The Cognitive Aspects of Autistic Spectrum Disorders Stephen McKeever L00086889 L00086889@student.lyit.ie 13th December 2012
"Not everything that steps out of line, and thus ’abnormal’, must necessarily be ’inferior’" - Hans Asperger (1938)."
Introduction The majority of people on planet Earth go on about their daily lives with the confidence and ability to meet and overcome everyday challenges and obstacles. They can perform tasks independantly, work hard and live the life of ’the average man/woman’. For others, this is not the case, as they may have been diagnosed at a young age with a long term 5
psychological disorder known as an Autistic Spectrum Disorder, or A.S.D. for short. The aim of this paper is to discuss the imapct of A.S.Ds on the cognitive development of the child. To begin, it will discuss the various levels of disability, and the characteristic traits. The developmental benefit of viewing negative traits in a positive light will be considered, as well as the role of intervention in improving cognitive ability and discuss
the use of alternative communication systems in enabling interaction. The impact of social impairment and importance of social skills training in cognitive development will 1
be studied. The role of neuroimaging techniques in advancing understanding of Autism will also be considered in this paper. A.S.Ds are associated with a number of characteristics or traits including poor com15
municational skills, repetitive behavioural patterns, and the lack of responsiveness to others. It affects 5 in every 10,000 children at birth, with 70% of them remaining dependant on others in their adult lives, due to higher functioning types of A.S.Ds. It was first described by Leo Kanner in 1943, who speculated that “children had been driven into their own worlds by a cold and unforgiving family environment”, thus leading to
the development of impaired characteristics which would later become known as Autism. This was disputed by Dr. Hans Asperger who, at around the same time identified a milder form of Autism, which is known today as Asperger’s Syndrome, which was characterized by “higher cognitive abilities and more normal language functions”. [Michael Passer, 2007]
Autism is a broad spectrum, ranging from the non-communicative to milder disorders, such as Asperger’s Syndrome. Other rarer forms include Rett’s Syndrome, and rarer still, Childhood Disintegrative Disorder. Rett’s Syndrome is a severe form of autism that affects girls at a very early stage, making them unresponsive, and causing severe loss of language skills, whereas Childhood Disintegrative Disorder is considered
to be the most impactive form of A.S.Ds, which begins to affect a child at ages 2 to 4. Children with this condition are “severely impaired and do not recover their lost functions”, thus remaining dependant on others for the simplest of tasks. [WebMD, 2008] As stated before, Autistic Spectrum Disorder are the impairment of social and communicational skils, however, there are more common traits, such as “repetitive and
stereotyped patterns” and “sensitivity to minute changes” – for example, when a piece of furniture is moved unknownst to the child, he or she will react in a exaggerative manner. Other severe and life-endangering symptoms include self-injury and a lack of awareness of risks and consequences. [Michael Passer, 2007] Around 20% of people with A.S.D. also have an incredibly high pain threshold and can become very ill before being aware
of it. [TheAutismCentre.co.uk, 2004]
It’s Not All Doom & Gloom Despite the negative impact Autistic Spectrum Disorders can have on the cognitive skills of a child or an adult, it’s not all bad news. According to Paul Trehin, the vice-president of Autism Europe, not all characteristics of Autistic Spectrum Disorders have negative 45
effects, provided that “they are identified as soon as possible and nurtured through an educational program”. He goes on to say that several characteristics of A.S.Ds which are classified as negative, could be used “in a positive way to help the development of a higher quality of life.” [Trehin, 2006] A number of well-known public figures and celebrities have been diagnosed with the condition, including Adam Young, the frontman/one-man-band
known as Owl City, Al Gore – former vice president of America, and even Bill Gates, the founder of Microsoft and a key figure in the development of technology, and the personal computer revolution. There are many more people who are believed to fall within the A.S.D. spectrum, including historical figures. For example, Mozart is believed to have had Asperger’s Syndrome, as are the writers Jane Austen, Sir Isaac Newton and
Albert Einstein. [Fattig, 2007] Another “Aspie” was the man who gave his name to the condition, Hans Asperger, and also the author of this paper. “Not all features of Autism are negatively impacting the outcome of Autistic future lives.” – Paul Trehin One such alleged negative feature is “repetitive behaviours”. Often considered an un-
desirable trait, this could mean the person has strong persistant interests, and focuses on fine details. He/she may then have the ability to recall minute details that others may have missed. Thus making him/her an invaluable asset in, for example, a large business, a science lab or in the forensics line of work. Even in art, this would be a positive attribute. Take a look at the work of Stephen Wiltshire, who was diagnosed
with severe autism at an early age, and was unable to talk until he got support from 3
Figure 1: Stephen Wiltshireâ€™s stunning landscape of London. http://www.stephenwiltshire.co.uk/art.aspx?Id=2483)
early intervention, but that did not stop him from drawing a picturesque landscape of London, all from memory. [Trehin, 2006]
Intervention and Social Interaction The intervention process is a way of developing cognitive and communication skills of 70
a child at an early age. For children with Autistic Spectrum Disorder, this is a large, essential stepping stone in his/her development, as it has long term effects on the childâ€™s communication skills, language and cognitive abilities. Intervention by professionals such as psychologists, speech and language therapists and occupational therapists can greatly improve the development of the childâ€™s communication skills, langage and cognitive
abilities. This process can also assist in the improvement of IQ levels, judging on the longevity of participation in the intervention program. Early intervention can have long 4
Figure 2: Results found from the High/Scope Perry Program. (Picture from: http://www.educationvoters.org/wp-content/uploads/2010/01/perry.gif) term benefits in the long-run. According to statistics given by the High/Scope Perry Pre-school Program, which was carried out in a school in Michigan from 1962 - 1967, 123 African American children who were given early intervention at the age of three, and 80
participated in a course of intervention for a full three years would benefit educationally and socially in their journey to adulthood. This study highlighted the difference of a group of 40 year olds who received regular intervention at an early age, to a group of 40 year olds who were not administered the program [Michael Passer, 2007]. It was found that the group who participated in the program had “higher earnings, more likely to be
employed, been arrested fewer times, and were more likely to graduate from high-school. “Children who are administered early intervention have shown “benefits in academic achievement, behaviour, educational progression and attainment, deliquency and delinquency and crime, and labor market success, among other domains.” [Lynn A. Karoly and Cannon, 2005]
Alternative mediums of communication are required to be acknoledged by those who have children who remain non-verbal throughout their early years, as well as the child 5
him/herself. PECS, which stands for “Picture Exchange Communication System” is a form of alternative communication specifically used for non-verbal children with A.S.D. It is used to allow the child to use picture representations to express his/her needs or 95
desires, allowing the parent or teacher to be able to understand what the child’s wishes. For instance, the child could show a picture of a cup in order to communicate that he/she is thirsty or a picture of a toilet to say that the child needs to go to the bathroom. The teacher would then confirm the request, i.e. “You want a drink?” before fulfilling the child’s request “thus reinforcing communication”. This system is said to be a relief for
the lack of communication from child to parent, improving the relationship and family bond However it may take a long period of time for the introduction of PECs to click, so patience and perseverance are essential. As well as PECs, other forms of communication, such as sign language, or communication through gestures can be utilised. Integration of extra classes and interventions
into the child’s education is necessary to allow improvement of their social and educational skills. This includes “taking into account the needs of the autistic child, for example: disiplines, admission, and even modifying the curicullum to suit the child [Autism-Help.org, 2005]. Thus, with the use of alternative communication systems, the child with A.S.D.
can interact and converse with others and open the door to learning. This can enable him/her to access the curriculum and improve cognitive development. Social interaction can be an area of great difficulty for the individual with Autistic Spectrum Disorder. Whether he/she is a child in the playground, a third-level student at a class party or an adult at an office function, the person with A.S.D. may stand out
as being awkward or socially inept. Interaction socially can be ectremely stressful. The rules and strategies of team based sports such as football or even playground “tig” can be difficult for the child to understand and are avoided in favour of solitary play. This can lead to isolation, exclusion, intimidation and even bullying. Being autistic, the child would not tell a teacher, or mention a word to their parents, for fear of consequences
that would follow, or because they can’t. Within a group, a child with A.S.D. can have problems with communicating with other peers. The child “may feel intimidated as they cannot read other pupils’ body language and may find “social rules” difficult to learn”. Added to that, a child with A.S.D. may not understand what bullying is, causing him or her to fall in with a “bad crowd” and not actually realise that what he/she is really
doing, is wrong [N.A.S., 2007, Thorpe, 2012]. While social skills may never come naturally, coping skills can be learned. Intervention programmes often include social skill training, where children with A.S.D. are taught strategies to deal with certain social situations. This can enable the child to cope better with day to day things like holding conversations and playground interaction. Therefore
social skills training enhances the social experiences of the child and by doing this, it can improve cognitive ablity.
Neuroimaging and its Contribution to Research Advancement in neuroimaging has allowed researchers to examine the differences in the brain of an individual with Autistic Spectrum Disorders. It has been observed that there 135
is increased brain volume when looking at someone who has been diagnosed. This is caused by an early period of “accelerated brain growth followed by a period of decelerated development”. Specifically, people who were diagnosed with the milder form of Autism, Asperger’s Syndrome “had significantly less gray matter in frontostraiatal and cerebellar regions, and widespread differences in white matter”. This suggests that people with
Autistic Spectrum Disorder have “abnormalities in the anatomy and connectivity of limbic-striatal brain systems”, and this is the same in different age groups, cultures and countries. From this observation, you can see that the use of neuroimagery when researching psychological disorders has enabled the “non-evasive study of the brain in individuals with A.S.D.” [Fiona Toal and Murphy, 2005].
Another discovery was made that individuals with Asperger’s Syndrome have in-
creased visual perception than that of a typical individual. From an experiment set up by the University College London, sixteen adults with A.S.Ds and sixteen typical adults participated in a series of visual search tests to prove the theory. One test revolved around finding a symbol or a picture on a computer program, such as a squiggle or a let150
ter, while another was based on quickly pressing an indicated key when a letter appeared in the middle of the screen. The findings demonstrated A.S.D. was in fact, associated with enhanced perception capabilities over someone without A.S.Ds. The nature of this abnormal enhancement is caused by the increased grey matter in the â€œparietal cortex in individuals with A.S.D.â€?[Anna M. Remington and Lavie, 2012].
The Autistic Adult As an autistic individual begins the journey into adulthood, the symptoms of A.S.Ds seem less severe; however, the impairment of language and communication still exists. In extreme cases, the symptoms may worsen, and the individual may remain dependable on autism services throughout adulthood. For others, the characteristics of A.S.Ds may
begin to emanate their positive side in employment. For example, someone who is very rule-bound comes to work on time, takes breaks religiously, and returns to work on time. Even if someone had limited social interest, they may stay more focused at work, and not waste time, which is what every employer wants at the end of the day! In many cases, symptoms of A.S.D., especially in Aspergerâ€™s Syndrome, resolve to the point where
further intervention is no longer necessary. With this in mind, the affected individual may require assistance with certain life skills, such as living arrangements in third level education, time management for assignment deadlines and important dates, as well as the likes of relationships and sexuality. The simple practice of basic skills such as answering a phone or managing finances
and bills such as government grants, and rent respectively, may require assistance, but will benefit the autistic individual in the end [O.A.R., 2012].
Cultural Impact of Autistic Spectrum Disorder The topic of whether ASD is a difference, or a disorder is a controversial and unsolved one, with one side looking for a cure for ASD, while another accepts autistic individuals 175
as different. In 1998, a British gastroenterologist, Dr. Andrew Wakefield speculated a connection between autism, and environmental factors such as measles and mumps. This recent speculation created a public health crisis, and led to the arrest of Wakefield for ethical, medical and scientific misconduct [Flaherty, 2011]. There are many rumours and theories about whether or not a cure is even possible. According to Doctor James Coplan,
“losing the symptoms of Autistic Spectrum Disorders in the adult stages of life does not equal a “cure”, as adults that have outgrown their diagnosis are still plagued by nonA.S.D. related neuropsychological disorders such as anxiety, depression and alcoholism. In the media, actors have taken on the roles of many characters in a situation faced by Autism. One example of this is the award winning stop-motion animation film, “Mary
and Max”. Directed by Adam Elliot, the film tells a story about a long distance friendship between two pen-pals, one being a little Australian girl (Mary), and a Jewish old man who lives alone in New York (Max). It is revealed mid-way through the movie that Max has Asperger’s Syndrome, which becomes a large influence on the theme of the movie. He refers to it as “Aspie’s” and refers to the thought of a cure for Asperger’s to someone
“changing his eye colour”, which is thought to be impossible. The movie presents a very powerful point that people reject the fact that A.S.Ds are an illness, but is part of who they are. Despite it’s dark, moody scenery, it portrayed the characteristics of an individual with Asperger’s Syndrome down to the nearest detail, with a little humour thrown in [Elliot, 2009].
Conclusion Living with an Autistic Spectrum Disorder has many challenges and pitfalls, but alternatively it can have many positive aspects. It is a disorder, not a disease and many 9
Figure 3: The protagonist â€œMaxâ€? from Mary and Max - (image from http://whatculture.com/wp-content/uploads/2010/10/Mary-And-Max1.jpg) individuals with A.S.D. have become very successful in the world of business, science, entertainment and even politics. This paper has discussed how early intervention can 200
greatly influence the cognitive development of individuals on the spectrum and enable them to fulfil their potential. The beneficial use of alternative communication systems in expanding interaction has been discussed. This essay has focussed on the difficulties of social impairment in daily life and highlighted the importance of social skill training. The invaluable contribution of neuroimaging in the study of Autistic Spectrum Disorders
has been emphasised, as current and future research in this area of neuropsychology will provide crucial information for the understanding of Autism and also in the development of educational strategies. In conclusion, it has been the aim of this paper to reinforce positivity in the consideration of those individuals who, running a different operating system, are striving to achieve their goals.
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