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A critique of Janet Wilde Astington's The Child's Discovery of the Mind
posted at 02:00 pm on 08-07-2008
Astington has provided us with a wonderful resource for understanding the theory around "theory of mind". She describes the history of the concept: who invented the term and what they meant by it, then philosophical discussions people had about what it should mean, then subsequent experiments and what they say about human cognitive development in young children.
And then she has a chapter on autism. A blood-pressure-raising stomp-on-the-book-in-a-fit-of-rage chapter on how autistic people probably lack theory of mind, and that lack of theory of mind may be the central deficit in autism. Warning! Do not read this chapter without plenty of drugs on hand. My preference is chocolate, but you may have other drugs of choice. Regardless, proceed with caution. Do, however, read everything else, merely avoiding all sentences with the word autism in them, if you want to get a good general understanding of theory of mind.
Theory of mind was a term coined by David Premack and Guy Woodruff, who wanted to know if chimpanzees could tell what someone was thinking by the context of the situation (i.e. does this person want bananas but can't reach them?). Some of the best research on human cognition has begun with research on chimpanzees. The mirror recognition test was also originally devised for research on chimps, then later applied to toddlers. (Sneak some rouge on the nose, put child or chimp in front of mirror, watch for reaction. Does the child point at the mirror, ha ha!, or investigate his own nose?)
As Astington describes, philosophers got a hold of this concept of theory of mind and juggled it back and forth for a bit. Then the philosopher Daniel Dennett decided that if people truly had theory of mind, they would understand false beliefs, not only in a naturalistic setting, but also in standardized tests. The psychologists Heinz Wimmer and Josef Perner came up with a set of standardized false belief tests, and off we go. In general, these tests show that three year olds cannot understand others' false beliefs, remember their own false beliefs, or distinguish appearance from reality, except maybe with contextual support, but sometime between the fourth and fifth birthdays, most kids can do this on their own fairly easily. It would be best to describe each test in its own critique, rather than go over all of them here, but there are a few basic formats:
1. Appearance versus reality: a sponge made up to look like a rock. Older kids can tell it looks like a rock but is a sponge, while for younger kids it is what it looks like, either a sponge or a rock depending on their mood.
2. Deception: Hide chocolate in one of two boxes, so that the child knows which but another person doesn't. The child passes the test if he or she lies to the other person, telling them to look in the empty box, so they can keep the chocolate (or coin, in another version) themselves.
3. False beliefs: This is the big one, the test that all people who discuss theory of mind need to be familiar with. The child knows an object has been moved from one place to another, or that one object has been substituted for another. Someone who doesn't know about the move or substitution will naturally think differently, and will be surprised to be wrong. Children pass the test when they know the other person will be fooled, and in some cases, that they themselves were fooled, too, before they were let in on the joke. Children too young to pass the test think the other person won't be fooled, and don't even remember that they were fooled themselves.
According to Astington, Francesca Happé found that there is a strong correlation between language ability and ability to pass the theory of mind tests (I haven't actually read this paper myself, so I'm not sure how accurately it's reported and what it's taken to mean). Also, research by Perner and colleagues shows that regular kids do better at theory of mind tasks if they come from larger families and presumably have more intense social interaction and therefore more practice at social cognition growing up. Astington's own research indicates that with ordinary kids, kids with better language ability and memory capacity (which generally go together) do better on false belief tests. But then she goes on to suggest (repeating the findings of Baron-Cohen and others) that autistic people lack theory of mind, which leads to the language and communication deficits typical of autism, instead of considering the possibility that autistic people have language and communication deficits, which leads to them doing less well on theory of mind tasks. And she'd already indicated that most autistic people do pass these tests at some point to some degree, so they can't lack theory of mind wholesale. Sigh. Do I have any hair left?
Other than her tendency to believe everything other researchers say about autistic people, Astington has written a good basic summary of theory of mind research, and it's worth taking a look (but a cautious one, and remember to have those drugs handy).
Source:
Janet Wilde Astington, 1993. The Child's Discovery of the Mind. The Developing Child Series. Harvard University Press.
Anemone Cerridwen
August 6, 2008
(also on my website, as usual)
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Late Talking
posted at 11:47 pm on 08-01-2008
Not everyone starts speaking at the exact same age. Some talk early, some talk at the average age, and some talk late. Most people who talk late get caught up once they start talking. Those who don't start talking until after age 6-7 do have problems, and those who don't start talking until past puberty never do get caught up, but most late talkers start talking before age 6-7. While most kids who talk late are below average in intelligence, there is a subgroup of gifted kids who talk late but are advanced in other ways. Late talking in this group is often confused with autism, but there are differences. This discussion is about these non-autistic gifted late talkers, and how they are similar and dissimilar to autistic kids.
First of all, they're late talkers, and kids with Asperger Syndrome aren't, by definition (see the DSM), so they don't have Asperger Syndrome. Let's just get that one out of the way.
Second of all, they typically talk late but otherwise communicate normally on schedule. They follow conversations just fine and communicate normally using nonverbals, for example pointing to show what they want instead of using words. Autistic kids with language delays will probably also be delayed in following conversations and participating in them nonverbally, as well as being late in talking. In other words, some kids talk late, but others have more pervasive communication difficulties and experience delays across a wider set of skills. The first ones aren't autistic - the second ones may be.
Also, it should be pointed out that these gifted late talkers may be socially impaired while they're waiting to catch up language-wise, but once they start talking, they do get caught up socially and some of them are not just socially normal, but even above average in their social skills. Autistic kids never do get caught up, as a rule, and continue to experience language and/or communication deficits and social problems as adults. Autism is a lifelong deficit, late talking isn't. If there's a pervasive, life-long delay, it may be autism. If it's just late talking, it isn't.
These late talking kids are often gifted analytically. They excel at puzzles. Later they do well at math and chess. They may also do well at music. Many of them have engineers as relatives. Almost all of them are related to one or more engineers, scientists, musicians, accountants, or pilots. They often also have musicians among their close relatives. In general, parents tend to be well educated. The few kids in one study old enough to have taken the SAT all scored above the 90th percentile on the mathematics scale. Many of them are precocious when it comes to reading, numeracy, or computer use.
These kids also have unusually good memory for details. They tend to be strong willed, and may have strong interests in some areas, with little or no interest in others, even going so far as refusing to participate in testing because the tests do not interest them. They tend to display an unusual degree of concentration for subjects that do interest them.
These kids tend to be clumsy, and many are delayed with respect to toilet training.
Unlike many gifted kids, who may be myopic and/or allergic and/or left handed, these kids tended to be right handed and not particularly allergic. It is as if giftedness has a price, and some pay it in myopia or allergies or left handedness, but these kids pay it in late speaking.
Most of these late talking kids are male (as is also true of autistic people). The ratio appears to be somewhere around 4:1 male to female, which is typical for sex differences for this sort of thing. Girls with language delay are rarer, presumably because girls' brains are less lateralized for language than boys' brains are, but the girls who are gifted late talkers tend to show the same set of gifts and deficits that the boys do. However, other than this they are not particularly boyish.
It is interesting that this particular group of kids has strong analytical skills. These skills are usually located in the left hemisphere, near where speech is produced, as is the ability to distinguish pitch (unlike visual-spatial skills and language comprehension, which are generally found in the right hemisphere). It is as if, as the brain develops, development of analytical skills takes away from neighbouring speech development, and the child only catches up with respect to speech as the brain continues to grow, increasing overall capacity and allowing other areas to also develop.
Thomas Sowell gives Albert Einstein as an example of a late talker with high analytical skills. Einstein was a late talker, and was obviously gifted, particularly in analytical functions, and had all the problems gifted people face, including social isolation and not fitting in. However, he does not appear to have been autistic, as his social skills caught up and were well within the normal range as an adult. Of course, with his gifts, he had a relatively small peer group, leading to some isolation as an adult, but he does not appear to have had problems networking and making friends when the friends were there to network with, unlike autistic adults who continue to struggle even in environments rich with people similar to them.
Simon Baron-Cohen would refer to these late talkers as high in systemizing, and believes that this pattern is typical of autistic people. Many people also believe Einstein was autistic, because he spoke late and was weird. Research on late speaking people, which hopefully will continue and expand, should clarify the difference between late speaking in people with an analytical bent, and autism, which is far more pervasive and lasting than simple late talking, and which may occur in people who have no analytical abilities whatsoever. There will be people who are both analytical and autistic, as there are people who are both gifted in other ways and autistic, and the overall pattern of analytical gifts and late talking is similar enough to autism to suggest that autism in some cases may be an extreme version of late speaking in analytical types, but it is important to note that there are differences, also. Not everyone in one group also belongs in the other. Autism and late speaking are not the same thing.
In summary, learn to tell the difference between late talking and autism.
My own father was late speaking (age 3) and became an accountant. He and his father would also have made good engineers. He is not autistic. As far as I know no one on that side of the family is.
Sources:
Sowell, Thomas, 1997. Late-talking children. Basic Books, NY.
Sowell, Thomas, 2001. The Einstein syndrome: Bright children who talk late. Basic Books.
Anemone Cerridwen
August 1, 2008
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The Empathy Quotient (EQ) - a critique
posted at 06:24 pm on 07-20-2008
(as usual, also posted on my website)
Baron-Cohen and Wheelwright (2004) have created their own empathy scale for measuring empathy in autistic people, rather than use a previously constructed scale. I am not familiar with most of the scales they reject, but I do object to their reasons for rejecting the Interpersonal Reactivity Index (IRI - Davis, 1980). The IRI consists of four subscales, each with its own score (there is no overall score): the Fantasy scale (FS - imagining yourself in fictional situations), Perspective Taking scale (PT - an intellectual approach to empathy), Empathic Concern (EC - an emotional approach to empathy) and Personal Distress (PD - anxiety that might get in the way of behaving empathically). Baron-Cohen and Wheelwright do not like the Fantasy and Personal Distress scales, but do not indicate any problems with the Perspective Taking and Empathic Concern scales. Given that the four scales are scored separately, Baron-Cohen and Wheelwright could simply have ignored the FS and PD scores, and used the PT and EC scores in their research. Instead they have chosen to construct their own scale.
There is nothing wrong with constructing your own scale if you end up producing a superior scale. But Baron-Cohen and Wheelwright have not done that.
The IRI is a well constructed instrument. Davis came up with over 50 items, submitted them to 201 male and 251 female subjects, and did a factor analysis which indicated four main concepts (which led to the four scales of the IRI). He then eliminated some items and added others to produce a better version of a four-factor instrument, submitted these 45 items to 221 male and 206 female subjects, ran a second factor analysis, then chose the best 7 items (based on this analysis) for each scale, submitted them to 579 new male and 582 new female subjects, and did a third factor analysis to ensure the instrument still measured four clearly separate concepts, which it did. In a separate paper (Davis, 1983), he then tested the external validity of the instrument by correlating scores on the different scales with other, related, scales, to see if they correlated the way they should. They did. All in all, the IRI is a well-designed scale designed to measure empathy as defined in a variety of ways in general populations. Since it was not intended to test any specific hypotheses, it is simply a general measure of empathy.
Baron-Cohen and Wheelwright, on the other hand, were not as rigorous. First, they generated a list of 60 items, including 20 filler items and 40 test items. They did not try to keep emotional (affective) and intellectual (cognitive) aspects of empathy separately, because they did not think they could do so.
Baron-Cohen and Wheelwright had four aims:
"to test whether adults with high-functioning autism (HFA) or Asperger Syndrome (AS) score lower on the EQ (study 1); to test whether the EQ is inversely correlated with the AQ (Autism Spectrum Quotient) . . . , as would be predicted if autism/AS is an empathy disorder (study 1) . . . ; to test whether the EQ inversely correlates with the FQ (Friendship Questionnaire . . . ) as an index of the validity of the EQ (study 1) . . . ; and to test for sex differences in empathy, given earlier reports of a female superiority (. . . study 2)." [Baron-Cohen and Wheelwright, 2004; p.166]
Note that the authors did not include the goal of first testing to see if the EQ measures empathy. Testing it against the Friendship Questionnaire (FQ - a scale that also has its own problems) is insufficient, especially since the FQ was created by the same people and likely reflects the same biases. Testing it against the AQ is problematic, since it seems the purpose of creating the EQ in the first place is to test if autistic people score low on empathy. Anything that correlates negatively with the AQ will fit that bill, without necessarily revealing anything relevant about either autistic people or empathy.
Basically, it looks as though the authors are looking for a scale that autistic people will score lower on, rather than looking to see if autistic people score lower on an empathy scale. The difference is critical.
Baron-Cohen intially tested the EQ on twenty control subjects, but did not do a statistical analysis of the results. They were just checking to see if the test items were understandable and that the scale gave a good range of scores. They also showed the test items to six experimental psychologists who were asked to rate the test items against their defintion of empathy: "Empathy is the drive or ability to attribute mental states to another person/animal, and entails an appropriate affective response in the observer to the other person’s mental state." [Baron-Cohen and Wheelwright, 2004, p.168]. All the test items passed this subjective measure of construct validity by at least five of the six judges. This is not a substitute for statistical analysis, since it is hard to know what a question is measuring until you actually see what it is measuring.
They then gave the EQ to 90 autistic adults (65 males, 25 females) and 90 controls matched for age and sex. They also gave the 90 autistic adults the AQ, and gave the FQ to 45 of them. As predicted, the autistic subjects scored quite a bit lower on the EQ than the non-autistic controls. Also as predicted, the EQ scores correlated negatively with AQ scores and positively with FQ scores. If you find what you are looking for this easily, how do you know you were searching objectively in the first place?
A quick glance at the test items indicates that at least 12 of them measure social/conversation skills (test items 1, 8, 14, 19, 26, 29, 35, 41, 44, 54, 57 and 58, e.g. "35. I don’t tend to find social situations confusing."). Given that autistic people generally have a hard time following conversations, isn't it a little unfair to include conversation skills in a questionnaire designed to measure empathy in autistic people?
"Our clinical interviews with a series of adults with AS (n=50) provided an opportunity to probe the reasons for their lower score on the EQ. They reported that even though they have difficulty judging/ explaining/ anticipating or interpreting another’s behavior, it is not the case that they want to hurt another person." [Baron-Cohen and Wheelwright, 2004, p.169]
Only among autistic people is difficulty interpreting interpersonal situations defined as lack of empathy. Most people would see the two as two distinct things. Consider the following model:
1. Sensory information goes into the brain (see, hear, smell, etc.).
2. The unconscious part of the brain interprets the sensory information so that it makes some sort of sense. ("Oh, that's Jenny. She's crying.")
3. The individual reacts on an instinctive/emotional/intellectual level to this information. This reaction may or may not be high in empathy, for a variety of reasons.
4. The individual then decides how to act.
5. The individual then acts, with varying degrees of competence.
The process can break down in any of these five stages. Only the third one involves empathy. The first two involve sensory perception and interpretation, and may be hampered by sensory or perceptual difficulties. The final two involve competence in the world, which is experience-based but may also involve difficulties in coordination of response. To assume the lack of an empathic response indicates lack of empathy when there are so many other factors involved is overly simplistic at best. You could also call it unempathic, when directed at a vulnerable demographic group, as it is in this paper. Worst of all, it is a missed scientific opportunity, since a properly accurate and detailed interpretation can lead to so many productive avenues of research.
Baron-Cohen and Wheelwright also found that non-autistic women tend to score higher than non-autistic men, which is no big deal. Other researchers have found the same thing with other scales, and it fits with general impressions of differences between the sexes. I'd be worried if they didn't find that, regardless of whatever it is they're actually measuring.
Recommendations:
1. Combine EQ and SQ into one scale. Do factor analysis to see if they measure two factors (or more, or fewer). If they do, reduce the scale to a smaller more focussed scale, using the best test items only. ELIMINATE ALL ITEMS THAT ARE BIASED AGAINST PEOPLE WITH LANGUAGE/COMMUNICATION DIFFICULTIES. Just as you do not test social skills in blind people by measuring their ability to read faces, do not test empathy in autistic people by measuring their ability to follow and participate in conversations.
2. Test validity of the scales by correlating EQ (and SQ) scores with other measures, created by other people not connected to these researchers, of the same or related concepts (e.g. the IRI). DO NOT assume that the EQ must be measuring empathy if autistic people score lower on it. First of all, there is no independent proof that autistic people are lower on empathy, just an assumption, not properly tested. Secondly, even if autistic people are lower on empathy and also score lower on the EQ, the EQ may still be measuring something else.
3. It is always dangerous to construct a scale to measure a general trait to test a specific hypothesis. Whenever possible, use a well-constructed scale previously designed by others, in order to avoid test construction bias.
4. DO NOT PUBLISH RESULTS related to specific demographic groups (e.g. autistic adults) until after you are sure the scale measures what it is supposed to. You can always print a retraction later, if it turns out you were wrong, but will anyone read it? And even if they do, can you undo the damage? Better to make sure you know what you're measuring first, before going out on a limb with it.
References:
Davis, Mark H., 1980. A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 1980, 10, p. 85. Retrieved June 14, 2008 at http://www.eckerd.edu/academics/psychology/files/Davis_1980.pdf
Davis, Mark H., 1983. Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44(1):113-126.
Baron-Cohen, Simon, and Sally Wheelwright, 2004. The Empathy Quotient: An investigation of adults with Asperger Syndrome or High Functioning Autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34 (2):163-175. Retrieved June 9, 2008 at:
http://www.autismresearchcentre.com/tests/eq_test.asp
EQ also available online at http://homepage.mac.com/lpetrich/Asperger/EmpathyQuotient.html
Postscript - Some reasons why autistic people might score low on empathy:
1. Stress: We might have empathy but we're too tired/overwhelmed to feel anything right now.
2. Self-fulfilling prophecy: We might score low if we think we're supposed to.
3. Diagnostic bias: People who are low in empathy might be more likely to be diagnosed with autism than people who are high in empathy, since they fit the stereotype better. So as a result, autistic people may end up having less empathy as a group (by definition).
4. Neurodiversity: Some of us are genuinely low in empathy. Same as for everyone else.
Postscript 2 - Ok, so someone did a factor analysis. But I'm still not impressed.
In a separate paper (E.J. Lawrence, P. Shaw, D. Baker, S. Baron-Cohen and A.S. David, 2004. Measuring empathy: reliability and validity of the Empathy Quotient. Psychological Medicine, 34:911–924, available at same link as EQ paper above), Baron-Cohen and colleagues did do additional analysis of the EQ, including a factor analysis of 29 of the 40 items scored in the EQ. 28 items loaded on three factors, including 7 items on a "social skills" factor, as well as 13 on a "cognitive empathy" factor and 12 on an "emotional reactivity" factor. Four items loaded on more than one factor, and one loaded on none. (They also found moderate correlations of the "emotional reactivity" factor of the EQ to the PT and EC scales of the IRI, for the 28 subjects who completed both scales.) To my knowledge, this factor analysis has not had an effect on the contents of the actual scale. I do not see a revised EQ (EQ-R) on their website. So why did they bother?
Anemone Cerridwen
July 20, 2008.
(Comments)
An Anthropologist on Mars and a complexity theorist on Earth
posted at 01:21 pm on 07-06-2008
I just finished rereading An Anthropologist on Mars, by Oliver Sacks, (having first read it years ago), and this time through, I was struck by the difference in tone between the first five chapters and the final two. In the first five chapters, Sacks describes a man who loses his colour vision; a man whose autobiographical memory peters out in the late 1960s; a surgeon with Tourettes; a blind man who gains, struggles with, then loses the ability to see; and a man who obsessively paints his childhood village in exquisite detail from memory. Sacks seems fascinated by their conditions, rightly so, but not particularly concerned with their membership in the human race. In other words, he seems to see them as regular people with neat conditions. He doesn't even mention their personhood. It's simply not an issue.
However, in the last two chapters, he describes two autistic people: Stephen Wiltshire, a young savant artist, and Temple Grandin, a livestock researcher, and his tone is completely different. Instead of describing two people with fascinating conditions, and how they interact with and relate to their conditions, he seems to spend a fair amount of time describing his own and others' confusion around these people. He is interested in how these people experience their conditions. But he also seems to be interested in how he experiences their conditions. He struggles to see them as people he can relate to, and so he struggles with their autism. But autism is their condition, not his, isn't it? What is going on here?
It's like with the other subjects, they have conditions and he observes them, but with the two autistic subjects, they themselves are the conditions that he (and others he describes) struggle with.
Autistic people as conditions that other, non-autistic people suffer from. It's strange, but that seems to be how many people seem to experience it. At least, that's how it comes across in the media. And that's how it comes across in this book. I find this fascinating, in a way. It might explain a great deal of the hostility and ignorance surrounding autism that persists today (though not on the part of Sacks).
It's as if people learn how to interact with others at a very young age, then get stuck interacting only in that way (or that range of ways) and then when they meet someone outside that range they can't do it. Imagine learning to speak your native language, and perhaps a few others, as a child, automatically and effortlessly, not even remembering how you did it, then losing the ability to learn new languages. Then as an adult, encountering other, unfamiliar languages for the first time, you are caught by a gulf you cannot cross. There are no dictionaries to translate words for you, no guidebooks to get you started, no way of kick-starting your brain to go back to what it was like as a child when you didn't have preconceived notions of how people interact. So you may see these people as unreachable, perhaps even a different species, the gulf is so wide. It's easy to feel threatened when you don't know how to read or communicate with someone - you have no idea what they're going to do next. And since the person isn't acting the way you would, and in some cases doesn't appear to be acting at all, it's even easy for some people to wonder if there's anyone in there at all.
My own reaction as a complexity theorist is that I wouldn't even question the personhood of an amoeba, let alone an autistic person, since every organism that isn't actually dead has a nervous system that is actively reading its environment and deciding what to do about it, including the lowly amoeba. An organism (from a complexity point of view) is a self-organizing self-regulating system, and it is an organism's job to stay alive, and to thrive, by paying attention to what's out there, deciding what it means, and responding accordingly. Autistic people are interacting with their environments just as much as everyone else, since that's what living beings do, and since they're Homo sapiens (what else would they be?), they're clearly active members of the human race. But autistic people often don't act on the surface the way non-autistic people generally do, and many non-autistic people do not seem to be able to read autistic people, even though the same underlying agenda of reading and responding to the environment is going on, because they don't even know what to look for. And so they wonder if there is anything going on under that unfamiliar, alien surface. Well, there has to be, since the person is still alive, but not everyone automatically assumes that. If you see "human intelligence" as "acting the way I would, more or less", and "interacting with me in a way I can understand", then you might have problems with seeing autistic people as having human intelligence. But if you see human intelligence as the intelligence a human being brings to understanding and interacting with the world, whatever the personal style of that person, then by definition autistic people have human intelligence because they have intelligence (their minds are working) and they're human. Their intelligence may work more or less well than yours in a given situation, but it is going at it and doing its best, same as for everyone else. If it were as broken as some people seem to think, the organism would die sooner rather than later, which it doesn't, since, contrary to popular thought, we do tend to live well into adulthood in spite of all the obstacles we face.
It seems that when people, even the most open-minded people, meet autistic people for the first time as adults, they don't even know where to begin when it comes to reading them and communicating with them, so nothing happens, and they get stuck in a relationship with the communication gap, instead of being able to move into a relationship with the other person. If even Oliver Sacks, clearly a gifted communicator as well as a curious, open-minded person, spends as much time talking about the gulf as about the person on the other side, it's no wonder autistic people are routinely excluded from society. We need guidebooks for translation, written by people who know how to bridge the gulf, so that those who painfully learn the language of how to communicate with unfamiliar autistic people can at least learn a few basics. Until then, or until it becomes the norm to see all persons as living organisms actively interacting with their environments even when you can't see the interactions, most people will probably have a problem seeing us as human at least some of the time.
Note: This is in no way intended as a slur against Oliver Sacks and his writing. His book was written some time ago, and reflects his early reactions to two autistic people. I'm not even sure how much he is describing his own experiences and how much he is describing the issues other people bring up about these people. He's out there, he's being honest, he's giving it his best, and he's made a valuable contribution to understanding autism and its place in human society. It would be interesting, though, to know if he's gone through any major shifts in perspective, to know how he sees things now, and whether he'd write anything differently or not if he were doing it over again.
Reference:
Sacks, Oliver, 1995. An anthropologist on Mars: Seven paradoxical tales. Alfred A. Knopf, NY.
Anemone Cerridwen
July 6, 2008.
(Comments)
Touched with Invisibility?
posted at 05:25 pm on 07-05-2008
I've just been rereading Kay Redfield Jamison's book Touched With Fire, which is a fascinating look at manic-depression (bipolar disorder), and its occurrence in highly creative people and their families, and it's really got me thinking about autism in famous historical figures (and their families). Now, there's been lots of speculation about autism with respect to some famous people, but also much disagreement (and I'm one of the disagreers a lot of the time). Jamison, on the other hand, is working with a well-known and easy-to-describe disorder which just about anybody could spot with a good checklist to work from. Lucky her. Of course, she also knows her stuff.
The manic part of manic-depression seems to make it easy to diagnose historical figures. Jamison describes people who swing back and forth between periods of normal functioning, intense or volatile energy (to the point of dysfunction), and black depression (also to the point of dysfunction). People with manic-depression typically have problems with alcoholism, extravagant spending and debt, unstable behaviour, chaotic relationships, periods of insanity, time spent in mental hospitals or under the care of physicians for insanity or instability, and high rates of suicide. Manic-depression appears to be highly heritable (though environmental factors appear to have an effect on if or how much the disorder emerges), and Jamison describes a history of alcoholism, instability, depression, time spent in mental hospitals, and suicide among relatives of these people as well.
On the other hand, speculation about possible historical cases of autism suffers from two weaknesses. One is that, unlike with manic-depression, we do not yet have a solid idea of what autism is and what it looks like in adults, since there is very little research on autistic adults even today. We also still don't know that much about the range of norms in child development either (e.g. when a developmental delay tends to matter and when it doesn't), since nobody really paid much attention to child development until the 1940s, and it's still a new field. Second, we also really don't seem to know that much about what it might look like in relatives, although we do know it is also highly heritable, and there has been some work on the broader autism phenotype (BAP). I don't know much about the BAP, but what I've seen doesn't seem to have much resemblance to the popular image of autism, and it also doesn't seem like the sort of thing people note in biographies either. Unlike manic-depression, which really puts on a show, well-behaved autism is just not that riveting to watch. If Dionysus and Ariadne and their amazing road show represent manic-depression (as Jamison suggests), then autism is probably represented by the shadowy Hades and Persephone, rulers of the underworld, who don't get out much and are rarely seen.
So instead of an extravagance of alcoholism and suicide, what can we expect to see in the families of autistic people, and in possible historical cases of autism? Well, if the fetal testosterone theory is correct, then abnormalities related to underdevelopment of the left hemisphere (and thymus?) might pop up in historical figures with autism and their relatives: for example left-handedness or mixed-handedness; homosexuality; people with language or communication abnormalities (although who knows what that might look like historically); people with allergies or environmental sensitivities; people with strong right hemisphere gifts, and in general, people who are unconventional. Among relatives, it might make sense to look for a surplus of family members who don't marry or leave home. Incompetence in business (from underdoing it rather than overdoing it) might also be a marker. In my own family, my mother's extended family runs to gay men, famous lawyers/politicians, and gifted women no one knows what to do with, but my mother's father was a Jesuit, then a government employee. My father's extended family runs to highly successful businessmen (you've heard of one if you're Canadian), but my father is an accountant and his father the not-very-savvy inheritor of a family business (successful, but in an inert kind of way). There is mixed-handedness/left-handedness on both sides, but who writes about that in biographies?
There may be fields in which autistic people and relatives of autistic people actually do concentrate, the way manic-depression is over-represented among poets, writers and painters. Autism is frequently linked (possibly erroneously) with high tech, but the high tech industry hasn't been around that long, so it's not likely to be of help in diagnosing people in the past. Science in an earlier, less competitive, era might be a place to look for similar temperaments. Autistic people may also turn up in fields that emphasize nitpickyness over competitiveness, for example some areas of law. Alternately, possible famous autistic people may turn up in fields that do not require collaboration: writing, painting, and music composition are all solitary pursuits; or in collaborative fields that are highly structured and organized, but that allow eccentricities (possibly the film industry in the studio era). Unfortunately, it's most likely that in the past autistic people stayed close to home and worked in family businesses/on family farms, or in workplaces that didn't have high social demands (letter carrier, file clerk) so we're not likely to see many of them in the history books. And for those who are famous, autism, unlike manic-depression, is probably never going to be obvious enough in adulthood for us to be completely sure of a diagnosis.
Of course, we still don't really know what autism is, so I could be completely wrong.
Reference:
Jamison, Kay Redfield, 1993. Touched with fire: Manic-Depressive illness and the artistic temperament. The Free Press, Macmillan, NY.
Anemone Cerridwen
July 5, 2008
(Comments)
Michael Fitzgerald's speculations about famous people and autism
posted at 08:22 pm on 06-29-2008
Michael Fitzgerald has written a number of papers and books diagnosing famous people of the past as autistic. [Note: as always, I use the term autistic to refer to everyone on the autistic spectrum, including Autistic Disorder, Asperger Syndrome, and Pervasive Developmental Disorder - Not Otherwise Specified.] These diagnoses are controversial - some people are happy to think of Albert Einstein, Hans Christian Andersen and Andy Warhol, for example, as autistic, while others are highly sceptical. It would take a considerable amount of time and space to critique every one of his diagnoses, so I will focus primarily on Hans Christian Andersen, since I had read up on him before reading Fitzgerald's assessment, and before having any idea anyone considered him autistic, and so had an opportunity to form my own impression without prejudice.
Fitzgerald diagnosed Andersen in his 2005 book: "The genesis of artistic creativity". But it would probably be a good idea to have a look at Fitzgerald's concept of autism, described in greater length in his earlier 2004 book: "Autism and creativity", first.
Fitzgerald and autism:
Fitzgerald believes that high functioning autistic people may be capable of great creativity, and that, by examining famous creative people who may have been autistic, we can learn about creative genius in general.
He writes:
"How individuals achieve greatness can hinge on many, often inexplicable, factors -- hence the fascination with puzzling personalities, which may prove difficult for the biographer. This point has been raised by Virginia Wolff and quoted by Kuehn. She declares that 'biographies are difficult, if not impossible to write, because people are all over the place'. Describing such people as 'all over the place' is in fact shorthand for being enigmatic, which is certainly part of the creativity and eccentricity of HFA/ASP. In this book the diagnosis of HFA/ASP attempts to reduce this chaos." [Fitzgerald 2004: 16]
I'm not sure that Wolff meant to imply that people who are "all over the place" are either enigmatic or autistic. It's possible she was referring to the tendency of all people to be both complex and inconsistent a lot of the time. But who knows?
Next, Fitzgerald discusses the nature of Asperger Syndrome:
"The present author has expressed the view that we should retain the term 'autistic psychopathy', particularly when serious antisocial behaviour is involved (see Table 2.1)." [Fitzgerald 2004: 23]
In the table (2.1) referred to here, he compares Asperger Syndrome to Antisocial Personality Disorder (what most people think of as psychopathy). He seems to believe that autistic disorders would be better described as personality disorders, along with Antisocial Personality Disorder, Narcissistic Personality Disorder, Schizoid Personality Disorder etc., instead of as developmental disorders, as they are now. This is not to imply that he thinks autistic people are psychopaths, just that he seems to take a different slant on autism than most clinicians do today. He does argue, though, that Hitler, everyone's favourite psychopath, was also autistic. I'm not sure where he gets that from, but it may be because Hitler was highly creative (he was a skilled artist) as well as highly screwed up. To my knowledge there is no documentation that Hitler had any social or communication impairment that significantly interfered with work or personal life, as is normally understood for autism.
Fitzgerald relies heavily on Gillberg's description of Asperger's:
1. social impairments
2. narrow interests
3. repetitive routines
4. speech and language peculiarities
5. non-verbal communication problems
6. motor clumsiness
Compare this to Oliver Sacks' shorthand description of autism, based on the original descriptions by Kanner and Asperger:
"Kanner's and Asperger's accounts were in many ways strikingly (at times uncannily) similar--a nice example of historical synchronicity. Both emphasized "aloneness," mental aloneness, as the cardinal feature of autism; this, indeed, was why they called it autism. In Kanner's words, this aloneness "whenever possible, disregards, ignores, shuts out anything that comes to the child from the outside." This lack of contact, he felt, was only in regard to people; objects, by contrast, might be normally enjoyed. The other defining feature of autism, for Kanner, was "an obsessive insistence on sameness," in the form of repetitive, stereotyped movements and noises, rituals and routines; finally, in the appearance of strange, narrow preoccupations--highly focused, intense fascinations and fixations. The appearance of such fascinations, and the adoption of such rituals, often before the age of five, were not to be seen, Kanner and Asperger thought, in any other condition." [Sacks 1995: 190]
It is unlikely that we will see this kind of detail from the childhoods of people long dead, especially since, in the past, people didn't pay much attention to child development. However, "aloneness" and "insistence on sameness" may show up in less exaggerated form in adulthood, especially the aloneness.
Fitzgerald relies heavily on social isolation for his diagnoses, which is fair, although it is probably normal for historic geniuses to be a little isolated - it's not as if there are tons of people just like them to hang out with, so you need to be careful with that. Unfortunately, Fitzgerald fails to distinguish between the kind of isolation typically experienced by gifted people, especially growing up, before they have had a chance to find a peer group (Webb et al., 2005), and the kind of lifelong isolation autistic people are vulnerable to. Narrow interests are also typical of many gifted people, and he fails to distinguish the two groups here as well. It is actually probably safe to assume that the vast majority of famous historical figures (especially the ones that got there under their own power instead of inheriting their fame) were exceptionally gifted in some way or other, but probably not autistic, since autism involves significant social impairment, and it's hard to become famous when you're socially impaired.
He argues, and I agree, that there are many eccentric people who are not autistic:
"Indeed, many people with HFA/ASP are described as being eccentric. At the same time the majority of the people, in my experience, who have the word 'eccentric' attached to them do not meet diagnostic criteria for HFA/ASP." [Fitzgerald 2004: 35]
However, in my view, he does not make a case that the people he describes as autistic are more than just gifted and eccentric.
He also argues, and again, I agree, that it is not particularly useful to distinguish between high functioning autistic (HFA) and Asperger Syndrome (ASP).
In general, Fitzgerald's argument frequently sounds like: "this person was x; autistic people are x; therefore this person was autistic", forgetting that sometimes non-autistic people are also x. What's more, x varies from one example to the next. Person 1 is autistic because they're anal-retentive about facts (as are autistic people). Then, with persons two and three, their mysticism points to them being autistic (autistic people may also sometimes be mystics, though I don't know how common it is). Additionally, he doesn't say "might be" with anyone - it's always "is", which is taking a strong stand when we can never be quite sure about people who are no longer around to be interviewed.
Fitzgerald and Hans Christian Andersen:
Hans Christian Andersen (1805-1875) was a Danish writer famous for his fairy tales, especially The Ugly Duckling and The Little Mermaid. He was obviously exceptionally creative and sensitive, and also socially isolated, living in Copenhagen while most creative types gravitated to Paris or Vienna. He was also highly effeminate, and probably homosexual or bisexual. He never married, and his sexuality posed problems for him his entire life. I read up on him some time before reading Fitzgerald's assessment, and did not see any reason to see him as autistic. Creative, yes. Unusual, yes. Isolated, yes. But not autistic. To me there was something missing, or rather, something not missing, that I would have needed to see, to see him as autistic.
Here are some of the comments Fitzgerald (2005) makes about him:
"He had a kind of autistic restlessness." [Fitzgerald 2005: 37]
As opposed to what other kind of restlessness?
"Was it an autistic imagination, like that of W.B. Yeats?" [Fitzgerald 2005: 38]
Didn't know there were other kinds of imagination, either.
"There is an autistic directness about his fairytales." [Fitzgerald 2005: 39]
Well, yes, his writing is direct, suitable for children. Fairy tales are usually like that. Autistic people can be direct, but not all direct people are autistic.
"He showed by the extent of his travels that he was a man of courage -- courage is a very common feature of persons with ASD." [Fitzgerald 2005: 43]
Well, I think so, too, but non-autistic people often travel, too, and can also be courageous, so travel and courage are hardly diagnostic.
"His autistic compulsiveness was shown in the way that he repeatedly told his life story. He also had the autistic persistence that often leads to success in highly talented persons. One of his rituals was to go to the theatre every night.
In 1827 he became obsessed with the Collin family; he held an autistic-like obsession with them for the rest of his life." [Fitzgerald 2005: 43]
Andersen was probably in love with Edvard Collin. I'd like to go to the theatre more often, though every day might be a bit much. I don't know about all the autobiographies.
"When he was a child, his mother noticed his fastidiousness in cutting clothes for his puppets. This appears to have been a rather autistic kind of activity, not unlike the paper cut-outs that he later indulged in, particularly at parties." [Fitzgerald 2005: 44]
His paper cut-outs were brilliant. If I concentrate hard, I can sometimes make snowflakes. I'm told they have competitions for this sort of thing.
"Nonetheless, as is common with persons with Asperger's syndrome, his self-esteem was fragile and easily crushed by people around him." [Fitzgerald 2005: 46]
Lots of other people have fragile self-esteem, too.
"Wullschlager has noted that he had 'a manic sense of self-grandiose ideas about fortune and nobility, interleaved with a fear of madness and rejection'. This kind of grandiosity is not uncommon in persons with Asperger's syndrome." [Fitzgerald 2005: 46]
And in other insecure people too?
"Anderson wrote in a letter in 1832: 'I am a peculiar being! . . . I can never enjoy the present, my life is in the past and in the future, and there is in reality too little for a real man. I have been in bad, very bad spirits.' His description of himself as peculiar is classically autistic." [Fitzgerald 2005: 47]
You don't have to be autistic to be peculiar, or to think you are peculiar, do you?
It seems that everything that make Andersen unique is attributable to autism, since Fitzgerald has already decided that Andersen was autistic: "Andersen was autistic, and Andersen was x, therefore x is an attribute of autism."
"Persons with Asperger's syndrome probably have a child's perspective, and because of their major difficulties with a sense of identity and a sense of self have enormous problems in their search for a sense of meaning to their life." [Fitzgerald 2005: 47]
And here I thought our mental processes were a mystery! I think this comment is a major stretch even if applied to a formally diagnosed individual.
"All his life, Andersen had homoerotic longings and obsessions with individual men. . . . He also had desires for women, but probably less intense than his desires for men. . . .
This sexual ambiguity is possibly a characteristic of Asperger's syndrome." [Fitzgerald 2005: 47]
And here I thought he was gay. Or bi. Or something.
"Even at an early stage his identity diffusion was clear, and was seen partly in his effeminacy and love of dressing up. One might say that he operated through a false self and had very little sense of a real self or core self." [Fitzgerald 2005: 48]
Gay, and effeminate. Remember, he made his puppets clothes, too.
"Around the age of 25 Andersen was experiencing the 'continuing loneliness of the rootless young man in the city uncertain how to make emotional connections, and aware of an attraction to certain male friends which none reciprocated with equal intensity'. Here he is showing the social relationship difficulties of autism." [Fitzgerald 2005: 40]
Or homosexuality pre 1990's.
Now we get to his writing:
" 'The Ugly Duckling' may represent Andersen with his Asperger's syndrome: he wishes that he could look in the water and become or a swan or something different, i.e. a non-autistic person." [Fitzgerald 2005: 40]
Most people don't take the story this way. Who knows what he was thinking? Maybe he just wished he could afford to move to Paris.
"Possible this [The Little Mermaid] was his most successful fairytale because it described so accurately the position of a person with autism cut off from the non-autistic human world. . . . The mermaid was an autistic mermaid." [Fitzgerald 2005: 41]
Well, I think he's describing alienation in a more general sense, but it could include autism, and homosexuality, and . . .
"One wonders whether the six mermaids at the bottom of the sea in 'The Little Mermaid' had autistic voices -- 'they had lovely voices, more beautiful than human beings'." [Fitzgerald 2005: 43]
I'm autistic. How come I can't sing like that?
"From the evidence presented above, it seems very likely that Andersen did in fact have Asperger's syndrome.' [Fitzgerald 2005: 49]
None of these arguments convince me, and some of them make me laugh. (I chose Andersen partly because some of the comments are so funny. Though Fitzgerald is serious, and he is trying to help. So don't laugh too much.)
It should be noted that Andersen was isolated and weird. However, it should also be noted that he was stuck in Copenhagen while his artistic peers were off in Vienna and Paris hobnobbing with each other. He did visit these cities, where he was made welcome, but he couldn't afford to live there, because there was no international copyright back then, so he only got paid for his Denmark sales, and relied on a pension (a government arts grant) from the king of Denmark to make ends meet, which meant he had to live in Denmark. Had he been able to life in Paris or Vienna full time, it is possible his shyness and social awkwardness might have worn off, and he might have taken to this social environment like a duck (or swan?) to water. But since he wasn't able to live there, we'll never know.
It is unfortunate that Fitzgerald's arguments are so weak. It is actually possible that some of the people he describes really were autistic (though not, in my opinion, any of the ones I am already familiar with, including Einstein, Warhol, and Andersen), but I couldn't tell from his descriptions. What I would like to see is a description of a degree of isolation that significantly impairs work or personal life or both (like the one provided by Oliver Sacks for Henry Cavendish - Sacks, 2002), not otherwise explainable, as Andersen's was by lack of funds. Not just isolation in childhood, when the person has no one who shares his or her interests or who is not on the same level intellectually, but also in adulthood, when there is a peer group to interact with, but still little or no interaction with peers, especially if the person wants to interact, but can't get it to work right. What I'd also like to see is a description not distracted by the kind of unconventionality common in high functioning eccentrics who are just weird people having a good time, and are not autistic, the way Fitzgerald's descriptions of Andersen and others get. If it's not diagnostic, leave it out.
We really could use some really solid role models from the past, to build up an accurate picture of what autism looks like from the outside, from a good distance away. It is unrealistic to expect society to accommodate us when they can't even tell what we are like. I would encourage anyone wanting to describe a historical figure as possibly autistic to go for it, but please, be more careful in your arguments.
References:
Fitzgerald, Michael, 2004. Autism and creativity: Is there a link between autism in men and exceptional ability? Brunner-Routledge, Hove and New York
Fitzgerald, Michael, 2005. The genesis of artistic creativity: Asperger's Syndrome and the arts. Jessica Kingsley Publishers, London and Philadelphia.
Sacks, Oliver, 1995. An anthropologist on Mars: Seven paradoxical tales. Alfred A. Knopf, NY.
Sacks, Oliver, 2002. Henry Cavendish: An early case of Asperger's syndrome? Neurological Foundation of New Zealand (Reprinted with permission from the American Neurological Association). Retrieved from http://www.neurological.org.nz/html/article.php?documentCode=26 on June 29, 2008.
Webb, James T., Edward R. Amend, Nadia E. Webb, Jean Goerss, Paul Beljan, and F. Richard Olenchak, 2005. Misdiagnosis and dual diagnoses of gifted children and adults. Great Potential Press, Inc. Scottsdale Arizona
Anemone Cerridwen
June 29, 2008
(Comments)
Critique of The Essential Difference
posted at 07:04 pm on 06-27-2008
The book:
The Essential Difference: The truth about the male and female brain, by Simon Baron-Cohen (2003). Basic Books, NY.
Baron-Cohen proposes that there are biological differences in male and female brains, leading to average differences in personality and cognition. Fair enough. There's a lot of research on that (e.g. Halpern, 2000; Kimura, 1999). Females on average tend to have better language skills while males tend to have higher visual-spatial skills, although females do better on memory for spatial location and males do better on verbal analogies (Halpern, 2000).
Instead of building on this research, however, Baron-Cohen describes the typical male brain as being hard-wired for systems and the female brain for empathy:
"The female brain is predominantly hard-wired for empathy. The male brain is predominantly hard-wired for understanding and building systems." [p.1]
This is where things start to get problematic. Baron-Cohen names the two brain types male vs female or systemizing vs empathizing. He defines empathizing as:
"Empathizing is the drive to identify another person's emotions and thoughts, and to respond to them with an appropriate emotion. Empathizing does not entail just the cold calculation of what someone else thinks and feels (or what is sometimes called mind reading). Psychopaths can do that much. Empathizing occurs when we feel an appropriate emotional reaction, an emotion triggered by the other person's emotion, and it is done in order to understand another person, to predict their behavior, and to connect or resonate with them emotionally." [p.2]
and systemizing as:
"Systemizing is the drive to analyze, explore, and construct a system. The systemizer intuitively figures out how things work, or extracts the underlying rules that govern the behaviour of a system. This is done in order to understand and predict the system, or to invent a new one." [p.3]
This sounds suspiciously like "men think and women feel", rather than "men are good at thinking in some ways and women in others". Fortunately for Baron-Cohen, his description of empathizing sounds more like relationship skills in general, and the ability to read nonverbal communication (something women are relatively good at - Halpern, 2000) and to communicate well, not just a tendency to react empathically to others. Similarly, he seems to be including spatial skills (also known to be higher in males than in females, though, among males, higher in less masculine males than in more masculine males - Halpern, 2000) and a fondness for technology in the concept of systemizing. Whether his two categories correspond to or correlate with the cognitive abilities males and females are already known to excel at is not clear. A quick glance suggests that "systemizing" is probably closer to visual-spatial skills than "empathizing" is to language skills.
At this point I should point out that neither of the scales Baron-Cohen is using to measure these concepts has been put through a factor analysis or external validation to see if they in fact measure what they are supposed to or not. The best test would be to combine the two scales and see if a combined factor analysis indicates that there are two main concepts here, and the two he claims to be measuring, rather than more than two, or one big one and a bunch of smaller ones, or whatever. In addition, external validation of the two scales to see if their scores correlate with other scales that measure the same or similar concepts would also ensure that the scales measure what they say they do. This process would probably help considerably in making sure the basic concept is clearly defined and stated.
Back to the main idea. While Baron-Cohen talks about systemizing versus empathizing, I think it would be more accurate to say that what he is saying is that men are, on average, more interested in and better at technology (things), and women are, on average, more interested in and better at relationships (people), and that this is a biologically based, lifelong tendency.
I have no quarrel with the men-like-technology/women-like-relationships dichotomy. It is not as sophisticated as the research on sex differences in cognition that is already out there, but it may still be a useful model (depending on the use it's put to). The problem I have here is what he calls it. First of all, calling it male and female (and not even "male" and "female") reinforces simplistic dichotomies, and is unfair to those who are atypical for their sex. Yes, he says in the text that these are average differences, not absolute ones. But the labels speak pretty loudly, too, and they suggest more absolute differences.
Second, when he doesn't call them male and female, he calls them systemizing and empathizing. While these labels allow men and women to be either or both, and are thus more accurate, I don't think these are accurate labels, either, as explained above.
An example from a description of a mathematician with Asperger Syndrome:
"Here was a man who could fathom any mathematical problem you could throw at him, but who was unable to work out the basics of friendship or how to have a phone conversation. Was there every a more dramatic example of dissociation between empathizing and systemizing?" [p.158]
It is hard for me to see how being able to have a phone conversation or not is related to empathy as people would normally define it. (More on that when I dissect the Empathy Quotient scale in another critique.) I think Baron-Cohen would be better off using the terms technology and relationships. And actually, this particular example points even more closely to known sex differences in cognition (visual-spatial versus language skills) than the rest of his discussion so far.
The main problem with Baron-Cohen's model of "male" versus "female" minds, and probably the main reason for it in the first place, is that he seems to be using autistic minds as the basis for his theory. It is true that unusual minds can point researchers to fundamental rules of brain and mind organization. For example, the existence of savant abilities (found in both autistic and non-autistic individuals, with both below normal and normal intelligence, but most obvious in individuals with below normal intelligence) indicates that there are distinct modules of ability (e.g. mathematical, musical) that are independent of general intelligence. So if autistic people had unusual abilities or lack of abilities, it would make sense to study these to see if they have something to say about minds and brains in general.
However, very little is known about what autism actually is, and stereotypes of the technologically-minded autist with little or no empathy may not be particularly accurate in the first place. As it is, right now males are diagnosed with autism far more often than females, and while it may well be true that autism is more common in males than females, it is also possible at the same time that females are underdiagnosed relative to males. This happened with respect to ADHD. At one time the stereotype of ADHD was more masculine than it was now, with an emphasis on hyperactivity. Then researchers noticed that there were many females with an inattentive form of attention disorder. Now there are still more males than females diagnosed with ADHD, but the ratio is much less extreme than before, and in the meantime the diagnostic criteria have been adjusted to take into account that ADHD often looks different in females.
If you assume that autistic people have "male" brains, then you will disproportionately diagnose people who fit the male-brain stereotype, mostly males and females who are less girly. Then when you study this population, you will find that they do in fact have "male" brains. Of course they do - that's how they were selected in the first place. It is probable that autistic girls and women do not fit the stereotype as well as boys and men do, and are being underdiagnosed. In another ten or twenty years, the face of autism may change as more girls and women (and "atypical" males) are diagnosed, and the stereotype may no longer hold true.
Even when we have a more accurate picture of what autism is, and what it looks like, we may not learn much more about major brain "types", since it's actually possible that autism has little or nothing to do with personality or cognitive domains. Given how very little is known about autism, especially in adults, people need to be careful just how much they assume at this point. I don't even know if anyone has checked to see how autistic people do on standardized visual-spatial and verbal-language tests to see how they compare with average populations. If autistic people generally do well on visual-spatial tasks, that's interesting, and suggests right hemisphere dominance. If they also do relatively poorly at verbal-language tasks, but no worse than the average male, that's also interesting, but not that exciting. If autistic people show specific verbal or language deficits on standard tests, that would be different. I'd get excited about that.
I would recommend that Baron-Cohen do a rigourous analysis of his Systemizing and Empathizing Quotients to see what in fact they are measuring, and how closely they are related to already known sex differences in cognition. He will have to make a very strong case to establish that his systemizing and empathizing are distinct from existing visual-spatial and language abilities, and that they add something significant to the body of information on sex differences that is already available. So far he hasn't done that.
Anemone Cerridwen
June 27, 2008
References:
Simon Baron-Cohen (2003). The essential difference: The truth about the male and female brain. Basic Books, NY.
Halpern, Diane, 2000. Sex differences in cognitive abilities. Third edition. Lawrence Erlbaum Associates, Mahwah, New Jersey.
Kimura, Doreen, 1999. Sex and cognition. MIT Press, Cambridge, MA.
(Comments)
The Friendship Questionnaire (FQ): A critique
posted at 01:06 pm on 06-21-2008
(also posted on my website)
The study:
Simon Baron-Cohen and Sally Wheelwright, 2003. The Friendship Questionnaire: An Investigation of Adults with Asperger Syndrome or High-Functioning Autism, and Normal Sex Differences. Journal of Autism and Developmental Disorders, Vol. 33, No. 5, October 2003.
This study does two things:
1. It provides a friendship questionnaire (FQ) with items based on what is written in the literature on male and female styles of friendship.
"An individual scores highly on the FQ if they report enjoying close, empathic supportive friendships; liking and being interested in people; enjoying interaction with others for its own sake; and finding friendships important." [page 510]
Females score higher than males. Mean score for males was 70.3; mean score for females 90.0. The score range is 0 to 135.
2. It compares the scores of autistic subjects to non-autistic subjects, in order to test the assumption that autistic people have extreme male brains (the extreme male brain (EMB) theory). The mean score for autistic males was 53.2; for females it was 59.8.
This study assumes
1. that you can place male and female friendship styles on a single linear axis and rate them as higher or lower in friendship, and that higher scores indicate a more feminine brain, and
2. if autistic people get lower scores, then they have more masculine brains.
First of all, putting male and female friendship styles on a single linear axis and ranking them on "friendship" sounds pretty sexist to me. The authors state:
"It is important to stress that the FQ has been designed to be neutral in terms of the value placed on the "male" and "female" style of friendships. That is, the wording is carefully chosen to indicate that individuals might value or prefer different things in relationships (e.g., confiding vs. shared activities), and that one preference is not better or worse than another--just different. As such, a particular score on the FQ is not indicative of any need for intervention, per se."
However, they do assign more points to the female style than to the male style, so it's hard to take their argument that they do not consider one style better than the other seriously. The general point of the literature on male-female differences is that the two sexes have two different styles, not that one sex or the other has more friends or a better style of friendship. Relationships may be more important overall to woman than men, and women may put more time and energy into them than men, but that doesn't mean you can compare relationship styles to give individual people a "friendship" ranking, or consider women to have higher "friendship-ness". It may well be suitable to consider the amount of time and energy people spend on their friendships, as well as whether the friendships are accomplishing what people want them to, but the style of friendship should surely be irrelevant?
If the Friendship Questionnaire is going to work for me, I'd want to see all items that score a person on their style of friendship removed, in order to avoid sexist bias. Alternately, if the difference in male and female styles is important, then have two scales, one for each style, to see how much a person leans in one way or the other. That might say something about the underlying personality of the person. I'd also want to remove all items that discriminate on the basis of ability (e.g. phone versus email for people with information processing issues), rather than preference, since ability and preference are two different things. Furthermore, a scale is not a scale in my book until it's been through a factor analysis or three. How do the authors know the items measure what they say they do? You can't tell by looking. For example, the authors seem to assume that whether people prefer enjoy an open office plan or a private office, with or without conversation, has something to do with friendship. But it may actually have more to do with ability to concentrate in each setting. The only way to tell if this is about friendship or not is to see which other items this item clusters with in a factor analysis. And if it turns out that male and female styles of friendship really do belong on a single scale, this should show up in the factor analysis as well.
In addition, I might suggest that 27 males and 49 females really aren't enough subjects to properly validate a questionnaire.
Second of all, even if this FQ were relevant, low scores for autistic subjects do not necessarily mean autistic people are lower in "friendship-ness". The scale may be measuring different things in autistic people than in non-autistic people. For example, autistic people typically have sensory issues, have difficulty following conversations, and have difficulty making friends. This probably affects their style of friendship when they do have friends, but not the importance of friendship. And even if the autistic friendship style resembles the typical male style more than the typical female style, it may be for different reasons (e.g. ability rather than preference). Additionally, the number of friends autistic people have may in no way reflect their interest in friendship, since autism may make people unable to make friends and socialize as much as they want to. There is a big difference between voluntary solitude and involuntary solitude.
It may well be fascinating to compare the autistic friendship style (if there is one) with that of typical men and women, but comparisons should be made with caution, since what is on the surface may not reflect what is underneath very well.
And in addition, I would like to point out (as I am going to do with pretty much any critique I write that discusses sex differences) that it is possible that autistic females are underdiagnosed compared to males, precisely because they do not conform to male autistic stereotypes. (This happened with ADHD in the beginning and has since been corrected.) So all theories that consider autistic people to be more "masculine" in any way should be taken with a large grain of salt. At least for the next decade or two.
For the record, I'm autistic and female, and I scored 96.
Anemone Cerridwen
June 20, 2008
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