tell you the other side of that story. In the late 1960s, when I was a student at Franklin Pierce College, I had access to the same terminal as Gates—the exact same Teletype terminal. The school’s computer system tapped into the University of New Hampshire’s mainframe. So I had as much access as I wanted, and I had as much firepower as I wanted, and it was all free. And you’d better believe I wanted to spend as much time as possible on that computer. I love that sort of stuff; I love to see how new technology works. The computer was called Rax, so when I turned on the computer, a message would type out on paper: Rax says hello. Please sign in. And I would eagerly sign in. And that was it. I could do that much—but that was all. I was hopeless.
Neuroanatomy isn’t destiny. Neither is genetics. They don’t define who you will be. But they do define who you might be. They define who you can be. So what I want to do here is focus on how the autistic brain can build up areas of real strength—how we can actually change the brain to help it do whatever it does best.
The idea of plasticity in the brain—that your brain can create new connections throughout your whole life, not just in childhood—is still quite new, and like so many new ideas about the brain, we owe our awareness of it to neuroimaging. Until the late 1990s, scientists tended to think that the brain remained essentially the same, or even deteriorated, over time. One particularly compelling finding that helped overturn this view was a 2000 study of London taxi drivers. In order to qualify for a license, a London taxi driver has to learn what’s known as the Knowledge—the location of every nook in the city, and the quickest way to get there. Specifically, he needs to memorize the names and locations of the twenty-five thousand streets that radiate from central London, a task that takes the average person two to four years. And the prospective cabdriver needs to demonstrate this knowledge in a series of tests taken over the course of several months. These tests consist of one-on-one interviews with inspectors who name a point of departure and a point of arrival; the applicant’s job is to describe how to make that trip, turn by turn.
“The brain behaves like a muscle,” Maguire said. “Use brain regions and they grow.” But if you don’t use a brain region, it won’t necessarily wither. Neuroscientists have been intrigued by a case in India: A man who had been nearly blind since birth had his vision restored.
Not only can dormant areas of the brain “come to life” and do what they were always supposed to do, but those areas can get repurposed and do what they aren’t supposed to do.
This generation is fortunate in an important way. They’re the tablet generation—the touchscreen, create-anything generation. I’ve already talked about how these devices are an improvement over previous computers because the keyboard is right on the screen; autistic viewers don’t have to move their eyes to see the result of their typing. But tablets also have other advantages for the autistic population. First, they’re cool. A tablet is not something that labels you as handicapped to the rest of the world. Tablets are things that normal people carry around. Second, they’re relatively inexpensive. They’re even less expensive than high-end personal communication devices traditionally used in autism classrooms. And the number of apps seems limitless. Instead of a device that performs a few functions, a tablet taps into a world of educational opportunities.
I’m concerned when ten-year-olds introduce themselves to me and all they want to talk about is “my Asperger’s” or “my autism.” I’d rather hear about “my science project” or “my history book” or “what I want to be when I grow up.” I want to hear about their interests, their strengths, their hopes. I want them to have the same advantages and opportunities in education and the marketplace that I did. I find the same inability to think about children’s strengths in their parents. I’ll say, “What does your kid like? What is your kid good at?” and I can see the confusion in their faces. Like? Good at? My Timmy?
For me, autism is secondary. My primary identity is as an expert on livestock—a professor, a scientist, a consultant. To keep that part of my identity intact, I regularly block out chunks of the calendar for “cattle time.”
The same is true of all the undiagnosed Asperger’s cases in Silicon Valley. Being on the spectrum isn’t what defines them. Their jobs define them. (That’s why I call them Happy Aspies.)
When I give lectures in Silicon Valley, I see a lot of people who are solidly on the autistic spectrum, and then when I travel around the country and speak at schools, I see a lot of similar kids who will never get the chance to work in Silicon Valley. Why? Because their schools are trying to treat the kids like they’re all the same.
When Mr. Carlock saw that I couldn’t do algebra—just could not do it—he redoubled his efforts to make me learn it. He didn’t understand that my brain doesn’t work in the abstract, symbolic way that solving for x requires. Mr. Carlock wasn’t someone who liked to give up on a student, and I’m sure he thought that by pushing me hard on algebra, he was helping me. But what he could have done instead is recognize my limitation in that area and play to my strength in another area. My engineering talent should have been a clue. Engineering isn’t abstract; it’s concrete. It’s about shapes. It’s about angles. It’s about geometry.
If an autistic fourteen-year-old can’t handle algebra because it’s too abstract, you don’t say, “Do algebra anyway.” You try moving him to geometry! If another kid can’t handle algebra or geometry or any other kind of math, you don’t say, “You have to do math before you can do anything else.” Instead, try turning her loose in the lab! If a kid can’t handle handwriting, let him type. If a kid like me invents something like the squeeze machine, you don’t say, “That kid should be like other students” and then destroy the machine; you say, “That kid isn’t like the other students, and that’s a fact.” The educator’s job—the role of education in society—is to ask, “Well, what is she like?” Instead of ignoring deficits, you have to accommodate them.
Unless the child is a true prodigy or a savant, you’re not going to be able to tell what kind of thinker she is at the age of two. In my experience, evidence of a predisposition toward picture, pattern, or word-fact thinking doesn’t emerge until second, third, fourth grade. Kids who are picture thinkers are the ones who like hands-on activities. They like building with Legos, or painting, or cooking, or woodworking, or sewing.
Like picture thinkers, pattern thinkers tend to love Legos and other construction toys, but in a different way. Picture thinkers want to create objects that match what they see in their imagination, whereas pattern thinkers think about the ways the parts of the object fit together.
A pattern thinker, however, would see the patterns a lot earlier. That’s what makes pattern thinkers good at math and music: They get the form behind the function. Many pattern thinkers, though not all, gravitate toward music. Pattern thinkers might find reading a challenge, but they’ll be miles ahead of their classmates in algebra, as well as in geometry and trigonometry. It’s important for schools to let them work at math at their own pace. If they’re ready for a math text that’s two grades away, give them that math text. Jacob Barnett, at the time a preteen autistic living in suburban Indianapolis, was so bored in grade-school math class that he started to hate math. Finally, out of frustration, he sat down with a bunch of textbooks and taught himself the entire high-school math curriculum in two weeks. Then he went to college—at the age of twelve.
You’ll know who these word-fact thinkers are because they’ll tell you. They’ll recite all the dialogue from a movie. They’ll rattle off endless statistics about baseball. They’ll calmly recall all the important dates in the history of the Iberian Peninsula. Their math skills will be only average, they won’t bother with the Legos and building blocks, and they won’t be all that interested in drawing. In fact, there might well be little point in forcing them to sit through art class. One way to help this kind of thinker learn to engage with the world is to encourage writing. Give them assignments. Let them post on the Internet. (Word-fact thinkers tend to have strong opinions, in my experience, so just make sure to monitor their Internet use for safety—which is good advice when supervising any child.)
Parents and caregivers need to get the kids out into the world, because kids are not going to get interested in things they don’t come into contact with. This point might seem obvious, but I am constantly meeting individuals with Asperger’s or high-functioning autistics who are graduating from high school and college with no job skills. Their parents have let them fall into a routine that never varies and that offers no new experiences.
Obsessions, in fact, can be great motivators. A creative teacher or parent can channel obsessions into career-relevant skills. If a child likes trains, read a book about trains and do math with trains. My science teacher used my obsession with my squeeze machine to motivate scientific study. He told me that if I wanted to argue that physical pressure is relaxing, I had to learn how to read scientific journal articles to support my thesis.
Unfortunately, a lot of the jobs that are ideal for word-fact thinkers are disappearing. Filing, record-keeping, clerking—these are tasks that increasingly are being handled by computers. The trick, then, is to let the computer become the word-fact thinker’s friend. A lot of these thinkers would be great at conducting elaborate Internet searches and organizing the results.
Mother made me do social stuff I didn’t want to do. I remember being scared to go to the lumberyard by myself because I was afraid to talk to the clerks. But Mother insisted. So I went, and I came back home crying. But I had the wood I wanted—plus a new social skill. Next time I could go to the lumberyard with less trepidation and greater confidence. These basics are just the foundation—the social skills that are a given for anybody entering the work force. People with autism, however, often have to master more specialized social skills.
Playing well with others, however, isn’t just about avoiding confrontations. It’s also about learning to try to please. My mother motivated me by making sure that I got real recognition when I did a good job—like when she framed a watercolor of the beach that I’d painted. Another time, I was allowed to sing a solo at an adult concert. I was thrilled. I knew this was a special privilege, and when the audience responded with applause and cheers, I felt tremendous pride.
From a neuroscience point of view, managing emotions depends on top-down control from the frontal cortex. If you can’t control your emotion, you have to change your emotion. If you want to keep a job, you have to learn how to turn anger into frustration.
When I was about eight years old, I learned that calling somebody Fatso was not appropriate. I’ve met a number of high-functioning autistics and Asperger’s individuals who have been fired from jobs because they made rude comments about the appearance of coworkers and customers. Even if you’ve reached adulthood without knowing what’s rude or how to relate to people in public, it’s not too late to learn.
Not only can you have different types of thinkers doing what they do best, but you can have them doing what they do best alongside other types of thinkers who are doing what they do best. When I recall collaborations in which I’ve participated, I can see how different kinds of thinkers worked together to create a product that was greater than the sum of its parts. I think about the work I did with a student (nonautistic) who was good at everything I was bad at. Bridget was an ace at statistics, very organized, and a wonderful data collector and record-keeper—someone I could trust to run the experiment right.
Fine. Good for us. Even if I weren’t autistic, we’d be a good team, because our kinds of minds complement each other. But the fact is, I am autistic, and the strengths I bring to the collaboration are strengths that belong to my kind of autistic brain—the quick associations, the long-term memory, the focus on details.
Some entrepreneurs have already made that leap. Aspiritech, in the Chicago suburb of Highland Park, and Specialisterne, in Copenhagen, both employ primarily high-functioning autistics and individuals with Asperger’s to test software. Their brains—wired to endure repetition, to focus closely, to remember details—are just what the job requires. The son of Aspiritech’s founder was diagnosed with Asperger’s at the age of fourteen, and as an adult he was fired from his job as a grocery bagger. But when it comes to testing software, he’s the go-to guy.
In the fall of 2009, John Fienberg, a high-functioning autistic, got a temp job at a New York City ad agency as a digital librarian—a great gig for a word thinker like John. It was supposed to last only a week, but John’s skills—accuracy, speed, and a willingness to perform repetitive tasks that vexed normal brains—made him a valuable asset to the agency. He continued temping there for six months, until the company found money in the budget to hire him full-time. Today he catalogues, files, and otherwise manages the product photography, advertising masters, and stock imagery in the ad firm’s digital library. “I am naturally very detail-oriented in a way that makes cataloguing very easy for me,” he wrote in an e-mail. The fact that he was communicating via e-mail was a reflection of his social skills. When we contacted him by e-mail (Richard heard about him through a friend), he said that he would be willing to be interviewed, but that he strongly preferred not to talk over the phone. He also said that meeting in person could be a problem; he knows he exhausts people with his over-talking. “My boss is aware of my disabilities and does his best to work with me,” John continued, “and I try to repay him by producing results that make it worth putting up with me when I don’t quite understand something the way he wishes I would. The rest of my coworkers do not interact with me except for the phone and through e-mails.” Still, he said, “to the best of my knowledge they all really like me and appreciate my contributions. I even got a commendation from one of them last month that was shared at the staff meeting.” John is 29 now and recently engaged. He and his fiancée plan to leave New York for “somewhere where the money I get goes further.” Don’t worry, though, about whether he can find another job that’s such a great match. “I have permission from work to telecommute permanently.”