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Theories of Autism Spectrum Disorders

May 2, 2022


Developmental disorders like autism are complex, even specialists in cognitive science fields recognize there is still much to learn; however, when a child receives an autism diagnosis, parents often turn to the latest cognitive theories to learn more about their child’s unique brain development and other autistic traits.

Theories of Autism Spectrum Disorders https://www.autismparentingmagazine.com/autism-spectrum-theories

Many parents would love a single, concise, and accurate autism theory that explains the characteristics and symptoms of their child on the spectrum. One hypothesis spanning the spectrum does not seem likely, but certain theories of autism, backed by research, have delivered valuable insight. The extreme male brain theory and mindblindness are two such autism theories…many others, ranging from the ridiculous to the intriguing, have aimed to explain the complexity of the autistic mind.  

From the (thankfully discredited) refrigerator mom theory to Professor Simon Baron-Cohen’s  hyper-systemizing, assortative mating theory of autism (which extends the extreme male brain theory), researchers continue to hypothesize about autism spectrum conditions. The complicated neurodevelopmental condition is not easily pegged down, and while some theories are backed by solid science, others seem constructed to assign baseless blame for a condition which many no longer see in terms of deficits. 

Austistic advocates celebrating neurodivergence are sometimes accused of only championing the cause of “high functioning” (a problematic term which some feel should be abandoned) autistic people. Theories hypothesizing about the other “end” of the spectrum, where many children are still lacking appropriate support to communicate effectively, are less mainstream. Theorizing about savants and autistic geniuses capture the imagination, but autism spans across a wide spectrum and research and media coverage should be inclusive of the entire autistic population.

With inclusivity in mind, let’s take a look at some autism theories. Some have been discredited, some have divided the scientific community, and some have inspired a school of thought where autism may one day be celebrated as the next step in human evolution.

The Refrigerator Mom theory

Capitalizing on women’s all-pervasive guilt—interestingly a study found men feel less guilt (Etxebarria et al., 2009)—this theory blamed autism on a mother’s lack of love. Sometimes referred to as Bettelheim’s theory of autism, it claimed mothers caused autism by depriving their children of the crucial bonding experience due to their cold, distant and rejecting parenting approach.

Bruno Bettelheim, who is behind the widespread acceptance of the refrigerator mom theory, went as far as comparing autistic children to those living in concentration camps. Moms were the Nazi guards in this offensive analogy. There is much speculation about Bettelheim’s alleged fraudulent academic credentials, patient abuse, and plagiarized research—and yet the idea of parental psychological abuse being the cause of autism ruled scholarly and popular thinking in the 60s and beyond.

The fact that these same so-called “cold” mothers often raised neurotypical children in addition to their autistic child in no way deterred many (even doctors) from believing autism was caused by faulty parenting. Bernard Rimland, a psychologist with an autistic son, was one of the first to refute the theory in his book Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior (1964).

Twin studies (Folstein & Rutter, 1977), revealing the genetic basis of autism, further discredited the refrigerator mom theory, but unfortunately the stigma continues. Parents, mostly mothers, are still held accountable: choices regarding vaccinations, food and oddly enough discipline, may be enough evidence of a mother’s creation of her child’s neurodivergence. 

Even though many people believe Dr. Leo Kanner contributed to the refrigerator mom theory, records reveal he was probably dismayed that Bettelheim blamed autism on “cold” mothering. In 1969 he said: “From the very first publication until the last, I spoke of this condition in no uncertain terms as ‘innate’.” He then went on to tell parents in attendance at the first meeting of the National Society for Autistic children in Washington D.C. that they are “acquitted,” something most modern parents still need to hear today. We want our kids to slide through life unscathed, we acknowledge every obstacle in their path with crushing guilt, as though personally responsible for its very existence.


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Although parents play a definitive role in their kids’ lives, it is now generally understood they cannot “cure” or cause autism. In fact, there is no one cause of autism; most scientists agree genetics play a major role, often in combination with complex environmental factors. The neurotypical world is a tough place for kids with a differently wired brain; parents are often the unsung heroes providing vital support. Theories of parental blame, scrutinizing every choice made (often for the child’s benefit) are unfair and add to the stress and guilt overwhelming most parents with kids on the spectrum.

The extreme male brain theory

Few theories are as intriguing as the extreme male brain hypothesis. The male brain, according to Professor Simon Baron-Cohen (2002) is wired for systemizing.The female brain has an opposite cognitive profile, it may be biased towards empathizing. Accordingly, autism can be thought of as an extreme of the typical male profile—the extreme male brain theory (Baron-Cohen, 2002).

Differentiating and generalizing often lead to controversy and Professor Baron Cohen has had to defend himself against claims of gender stereotyping and neurosexism. It should be noted that this theory applies to averages, it goes without saying that there are always exceptions to every rule. Furthermore, the theory suggests that autistic individuals, male and female, mostly possess an extreme male brain profile. One study found autism to be three times more likely in females with male-like brains (Ecker et al., 2017).

The core characteristics of autism, as defined by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013) focus on social communication and interaction impairments and restricted repetitive behaviors. The stereotypical image of an autistic child is male, socially awkward, and obsessed with “boyish” pursuits like trains, maps and astronomy. Does this mean the extreme male brain theory is a valid hypothesis? 

A study (van Eijk & Zietsch, 2021) testing the extreme male hypothesis did find a higher mean brain maleness score in the autism group—in comparison to controls. Interestingly, however, the authors found the greater male-type brain, found in autistic and male individuals, was due to these groups having relatively larger brains. 

In summary the authors, van Eijk and Zietsch (2021) suggest greater maleness of the autistic brain is determined by brain size. Women’s brains are approximately 11% smaller than men’s, in proportion to their body size (Ritchie et al., 2018). 

Research does seem to suggest autism is associated with a more male-type brain; but this may be due to males and those on the autism spectrum having larger brains than females (and controls). Although brain volume may influence intelligence, associations explored by studies have been weak. It seems the size of specific parts of the brain, and connections between different regions may play a more significant role, a role that needs to be explored in future research.

The extreme male brain theory was extended by Professor Baron-Cohen in the hyper-systemizing, assortative mating theory of autism, which suggests the systemizing mechanism is set too high in autistic people (Baron-Cohen, 2006). This theory may explain why some children on the spectrum deal well with highly “lawful” systems, but struggle with systems of great variance like the social sphere and the minds of peers. The work of Prof. Baron-Cohen, reviewing evidence of autism as a genetic result of assortative mating of two high systemizers, is another intriguing autism theory.

The central coherence theory

This hypothesis, also referred to as the weak central coherence theory, was proposed by Uta Frith in the late 1980s. A simple explanation of weak central coherence is the inability to see the big picture. This is not always a bad thing, it may actually be one of the strengths of the autistic mind. Focusing on, and remembering details, instead of the global form or meaning (the “big picture”) is a definite advantage in appropriate circumstances.

An older study (Happé et al., 2001) tested parents and brothers of boys with dyslexia, autism and neurotypicals on central coherence tests. Autistic children usually score high on tasks favoring part or detail processing. Study results indicated fathers of autistic boys displayed piecemeal processing across four tests of central coherence.

A razor sharp, detail-oriented focus is an autistic strength that deserves much more attention, but it does mean kids on the spectrum sometimes zone in on a specific tree to the extent that they miss the existence of the forest. Fortunately, as autism research identifies more unique traits and characteristics, more accommodations become available to ensure kids on the spectrum thrive. 

To accommodate weak central coherence, intervention may be needed; for example when children learn to read. Kids on the spectrum often have a great vocabulary but many struggle with reading comprehension. They may focus on details of a story to a degree that they miss the main idea of the narrative. Programs like the Nancibell® Visualizing and Verbalizing® Language Comprehension and Thinking program may help kids with weak central coherence improve reading comprehension

More research is needed to structure programs that enhance and embrace the skills associated with a local or detail-focused processing/thinking style, while simultaneously providing the assistance needed to link concepts and generalize learning to accomplish tasks where extraction of global meaning is crucial.

Theory of mind

The theory of mind not only helps us understand the mind of others, but also our own. Simply put it is the capacity to think or reason about mental states. The theory of mind system of the brain develops from around 18 months, and progresses through various stages, enabling a young child to grasp the perspectives of others— it also bestows the realization that their own mental state is distinct from others.

This cognitive capacity is crucial for the development of social communication. There is an abundance of literature and research showing theory of mind is impaired in those with autism spectrum disorder (Rosello et al., 2020). The so-called false belief test is commonly employed to test the capacity for theory of mind in young children. Kids on the spectrum often do not pass the false belief test (Baron-Cohen et al., 1985). 

Researchers suggest the inability to anticipate the mental state of others, especially when it’s different to the child’s own, may contribute to the social communication difficulties experienced by most individuals on the spectrum. Utilizing years of research as a foundation, Professor Baron-Cohen concluded that children with autism suffer from “mindblindness”—an impairment in mindreading (Baron-Cohen, 1995). “Mindreading” is something most neurotypical individuals do effortlessly, a necessary skill to predict and participate successfully in social interactions.

As mentioned earlier many gifted, intellectual autistic individuals are dedicating themselves to the cause of acceptance and celebration of the neurodivergent mind. Furthermore, many theories are tested and deduced from the behavior of children with what was once called asperger syndrome or “high functioning autism”. This is changing as advocates are urging acceptance of the entire spectrum. 

Nonspeaking autistic children, according to an article (Berube, 2021), have a unique way of understanding the world, different theories of mind, and sufficient awareness to communicate if only the appropriate opportunities are provided. The article concludes that our neurotypical society lacks comprehension of the fact that autistic people are “speaking a second language” which requires aid with translation.

This sentiment sums up why theories of autism are important and useful; a better understanding of the strengths (and areas where accommodations are needed) of the autistic mind should be used to transform neurotypical society to a more inclusive world for differently wired minds. 

When we embrace neurodivergence we may be contributing to a new theory of autism where we recognize its value. A theory where we acknowledge that autism has contributed to human progress, especially in fields like technology. Indeed, according to Professor Baron-Cohen’s new book The Pattern Seekers: How Autism Drives Human Invention we should consider how we treat those who think differently, as these “pattern-seekers” are essential to our species’ inventiveness.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Berube C. (2021). Autism and Hidden Imagination: Raising and Educating Children Who Cannot Express Their Minds. Healthcare (Basel, Switzerland), 9(2), 150. https://doi.org/10.3390/healthcare9020150

Baron-Cohen S. (2006). The hyper-systemizing, assortative mating theory of autism. Progress in neuro-psychopharmacology & biological psychiatry, 30(5), 865–872. https://doi.org/10.1016/j.pnpbp.2006.01.010

Baron-Cohen S. (2002). The extreme male brain theory of autism. Trends in cognitive sciences, 6(6), 248–254. https://doi.org/10.1016/s1364-6613(02)01904-6

Baron-Cohen, S. (1995). Mindblindness: An essay on autism and theory of mind. The MIT Press. 

Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of mind”?. Cognition, 21(1), 37–46. https://doi.org/10.1016/0010-0277(85)90022-8.

Ecker, C., Andrews, D. S., Gudbrandsen, C. M., Marquand, A. F., Ginestet, C. E., Daly, E. M., Murphy, C. M., Lai, M. C., Lombardo, M. V., Ruigrok, A. N., Bullmore, E. T., Suckling, J., Williams, S. C., Baron-Cohen, S., Craig, M. C., Murphy, D. G., & Medical Research Council Autism Imaging Multicentre Study (MRC AIMS) Consortium (2017). Association Between the Probability of Autism Spectrum Disorder and Normative Sex-Related Phenotypic Diversity in Brain Structure. JAMA psychiatry, 74(4), 329–338. https://doi.org/10.1001/jamapsychiatry.2016.3990

Etxebarria, I., Ortiz, M. J., Conejero, S. y Pascual, A. Intensity of habitual guilt in men and women: Differences in interpersonal sensitivity and the tendency towards anxious-aggressive guilt. Spanish Journal of Psychology, 2009; 12 (2): 540-554

Folstein, S., & Rutter, M. (1977). Infantile autism: a genetic study of 21 twin pairs. Journal of child psychology and psychiatry, and allied disciplines, 18(4), 297–321. https://doi.org/10.1111/j.1469-7610.1977.tb00443.x

Happé, F., Briskman, J., & Frith, U. (2001). Exploring the cognitive phenotype of autism: weak “central coherence” in parents and siblings of children with autism: I. Experimental tests. Journal of child psychology and psychiatry, and allied disciplines, 42(3), 299–307.

Rosello, B., Berenguer, C., Baixauli, I., García, R., & Miranda, A. (2020). Theory of Mind Profiles in Children With Autism Spectrum Disorder: Adaptive/Social Skills and Pragmatic Competence. Frontiers in psychology, 11, 567401. https://doi.org/10.3389/fpsyg.2020.567401

S.J. Ritchie, S.R. Cox, X. Shen, M.V. Lombardo, L.M. Reus, C. Alloza, M.A. Harris, H.L.Alderson, S. Hunter, E. Neilson

Sex differences in the adult human brain: evidence from 5216 UK Biobank participants Cereb. Cortex, 28 (2018), pp. 2959-2975

van Eijk, L., & Zietsch, B. P. (2021). Testing the extreme male brain hypothesis: Is autism spectrum disorder associated with a more male-typical brain?. Autism research : official journal of the International Society for Autism Research, 14(8), 1597–1608. https://doi.org/10.1002/aur.2537

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