Saturday, March 31, 2012

Autism is mind blindness


The young couple first approached a physician practicing in Indian system of medicine (Ayurveda) and then a Homeopath for the remedy of their only male child’s abnormality in behaviour. Both the Ayurvedic physician and the Homeopath assured the young couple a ‘complete cure’ from the curious malady of their son. But treatment which lasted for many months in both the systems failed and there was no relent in the devastating symptoms of the child. Finally they decided to seek the opinion of modern medicine and they approached a pediatrician who advised them to seek the help of a psychiatrist.
The young couple described the peculiarities of their son. Till the third birth day they did not notice any abnormality in the child. The first thing they noticed about their son is that he doesn’t like people to hold him or touch him. He often doesn’t respond when they call him. Even when they move their hand in front of his face he doesn’t respond. They had to pick him up to get his attention. His speech also is defective. The parents couldn’t often follow what he was saying. He repeats whatever he heard as echo but he doesn’t know the sense of many words he repeated. He could not follow their instructions like sit, come here, stand up etc. The most distressing behaviour was his avoiding of looking into their eyes. Evidently their son was suffering from autism. There was no medicine to cure the devastating disorder. Only special training, care and attention would improve the condition of the child. I explained the various aspects of autism to them.
Autism is a pervasive developmental disorder. It was discovered independently by two physicians, Leo Kanner in Baltimore and Hans Asperger in Vienna, in the 1940s. Both doctor had any knowledge of the other, and yet by a strange coincidence they gave the malady the same name: autism. The term was derived from the Greek autos which means self. They gave this name because the main feature of the disorder is confining to self withdrawing from the outside world.
The symptoms of the disorder can be categorized into two groups. The first group of symptoms pertains to the cognition of the child and its relationship with the outside world. Mental aloneness and lack of contact with the world, particularly the social world, as well as a profound inability to engage in normal conversation are the hallmark of this disorder. Going hand in hand with this is an absence of empathy for other which means a failure to understand others’ feelings and emotions. 
The second cluster of symptoms pertains to the sensory and muscular systems of the child. The autistic children find specific sensory stimuli highly distressing. Certain sound, for example, can set off a violent temper tantrum. There is also a fear of novelty and change and an obsessive insistence on sameness, routine, and monotony. The symptoms of motor system include to-and-fro rocking of the body, repetitive hand movements including flapping motions and self-slapping, and sometimes elaborate, and repetitive rituals. These symptoms are not quite as definitive or as devastating as the social-emotional ones, but they occur so frequently that must be connected somehow.
Mind Reading and Mind Blindness
Uta Frith
Uta Frith, leading developmental psychologist working at the Institute of Cognitive Neuroscience at University College, London put forward for the first time the cognitive theory of autism. She wrote: “Individuals with autistic disorder have occasionally commented on what they perceive as an unfathomable yet ubiquitous ability of other people to “mind read” during ordinary social interactions. Normal people indeed behave as if they have an implicit theory of mind, and this allows them to explain and predict others' behavior in terms of their presumed thoughts and feelings. To give an example: you might observe me in my office bent over a filing cabinet drawer pulling out and putting back folders. You would make sense of this behavior by mentalizing, that is, automatically recognizing that I am looking for a paper that I believe is in one of the folders and that I wish to retrieve. You would think this even if you knew that the paper was not there. To explain my behavior, it is immaterial whether the missing file is in the cabinet or really somewhere else. Suppose that you say to me “Try Debbie's desk,” and I respond with “I might have known.” Without mentalizing, this everyday exchange would seem like complete non sequiturs. Further, without mentalizing, you might come up with an outlandish interpretation of what I was doing—perhaps practicing back bending and finger moving? The important point of the example is that for an instantaneous interpretation of ordinary behavior, we automatically take account of the mental state of people, their desires, and their beliefs.” Neuron Vol. 32, no. 6, 12/20/01 pp 969-979. The difficulty in mind reading would result a condition called mind blindness which is main characteristic of autism.

Mirror neurons and mind reading
In the 1980s and 1990s, neuro scientists Giacomo Rizzolatti, Giuseppe Di Pellegrino, Luciano Fadiga, Leonardo Fogassi, and Vittorio Gallese working at the University of Pama, Italy discovered mirror neurons. They found that some of the neurons controlling the movements of muscles of hands responded when the monkey observed another monkey moving hands without moving its own hands. They called these neurons mirror neurons because they acted like mirroring other monkey’s actions. Further studies confirmed that about 10% of neurons in the lower parts of the frontal and parietal lobes of the monkey’s brain have “mirror” properties. A mirror neuron is the nerve cell that fires or becomes live both when an animal acts and when the animal observes the same action performed by another. Thus the neuron mirrors the behaviour of the other, as though the observer were itself acting. Such neurons were observed in various species of animals such as primates and bird.
V S Ramachandran
According the cognitive neuroscientist Vilayanur S Ramachandran, the mind reading ability derives from the mirror neurons situated in the various parts cerebral cortex. Ramachandran writes: “The clue comes from mirror neurons. In the late 1990 it occurred to my colleagues and me that these neurons provided precisely the candidate neural mechanism we were looking for. The discovery of mirror neurons was significant because they are essentially a network of mind-reading cells with the brain. We were struck by the fact that it is precisely these presume functions of mirror neurons—such as empathy, intention-reading, mimicry, pretend play, and language learning—that are dysfunctional in autism.”  The Tell Tale Brain pp 139,140

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