Autism Hearing Transcript: Dr. Alan Guttmacher

Before the first panel of expert witnesses started to speak, Rep. Issa spoke briefly to take care of some procedural business and to swear in the witnesses: 

Still image of Rep. Darrell Issa, taken from this video

____________________________________________________________________________________________________________________
I thank the gentleman [referring to Rep. Kucinich, who has just yielded back the floor]. 

On all sides, I now ask unanimous consent that our colleague from New Jersey, Mr. Smith, be allowed to participate in today’s hearing. Without objection, so ordered. 

I will announce that if any individuals would like to be in a little more comfortable situation, we do have an overflow room, so just let our staff know, they’d make sure that, if they gave up their seat here, that they’d be able to be in the overflow room. It may be more comfortable for some of our guests.

I now turn to our first panel. The distinguished Dr. Alan Guttmacher is director of the Eunice Shriver National Institute of Child Health and Human Development at the National Institutes of Health --- and I actually knew the namesake of your organization, during her time --- and Dr. Coleen Boyle is director of the National Center on Birth Defects and Developmental Disabilities at the CDC.

With that, pursuant to the requirements and rules of this Committee, would you please rise to take the oath

(pauses while Drs. Guttmacher and Boyle stand up)

Raise your right hands.

Do you both solemnly swear or affirm that the testimony you are about to give will be the truth, the whole truth, and nothing but the truth?

(Drs. Guttmacher and Boyle nod their heads)

Thanks. Please be seated, and let the record indicate both witnesses answered in the affirmative.

You are important witnesses and we will not stop you if you go slightly over five minutes, but we do have a large second panel and we would ask that you bear in mind that all of your opening statements and additional extraneous material you may choose to submit to us will be placed in the record, so if you abbreviate or go off-message, it doesn’t change the official record for you. And, with that, Dr. Guttmacher, you are recognized.
_____________________________________________________________________________________________________________________

Still image of Dr. Alan Guttmacher taken from this video

And here is Dr. Guttmacher's speech:
______________________________________________________________________________________________________________________
Thank you, Mr. Chairman.

I am also a pediatrician and medical geneticist, and a member of the Interagency Autism Coordinating Committee, or IACC, re-authorized most recently by the Combating Autism Reauthorization Act of 2011.

Let me thank the Congress for its continued support of research and other activities regarding autism spectrum disorders. That support has made possible remarkable advances in autism research and helped to better identify and meet the needs of people with ASD and their families.

ASD includes diverse conditions that share distinctive styles of, or impairments in, communication skills and social interactions, as well as restricted, repetitive, or stereotyped behaviors. The combination and degree of impairments vary, creating an array of conditions that range from what many would see as normal to significantly disabling. Two decades ago, ASD was thought rare. Today, with CDC’s latest prevalence estimates, it is a national health priority.

The IACC plays a pivotal role in bringing together federal agencies, nonprofit organizations, and the public to identify priorities and strategies to address them. It includes individuals on the autism spectrum, parents of children and adults with ASD, other advocates, researchers and service providers, and officials from federal agencies. The IACC welcomes public comment at all full committee meetings, and regularly invites written public comments and holds town halls. Thus, a diversity of perspectives on ASD informs IACC activities and recommendations. It is a committed group; while the law requires two meetings a year, the committee and its subcommittees meet as many as seventeen times a year. The law charges the IACC to update a strategic plan annually. We are drafting --- as always, with autism community input --- a 2012 update that includes the latest advances, remaining gaps, and emerging needs in autism research. The plan encompasses priorities from fundamental biology to services across the life span.

Over the past decade, autism research funding has grown substantially. The NIH leads federal research in ASD, investing $169 million in fiscal year 2011, three times more than ten years ago. In 2009 and 2010, $122 million in additional American Recovery and Reinvestment Act funds were also invested.

As Congress has emphasized, early diagnosis and intervention are critical. This year, NIH-funded researchers identified brain pattern aberrations as early as six months of age in infants who went on to develop autism, the earliest such changes ever recorded in autism, and one of a number of recent findings which suggest that the factors causing autism may operate very early in development. Last year, researchers demonstrated that doctors’ offices can use a short questionnaire to screen inexpensively for ASD at the one-year well-child visit. Another promising diagnostic tool, a one-minute test that detects eye-gaze patterns specific to autism, had nearly 100% specificity in infants as young as fourteen months.

But early diagnosis is valuable only if effective interventions are available. Recent ASD trials have validated early interventions to improve health outcomes and quality of life. For instance, a recent behavioral intervention study showed improved IQ, language, and social development in young children, and progress is also being made on interventions for adults. A recent study showed, for instance, that for the many adults with ASD who have impaired ability to recognize faces, a computerized training program improved facial-recognition skills.

Many recent advances have come from NIH's Autism Centers for Excellence program, which currently supports nine centers and networks across the country, with two additional awards expected in 2013. The research covers a variety of topics aligned with the IACC strategic plan, including nonverbal ASD, genetic and environmental risk factors, potential treatments, and determining why ASD is five times more common among boys.

We do not know the causes of ASD, but recent findings highlight the need to focus on both environment and genetics. NIH and CDC established large research networks to collect extensive data on environmental exposures and health outcomes, and conduct powerful analyses to identify factors that contribute to autism. Those networks explore possible causative factors in the environment before, during, and after pregnancy. Just this week, one of these networks published a study that suggests prenatal and early-life exposure to car emissions is associated with autism.

On the services front, HRSA has invested substantially in improving physical and behavioral health of people with ASD, practitioner training and service provision. In fiscal year 2012, Congress appropriated over $47 million to HRSA for autism and other developmental disorders. This supports 43 interdisciplinary training programs which provide services and training to 41 states, and include autism intervention projects for underserved populations. Federal agencies also use public-private partnerships to maximize our work, such as NIH’s National Database for Autism Research, which coordinates with other autism data repositories to enhance researchers’ access to data.

Programs like these, that involve collaboration with patients and families, bring together hundreds of researchers and clinicians with tens of thousands of people nationwide affected by ASD. The Administration on Intellectual and Developmental Disabilities, with help from several nonprofit organizations, supports the Autism Now project, offering a call center, web-based clearinghouse for resources and twice-weekly autism webinars. The NIH-supported Association for University Centers on Disabilities is improving early identification of autism through 25 Act Early ambassadors who train doctors in identifying, diagnosing, and managing ASD.

In conclusion, since the establishment of the IACC, a wide variety of research, service, and education expertise have come to bear on autism. Research is rapidly translating into practical tools for use in the clinic and the community. Federal agencies are coordinating efforts to identify best practices to support the lifelong health, education and employment needs of people on the spectrum.

Thank you for this opportunity to provide testimony on such an important topic. 
_____________________________________________________________________________________________________________________
(end transcript)

You can see the Strategic Plan he talks about here. It is structured as a list of seven questions for the IACC to use as guiding principles in deciding which research projects to fund. In each annual update to the Strategic Plan, they list what research has been done relating to each question, and what gaps remain in their knowledge.

These are the seven questions, with a little more explanation on the ones I think are vague or overbroad:
1) When Should I Be Concerned? - developing new diagnostic tools, especially for use at younger ages, and improving existing ones

2) How Can I Understand What Is Happening? - fundamental biology research, including topics like brain structure, brain activity, gene expression, animal models, the role of glial cells, and how the various genetic mutations that have been found to be associated with autism affect brain development and/or synapse formation

3) What Caused This to Happen and Can It Be Prevented? - looking for factors that predispose a person to develop autism: genes, environmental exposures, characteristics of the parents that aren't necessarily genetic (e.g., age, epigenetics)

4) Which Treatments and Interventions Will Help? - evaluating early behavioral interventions, various kinds of training or therapy for older children (e.g., cognitive behavior therapy**, social skills training, mindfulness training), and of course drugs (blargh!)

5) Where Can I Turn for Services? - looking at disparities in access to diagnostic services and therapies, and at quality-of-life issues like wandering, restraint and seclusion***, and caregiver stresses

6) What Does the Future Hold, Especially for Adults? - developing diagnostic tools for adults, determining prevalence of autism among adults, and looking at quality of life among autistic adults

7) What Other Infrastructure and Surveillance Needs Must Be Met? - trying to make it easier to do the kind of research they want, by making it easier for different research teams working on similar problems to pool data

Also, looking at the bibliography they have at the bottom of this page, it looks like the study he mentions dealing with "prenatal and early-life exposure to car emissions" is this one.

*I learned a new word. It means "not autistic."

**I am confused about that; I thought cognitive behavior therapy was what you used to try and overcome distressing, irrational or self-defeating thoughts, like you get when you have OCD or depression. I'm not sure how it could be useful to an autistic child, unless maybe it's supposed to help them overcome their need for rigid routines or deal with sensory overload better. I could see either or both of those working, maybe.

***I'm immensely happy that people in the government know that restraint and seclusion in schools is a problem! All this time I'd been thinking it was just activists and parents who knew that and were fighting against it.

Autism Hearing Transcript: Dennis Kucinich

Still image of Rep. Dennis Kucinich, saved from this video.

________________________________________________________________________________________________________________________

Thank you very much, Mr. Chairman.

Having had the opportunity to work with Mr. Burton on this for the last 10 years, I remember well, as I’m sure Mr. Burton does and some members of this Committee do, a time when a provision was snuck into a bill on homeland security that essentially shielded from lawsuits the manufacturers of thimerosal.

This was ten years ago.

And you know what? No one, for the members that have been here less than ten years, no one knew where that provision came from. It came out of nowhere and ended up getting buried in a conference report. Of course, it passed.

I mention this because it’s not as though we just discovered this matter, and while I salute the Chair for holding this hearing, we didn’t just discover this. My own theory is, while there are studies that are out there that are implicating environmental factors in autism, think about this for a minute: We know, as Mr. Burton laid out, the component of thimerosal, the component that stabilizes it, is mercury. We all know that mercury is more than a contaminant, it’s an environmental toxic. But it doesn’t only exist in liquid form! Mercury can also be inhaled.

And I would guess, and this is just my theory, that we’re not only talking about drug manufacturers; we might be talking about coal companies too. We have to be aware, there are reasons why this Congress and this government, has not effectively addressed this issue. When you had Lilly and others, Eli Lilly and others, contributing millions of dollars to trying to affect the outcome of elections, I will tell you: I salute this Chair for taking a shot, because, at the bottom of this, you have special interest groups who would resist any deeper research on it because it’s going to affect their bottom line. Meanwhile, you have children all over the country turning up with autism, so this is a new beginning, I salute the Chair for making it, but this goes way beyond thimerosal and start thinking about coal. Thank you.

_______________________________________________________________________________________________________________________

(end transcript)

If I were a swearer, I would be swearing right now.

Coal companies and pharmaceutical companies in league with each other in some dastardly plot to pump mercury into the veins of Amerca's youth, turning them all ... (gasp) ... autistic? The horror!

(Why they would want to do this is not really addressed, but whatever.)

I liked Dennis Kucinich before I heard this.

Autism Congressional Hearing Transcripts: Dan Burton

Still image of Rep. Dan Burton saved from this video

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Thank you, Mr. Chairman. 

Let me start off by saying, contrary to what has been stated in the media over the years, I am not against vaccination. I believe that vaccinations have a very important place in our society and have given us one of the best health regimens in the history of mankind. People live longer, and live better, and have less disease because we have vaccinations. 

What we have always opposed is putting toxic chemicals, or mineral --- metals --- in the vaccinations. 

Thimerosal contains mercury. When I was a boy, we used to have mercury in thermometers, and they said if you break that thermometer and the mercury gets on your hands, as years went by, that was toxic. 

In Indianapolis, we had a school where, in the chemical laboratory, in the health science room, they broke a vial that had some thimerosal in it, they evacuated the school, they burned the clothes of kids that came into contact with it, and the fire department came in with all kinds of equipment to make sure they weren’t exposed to it. 

Women who are pregnant, they say don’t eat fish that has mercury in it, and they caution them that there’s certain kinds of fish you don’t eat. You don’t drink water that has any mercury in it. There’s all kinds of reasons not to be exposed to mercury, and yet we continue to put it in vaccinations as a preservative. 

In 1929, they came up with thimerosal. They tested it on 29 people that had meningitis. They all died of meningitis, but they said the mercury in the vaccinations, or the thimerosal, didn’t cause any problems, it was not a contributing factor. So ever since 1929, it has never been completely tested, and they continue to put it in vaccinations! 

It wasn’t so bad when a child got one vaccination, or two or three. But when they get as many as 28 or 29 before they go into the first grade, it really hurts them. It causes a cumulative effect. The brain tissues do not chelate it, and it stays in there and causes severe, severe problems. 

Now I had, during the chairmanship which I had in this committee, when I was chair, for six years, we had about four years of hearings. We had people from all over the world: scientists from every part of the world, doctors from every part of the United States, who testified. And people from CDC and FDA said, “There’s no evidence that the thimerosal causes any neurological problems in people who are vaccinated.” And then we kept on, kept on, and finally we had some people from FDA and CDC who came and testified and said --- get this word --- there is no conclusive evidence that the mercury in the vaccinations causes neurological disorders. 

No conclusive evidence. 

Now, that word “conclusive” ought to stick in everybody’s mind, because what it means is there’s a possibility. Now my question has always been --- and I’m convinced that the mercury in vaccinations is a contributing factor to neurological diseases such as autism and Alzheimer’s, I’m convinced of it after all those years we had hearings --- but that word “conclusive,” “there’s no conclusive evidence,” creates a doubt. 

And my question to the presidents and CEOs of pharmaceutical companies has always been, if there’s any doubt, if there’s any doubt that the mercury in vaccinations can cause a neurological problem, then get it out. 

You shouldn’t put mercury in any form in the human body, especially in children in vaccinations. Or adults, in my opinion. 

When we get a vaccination for flu --- every year we get a flu vaccination --- we have thimerosal, fellas. I don’t know if you know that. They’re injecting a certain amount of mercury in your body. And over time, I believe it does have an adverse impact on the neurological system. Of adults. I think it’s a contributing factor to other diseases such as Alzheimer’s. 

Let me just say that the thing we need to do is always err on the side of safety. If the pharmaceutical industry were to go to single-shot vials, then you would eliminate the possibility of neurological problems because there wouldn’t be any mercury in them. 

The last thing I want to say real quickly --- I’ve got 20 seconds --- we passed a vaccine injury compensation fund to compensate those people who were injured by vaccinations. And it was supposed to be something that people could work with the government to get that money --- the pharmaceutical companies were putting money into that fund --- but it’s so hard for a person who’s had a damaged child or a damaged adult to get any money out of that fund, it’s unbelievable. We need to reevaluate that fund to make sure that people who are damaged by mercury in vaccinations need to have access to that so they can at least have some compensation to help with the rest of their lives. These people are going to live sixty, seventy years and they’re going to be a burden. Not only on the families, but on society itself.
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(end transcript)

You know you're not going to hear anything good when the speaker feels compelled to preface it with, "Now, I'm not against vaccines, but ..."

That's another five minutes of this hearing wasted on the completely fictitious vaccine hypothesis, and it really does not make me feel good about this hearing at all, or about Congress in general and their likelihood of doing anything helpful for autistic people, that this guy, with his thimerosal obsession, was apparently the driving force behind this committee's decision to look into autism. 

On a lighter note, this is the first I've heard anyone suggest that vaccines might be causing Alzheimer's disease, too! 

Autism Congressional Hearing Transcript: Opening Statement (2)

Right after Rep. Darrell Issa gave his opening statement, the Oversight Committee's ranking member, Rep. Elijah Cummings, gave a second opening statement.

Here's the video:

Transcript
_____________________________________________________________________________________________________________________

Thank you for that, Mr. Chairman, and I do thank you for holding today’s hearing. Before I get started I want to take special note, as you have already done, to our friend who is leaving, Mr. Burton. Over my seventeen years on this Committee, this has been an issue that he has constantly put forth and constantly made sure that we tried to address as best we could. Mr. Burton, I want to thank you for your vigilance and I want you to know that although you may be leaving the Congress, as the Chairman just said, we will continue the fight. And I know you will too.

Mr. Chairman, we have learned much about autism spectrum disorders over the past decade. Taxpayer-sponsored research has identified risk factors and evaluated therapies to assist with some symptoms. Physicians and parents now have a better understanding of the developmental signs and the symptoms, allowing for earlier detection, and educators have experience with new methods and approaches for assisting children with autism. 

Congress has also acted to help individuals with autism and their families in significant ways. In 2010 we passed the Affordable Care Act, which contained significant new protections. Insurers may no longer discriminate against people based on pre-existing conditions. Insurers may no longer impose lifetime caps on health care coverage. New plans must include screening for autism without additional costs to the parents. And young people diagnosed with autism spectrum disorders may remain on their parents’ health insurance plans until they are 26 years old. These are real and significant protections that will improve the lives of millions of American families. 

Even with this progress, there is still more to learn and there is still more to do. While autism affects all racial, socioeconomic and ethnic groups, some studies have shown that African-American, Hispanic and Asian children are less likely to receive an early diagnosis. These delayed diagnoses cause minority children to be further behind in development of language and motor skills. We must be vigilant in emphasizing earlier detection for all our children, as an early diagnosis can make a critical difference in the lifelong development of a child.

We must also continue to invest federal research dollars in new and evolving therapies to improve the lives of those with autism spectrum disorders. In my district we house the Kennedy Krieger Institute [link], an internationally recognized institution dedicated to improving the lives of individuals with developmental disorders. These institutions improve the quality of life, education, and continued development of those affected by autism spectrum disorders, and we must continue to support them. 

Today’s hearing is an opportunity to examine what has been done about autism spectrum disorders to date and what more needs to be done in the future. There are many experts, individuals and groups who can help us in this effort. I want to take this moment to thank all of you for being here. 

As the Chairman said, there are so many people who are interested in this issue, so many who wanted to speak, but I want to say to you what I said to Bob Wright of Autism Speaks a little earlier in the day: I thank you for caring about somebody other than your children and yourselves, because what you are doing here today is raising this issue so that other children, other than those, or other folks, other than those maybe in your own families, maybe your friends, will benefit in the future. 

In other words, you are touching the future, and you are making it possible for those who are going through the autism spectrum disorders to have a better future. And so I thank you all for what you are doing, and as I said to Bob Wright, you must stay the course. One of the things that I’ve learned from being in Congress these seventeen years is that, in order for these causes to move forward, you have to keep banging the drum, and you must keep banging it louder and louder and presenting your case so that, after it’s all over, there’s high, as my mother would say, motion, commotion, emotion, and no results. I want you to be successful in what you’re doing. Life is short, and so what we must do is try and use our energy so that we can get the best possible results. And I am so glad the Chairman said what he said, about sticking with this, addressing it, and we encourage all of you to work with us as we move forward, and with that, Mr. Chairman, I thank you.

_______________________________________________________________________________________________________________________

(end transcript)

Rep. Cummings raises some important points: he's absolutely right that there are inequities in who gets diagnosed with autism, and in who has access* to the kinds of therapies, services and educational accommodations that can make an autistic person's life so much easier. He is absolutely right that these inequities are starkest along racial, ethnic and class lines.

He's also right to point out the gains autistic people and their families made with the passage of the Affordable Care Act. 

Unlike Rep. Issa, Rep. Cummings seems to place the highest priority on identifying and providing services that improve actual, living autistic people's lives, as opposed to the more academic, theoretical research about what causes autism or what autism is at the molecular level.

I admit that I find the latter category of autism research more interesting, because I majored in biochemistry and I want to know about everything at the molecular level, but there's no question that the former category of research is more useful.

You can make the argument that scientific research shouldn't be funded solely based on its potential usefulness, or lack thereof, and I'd agree with you, but given that we're dealing with a limited amount of money that's supposed to cover pure research and applied research and actual provision of services, and that right now the bulk of the funding from both public and private sources goes to pure research, I'm okay with funneling some of that (public) money into the other two avenues. Private charities (looking at you, Autism Speaks!) would, of course, continue to be free to allocate grant funding however they see fit. 

*As this article from the Los Angeles Times makes clear, these disparities persist even when services are supposed to be paid for by the state. In 2010, the California Department of Developmental Services spent $11,723 per child on white autistic children ages 3 to 6; on services for Asian children, they spent only slightly less: $11,063 per child. Black and Hispanic children fared the worst, with the state spending only $6,593 per child (just a little over half what they gave the white families!) on the former and $7,634 per child on the latter.

Autism Congressional Hearing Transcript: Opening Statement (1)

I'm slowly making my way through watching the video of the Nov. 29 congressional hearing, transcribing as I go.


(I'm not just doing it to have a complete, public, textual record; I also find having something I can read helps my own understanding, too.)

I'm going to post a bunch of separate, shorter transcripts here, one for each separate speaker.

Here's Rep. Darrell Issa*, Chairman of the House Oversight and Government Reform Committee, calling the meeting to order and making his opening statement**:
____________________________________________________________

(gavel pounding)

The Committee on Oversight and Government Reform will come to order. This hearing on “1 in 88 Children: A Federal Response to Rising Rates [of autism]” will come to order.

The Oversight Committee exists to secure two fundamental principles: First, Americans have a right to know that the money Washington takes from them is well spent, and second, Americans deserve an efficient, effective government that works for them. Our duty on the Oversight and Government Reform Committee is to protect these rights. Our solemn obligation is to hold government accountable to taxpayers, because taxpayers have a right to know what they get from their government. We will work tirelessly in partnership with citizen watchdogs to deliver the facts to the American people and bring genuine reform to the federal bureaucracy. This is our mission, and I might say today, in many cases we are dealing with people who, because of this affliction, may never pay taxes, but in fact their families and others pay for their entire life. 

Congress spends a lot of time discussing and debating issues, and in determining by our philosophical beliefs what the role of government should be. As we have seen in these debates surrounding TARP, stimulus, healthcare reform, these kinds of issues oft come down to where you fall on an ideological spectrum.

Today is no such thing. We’re having a hearing focused on something that spans from the ideological left to the ideological right. We’re drawing attention to something that has no political affiliation, no partisan allegiance, and sometimes --- and we believe, today --- not nearly enough focus on something that does not shorten life but dramatically --- or even slightly, but usually more than slightly --- reduces the quality of life, both for the individual and for their families.

I’m a father. As far as I know, I’m one of the fortunate ones. I’m not the 1 in 88. But right now, if the numbers are accurate, and if they continue to grow from the now 1 in 88 who are in some way ASD-affected, we in fact have an epidemic. It could be that some of the 1 in 150 at the start of this century was too low, that in fact people were simply not diagnosed. But few people believe that, in fact, there aren’t factors in our society and our behavior, in the air we breathe, the water we consume, or others, that are affecting how many people will be afflicted. 

We’re going to hear from a distinguished panel first, of people who do this for a living, try to get to the causes, prevention --- I won’t say “cure” today --- but at least the treatment, the understanding, and perhaps, in some cases, truly something that would mitigate their suffering. I know they’re frustrated. Congress, although we put nearly a quarter of a billion dollars a year directly into research, has not put the kind of dollars, perhaps, that could bring specific outcomes sooner.

On our second panel, a number of individuals who will say that in fact, one of the problems is we’re looking on one side of the equation and not nearly enough on what to do for the victims of various forms of autism.

The fact is, they’re all right. There is not enough money being placed into the various possible causes of autism. There is not enough study. Our government does not collect statistics as well as perhaps someday soon we will, so that in fact we can find out what the true number is, cross-check every aspect of how that number, which is a human being, came to be afflicted. 

The truth is we have a lot to do. I will not claim that I have come here timely. This is the last two days of my first two years as chairman, and this is our first hearing. But what I will promise you here today is that we will stay involved in this issue. We will stay involved through staff and through, if appropriate, additional hearings. I also would say to our first distinguished panel that one of the most important priorities I place today is in fact that we work with you and help you in this process, that we be a conduit to the rest of Congress on this important issue. In a few moments I’ll be swearing in --- I’m sorry, I’ll be recognizing, by unanimous consent, a number of members who would not ordinarily be here at a hearing, because they are involved in this issue but serve on other committees. 

Additionally, I want to apologize to all of those people who, rightfully so, would be well (?) to be heard here today. I could’ve had a second panel of at least twenty witnesses from organizations and affected individuals. We had the difficult job of selecting just six, and as the ranking member will undoubtedly agree, six is already a fairly large single panel. 

That’s one of the reasons I pledge to you today that any organization or individual that in the next seven days provides to us, as required by our rules, in electronic format --- or, if you give it to us in paper we will try to scan it --- we will include your statements and your information in the record. 

We’ll hold the record open so that the many who could not be heard live in testimony will in fact be at least in the record. I want to particularly recognize Brian Hooker [link] with Focus Autism [link] in the American Academy of Children --- well, actually it’s a long, long title --- sorry --- who in fact has been one of the people who has championed for today’s hearing, and a number of others. They’ve been essential in my getting a better understanding. 

I’d also like to thank --- and we will be recognizing two witnesses, er, two members, on each side: the former Chairman of the [mumble] Committee[***], Dan Burton, who years ago began a process of focusing on some aspects of this terrible disease. We in fact don’t know enough; our goal is to know more, and today is but a down payment on that. With that, I’d like to thank the ranking member for his assistance in putting together today’s hearing and recognize him for his opening statement.

_____________________________________________________
(end transcript)

I won't be offering a whole lot of commentary right now, but I would like to make note of the two people to be name-checked in this short speech: Rep. Burton, whose testimony I will put up shortly and which really speaks for itself, and this Brian Hooker, who is affiliated with some group I'd never heard of called Focus Autism. It turns out to be a crank group dedicated to the notion that vaccines are "an important contributing factor" to autism in children.

So that's not good. We're just in the opening statement, and already the vaccine hypothesis --- which ought to have no place at all in a discussion of how best to spend federal money on autism research, therapies and services --- has been moved front and center.

*I'd post the video, too, but I cannot find a separate clip of just this speech. I can find one for the second opening statement, by Rep. Elijah Cummings, but I can't find one for Rep. Issa's statement. If you can, and you give me a link in comments, I will gladly embed it.

**I'm not going to blockquote my transcripts because I find that, in this blog template at least, blockquoting makes things a lot less readable! These transcripts are going to be kinda long, so I really don't want to sacrifice readability. I will set them apart some other way, like drawing lines above and below the transcribed speech.

***I didn't completely catch this, but looking at Rep. Burton's webpage, he has chaired both the Oversight Committee and another committee, a subcommittee of the House Foreign Affairs Committee. Rep. Issa is probably referring to his past chairmanship of the Oversight Committee. 

The Small World of Words

Neuroskeptic posted recently about this online project called "The Small World of Words," which is an effort to create the largest word-association database ever by having lots of people complete this interactive exercise.

They show you fourteen words, one at a time, and you type in the first three words that come to your mind in the three empty fields below the prompt-word. 

If nothing comes to your mind, you're supposed to type "no response." I had one word where that happened (the word was "grief", and instead of seeing an image I could describe, or a color, or hearing the word echo and mutate into various sound-alikes, I actually felt an attenuated version of grief itself), so I entered that into all three fields.

They do want everyone taking the test to be a fluent English speaker, but other than that there are no restrictions. And you can be from anywhere, and you don't have to be a native speaker --- just fluent.

Probably, if your English is good enough for you to be reading this blog, you can participate in this study.

It's Gollum!

So I only carved one jack-o'-lantern this year --- it's a measure of how excited/worried I am about this election that Halloween has almost completely slipped my mind this year --- but I'm really pleased with the way it turned out, and I did remember to take lots of pictures at different stages of the process.

I decided I wanted to carve it in the likeness of Gollum from The Hobbit and The Lord of the Rings, as he appears in the "Lord of the Rings" movies.

This is the picture I worked from:

This is my negative-space interpretation* of that picture, after I had finished transferring it to the pumpkin by taping my drawing to it and poking zillions of little holes all along every line. 

Here, I have recreated the negative-space drawing on the pumpkin by tracing over the pin-holes with a Sharpie:

And here is the finished project:

Finally, here it is all lit up:

Happy Halloween!!

*Drawing from the movie still, I actually produced a line drawing first, and then turned that into a negative-space drawing so that my lines would actually show up on a jack-o'-lantern. It occurs to me now that I ought to have scanned the original line drawing, but whatever.

Cognitive Sex Differences within Autism - Part I

One hypothesis about why there are so many more boys and men on the autism spectrum than there are girls and women is that boys and men, for whatever reason, are more likely to get diagnoses of autism spectrum conditions.

One of the reasons commonly put forward by people (including me) making this argument is that the diagnostic criteria reflect a picture of autism derived disproportionately from autistic boys and men, and autistic girls and women differ sufficiently from their male counterparts in their abilities, behavior, developmental histories etc. to ensure that they will often fail to meet those criteria.

While browsing PLOS ONE I found a couple of recent-ish articles looking into what those differences might be.

The more recent study, just published this week, involved giving four largish groups of participants (one autistic and one neurotypical group within each sex, with each group having thirty-two people in it) a battery of tests designed to measure five different skills: theory of mind, emotion recognition, executive functioning, perceptual attention to detail, and manual dexterity.

What are all those things and how would you go about measuring them? Well, the first of those skills, theory of mind --- also called cognitive empathy or mind-reading --- is one I've written a lot about on this blog. I've also written a lot (usually in the same posts) about the tool psychologists seem to use most of the time to assess this skill in adults: the Reading the Mind in the Eyes Test. I don't think I need to say anything more about either the skill or the test; the test is relatively straightforward, a series of black-and-white photographs of faces, cropped to show only the eyes, paired with a choice of four emotion words. You are supposed to guess which of the words best describes what the person whose eyes are in the photograph is feeling.  

I listed theory of mind and emotion recognition separately, even though the Reading the Mind in the Eyes Test obviously involves both. There's another test the researchers used, one that they describe as a test of emotion recognition, that reads to me like it's almost the same thing as the Reading the Mind in the Eyes Test, only it uses pictures of entire faces instead of just eyes. It's called the Karolinska Directed Emotional Faces Test.

To test the participants' executive-functioning abilities, the researchers used something called the Go/No Go Task. This involves pressing buttons on a computer keyboard in response to certain cues appearing on the computer screen; in this study the cues were arrows pointing either to the right or to the left. (Right and left were each associated with a different target key: P for right and Q for left. So the people taking the test were literally minding their P's and Q's!) The test also includes extraneous cues that test takers are not supposed to respond to. So what's being tested is not just one's ability to hit a key when a light goes on; it's also one's ability to restrain one's key-hitting impulse when something close to, but not exactly like, the target stimulus appears.

There were some other things the researchers included under the umbrella of executive functioning: working memory (tested by having the participants repeat nonsense syllables), word generativity (ability to come up with lots of words beginning with the same letter in a short amount of time) and motor planning, which they tested using the Assembly subtest of the Purdue Pegboard Test. (This involves putting simple objects together in a set order using whatever hand they tell you to use.) This obviously assesses manual dexterity as well as the ability to figure out what you need to do in what order (i.e., motor planning), although they also had the participants complete the other parts of the Purdue Pegboard Test to test manual dexterity alone.

Finally, the test they used to measure attention to detail was the Embedded Figures Test, which I've also blogged about before, noting that autistic people have shown a particular aptitude for this task.

The results are mostly unsurprising: the autistic study participants did worse at both of the facial-expression-interpreting tasks, and also at pressing the right key in the Go/No Go task. On the two language-related memory tasks, they performed no differently than the control group. (This is not surprising given that all of the participants are described as "high-functioning," having average-to-above-average IQs (about 115, plus or minus about 15 points) with verbal IQ greater than or equal to performance IQ).

The emotion-recognition data get more interesting when you look more closely at them, though; apparently the autistic study participants had more trouble identifying some emotions than others. Fear was the one it took them longest to recognize; it was also the hardest one for the non-autistic people to identify, too, but the gap between the two groups' average reaction times is the biggest in this category. It took the autistic study participants, on average, somewhere between four and five seconds (closer to five) to identify the fearful faces. For the non-autistic participants, it took maybe three and a half seconds. Happy faces were the easiest for both groups to identify, and the difference between groups was only half a second compared to the 1-1.5 second gap in their response times to fearful faces. All the other reaction times are clustered within a relatively narrow range for both groups: between 2.5 and 3 seconds for the autistic group, and between 2 and 2.5 for the control group. So, even though fear was tricky for everyone, it proved especially challenging for the autistic people. The study authors guess that maybe this is because autistic people studiously avoid looking at other people's eyes, and the eyes are apparently the most important cue that someone looks frightened.

There were also a couple of novel findings, too, though. For instance, on the Assembly component of the Purdue Pegboard Test, it was only the autistic men who had any problems relative to their same-sex control group. The autistic women were, you might say, indistinguishable from their peers. 

But the most surprising thing, for me, was their results on the Embedded Figures Test. This is a pretty solidly defined Thing Autistic People Are Really Good At, yet in this study, where there was a difference between autistic and non-autistic groups, it was the non-autistic people who found the hidden shape faster. (That was also true for the men and not for the women).

In general, the authors describe a pattern of male and female autistics having more or less the same degree of impairment in what they call the "hallmark" of autism spectrum conditions, which is inability to pick up on another person's nonverbal cues to their mental or emotional states*, but with the autistic men, and not women, also having additional impairments in other domains.

The authors point out that this contradicts what had been conventional wisdom about cognitive sex differences within autism, which held that autistic women were usually more severely disabled than autistic men**.

I haven't forgotten about the other, earlier study; I'm just going to give it its own post so as not to make this one overlong.


Lai, M., Lombardo, M., Ruigrok, A., Chakrabarti, B., Wheelwright, S., Auyeung, B., Allison, C., , ., & Baron-Cohen, S. (2012). Cognition in Males and Females with Autism: Similarities and Differences PLoS ONE, 7 (10) DOI: 10.1371/journal.pone.0047198


*This elusive quality can be called theory of mind, mentalizing, "mind-reading" or empathizing. It may also involve more than one cognitive, emotional or perceptual ability, but this study doesn't really go into that.

**To be REALLY picky, this study doesn't address the issue of intellectual disability, as no one who participated in it would meet the criteria for having ID. This shows that autistic men of slightly above average IQ are more likely to have problems with motor planning and figure disembedding.

My Favorite Thing!

(Spoiler alert: the subject of this post is not actually my favorite thing.)

I just discovered a blogger I find interesting; her name is Gretchen Koch* and she has a Ph. D.  in the cognitive science of religion. She mostly writes about that.

One of the things she writes about when she's not writing about the psychological underpinnings of religion and ethics, though, is feminism. A while back she wrote a pretty decent, thoughtful, well-argued post on objectification (a much-discussed topic, on which she managed the not-inconsiderable feat of adding something new).

That post drew the predictable ire from the knuckle-dragging community, but it took a really bizarre form:

After noticing a number of hits here that came from [sexist douchebag]'s blog, I returned to see that he had written a follow-up post which talked about my post. Want to guess what it said? I'll make it a multiple-choice question:

A. You know what? I am actually reading too much into this, and should go with the simplest explanation rather than making other men's attraction all about my particular ideological agenda.

B. You know what? I don't think I was given a fair shake -- there are actually differences in the appearance of feminists vs. non- or anti-feminists, and while I didn't go to much trouble to articulate these or why they should exist, that's a factor that should be taken into account here.

C. You know what? It's really weird that I didn't make a distinction between "attractive" and "attractive to me," since I can only speak for myself and since (as with everybody, whether they admit it or not) my own perception of what I consider attractive is shaped by my ideological convictions.

D. You know what? Gretchen's ugly. And probably autistic.

I'll give you a moment to think before answering. 

Done? Yeah, I didn't think it would take long. The answer is ... D!

Yes, it's my favorite rhetorical tactic in the world, Disagreeing by Diagnosing!

The argument assertion in the post she links (which I don't recommend reading, unless you've got a few dozen extra brain cells you won't miss) is that all feminists, and all male anti-feminists calling themselves "men's rights activists" (read this blog if you are unfamiliar with the genus), are autistic.

Here is normally where I would spell out what the writer is arguing, how he or she is using autism as a metaphor, and what the implications of that metaphor are, but it's not being used as a metaphor in this instance. He's just saying "all feminists are autistic," and that the only reason they are feminists is because they are so bad at social interaction that they have become completely alienated from men, and from society in general.

I was actually really conflicted about posting this, because it's a really stupid instance of Disagreeing by Diagnosing, and there isn't actually much to pick apart and criticize in it, but I've developed a collector's mentality about this fallacy, so I feel compelled to post about every instance of it that I hear about. 

The quality of the blog may suffer as a result of this compulsion, but gosh darn it, at least you'll know just how widespread this fallacy is!  

*Presumably not related to Charles and David Koch, though if she were I probably wouldn't hold it against her.

Another "Extreme Female Brain" Sighting

EXECUTIVE SUMMARY: Simon Baron-Cohen's E-S theory of autism, sex differences and whatever else he's applied it to lately states that people have one of three basic cognitive styles: Type E, the empathizer, who understands people and relationships; Type S, the systemizer, who understands abstract ; and Type B, who can do both. Prof. Baron-Cohen has identified autism as exemplifying the Type S cognitive style taken to extremes, but hasn't written much about its opposite, the extreme Type E, or Extreme Female Brain. He allows that it must exist, but he doesn't think it would be as disabling in modern society as an Extreme Male Brain --- autism --- is. Other people (Crespi and Badcock) have suggested paranoid psychosis as the condition typical of the Extreme Female Brain, as it involves being morbidly obsessed with other people. In the paper I discuss here, a pair of evolutionary psychologists make the case that the psychopathology characteristic of the Extreme Female Brain is disordered eating.

The paper I discuss in this blog post describes a series of four different "experiments" in which groups of college students, of varying size (as large as n = 160, as small as n = 37), are given multiple psychometric exams. They are tested for the following things: disordered eating, sensitivity to other people's judgments, Empathizing Quotient (EQ), Systemizing Quotient (SQ), performance on various tasks considered representative of either empathizing or systemizing (e.g. guessing what emotion people in photographs are feeling, or mentally rotating three-dimensional objects), and schizotypal personality disorder. Some of the data are compatible with the idea of a high-empathizing, low-systemizing Extreme Female Brain that is particularly susceptible to disordered eating, and some are not.
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Thought to exist, but seldom glimpsed in the wild

Today on the fascinating psychology blog BPS Research Digest, I saw that some other researchers think they've found a candidate for an Extreme Female Brain, which according to Simon Baron-Cohen's E-S theory ought to exist, probably in about the same numbers as the Extreme Male Brain (which he identifies as autism) does, but which hasn't been described in the psychological literature.

The new article, by evolutionary psychologist Gordon G. Gallup, Jr. and assistant professor of psychology Jennifer Bremser --- both affiliated with the State University of New York --- and published in the journal Evolutionary Psychology, tries to make the case that eating disorders stem from the heightened sensitivity to others' judgments that is characteristic of the Extreme Female Brain.

What they did was to give a group of undergraduate psychology students at SUNY a battery of tests: the Eating Attitudes Test (EAT), which looks for disordered attitudes about eating (sample questions: "I feel extremely guilty after eating"; "I feel that food controls my life"); the Fear of Negative Evaluation Scale, which measures how anxious you are about what other people think of you (sample questions: "I often worry that I will say or do the wrong thing"; "I feel very upset when I commit some social error"; "When I am talking to someone, I worry about what they may be thinking about me"); Simon Baron-Cohen's Empathizing and Systemizing Quotients (which I have critiqued here and here); the Schizotypal Personality Questionnaire (PDF), which tests for nine traits associated with schizotypal personality disorder: ideas of reference (which means thinking that other people, or the media, are talking specifically to or about you when they aren't really), excessive social anxiety, odd beliefs or magical thinking, unusual perceptual experiences, odd or eccentric behavior, a lack of close interpersonal relationships, odd speech, constricted affect (i.e., not being very good at showing one's feelings), and general suspiciousness; and several tests that measure skills that would be associated with either an empathizing or systemizing cognitive style: the Reading the Mind in the Eyes Test, the Intuitive Physics Test and the Redrawn Vandenburg and Kuse Mental Rotations Test (Version A). Then they looked for relationships between all of these different test scores, and between any given score and the test taker's sex.

Their hypothesis --- that an empathizing cognitive style is more characteristic of women than of men, and tends in its extreme form towards disordered eating and social anxiety --- would predict the following: women scoring higher, on average, on the EQ and Mind in the Eyes tests, and lower on the SQ, Intuitive Physics, and Mental Rotation tests; women scoring higher than men on the measures of disordered eating and fear of negative evaluation, and high scores on those measures being correlated with high scores on the EQ and Mind in the Eyes tests for both sexes. 

They found significant differences between the sexes on the measures of disordered eating and fear of negative evaluation (both were higher for women), and also on the EQ, but not on the SQ. Women were also likelier to display something called "empathizing bias", which they defined numerically as each study participant's z-score on the EQ minus their z-score on the SQ. (Z-scores are a measure of how far an individual's score on a given statistical measure is above or below the average score. A negative number means the person, or sub-group, scored below average, while a positive number means they scored above average). Thus, the empathizing bias score is supposed to represent how much better a person does at empathizing than systemizing (or not, if it's zero or a negative number).

There was also a disparity between how participants scored on the EQ and SQ versus how they did on the more "objective" measures of systemizing or empathizing skill, the Intuitive Physics, Reading the Mind in the Eyes and mental rotation tests. The sexes differed strongly on their (self-reported) EQ scores, but performed almost identically on the Reading the Mind in the Eyes test. Obviously guessing what emotion a black-and-white photograph of a stranger's eyes is meant to convey is very different from accurately gauging the emotional states of one's relatives and friends, so that still leaves open the possibility that women perform better at this task when it involves real people who are known to them, but it's just as likely that women tend to overrate, and men to underrate, their interpersonal sensitivity on self-reported measures, and that real differences between the sexes on this ability are minimal. 

The opposite pattern occurred between the SQ and one of the "objective" measures of systemizing ability: men and women scored equally on the SQ, but men outperformed women on the Intuitive Physics test. (I can't find any results on the mental-rotation test broken down by sex).

There was also a very inconsistent pattern of correlations between disordered eating, fear of negative evaluation and the various systemizing and empathizing variables. High scores on the disordered-eating measure correlated with high scores on the fear-of-negative-evaluation (FNE) measure, and also with high scores on the EQ. There was no relationship between SQ scores and either disordered eating or fear of negative evaluation, and EQ and SQ scores were positively correlated with each other. Most strangely, SQ scores were correlated positively with empathizing bias: the number that reflects the imbalance between one's empathizing and systemizing abilities!

Also, within each sex the overall pattern of disordered eating patterns correlating with greater empathic ability (whether self-reported or "objectively" measured) seems to fall apart. 

Two graphs, Figure 1 and Figure 2, show bars for average male and female performance on both the EQ and the Reading the Mind in the Eyes Test, at low and high ends of the disordered-eating spectrum. According to these graphs, women score about the same on these tests regardless of whether they show disordered eating patterns or not, and for men the results are all over the place. On one test (the Mind in the Eyes), men who score low on the Eating Attitudes Test do equally well with all women, while men who score higher do more poorly on average, but their range of results is very, very broad. The error bar is wider than the bar on the graph is tall. 

On the EQ, the men show more or less the pattern the researchers expected: men at the high end of the disordered-eating spectrum scored higher than men at the low end on average, but for the former group especially there was a lot of within-group variation.

They also found correlations between disordered eating, fear of negative evaluation and several of the traits that make up schizotypal personality disorder: disordered eating correlates positively with ideas of reference (i.e., thinking everything refers to you, specifically), magical thinking and suspicion. Fear of negative evaluation correlates positively with ideas of reference, suspicion, social anxiety and constricted affect. (This latter makes sense --- if you are afraid people are judging you, of course you are going to try and minimize the extent to which those people are able to tell what you're thinking or feeling! It's called a "poker face".)

They also wanted to see if any of these psychological problems --- disordered eating, fear of negative evaluation, schizotypal personality disorder or any of its component traits --- interfered with one's ability to rotate three-dimensional objects in one's head. (Their reasoning for doing this wasn't just for giggles --- let's take a bunch of emotionally stressed people and ask them to do something both pointless and difficult! Hilarious! --- it can be hard to shake the idea that a lot of psychological experiments are done with precisely that objective --- but because they wanted to see if people who were unusually and morbidly concerned with what other people thought of them, and were thus "hyper-mentalizers" who would be reckoned extreme empathizers in Simon Baron-Cohen's typology would also show the expected impairment in systemizing tasks. 

Annoyingly, they did not compare people's scores on the mental-rotation task with their scores on other direct measures of systemizing or empathizing ability: they assumed, given earlier findings, that high scorers on the measures of disordered eating and fear of negative evaluation are also high empathizers. As I have said above, the data are less than clear in their support of this assumption. 

They found that people (they do not break it down by sex, probably because at this stage in the study they were dealing with a lot fewer participants) who scored high on their measure of disordered eating tended to do worse at mental rotations, consistent with their prediction. However, they also found a small (too small to be significant) positive correlation between mental-rotation scores and fear of negative evaluation. Of those two things, I'd consider the FNE score to be the more pure indicator of a "hypermentalizing" excess of concern for what other people think; there's a lot that's still unknown about the psychology of eating disorders, to the point that calling disordered eating a behavior born out of a fear of negative evaluation by others would be speculative.

The correlations they found between the various schizotypal personality traits and mental rotation ability surprised me, too. You'd think, if greater skill at mental rotation of three-dimensional objects indicated a logical, "systemizing" type of mind, that there would be a strong negative correlation between mental-rotation scores and those schizotypal traits that bespeak irrationality, like magical thinking or ideas of reference. (Especially magical thinking). But no, there's no correlation between either of those things and how well one does at mental-rotation tasks. The only components of schizotypal personality disorder that showed any significant relationship to mental rotation were social anxiety and constricted affect, both of which were negatively correlated. 

A negative correlation between skill at mental rotation and one's score on the social anxiety subscale of the Schizotypal Personality Questionnaire does fit with the researchers' idea of "hyper-mentalizing" at the expense of systemizing. But the lack of such a correlation with fear of negative evaluation does not fit, and instead makes one wonder if what's going on is, instead, anxious people's anxiety interfering with their ability to perform the rotations. 

In their Discussion section, the researchers do not comment on most of these discrepancies, but the one they do address --- worse performance on the Reading the Mind in the Eyes Test* by people with more severely disordered eating --- they attribute to those people's having greater, not less, emotional sensitivity**. Why, they're so sensitive they see things that aren't even there, so they do poorly on certain tests of emotional sensitivity and interpersonal acuity like the Reading the Mind in the Eyes Test.

I'm being silly, but that really is their explanation:

Comparable to the heightened sensitivity to sensory stimuli (auditory, visual and tactile) common among people with autism, individuals with the EFB [Extreme Female Brain] may be hypersensitive to social stimuli. Disordered eating may ameliorate the experience of negative evaluation anxiety that results from heightened sensitivity to social stimulation. 

Consistent with this idea, emotional processing deficits have been linked with eating disorders including the inability to recognize, label and describe emotions in detail and to link feelings with bodily correlates (Bourke, Taylor, Parker and Bagby, 1992 [link]; Eizaguirre, de Cabezon, de Alda, Olariaga and Juaniz, 2004 [PDF]; Garner, Olmsted and Polivy, 1983 [link]) Also, compared to healthy controls, women with anorexia had difficulty recognizing emotions from facial expressions and vocal tones (Jansch, Harmer and Cooper, 2009 [link]; Kucharska-Pietura, Masiak and Treasure, 2003 [link]).

Jones, Harmer, Cowen and Cooper (2008) [link] investigated emotional face processing in female undergraduates with high and low levels of disordered eating. Participants completed the Eating Attitudes Test-26 and the Facial Expression Recognition Task, a computer task in which participants view faces depicting 7 different expressions (anger, disgust, fear, happiness, sadness, surprise, and neutral) at different intensities. The participants with higher levels of disordered eating were less accurate in identifying happy and neutral faces. Among participants with high levels of disordered eating, there was a tendency to classify more happy faces as neutral, and more neutral faces as either angry or sad. In addition, there was evidence that reaction times to recognize disgust were longer, while reaction times to recognize fear were faster than participants with low levels of disordered eating. When disordered eating reaches clinical levels, the effects of hyper-mentalizing may manifest as mental state misattributions. This may be because they are using their own experience to model the experience of others, and their bias to classify emotions with a negative bias may influence their attributions. For instance, when shown pictures of women who are said to have overeaten, females with high levels of disordered eating ascribed more negative emotional states to these women than control participants do. Thus, women with higher levels of disordered eating appeared to use their own experience of overeating to describe how the other women would feel (Beebe, Holmbeck, Schober, Lane, Rosa, 1996 [link]).

It is also possible that the physiological and cognitive effects of starvation produce deficits in performance. In a study looking at performance on the Reading the Mind in the Eyes Test, individuals with anorexia performed worse compared to healthy controls (Russell, Schmidt, Doherty, Young and Tchanturia, 2009 [link]. 

An alternative explanation is that low scores on the Reading the Mind in the Eyes task does not represent a deficit of theory of mind ability, but rather an excess that reflects hypermentalizing. Abu-Akel (2003) [PDF] suggests that theory of mind dysfunctions range from the complete absence of the ability to represent other people's mental states (as shown in severe autism) to having the representational understanding of mental states, but a deficit in the ability to apply this understanding (as in Asperger's syndrome) to the abnormal or excessive attribution of mental states (as in schizotypy). It may be that this third class of dysfunction is misconstrued as a deficit, rather than an excess. Consistent with this interpretation, the RME is one of the most widely used instruments to investigate theory of mind performance in adults; however, scores on the RME depend only on accuracy. The test does not identify the nature of the errors that impede performance. For example, there can be errors of absence (failing to detect a mental state when it is present) and errors of excess (wrongly inferring a mental state in its absence). We suspect the second class of errors (errors of excess) account for most of the lower scores on this test among individuals with anorexia.

(They also seem to be arguing that people cursed with an excessive degree of awareness of other people's judgment of them might be self-medicating by starving themselves: if they are women, they will produce much less estrogen, which the authors believe "may also produce changes in empathizing and theory of mind performance." So that's a novel proposal --- people with eating disorders starve themselves to dull their razor-keen interpersonal sensitivity, in the interests of making their lives bearable. Obviously there's no evidence for this, and I've never seen anyone who has an eating disorder describe it like that, but at least it does people with eating disorders the courtesy of treating them as rational beings, which not all of the accepted explanations do.)

I do not doubt at all that people who have this kind of hypersensitvity exist --- I know a few! What I doubt is that 1) these people are all the same, and all have this skill for the same reason; 2) these people are any likelier to develop eating disorders than the general population; and 3) these people are necessarily bad at "systemizing," which seems to include such things as logical reasoning, pattern recognition, organization and spatial cognition. Indeed, the data from this same study suggest that people who are good at one half of the empathizing/systemizing duality seem to be good at the other half, too.

You can also count me as agnostic, still, on the question of whether women are, overall, better empathizers and men better systemizers. I don't rule it out, as at least some cognitive differences between the sexes do seem to exist, and show up consistently in studies, but as yet I don't see strong empirical support for it. 

Also, they dance around this in their Discussion section, but never directly address it: disordered eating is quite common in autistic girls and women, and even non-autistic people with eating disorders, particularly anorexia, perform similarly to autistic people on tests of mentalizing ability (the Reading the Mind in the Eyes test again), mirror self-recognition, emotion recognition, body awareness, executive function and central coherence (the Embedded Figures Test).

If autism is supposed to be the Extreme Male Brain, and the Extreme Female Brain is supposed to be its opposite, doesn't that complicate things a lot? 

Bremser JA, and Gallup GG Jr (2012). From one extreme to the other: Negative evaluation anxiety and disordered eating as candidates for the extreme female brain. Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior, 10 (3), 457-86 PMID: 22947672

*In the present study, it was only the male participants who showed this pattern, but the researchers cite lots of other studies of people with eating disorders, particularly anorexia nervosa, who show the same impairment. Some of the other researchers hypothesized that insufficient nutrition made those patients less able to perform complex cognitive operations of any sort, which sounds convincing to me.

**I am having UNBELIEVABLE trouble spelling "sensitivity" today. I always seem to leave out one of the "I's".