For My New Reader

I just had someone contact me on Etsy to tell me they loved the blog, and to ask for suggestions on further reading.

I rattled off a few of my favorite bloggers, but also suggested to the person that they check out various aggregator sites (and, I'd like to add, blog carnivals) to look around and see what most appeals to them there.

So, here you go, Olin.

Blog Aggregator Sites
Autism Blogs Directory (mostly personal blogs by autistic people or parents of autistic children)
AutismBlog.org
Autismo
The Autism Hub (not as big as it used to be, but still going)
wrtAUTISM (has a lot of research-oriented blogs)

Blog Carnivals
Autistics Speaking Day
Blog Against Disablism Day (2011, 2010, 2009, 2008, 2007, 2006)

Also, if any of you have any ideas for blogs, websites etc. that you consider Essential Reading, feel free to mention it in comments!

Autistic Artist: Justin Canha

An article in the New York Times from a few weeks ago profiled a young man named Justin Canha, who is a very interesting person. He loves to draw, and would like to be an animator or illustrator one day.

The article was about his struggles to find a job and live independently, and the "transition to adulthood" program* that is helping him to do that, but it also mentioned his art, and included a link to his website, where you can see a whole lot of his work, which includes charcoal and pastel drawings, comic strips and Flash animations.

I really like his "Carnivorous Plants" series; they look eerie and alien, but are beautifully colored. The drawings look representational and abstract at the same time, which is an effect I find mesmerizing.

Here are a few of my favorites:

*One thing that stood out to me, reading the article, was how intensively micromanaged his life seems to be! I notice this a lot about the lives of autistic people younger than I am, who have had behavioral therapy throughout their childhoods. I don't doubt that it's helping him learn to navigate the world, and I'm sure graduates of such programs end up better equipped for it than I am (maybe - one blogger has described behavioral therapy as taking away her ability to make decisions on her own, without "rules" to go by), but damn, if that were my life, with someone telling me how to spend every minute of every day, and getting on my case if I wanted to engage in "activities not directly related to finding a job"? I'd be a walking powder keg of fury. I don't respond well to control. I suspect that a large part of the reason I don't have a huge anger problem today is that I am used to having my boundaries respected; I don't feel like I have to explode and destroy things in order to be heard.

Did You Know ...

(T. S. Eliot, wearing a white rose)

One of my favorite poets, T. S. Eliot, apparently wore a white rose in his lapel to show loyalty to Richard III (whom he is supposed to have called the last legitimate English king, per this article in The New Yorker about him) and the house of York, on the anniversary of the Battle of Bosworth Field (when Richard was killed).

From this, and from the fact that the Song of Ice and Fire is (very loosely) based on the events of the Wars of the Roses, I conclude that, if he were alive today and would condescend to read science fiction or fantasy (which is probably a greater leap than bringing him back from the dead --- the man was a humongous literary snob), he would probably be a Stark fan. :)

Winter is coming!

Simon Baron-Cohen Responds to Criticism from an Autistic Blogger - Part II

Now, I'd like to focus on the first two points in Simon Baron-Cohen's response to Rachel Cohen-Rottenburg, where he addresses her argument that autistic people's generally heightened perceptual sensitivity, and our lack of any sort of filtering mechanism, tends to make us more empathic, not less.

She says:

Many of us experience such a high degree of empathy that we are constantly putting ourselves in other people's shoes and trying to see all sides in any controversy or conflict. Many of our problems with sensory and emotional overload derive from an excess of this ability, not a deficit.

He replies:

1. Rachel challenges whether people with autism have 'theory of mind' difficulties and instead argues that people with autism have high degrees of empathy.

This is however hard to reconcile with the scientific evidence. Literally dozens of studies from around the world have documented the theory of mind difficulties in autism. And the empathy difficulties are also well documented and widely replicated, both on performance tests (e.g., emotion-recognition tests from the face and voice) and on self-report measures (such as the Empathy Quotient or EQ).

Consider the latter, where 81% of people with autism score less than 30/80 on the EQ, by their own self-report, whilst only 12% of people without autism score at this low level. These results are mirrored when parents complete the EQ about their children, in many independent samples. So, whilst some people believe that theory of mind and empathy difficulties in autism are mythical, the results of many independent scientific studies suggest otherwise.
...
2. Rachel challenges whether people with autism have difficulty knowing when they have hurt others, and wishes I had not stated that children with Asperger syndrome (AS) are delayed in being able to figure out what might hurt another person. Indeed, she finds my statement hurtful.

As a working scientist, all I can do is summarize the empirical evidence. An example is the Faux Pas Test, where children are asked to identify if anyone said anything they shouldn't have said, whilst listening to short audio recorded stories. Children with AS as a group on average scored significantly lower than children without AS, despite being older than the comparison group. Indeed, the design of this experiment allowed us to estimate the size of the developmental delay in AS, since the 12 year old children with AS performed more like typical 9 year olds. So, although Rachel may not like hearing these results, this is what the science finds.

I am not Rachel, but it seems to me like she wasn't denying the existence of those results at all; just saying that those results don't tell us much of anything about what the autistic people in the various studies were actually thinking that led them to do the test "wrong." We know that autistic people don't interpret social situations the same way non-autistic people do; what we don't know is how autistic people do interpret them.

(I am basing the above paragraph on what Rachel has written in this post on the Sally-Anne test for Theory of Mind, as well as her three-part series critiquing the EQ. Her post on the Sally-Anne test, in particular, is interesting because it describes an alternate thought process for a hypothetical autistic child taking the test, and coming up with reasons why Sally might look in other places than where the researcher wants her to look. What's important is that it's not that the kid in this example can't imagine Sally's point of view, it's that ze is drawing on different thought processes and experiences to arrive at different predictions for what Sally will do. The problem with the test is that it treats all wrong answers as failures to imagine Sally's mental state.)

Because I understand Prof. Baron-Cohen's need for empirical validation of these possibilities, I've even come up with an experimental design he (or anyone) could use to evaluate the two-way-street hypothesis that I've been promulgating here.

You'd have a bunch of people, half of them autistic and half of them not, and you would group them into pairs, with each pair including one autistic and one non-autistic member, both the same sex, same age and roughly similar verbal abilities, and just have them interact together for a short while, like 5-10 minutes. You would record their interaction on video, and then you would ask each person, separately, some questions about what happened between them. What they thought felt at certain points (decided on by the researchers sometime between the actual exchange and the individual Q&A sessions), what they thought the other person was thinking or feeling at certain points. You would then compare the two participants' answers to see how well they overlapped. You would also do this with autistic/autistic and NT/NT pairings, and then compare the average degree of similarity of the paired accounts across all three permutations.

This would allow you to see whether autistic people seem to understand each other better than they do NTs, or whether NTs are equally baffled by autistics.

It would also end the stalemate between Baron-Cohen's "well, the evidence says autistic people just don't understand social situations" and autistic people's self-reported experiences of both understanding other autistic people, and of having non-autistic people spectacularly fail to understand, or empathize with, them.

Simon Baron-Cohen Responds to Criticism from an Autistic Blogger - Part I

EXECUTIVE SUMMARY: Many autistic and feminist bloggers have criticized Simon Baron-Cohen's theories about autism and gender differences, but not very many have had him respond to their criticisms personally. Rachel Cohen-Rottenburg is one of those lucky people; she posted a critique of his E-S theory on her blog a couple years ago, and he has just now written a ten-point response to it. In this part of the post, I talk about Rachel's objection that the characterization of autistic people as poor empathizers ignores the differences between cognitive and affective empathy, and that even autistic people who lack cognitive empathy often have great capacity for affective empathy. I also talk about Baron-Cohen's response to this objection, and how his thought on empathy and autism has undergone a further evolution in the two years since Rachel wrote her post.
_________________________________________________
Sandrine (a French woman living in Turkey, who has an autistic son) at The Paris Ankara Express pointed me to this guest post by the famous autism researcher Simon Baron-Cohen at the Autism Blogs Directory.

In his guest post, Prof. Baron-Cohen responds to criticism of his Empathizing-Systemizing (E-S) theory of autism from Rachel Cohen-Rottenburg, who writes the blog Journeys with Autism and also curates a web-anthology on Autism and Empathy.

He identifies ten points that Rachel makes in her essay, and writes a paragraph (or two or three) addressing each one. They seem to be split about half and half between questioning Baron-Cohen's conception of empathy (as in, autistic people actually tend to be quite sensitive to other people's emotions, particularly distress) and questioning whether his model is actually any more descriptive, or helpful, than older "deficit" models.

(You could argue --- and many people do --- that the E-S/Extreme Male Brain theory is still a deficit model since it considers a deficit in empathizing skills to be a defining characteristic of autism; it offsets this by also including normal or superior systemizing skills as part of the definition, but if you look at most of the psychological, educational, or behavioral literature on autism, you find all sorts of articles on remediating, or sounding the depths of, autistic deficits and not very much on nurturing or characterizing autistic strengths. So the offset deficit model isn't actually offset all that much, in practice.)

Rachel's post is a response to this paper from 2009 (Rachel's post is also from 2009) spelling out what the E-S theory says about autism. The article describes the E-S theory, particularly its evolution from Baron-Cohen's earlier "mindblindness" theory of autism. He lists five things the earlier model failed to explain that he thinks the newer one does adequately explain: 1) nonsocial aspects of autism, like attention to detail, love of patterns or routines, stimming etc., 2) empathy isn't just "mind-reading", it's also feeling something for the other person, and the "mindblindness" model only deals with mind-reading, 3) autism isn't the only condition that can produce mind-blindness, 4) some studies have failed to find any differences in Theory of Mind between autistic and non-autistic subjects, and 5) autistic strengths.

Rachel responds that, no, actually the E-S theory doesn't do any better at explaining these things. She thinks he totally misreads stimming, for one thing: to her, it's not about "systemizing" at all, it's about self-calming. It's a way to handle emotions, not a form of empirical investigation.

She also takes issue with his contention that we lack both cognitive and affective empathy:

The everyday experience of many autistic people, all across the spectrum, contradicts the professor's theory. Many of us experience such a high degree of empathy that we are constantly putting ourselves in other people's shoes and trying to see all sides in any controversy or conflict. Many of our problems with sensory and emotional overload derive from an excess of this ability, not a deficit.
...
From my contact with autistic people, it's clear to me that our empathy leads many of us to constantly question the impact of our words. While I am far from perfect, choosing my words carefully may very well rank as one of my Aspie obsessions. However, the professor believes that "the typical 9-year-old can figure out what might hurt another's feelings and what might therefore be better left unspoken. Children with Asperger syndrome are delayed by around 3 years in this skill." (Baron-Cohen, 69)
...
Baron-Cohen goes on to say that, in addition to not empathizing well, we don't know how to respond to someone even after the person tells us what's wrong.

News flash: Once someone tells me how he or she feels, I don't usually have a problem with an empathetic response. Sometimes, I'll make sure that my response is welcome, out of respect for the other person's boundaries. For instance, if a person is crying, I might ask whether the person would like a hug, or whether the person would like to talk. Some people want hugs, and some people want to be left alone. I consider it courteous to ask. Once I know people fairly well, however, and I know what works for them, I simply respond. Just ask my husband, my daughter, my daughter's friends, my friends, my former co-workers, my neighbors, and all the animals I've ever helped care for in various stages of illness.

I feel like I have to back up now, because Prof. Baron-Cohen says explicitly in his response to her (he even draws a picture!) that he thinks autistic people are only impaired in cognitive empathy, and that we are just as capable of affective empathy as anybody, which is pretty close to what Rachel was saying, too.

His thinking has shifted somewhat since he wrote the paper Rachel was responding to; in that paper, he not only doesn't say that autistic people have affective empathy, but he also implies that we are deficient in both kinds of empathy --- he mentions the EQ as a measure of both affective and cognitive empathy, and also mentions that autistic people tend to score lower on the EQ than non-autistic people:

Most people regard [Theory of Mind] as just the cognitive component of empathy in that it simply involves identifying someone else's (or your own) mental states. ... [M]issing from ToM is the second component of empathy, the response element: having an appropriate emotional reaction to another person's thoughts and feelings. This is referred to as affective empathy (Davis 1994). On the Empathy Quotient (EQ), a questionnaire is filled out either by an adult about themselves or by a parent about their child, both cognitive and affective empathy are assessed. On this scale, people with autism spectrum conditions score lower than comparison groups.

So, while Rachel's objection --- yes, we do have affective empathy --- might seem redundant to someone who has read Baron-Cohen's more recent writing on the subject of empathy (his most recent book, Zero Degrees of Empathy, contrasts autistic people with psychopaths: the former group has poor cognitive empathy but normal affective empathy, while the latter has normal cognitive empathy but poor affective empathy), she is actually bringing up something that is not addressed in the text she's working with.

(I also think there is still a problem in Baron-Cohen's work with measuring empathy --- measuring it at all, much less measuring each component separately --- in that most of the tests he uses that directly measure some aspect of empathy, like the Sally-Anne test, the Faux Pas test, or the Reading the Mind in the Eyes test, are measures of cognitive empathy only. The indirect measures, which are usually questionnaires, have their own problems. With any self-reported measures, there's a risk of stereotype threat, where the test takers' awareness of stereotypes about some group to which they belong biases their answers toward whatever the stereotype predicts: women/girls and members of some ethnic minorities, like African-Americans, Latin@s, or Native Americans, tend to do worse on math tests when they are reminded of their group membership, even by something as innocuous as a check-box at the top of the page for race and gender. Since autistic people are often taught from early childhood that their way of speaking, acting, feeling, or relating to other people is weird and wrong, I would not be surprised if they tended to rate themselves low on things like fitting in, participating in conversations or getting along with other people. Also, a lot of the questions on things like the EQ measure some mixture of cognitive and affective empathy; they ask about intuitively knowing what a person feels and then reacting to it, like knowing to comfort someone who is upset. There is one measure that has subscales geared just toward having intense feelings on other people's behalf, and that is the Interpersonal Reactivity Index, which one study found autistic people scored either very close to, or even better than, non-autistic people on all but one subscale.)

So his position on affective vs. cognitive empathy in autism has shifted somewhat since he wrote the paper Rachel was responding to, and he doesn't explicitly acknowledge that in his response to her; instead, he makes it sound like that's what he was saying all along:

Rachel says "once someone tells me how he or she feels, I don't usually have a problem with an empathic response." This is exactly the point. For most people, they don't need to be told by the other person, "I am upset." They can just read this information in the other person's facial expression, vocal intonation, or 'body language', and they can make inferences about what the other person might be thinking, in the absence of being directly told. For many people with autism these non-verbal cues may be hard to read and instead they may only know how someone feels if they are told explicitly. The evidence for this again comes from many scientific studies documenting difficulties by people with autism in reading the mind in the eyes, the face, the voice, or in action (e.g., film). Rachel's own self-description seems consistent with this: "Now, I will readily admit that I cannot infer a person's mental state by reading nonverbal cues."

But I completely agree that once it is explicitly pointed out, people with autism are very capable of an empathic response. Rachel may be surprised to hear that I agree with her on this one, but it hinges on the distinction between 'cognitive' and 'affective' empathy. Cognitive empathy is the ability to identify another person's state of mind (not just through language) and affective empathy is the drive to respond with an appropriate emotion to another person's state of mind. A growing number of studies suggest that the empathy difficulties in autism are largely restricted to the cognitive component, whilst the affective component is often intact. For this reason, people with autism are often highly motivated not to upset others or hurt others, and are themselves upset to hear that they may have done this if it is pointed out. And once they know that someone else is upset or suffering, they are very often motivated to want to help or offer comfort.

(This seems like a really patronizing response to me. She has addressed theory of mind in other parts of her post; with the passage he's quoting, she is explicitly addressing the "emotional response" aspect of empathy. To make the point that her capacity to form an empathic emotional response is working just fine, thank you, she's describing that faculty in isolation. He ignores that context so that he can go, "Ah-ha, see, she has to be TOLD what someone is feeling!" Well, no, she doesn't always. She's just describing a particular scenario where her cognitive empathy cannot be called into question --- because she doesn't have to use it --- in order to focus on her affective empathy.)

No, I am glad he understands that we care about other people, too. I still disagree somewhat with his assessment of our difficulties with cognitive empathy; that, I think, stems as much from our being profoundly different from other people in terms of our sensory and emotional responses as it does from any objective inability to "read" other people. I think he ignores just how badly non-autistic people fail to notice the signs of our distress, or misinterpret our body language or tone of voice. I think they are just as bad at reading us as we are at reading them; it's just that because they're the majority, their failure to understand us is not as disabling as our failure to understand them.

I had more things I wanted to point out about his response to Rachel, but I've ended up spending so much time untangling this one little snag where they seem to be talking past each other that I think I will split this into multiple posts.

Cat Pic of the [variable time period]

Boots, on a wicker chair on the deck. Ben is behind the chair, visible through the space under the arm.

Boots is very assertive; if something new appears, he has to get on it, play with it, bite it, or otherwise make it his own right away. Ben and Magic are more conservative; they have to wait awhile to make sure the new thing isn't a threat before they will approach it.

Two New(ish) Necklaces

One of them really is new; I made it a few days ago, and only took pictures of it today.

Here I am, modeling it: (In that light, I have to hold the camera above my head and tilt it downward somewhat to avoid triggering the flash --- it doesn't always work. But it gives a warped impression of how big my head is compared with my neck and shoulders; here's another photo taken from a more straight-on angle: you can see that my neck is actually about the same width as my face at its broadest point. But the top photo is the only one in which I'm not making some kind of "Eek! Flash! Too bright!" face.)
I took advantage of having the camera out and wearing a purple shirt to model another necklace, one I made a while ago.
I don't think any of the pictures I took of this one really do it justice; I really like the way it turned out, with the mix of colors and the little beaded panels, but if I want to get my face in the picture, too, I can't zoom in to show the details that I think are the best thing about this necklace.

With some of my jewelry, the overall shape of it is interesting enough, or big enough, that a photo of me wearing it shows something a photo of just the necklace can't show; I guess the necklaces like the second one shown here aren't in that category.

This Is Awesome

Amanda Forest Vivian has an idea that I think really rocks, and one that I definitely want to be part of.

It's a website for people with disabilities to post pictures/videos of their art, with each person getting their own site where they can showcase their art however they want:

Crazy House is the name of a book by Henry Darger, an outsider artist. Outsider art is a hard-to-define category, but many people labeled as outsider artists have psychiatric or developmental disabilities.

Crazy House the website is an imaginary house where you can have your own room. Which is to say you can apply to be hosted on the domain which I have yet to buy, and then you could make a site for your art. All of these sites would be linked to from the main page, and would make up the Crazy House.

It's perfectly worth asking why this is necessary when there are so many places on the Internet where you can upload and share art. I'm not really sure why I want to make the Crazy House, except that I like the idea of sharing an imaginary house with other people instead of just having a lot of usernames on different huge websites. I also like the idea of an art space that is somewhat centered on disabled identity.

I would like to buy the Crazy House domain with other people for two reasons. First, it would be cheaper, and second, I would like the Crazy House to be something that isn't dependent on one person, but on several people. If anyone is interested in buying the Crazy House domain with me, please email me at awf.vivian at gmail (I'm hoping to figure this out by November or December).

If anyone can't or doesn't want to be part of buying the Crazy House, but would like to room in the Crazy House, sit tight. Hopefully I will be back in November or December telling you how to do so. And please signal boost.

I don't know if I have any readers who aren't also readers of Amanda's blog, but I thought I'd try and signal-boost anyway.

I also think the idea of a smaller, self-selected group of artists having a website to showcase their art together is a cool one, and I also like the idea of each person having total control over what their own site looks like. With Flickr or other image-sharing websites, you're restricted to showing your images one at a time in a slideshow, which can take away from the effect if you've got a series of related pieces. This also gives people room to have things together on one page that are in different formats, like art, video, music, animation, whatever else.

(I am a little intimidated by the prospect of having to build my own webpage from scratch, since I don't know anything about programming, but I figure I can probably learn what I need to. My dad has built a webpage for me before, to showcase my jewelry, and I learned a bit about how to do it by watching him. It doesn't look super hard; just something I've never done before.)

Another Writer Uses "Autism" Where He Means "Selfishness" or "Amorality"

I'm getting quite a collection of examples of this sort of rhetoric, in which the writer/speaker tries to discredit someone else's political philosophy by calling it, or them, "autistic."

So far, I have a literary critic contrasting Jean-Paul Sartre's nihilism and profound alienation from other people (which he calls "autistic") with Albert Camus's more humanistic philosophy; a liberal editorial writer asking "Are Republicans Autistic?"; a liberal talk-radio host comparing Republican reliance on "talking points" to autistic verbal stims; and a liberal podcast blaming President Barack Obama's inability to overcome opposition by a vocal Republican minority on his inability to understand them, coupled with his overly scrupulous adherence to rules.

The latest addition to this group, which I saw on Emily's blog, A Life Less Ordinary?, is the author, neuroscientist and outspoken atheist Sam Harris talking about why he thinks Ayn Rand's philosophy of rational selfishness is unrealistic, morally obtuse and incompatible with actual human nature.

Here is the relevant part of that post (I'm including a bit more context for the offending one-liner than Emily did, because I'm interested in exactly what "autism" is supposed to imply here):

Many readers were enraged that I could support taxation in any form [in an earlier post on taxes and income inequality in the US]. It was as if I had proposed this mad scheme of confiscation for the first time in history. Several cited my framing of the question --- "how much wealth can one person be allowed to keep?" --- as especially sinister, as though I had asked, "How many of his internal organs can one person be allowed to keep?"

For what it's worth --- and it won't be worth much to many of you --- I understand the ethical and economic concerns about taxation. I agree that everyone should be entitled to the fruits of his or her labors and that taxation, in the State of Nature, is a form of theft. But it appears to be a form of theft that we require, given how selfish and shortsighted most of us are.

Many of my critics imagine that they have no stake in the well-being of others. How could they possibly benefit from other people getting first-rate educations? How could they be harmed if the next generation is hurled into poverty and despair? Why should anyone care about other people's children? It amazes me that such questions require answers.

...

As someone who has written and spoken at length about how we might develop a truly "objective" morality, I am often told by followers of Rand that their beloved guru accomplished this task long ago. The result was Objectivism --- a view that makes a religious fetish of selfishness and disposes of altruism and compassion as character flaws. If nothing else, this approach to ethics was a triumph of marketing, as Objectivism is basically autism rebranded. ...

And I say this as someone who considers himself, in large part, a "libertarian" --- and who has, therefore, embraced everything that was more or less serviceable in Rand's politics. The problem with pure libertarianism, however, has long been obvious: We are not ready for it. Judging from my recent correspondence, I feel this more strongly than ever. There is simply no question that an obsession with limited government produces impressive failures of wisdom and compassion in otherwise intelligent people.

This passage rests on the same assumption I noticed in the editorial "Are Republicans Autistic?", which is that autism is the same thing as selfishness. There is also the implication that to be autistic is to be profoundly ignorant of how the world works, how people are (Randians try to live by a philosophy that might work for some alien species that is 100% rational and naturally solitary, but which does not map very well onto human lives), or even the circumstances of their own lives (later in the article he mentions how much luck is involved in even the most "self-made" person's success, and alludes to people erroneously attributing to their efforts things that practically fell into their laps by virtue of their being in the right place at the right time, knowing the right people, and being the right "kind" of person).

It seems to me that it's no accident that all these rhetorical uses of "autism" to characterize a deeply selfish person or worldview are cropping up at the same time the popular conception of autism is shifting to "someone without empathy." It seems to me that those two things are actually mirror images of each other; as long as people talk about autistic people as being without empathy, autism will be the metaphorical diagnosis of choice whenever someone wants to talk about an actual lack of empathy.

So the stereotype gets reinforced from both ends.

City Mouse, Country Mouse, Autistic Mouse

There's one more thing from Unstrange Minds that stuck in my head, that I didn't think to include in this post and which probably deserves its own post anyway, given how much stuff was already in the other post.

Anyway, in the chapter on autism in South Korea, Roy Richard Grinker alludes to something I've seen mentioned before, and am curious about.

While describing differences between rural South Korean villages and the capital city of Seoul in how these communities treat their autistic members, Grinker mentions some research conducted by the World Health Organization comparing how well people with mental illnesses fare in developed vs. developing countries:

An agricultural area often belittled by Koreans and long neglected by the government, Cholla-do remains the most underdeveloped region in one of the richest countries in the world. Cholla residents are familiar with discrimination and adversity and find it hard to improve their class and social status. They consider it a great success to make one's career in Seoul, where more than 25 percent of South Korea's 44 million people now live.
...
Still, after asking a few questions here and there (Are there any children who don't speak well? Are there children here with brain disorders?), I found a sixteen-year-old boy and a nine-year-old girl in a mountainous county. Everyone seemed to know about them. And when I talked to the barber and the local grocery-store owner about them, there was no hint of discomfort or pity. Peter, as his mother wanted him to be called, was good with bicycles and served as a messenger for two villages, delivering letters and packages with a broad smile. He saw a doctor once every two months and was medicated with a small dose of an antipsychotic drug that calmed his anxiety and some of his repetitive movements. The girl, Soo-Rin, was in the village with her single mother only on weekends because she attended a special school for children with Down syndrome, cerebral palsy, and mental retardation. But everyone knew her too. Her room at home was lovely, pink with lace curtains, stuffed animals, and Disney characters. Her mother said she takes a medication at school to help her pay attention, but she didn't know what it was called. In these villages, you can find proof of something the World Health Organization has been arguing for years: People with mental disorders do better over time in remote, nonindustrial societies than in urban, industrial ones.

I'd read about that research before, in Robert Whitaker's book Anatomy of an Epidemic; in that book, he argues that the reason the people in developing countries are more likely to recover from acute mental illnesses, and don't become chronically mentally ill as often as people in developed countries, is because people in developing countries often don't have access to psychiatric medication, which Whitaker argues actually worsen a person's condition over time.

Grinker lists an earlier book by Whitaker --- Mad in America --- in his bibliography, along with a book-length follow-up to this study (full text here), but he is not making Whitaker's argument here. Instead, he thinks the people in the rural villages are more accepting than the people in the cities:

This is not to say that life for the disabled is easy in the villages --- even someone with a mild speech impediment, who is otherwise normal, will have just as much trouble finding a spouse as an urban dweller with the same problem. And parents can be just as devastated. One man confessed to me that in his despair he once took his young autistic son high up in the mountains, intending to slit his throat, but couldn't bring himself to do it. But for most parents of disabled children, life in the rich city of Seoul is more stressful than in the more humble village. One of the paradoxes of rural life is that people in the villages tend to be relatively accepting of diversity. Little remains secret, and there seems to be a place for everyone. In the rural areas, people assume that things would be much better for their children in the city. But in the city, in the sprawling, indistinguishable apartment complexes of Seoul, most people do not know their neighbors, even though they watch them as closely as they can. The pressures to measure up can seem overwhelming, and families try to keep anything that might reflect badly on their status hidden from view. The moment you bring your disabled child outside in this densely populated city is the moment you are confronted by strangers, people who will watch and judge you.

Later on, he says something that would seem to rule out Whitaker's non-drug hypothesis: the children he met in the rural villages were taking psychiatric medications, while very few of the children he met in Seoul were taking any.

He sees this as symptomatic of the prevailing viewpoint in Seoul that autism is basically a death sentence; if nothing can make an autistic child non-autistic, what's the point of drugs or therapies? It all just costs money, and with drugs there's also the matter of side effects to consider.

(I actually thought his interviewees' concern about the side effects of psychotropic drugs was sensible; I thought Grinker in this passage was being way too uncritical of US psychiatrists' willingness to prescribe these drugs to children when so little is known about their long-term or developmental effects. I think his point about the all-or-nothing mentality is a valid one --- and that mentality is certainly not restricted to South Korea! --- but I don't share his faith that drugs always lead to better quality of life. Indeed, often their use is a symptom of the same societal rigidity that he blames for making urban life so much harder for autistic people to participate in than rural life.)

Anyway, his mention of those WHO studies reminded me that I had wanted to read them (and there are still more follow-ups, meta-analyses and similar studies from more recent years, too), and post about them.

Strangers in an "Unstrange" Land

I just finished Roy Richard Grinker's book Unstrange Minds: Remapping the World of Autism, and I very much recommend it to just about anyone with an interest in autism.

It's written from a parent's point of view, and mostly (it seemed to me) for an audience of other parents, but there's a lot in it to interest people outside that core audience, too. There's a lot of historical stuff about the first descriptions of autism, and about how psychologists have tried to understand it over the past six decades or so; Grinker's father, grandfather and great-grandfather were all psychoanalysts (psychiatrists, too --- his grandfather founded the Archives of General Psychiatry), so he has a very strong grounding in the history of psychology and psychoanalysis.

He also addresses the question of whether there is or is not an autism epidemic, going into some detail about how diagnostic categories have changed, how the availability of special-education services varies by diagnosis, and how the ways of measuring the prevalence of autism have changed.

The first edition of the DSM to have "autism" as a category was the DSM-III, published in 1980. The criteria for "Infantile Autism" were fairly specific:

A. Onset before 30 months of age
B. Pervasive lack of responsiveness to other people (autism)
C. Gross deficits in language development
D. If speech is present, peculiar speech patterns such as immediate and delayed echolalia, metaphorical language, and pronominal reversal.

(There was also a category for people meeting all of these criteria, but with the condition not appearing until after 30 months of age; there were also "residual state" diagnoses for people whose speech problems or unresponsiveness had lessened to the point that they no longer met the above criteria).

The DSM-III-R criteria were somewhat looser, getting rid of the age-of-onset criterion and collapsing the "residual states" into Autistic Disorder itself --- you could have an autism diagnosis even if you did not currently meet all the criteria, as long as you had met them before.

The loosest criteria of all were those of the DSM-IV, which I had already known, but what I didn't know was that their flexibility wasn't all by design:

[T]here was an error in the final manuscript. It is not well known, even among experts, but in 1993, when the authors of the child psychiatry section of the DSM were editing the proofs of the new DSM-IV, which would be published in 1994, they missed a critical mistake. For PDD-NOS, the largest group of autism spectrum disorders, they had intended to write as the criteria, "impairment of reciprocal social interaction and in verbal or nonverbal communication skills." A different text was accidentally published. It said, "impairment of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present." The authors had wanted someone to qualify as autistic only if they had impairment in more than one area, but the criteria, as published, required impairment in only one area for a diagnosis of PDD-NOS.

Another interesting aspect of his discussion of autism diagnoses hinges on the different priorities of clinicians and researchers, and his idea (well-buttressed with quotations from prominent psychiatrists) that autism diagnoses are often made not because "autism" accurately describes the child being evaluated, but because they think the special-education services targeted at autistic children will do the most good for that child. That would go a long way toward explaining the "diagnostic substitution" that's occurred over the years, with more children being classified as "autistic" at the same time as fewer children are being classified as having plain old intellectual disability. (Grinker also includes a parallel instance of a diagnostic category that no one would argue is actually becoming more common --- traumatic brain injury --- becoming more widely used over the same period of time, due to changes in the U.S. Department of Education's disability coding system).

The part of the book that was most interesting to me was the series of chapters on cultural attitudes toward autism in three other countries: India, South Korea and South Africa. For each country, Grinker profiles one or two families with autistic children, usually starting with the mother, and letting her tell the story of how she came to suspect that there was something different about her child, and how she overcame varying degrees of stigma, disbelief and lack of services to get her child therapy, special education and a place to live when she could no longer take care of him/her.

We meet Golden and Suzanna Khumalo, and their son, Big Boy, who moved from Soweto to Cape Town in South Africa to get their son to a psychiatrist, and away from Golden's parents and ex-wife, who blamed Big Boy's autism on, respectively, displeased ancestors and witchcraft. We meet a woman named Merry Barua, in Delhi, India, who founded a school for autistic children called Open Door, which she began for her own son, in the absence of any other school that met his needs. We also meet two families from South Korea: a woman named Seung-Mee, with an autistic daughter named Soo-Yong, who joined a Christian church because the church members were the only people she ever met who really seemed to accept her or her daughter, and another family with three children, one of whom is autistic and kept hidden from the world. Autism is a highly stigmatized condition in South Korea, and one that reflects poorly on an entire family, so often doctors will diagnose a child with an attachment disorder instead. Grinker does think it's getting better for autistic people there, though: a recent film about an autistic marathon runner is lessening the taboo somewhat, and giving people the idea that autistic people can do more, and have fuller lives, than they had previously thought.

There was one aspect of autism that I thought this book didn't go into very much, though: he doesn't include very many quotes from autistic people themselves. (I can only remember one, actually --- at the very end, talking about a college class on autism he taught where one of the students had Asperger's syndrome). This didn't bother me as much as it might have, since he wrote about his autistic daughter Isabel in such an empathic way; rather than simply describe her behavior as if she were some kind of space alien, he gives context for everything she does, and tries to convey something of her feelings. He lets us see her grow up, learn things, acquire skills, and pursue her special interests. He writes from a caregiver's point of view, and everyone he interviews is also a caregiver, but he writes about his daughter with such love, respect and understanding that I never got the feeling that he thought of her as a burden, as an extension of himself or as anything but her own person.

Born This Way

Some book I read a long time ago --- it may have been Steven Pinker's The Blank Slate --- maintained that, in the US, conventional wisdom has swung back and forth on whether differences between people that show up in adulthood have been present since birth, or whether they are acquired during childhood and adolescence.

It's usually intelligence that gets discussed in this way, almost always in the context of racist, sexist, or otherwise inequality-justifying theories about some groups being naturally smarter than others, but there's been a similar periodicity in thinking about other things, like personality traits. (Gender differences in cognitive style, interests, and personality are some of the things that are now widely believed to be present at birth; see Cordelia Fine's book Delusions of Gender for a lot more about these ideas' ubiquity and the still-ambiguous nature of the evidence they're supposed to be grounded in).

Right now, I want to talk about how this idea has gotten established in two different subcultures to which I belong: the autism community* and the gay community.

Autism and homosexuality have somewhat similar recent histories in US culture: both either are, or have been, considered mental disorders, both were thought in the 1950s and early '60s to be caused by some warping of the normal bond between mother and child (either, as with autism, too much distance between them, or with male homosexuality, not enough), and papers from the 1960s, '70s and '80s document various attempts to "treat," with aversion therapies that would now be considered abusive, children showing signs of either one. (One researcher even worked on both projects: O. Ivar Lovaas, who has done famous, if controversial, work adapting Applied Behavior Analysis (ABA) for use with autistic children, has also co-written several articles about "feminine boys," and using ABA to normalize their behavior).

Homosexuality was removed from the DSM in 1973, but there are still people who consider it (or anything deviating from straight, married monogamy, really) a pathological condition, and therapists who specialize in trying to turn gay people straight.

In contrast to that idea --- that gay people can change, and therefore should change --- the gay-rights movement has embraced the idea that sexual orientation is inborn. (And most mental-health professionals, including groups like the American Psychological Association, the American Psychiatric Association, the American Counseling Association, the National Association of Social Workers, and the American Medical Association, pretty much agree with them that no sexual orientation is inherently pathological, and that you can't change a person's sexual orientation through therapy).

The picture is somewhat different for autistic people. Not only is autism still considered a disease, and a pretty serious one, by almost everybody, but the idea of innateness, when it comes to autism, doesn't have the same implied corollary of "... and therefore you should accept us the way we are" that it has in reference to sexuality.

No, the shift from "psychogenic" to "biogenic" theories of autism happened for two reasons: first, and probably most important, the evidence (what little there was in the early '60s) didn't fit well with the psychogenic model**, and fit better with the biogenic one; another factor was activism by parents, who were fed up with being blamed for their children's condition, and who called for more research into potential biological causes.

Here, Boston University law professor Daniela Caruso, who has written an article on the history and legal impact of autism advocacy in the US, describes the relationship between the nascent field of biomedical research into autism and the beginnings of the US's major autism-advocacy groups:

It was only in 1964 that Bernard Rimland put forth an alternative explanation of the syndrome, based not on psychodynamics but rather on neurobiology. In 1965, Rimland founded the American Society for Autism (ASA) which is, to this day, a major center of advocacy.

Following Rimland's work, activism in the name of autism began to flourish thanks to both grassroots efforts and power houses. Some groups - most visibly Cure Autism Now (CAN) and the National Alliance for Autism Research (NAAR) - coalesced around genetic research and investigation of toxic substances potentially related to the surge of autism. It is no coincidence that such movements emerged in a context of burgeoning environmental activism. Many other capillary initiatives focused instead on the reality of living with autism by developing information centers for parents of newly diagnosed children, and starting awareness campaigns aimed at educating the public about this poorly-understood phenomenon.

(See also: this post, which discusses another article on the history of autism advocacy in the US. I also found another recent article about the role of parent activism throughout the history of autism, but I can't get at the full text of it).

I also found this snippet in Rimland's book itself (that part of it I could see on the Internet, anyway; I don't own the book), discussing why he thought so many researchers were reluctant to consider the possibility that autism had a biological basis:

In discussing the obvious prejudice against the hereditary viewpoint, Nolan Lewis (1954) points out, "It would seem that most of the prejudice against genetic inheritance stems from a feeling in the realm of wish fulfillment, based on the idea that acceptance of genetic factors would create an attitude of therapeutic hopelessness." Williams (1956) cites this point among others in his attempt to penetrate the prejudice against heredity. He notes that hopelessness is by no means justified by the evidence, and cites the ready correction of diabetes, phenylketonuria and hypothyroidism as examples.

So, that's kind of interesting --- that, at the outset, there was reluctance to adopt a conception of autism as innate and biologically based because of worries that that might mean it was impossible to eradicate through treatment --- but the answer to that wasn't, "so let's not try to make them non-autistic, let's just try to integrate them into society to the best of our, and their, ability", it was "don't be silly, of course we can make them non-autistic!"

I'd also want to point out that the two competing narratives of autism came from the same source: medical professionals, whether psychoanalysts or biomedical researchers. This is in contrast to the two competing narratives of homosexuality, one of which came from medical professionals and the other of which came straight (heh) from the people they were trying to describe. It wasn't until much later that autistic people's own viewpoints were even known to exist, much less taken into account by medical professionals and policymakers.

So, while as far as I know most autistic people do think they were born autistic, that idea doesn't have the same liberatory subtext for autism that it has for sexual orientation. (Indeed, the switch over to a mainstream view of autism as innate and biologically based had already happened when research into "extinguishing" autistic behaviors was at its peak.) The biggest thing it did was to free parents from guilt at having caused the autism, which is important and was definitely needed, but it left the position of the autistic people themselves unchanged.

*I'm using that phrase --- instead of "the autistic community" --- because I am mostly talking about parents. I've made this distinction before: the autism community, which includes parents/caregivers, healthcare workers, autism researchers, and educators; and the autistic community, which is the autistic people themselves. Sometimes the latter group is included in the former, but mostly it is not, and sometimes the two groups are at odds with each other.

**See Chapter 3 of Rimland's 1964 book, Infantile Autism, for a discussion of what those findings were and how they conflicted with the psychogenic model of autism.

More Autistic Strengths: Symmetry-Spotting

EXECUTIVE SUMMARY: A recent study has added to the list of cognitive strengths peculiar to autism: in this study, a group of autistic teens/young adults and a group of age-, IQ-, sex- and eyesight-matched control subjects were shown a series of paired images, all of them different arrangements of lots and lots of tiny black-and-white dots, and determine which of the two images has some of the dots arranged in a symmetric pattern. Consistently, the autistic young people were able to pick out the symmetrical images at lower signal-to-noise ratios (i.e., with smaller proportions of the dots possessing mirror images) than their non-autistic peers.
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Michelle Dawson and Laurent Mottron have done lots of research on perception and cognition in autism --- particularly visual processing. (Morton Ann Gernsbacher is another frequent collaborator, but she didn't participate in the research I'm about to describe).

Their research has identified several cognitive strengths* specific to autism: enhanced sensitivity to pitch; enhanced sensitivity to, and recall of, details (without any corresponding loss of ability to see the big picture); ability to switch between different strategies (big-picture vs. small details) as needed; . Autistic people also do a lot better on one particular IQ test, Raven's Progressive Matrices, than you would predict based on their scores on other IQ tests (e.g., various Wechsler tests).

A new skill has just been added to this constellation: the ability to quickly determine whether a complex pattern is symmetrical or not.

In a study published this past spring in PLoS ONE, a group of Canadian researchers --- Mottron and Dawson, along with three others: Audrey Perreault, Rick Gurnsey and Armando Bertone --- had participants look at very complicated, visually "busy" patterns of small dots arranged on a video screen and determine, in the very short time the pattern remained onscreen (250 milliseconds), whether it was symmetrical or not. (They were shown two different patterns, one symmetrical and one not, and they had to identify the symmetrical one.)

Here's an example of the kind of image they would have to categorize:
(If it looks obvious to you, remember they only got a fraction of a second to look at it!)

The images were all just black and white, except for the one colored dot in the center, where the participants were told to focus their attention. In the above image, which is 100% symmetrical, each dot has a twin, the same size and color, placed so that they would lie one on top of the other if you printed the image out and folded it along its axis of symmetry. In that image, you can see that the vertical axis is the axis of symmetry; some images are symmetrical along the horizontal axis, and others are symmetrical along an oblique axis, the line y = x in a Cartesian coordinate plane with the colored dot at the origin.

These shapes are symmetrical about the horizontal (x) axis:
These shapes are symmetrical about the vertical (y) axis:

The pink and green curves are symmetrical to each other about the line y = x (blue)

Some of the images were also only partially made up of symmetrically-paired dots; the study participants were supposed to identify which of the two images shown to them had any degree of symmetry at all. (It was always just one; I guess you could design an experiment where both of the images had some degree of symmetry and the participants had to determine in which the degree of symmetry was greater, but that would be harder than just picking out which one had any degree of symmetry at all.)

The two groups whose performance was compared in this study were a group of 14** autistic young people (ages 14 to 35) and 15 typically-developing young men matched with the autistic subjects for age, IQ and visual acuity.

The criterion used to compare the two groups was "symmetry detection threshold", or the proportion of dots in a symmetrical design that had to have mirror images before a given person could identify the symmetrical design 75% of the time. Average detection thresholds were compared across groups, and also across what type of symmetry the image displayed. Both groups did best at spotting symmetry along a vertical axis, and both groups did the worst at spotting it across the line y = x.

But for all of these conditions, the autistic people had lower detection thresholds --- they correctly found symmetry more often in patterns that had less of it, relative to background noise --- than their non-autistic peers.

The study authors see this as indicative of our (autistic people's) ability to look at things more than one way simultaneously. (Another recent study, not referenced in this one, also found something suggestive of that: autistic people were better able to reproduce "ambiguous figures," or line drawings that look like they could be one of two things, depending on how you look at them). They also see their results as incompatible with the "weak central coherence" theory of autism, which explains our relatively keen collective eye for detail as a deficit in big-picture thinking. But this symmetry-spotting task requires both processes at once --- local-level, small detail perception for checking individual dot pairs to see if they really are exactly symmetrical, and also larger-scale, "gestalt" perception of whole shapes created by all the dots together.

Perreault, A., Gurnsey, R., Dawson, M., Mottron, L., & Bertone, A. (2011). Increased Sensitivity to Mirror Symmetry in Autism PLoS ONE, 6 (4) DOI: 10.1371/journal.pone.0019519

*Other, earlier research has also identified autistic strengths: as early as 1983, Amitta Shah and Uta Frith discovered that autistic children did especially well at disembedding figures; those two researchers were also the ones who identified the other really well-known "islet of ability", in the Block Designsection on various IQ tests.

**There were originally 17 people in that group, but three of them couldn't do the experimental task, so they did not contribute any data.

A Fun Fact About Leo Kanner

I just started reading Roy Richard Grinker's book Unstrange Minds: Remapping the World of Autism, and in a chapter on the early history of autism (covering Kanner and Asperger, plus Eugen Bleuler's and Sigmund Freud's use of the term "autistic" to describe aspects of other conditions, and also stories of feral children, whom Grinker believes were probably autistic), I came across this anecdote:

In 1943, a New York psychoanalyst named Abram Blau wrote a paper in which he argued that whereas there were numerous words, proper and slang, for the penis, there were few words, and virtually no slang words, for the analogous organ in women, the clitoris. Based on this assumption, Blau made grand arguments about the universal symbolic importance of the penis to humanity. Kanner, as evidence-based as anyone in psychiatry at that time, was furious about Blau's assumption, based on no data collection at all, and quickly wrote a paper with the dry title "A Philological Note on Sex Organ Nomenclature," which he published in a psychoanalytic journal. In it, Kanner listed dozens of words for the clitoris, from languages all over the world, and all of them, he claimed, from memory. He destroyed Blau's argument.

Grinker included it to illustrate Kanner's prodigious memory, which Grinker believes was one of the "subclinical," autistic-like traits Kanner possessed that may have given him insight into the inner lives of the children he studied.

I'm posting it here because I think it's funny. Male psychoanalysts and their penis fixations never cease to amuse me.

(Unfortunately, the only copy of the article I can find online is here, with the full text only accessible to subscribers to that website. So I can't find any of the words Kanner listed, which is annoying.)

Cat Pic of the [variable time period]

(Can you spot Ben, the gray tabby, in this picture?)

I just finished this necklace, and was photographing it for listing on Etsy this morning. Ben was very interested in those proceedings, and decided he had to take part in them, too.

British Neuroscientist Thinks the Internet Is Rewiring Our Brains

A famous British neuroscientist and popular-science writer, the Baroness Susan Greenfield, who is a Professor of Synaptic Pharmacology at Lincoln College, Oxford, a member of the House of Lords, and until recently was the Director of the Royal Institution of Great Britain, has suggested that widespread Internet use might have something to do with the increasing prevalence of autism.

Here she is, quoted in an article in the Guardian:

"It could be the case that this different environment is changing the brain in an unprecedented way. It's such an important issue and I'm just putting it before people to discuss." Greenfield said there was a need for work to be done, but measuring subtle changes in the brain was extremely difficult. She cited an article in Scientific American that showed US teenagers may be losing their ability to feel empathy. "When you are social networking online and not learning how to connect face to face or how to hug, not out there rehearsing those things, then could that mean a child goes on to exhibit autistic-like behaviour?"

"I point to the increase in autism and I point to internet use. That's all. Establishing a causal relationship is very hard but there are trends out there that we must think about. I have not said that internet use causes autism and I would apologise to any family who is upset by anything I have said."

She added: "I have never, ever said that the internet is bad for the brain. But if the environment is changing, then the brain will change to adapt. All I have ever said is, let's talk about this. The internet has become the central, iconic feature of young people's lives and to say our brains will not be affected by that is to deny our evolutionary heritage."

Asked in this interview with New Scientist for any evidence supporting this hypothesis, she cites two studies: this one describing differences in brain anatomy between healthy and Internet-addicted Chinese university students, and this review (full text here) of the psychological and neurological literature on the effects of various electronic media.

She also cited this article, mentioned in this Scientific American podcast, which is a meta-analysis of 72 studies of empathy in American college students, all conducted between 1979 and 2009, and all using the same measure of empathy: the Interpersonal Reactivity Index. I will talk about that study in another post; for now, I'd like to focus on the Internet-addiction study.)

The Chinese study used diffusion tensor imaging (a type of magnetic resonance imaging that measures the movement of water molecules along a tract of fibrous tissue and uses the three-dimensional vectors, or tensors, describing the water molecule's motion to build a three-dimensional computer model of the tissue) to look for differences in gray-matter volume and white-matter structure between two groups of eighteen young people (twelve young men and six young women in each group), one consisting of people meeting diagnostic criteria for Internet addiction (using the Young Diagnostic Questionnaire for Internet addiction), and the other consisting of healthy, age- and sex-matched control subjects who said they used the Internet for less than two hours per day.
(Figure 1A, in Yuan et al., 2011 - orange blotches represent brain regions where the 18 Internet-addicted young people in this study had less gray matter than non-addicted people of the same age and sex)

They found that the Internet-addicted people had less gray matter, on average, than the non-Internet-addicted people in a few areas: the dorsolateral prefrontal cortex (i.e., the part of the prefrontal cortex that's on top and to the sides), the rostral anterior cingulate cortex (on the left side only), the orbitofrontal cortex, the cerebellum and the supplementary motor area straddling the boundary between the frontal and parietal lobes. For a few of these areas (the left anterior cingulate, the right dorsolateral prefrontal cortex, and the right supplementary motor area), the degree of atrophy correlated with how long the person had been addicted --- i.e., the longer they'd been addicted, the smaller those brain areas would be.

They also found differences in white-matter distribution between the two groups in two regions: the left posterior limb of the internal capsule and the right parahippocampal gyrus.
(Figure 2, in Yuan et al., 2011 - top series of images show major white-matter tracts in study participants' brains; image (b) gives a side view of the brain and shows an area in blue where Internet-addicted subjects are thought to have less white matter than control subjects; image (c) shows an area in orange where the Internet-addicted subjects are thought to have more white matter than controls. Bottom graph shows the relationship between their measure of white-matter density, taken at the blue area, and the duration of individual study participants' Internet addictions.)

The measure they used, fractional anisotropy, reflects the degree to which the diffusion of water is constrained by the presence of linear fibers. If there were nothing there, water molecules would diffuse outward in a sphere; the degree to which the diffusion pattern deviates from a perfect sphere, and the direction in which the most diffusion occurs, give you an idea of where the fibers are and how many of them there are.

This short, but very technical, article describes how this measure is typically used in neuroimaging studies*:

Much progress has been made in modeling more complex diffusion geometries that a single tensor fails to model, but most clinical studies still rely on simple [diffusion tensor imaging]-derived scalar measures. Some of these, such as the trace of the covariance matrix or mean diffusivity (MD) can adequately describe isotropic water diffusion, but this only occurs in the cerebrospinal fluid spaces of the brain. In the white matter, myelinated fibers resist water diffusion orthogonal to the local dominant fiber orientation, and diffusion occurs preferentially along local fiber tracts. In clinical research, white matter fiber integrity is commonly assessed by determining how strongly diffusion is directionally constrained. One common scalar measure of directional diffusion, the fractional anisotropy (FA), is computed from the diffusion tensor's eigenvalues, and quantifies the magnitude of this directional preference. Clinical studies now routinely use FA as an index of white matter integrity, sensitive to white matter deterioration in aging and neurodegenerative diseases.

Using this explanation of what fractional anisotropy values are understood to mean --- higher numbers mean more diffusion occurring in the same direction, which is taken to mean that fibers running in that direction are numerous and thick; lower numbers imply fewer and/or thinner fibers --- you can see that the researchers are saying they think their Internet-addicted subjects have less white matter (lower FA value) than their non-addicted subjects in the parahippocampal gyrus, and also more white matter (higher FA value) in the left posterior limb of the internal capsule.

The researchers believe that these changes are a result of the Internet addiction, although they can't totally rule out the possibility that they existed before the onset of addiction, and may actually have been part of the reason those young people were susceptible to addiction in the first place. In favor of their brain-changes-as-effect-of-Internet-addiction model, they cite the positive correlations they found between several of the changes they found (decreased gray matter in the left anterior cingulate, right dorsolateral prefrontal cortex, and right supplementary motor area, along with increased white matter in the left posterior limb of the internal capsule) and duration of Internet addiction. But not all of the changes showed such a correlation --- less than half, to be exact.

When you take into account brain lateralization, you come up with eleven areas that differed between groups: four of the five regions showing loss of gray matter were affected on both sides, for a total of eight affected areas, plus one more (the left anterior cingulate) and the two regions showing white-matter changes (both confined to one side of the brain). That gives you only four out of eleven affected regions where the change showed any relationship to how long the person had been addicted; if the relation to time was meaningful, you'd expect it to show up more consistently. As is, it leaves open the possibility that whatever correlations were observed are just statistical noise.

Does extensive Internet use physically change the brain? It's certainly possible, given what we know about neuroplasticity, but this study doesn't shed a whole lot of light on it. Its design makes it impossible to know whether the brain differences observed between Internet-addicted and non-addicted students were effects or potential causes of Internet addiction.

Even granting that possibility (that extensive Internet use can, over time, remodel an Internet user's brain), though, it's still very, very unlikely that there's any connection between widespread Internet use and increasing prevalence of autism. The timing is wrong, for one thing --- most autism diagnoses are given in early childhood, and a lot of parents begin to ask questions and look into it when their child is an infant or toddler. Given the text-based nature of the Internet, it is highly unlikely that pre-literate children are doing a lot of web surfing on their own.

For more about this weirdness, see Neuroskeptic, Jon Brock, Dorothy Bishop, Neuroskeptic again, and this hilarious website riffing on Greenfield's gnomic comment "I point to the increase in autism and I point to the Internet. That's all."

*The article also criticizes the measure as being too vague, and not a very good predictor of actual fiber density and location. It describes an alternative measure that the authors consider more accurate.

Yuan, K., Qin, W., Wang, G., Zeng, F., Zhao, L., Yang, X., Liu, P., Liu, J., Sun, J., von Deneen, K., Gong, Q., Liu, Y., & Tian, J. (2011). Microstructure Abnormalities in Adolescents with Internet Addiction Disorder PLoS ONE, 6 (6) DOI: 10.1371/journal.pone.0020708