"research in ASD has tended to use overwhelmingly White, middle to upper middle class samples, and has often excluded children with multiple disabilities and/or severe to profound intellectual disabilities". [underlining added - HLD]
Catherine Lord, Social Policy Report, Autism Spectrum Disorders Diagnosis, Prevalence, and Services for Children and Families
Yet another fMRI brain scan study, The neural basis of deictic shifting in linguistic perspective-taking in high-functioning autism, has been published in which Low Functioning, Intellectually Disabled autistic subjects are, by design, excluded in favor of subjects with High Functioning Autism. This study published in the journal "Brain" by researchers Marcel Just, Akiki Mizuno and their collaborators at CMU's Center for Cognitive Brain Imaging (CCBI) and described in a PR Newswire Release found that errors in choosing a self-referring pronoun (eg. "you" instead of "I") "reflect a disordered neural representation of the self, a function processed by at least two brain areas — one frontal and one posterior".
As evidenced by the above quote from autism expert Catherine Lord low subjects with low functioning autism, which would include the 80% or persons with Autistic Disorder (DSM-IV) and intellectual disability, are often excluded from autism research. That exclusion of low functioning, intellectually disabled subjects from recent fMRI "autism" brain scan studies has been even more obvious.
The Carnegie Mellon researchers should be commended for describing their conclusions, as their study title expressly states, in terms of High Functioning Autism given that their study subjects were all high functioning autistic persons. Unfortunately the press release, which identifies Carnegie Mellon as the source of its information, is not as meticulous and generalizes the study to the entire autism spectrum in its title and content, including quote from lead research Marcel Joust:
New CMU Brain Imaging Research Reveals Why Autistic Individuals Confuse Pronouns
...
The results revealed a significantly diminished synchronization in autism between a frontal area (the right anterior insula) and a posterior area (precuneus) during pronoun use in the autism group. The participants with autism also were slower and less accurate in their behavioral processing of the pronouns. In particular, the synchronization was lower in autistic participants' brains between the right anterior insula and precuneus when answering a question that contained the pronoun "you," querying something about the participant's view.
"Shifting from one pronoun to another, depending on who the speaker is, constitutes a challenge not just for children with autism but also for adults with high-functioning autism, particularly when referring to one's self," Just said. "The functional collaboration of two brain areas may play a critical role for perspective shifting by supporting an attention shift between oneself and others.
"Pronoun reversals also characterize an atypical understanding of the social world in autism. The ability to flexibly shift viewpoints is vital to social communication, so the autistic impairment affects not just language but social communication," Just added.
...
Ongoing research at the CCBI is assessing the white matter in detail, measuring its integrity and topology, trying to pinpoint the difference in the autistic brain's networks.
"This new understanding of what causes pronoun confusion in autism helps make sense of the larger problems of autism as well as the idiosyncrasies," Just said. "Moreover, it points to new types of therapies that may help rehab the white matter in autism."
New CMU Brain Imaging Research Reveals Why Autistic Individuals Confuse Pronouns
...
The results revealed a significantly diminished synchronization in autism between a frontal area (the right anterior insula) and a posterior area (precuneus) during pronoun use in the autism group. The participants with autism also were slower and less accurate in their behavioral processing of the pronouns. In particular, the synchronization was lower in autistic participants' brains between the right anterior insula and precuneus when answering a question that contained the pronoun "you," querying something about the participant's view.
"Shifting from one pronoun to another, depending on who the speaker is, constitutes a challenge not just for children with autism but also for adults with high-functioning autism, particularly when referring to one's self," Just said. "The functional collaboration of two brain areas may play a critical role for perspective shifting by supporting an attention shift between oneself and others.
"Pronoun reversals also characterize an atypical understanding of the social world in autism. The ability to flexibly shift viewpoints is vital to social communication, so the autistic impairment affects not just language but social communication," Just added.
...
Ongoing research at the CCBI is assessing the white matter in detail, measuring its integrity and topology, trying to pinpoint the difference in the autistic brain's networks.
"This new understanding of what causes pronoun confusion in autism helps make sense of the larger problems of autism as well as the idiosyncrasies," Just said. "Moreover, it points to new types of therapies that may help rehab the white matter in autism."
Presenting the results of a study of High Functioning Autism subjects as representing all persons with autism, including the low functioning, intellectually disabled excluded from the study is misrepresentation. It helps promote ignorance, both in the general public about the many intellectually disabled persons with low functioning autistic disorder identified by CDC autism expert Dr. Marshalynn Yeargin-Allsopp as autistic disorder's "vast majority".
The fMRI study is flawed in many ways. It looks at only verbal individuals. Echolalia (pronoun reversal)is not a diagnosis specific finding. Transient pronoun reversal has been reported in typically developing children, schizophrenia and in adults in the aftermath of stroke.
ReplyDeleteVerbal youngsters diagnosed with autism and adult stroke patients may both demonstrate echolalia, social impairment and obsessive behaviors. The evidence based therapies for both conditions are the same, early diagnosis, behavioral therapy, speech and language therapy, occupational therapy and physical therapy.
As is the case with autism outcomes vary subtantially.
http://www.ncbi.nlm.nih.gov/pubmed/9533994
http://www.ncbi.nlm.nih.gov/pubmed/19585352
What is this fMRI study actually stating? Pronoun reversal is not diagnostic specific and is rather associated with atypical brain structure.
Although I retweeted it because I think the pronoun reversal is very important to understanding language deficits, I didn't like the "story" from my son's perspective, either. Your child is ignored, mine is crazy.
ReplyDeleteIt's got a "voo-doo psychiatry thang" going on:"reflect a disordered neural representation of the self," It's easier to distance and label crazy. As long as we go there, and not see things from the perspective of the seriously language challenged child, not much progress will be made. Considering their language processing differences, it's quite brilliant that they figure out in this way to communicate. Imagine yourself in China, understanding nothing...and repeating the sounds you heard in a particular situation in order to obtain what you needed.
What they would have us believe is altruism, boils down to no more than elitism,in many respects.
Unfortunately, when the DSM-5 comes out, "Autism Spectrum Disorder" will just mean "Asperger's Syndrome" and all of the old research will magically become valid. The vast majority of the people with real autism will have a new diagnosis - "Intellectual Developmental Disorder".
ReplyDeleteAutism needs more attention. They need training and support from their families.
ReplyDeleteThis study seems to conflict with another research study I saw that found the reason for pronoun reversal is the inability to create the pronoun language shortcut for having to use the formal name triggering a visual picture in the brain of the representation of that person - in essence, the brain cannot hold so much information and the pronoun was a language-energy advancement that allowed non-Autistic / non-ATypical brains to handle the information overload that would occur without pronoun neural shortcuts. It has to do with the brain activation areas of pronoun vs. whole visual image of the person referenced. This seems to jive with what we already know about Autism cannot filter out the information overload. I agree with the repeated criticisms you keep making about how these Autism studies are leaving out the lower functioning people with Autism, and this is hugely problematic in getting a non-conjectural understanding of the parts of the Autism spectrum who are not the highest functioning.
ReplyDelete