WHAT IS AUTISM – The SCS Philosophy

© David Sponder, L.E.P., BCBA, RDI CC, Floortime C2 Certified
Executive Director Sponderworks Children’s Services

Autism represents a difference from typical developmental pathways that starts with neurological bases, and then takes on cascading effects in other areas of development (it “pervades development or has “pervasive effects on life and development” – hence it is a Pervasive Developmental Disorder).   Autism especially affects those areas of development and function that involve emotional and social understanding and communication.   This is a merely an outline to help you understand the basic nature of Pervasive Developmental Disorders (PDDs).

PDDs are characterized primarily by a failure of the brain to integrate various different functions that it carries out

PDDs begin with neurological factors that affect development.  We take a Developmental Psychopathology perspective in our understanding of what Autism and related disorders are and what treatment options are appropriate and available.  That is, we look at typical development and examine the individual differences in development occurring within the individual with whom we are concerned.  These differences are always unique.  There is extreme heterogeneity among individuals that share PDD and Autism Spectrum Disorder diagnoses.  This is why many people say, “If you’ve met one person with autism – you’ve met one person with autism.”

Factors Affecting Typical Development

In order to grow and develop along a typical path, children must feel internally secure.  They must be free from overwhelming or
persistent pain, illness, fear, or worry, and they must be able to trust their senses.  A child/Student preoccupied with coping with stress will not be able to bond, focus, and explore properly.  Over time, this will result in cascading, negative and distorting effects on neurological and biological development.   Stanley Greenspan’s Stages of Development help us understand both how the foundations of typical emotional, cognitive and communication development work together and how failure to master early developmental stages can lead to cascading effects on later development.

Development proceeds through maturation of individual brain modules (circuits of neurons that perform single functions), and the gradual connection and synchronization of these modules across the brain.   Here are some examples of how specific brain modules can be:

Individual and separate brain modules (circuits of neurons or “neuronal assemblies”) that recognize the phonemes “k” “a” “t”
Neuronal assemblies that assemble these sounds “cat”
Neuronal assemblies that simply stores the word definition “cat”
Neuronal assemblies that stores a visual image of a cat
Neuronal assemblies that form representations of other things one knows or feels about cats
Neuronal assemblies that recognize the word “cat”
Neuronal assemblies that connect to other meanings of the word (a lion, panther, a leopard are also cats; A “cat” as a Jazz musician…)

In actuality, these modules are probably even more specific.  For instance, the visual image of a cat is made up of smaller circuits
that conjure the color, shape, movement, or other features of the cat.  Therefore, with integration of the above neuronal assemblies (brain modules), when the word “cat” is heard, connections are made across the brain to form an integrated and holistic concept of a cat.  The simplest of concepts may involve hundreds of thousands of these circuits.  An abstract concept such as “fairness” involves extremely complex and multiply layered integration of mini-circuits across the brain.

Development proceeds towards integration of individual modules into complex and multiply layered mega-modules that must function in coordinated and synchronous ways.

Early infant development is characterized by simple formation of hundreds of millions of these individual modules.  As it proceeds, modules become interconnected across the brain into more holistic perceptions, and ultimately – conceptions and abstractions.

If these modules cannot work together, simple perceptions can be impaired, resulting in pixilated, unintegrated sensations that cannot be trusted or integrated into larger circuits.  This has an arresting and cascading effect on development.

Article: Neural Coherence: Crossmodal binding through neural coherence: implications for multisensory processing
Article: Autism as a Complex Information Processing Disorder: A Neurocognitive Model
Article: Autism, Context/Noncontext Information Processing, and Atypical Development
Article: Autism and the Cerebellum: A Neurophysiological Basis for Intervention
Article: Autism and Nonverbal IQ: A “Systems Perspective” from “Noticing” to Reading other People’s Minds

PDDs as “Neurogenic” Attachment Disorders

Attachment is the most essential process involved in fostering development of the brain, and it is especially involved in the process of brain integration. 

The process of attachment and bonding is a two-way street.   In a “conventional” attachment disorder, the failure of the environment to provide consistent, responsive, and empathic care is what arrests development.

In a PDD, it is the infant’s inability to participate normally in this process that arrests development.  THE POINT IS, THE EFFECT IS SIMILAR IN MANY WAYS.

This is a fresh perspective on developmental disorders, including those not typically associated with PDDs, such as attachment and conduct disorders (really the same thing).  Both result in similar, uneven patterns of development. Symptoms such as sensory integration dysfunction, failure to develop a theory of mind (and later on empathy), emotional dysregulation (i.e. affect, arousal, etc.) and executive dysregulation (i.e. attention, sequential thinking and movement, impulse control, etc.), as well as similar forms of cognitive and language dysfunction.

How PDDs affect Trust

Trust in the world comes from feeling safe within it.  A primary attachment figure (a single person who is biologically and emotionally equipped to meet the child/Student’s basic survival and emotional needs – mothers the vast majority of the time) engages the Student to help her maintain positive and secure emotional states

How PDDs affect Exploration

Remember Greenspan’s Stage I: “Calmness and Interest in the World.”  Preoccupations with pain, illness, impinging or painful sensory input, inability to process information, inability to control motor reflexes and responses, etc., interfere with the natural attachment/bonding process so necessary for normal development.  A child/Student preoccupied with overwhelming or distorted sensations cannot develop normal stress coping mechanisms, and cannot establish the most basic foundations of learning (abilitie to make sense of sensory information; abilities to regulate arousal, attention, emotion, movement; coordination of basic motor reflexes and sequential movement, etc.).

How PDDs affect Emotional, Mood and Behavioral Regulation

The brain is primarily an adaptive organ, which controls the regulation of all body systems.  Chronic stress from illness, pain, or abnormal sensory experience can lead the brain to adapt to chronic anxiety states.  In other words, chronic stress often leads to a maladaptive stress-coping process based on anxiety, fears, habitual and/or irrational responses, etc.  Neural pathways that form to deal with these chronic states, especially if they were formed early in life can have permanent effects, leading to a baseline anxiety states.

IMPORTANT CONTRIBUTORS TO SPONDERWORKS UNDERSTANDING OF AUTISM AND PHILOSOPHY OF INTERVENTION

We believe that to intervene in autism requires an understanding of typical development and the mechanisms of deviation that result in the atypical developmental track that the diagnosis represents.  Interestingly, behaviorists and the ABA establishment has never proposed a theory of autism and still does not have one.  They look at autism as a series of skills deficits (no argument here) and believe intervention should proceed directly from an inventory of these deficits to teaching skills and changing behaviors.  A big difference in the major Relationship-based Theories and Approaches described below is that they work from a theory of autism and then seek to intervene at the level of the mechanisms of deviation.  This approach has the potential not only to change skills and behaviors, but the trajectory of development itself, which we believe has more power and internal consistency than a scattered approach, or a curriculum of teaching focused on treating surface symptoms (e.g. Discrete Trial Training; Verbal Behavior)

Contributions to the Understanding of Autism from Greenspan

The late Stanley Greenspan, M.D. was a Child Psychoanalyst and a giant in the field of Infant Mental Health.  He published 38 books and saturates the peer-reviewed literature not only in the field of Infant Mental Health, but also in the fields of Autism and Autism Intervention, Psychiatric Disorders in Children, Neuroscience and Evolutionary Psychology. His approach to the understanding of Autism is consistent with the Developmental Psychopathology approach that Sponderworks takes.

Greenspan’s model of autism (which he labeled the Developmental, Individual Difference and Relationship-Based or “DIR” model) emphasizes the “cascading effects” and mechanisms of deviation from typical tracks of development and the mechanisms that cause the deviation into atypical patterns of development exemplified in the science of developmental psychopathology.  DIR refers to the theoretical basis of the intervention for autism which he and Serena Wieder developed called “Floortime.”

Greenspan describes the cascading effects as “affect diathesis.”  The term “affect” in psychology refers to one’s intentions, feelings and desires, as well as the outward displays of these processes, especially in facial expression, postural and gestural , and other forms of nonverbal as well as verbal behavior.

“Diathesis” has to do with the cascading effects or “spread” among developmental domains, based on the interaction between innate, genetic vulnerabilities and environmental, particularly stressful events (what I refer to as “preoccupations” with defending one’s self against).  Affect diathesis stress is the mechanism of deviation from typical to atypical development.

The affect diathesis hypothesis suggests that affect invests not simply the capacity for complex interactions to give meaning to sounds, words, and behaviors, but also invests processing capacities, such as motor planning and visual spatial processing.  It gives meaning and functional range to these capacities. Individuals can then use different processing capacities in a variety of ways—not just to solve an equation, but also for social, personal problem-solving (e.g., figuring out how to work the crowd politically).

Stanley Greenspan, M.D. 2001

Greenspan’s Core Deficits

While it is difficult to summarize briefly Greenspan’s model of the core deficits of autism, he starts with a very primary concept, common to all individuals that have “disorders of relating and communicating” – ‘the ability to connect affect or intent to motor planning capacities and emerging symbols.’  He refers to this as the “Affect Diathesis Model” of Autism.  Here are some defining quotes (I will never write better than Dr. Greenspan!) from the seminal article from the Special Edition of the Journal of Developmental and Learning Disorders (2001) – an absolute MUST READ for any professional seeking to understand what
autism is and the implications of this understanding for autism intervention.

In clinical work with infants and children with biological and environmental challenges and without challenges, we have found that the capacities for empathy, psychological mindedness, abstract thinking, social problem-solving, functional language, and affective reciprocity all stem from the infant’s ability to connect affect or intent to motor planning capacities and emerging symbols …

the infant needs to have an emotional desire or wish (i.e., intent or affective interest) that indicates what he wants. The infant then needs to connect his desire or affective interest to an action plan (i.e., a plan to get his toy). The direction-giving affects and the action plan together enable the child to create a pattern of meaningful, social, problem-solving interactions. Without this connection between affect and action plans, complex interactive problem-solving patterns are not possible.   Action plans without
affective direction or meaning tend to become repetitive (perseverative), aimless, or self-stimulatory, which is what is observed when there is a deficit in this core capacity
.

…Relative deficits in this core capacity leads to problems in higher-level emotional and intellectual processes. The core psychological deficit in autism may, therefore, involve an inability to connect affect (i.e., intent)
to motor planning and sequencing capacities and symbol formation.

A child’s capacity to connect affect to motor planning and emerging symbols becomes relatively apparent between 9 and 18 months of age as the infant shifts from simple patterns of engagement and reciprocity to complex chains of affective reciprocity that involve problem-solving interactions

As the ability to form symbols emerges, the child needs to connect her inner affects (intent) to symbols to create meaningful ideas, such as those involved in functional language, imagination, and creative and logical thought. The meaningful use of symbols usually emerges from earlier and continuing meaningful (affect-mediated) problem-solving interactions that enable a toddler to understand the patterns in her world and eventually use symbols to convey these patterns in thought and dialogue. Without affective connections, symbols like action plans are used in a repetitive (perseverative) manner (e.g., scripting, echolalia).”  (Greenspan et al; 2001)

In collaboration with other researchers for the National Institutes of Mental Health, Greenspan identified 6 primary stages of
developmental capacities in typical development and ways to remediate through the use of the method – Floortime.   He calls the progression through these stages “transformations.”  The following is a brief description of these six transformation (here again, the best thing to do is simply to quote Greenspan… (Note: In the 2001 article, Greenspan doesn’t name the Stages or “transformations,” although they certainly existed under those names at the time.  I have included the names here.  Everything else is Greenspan’s words from the article)

  • Being Calm and Interested in All the Sensations of the World (Homeostasis):  “…to attend to the outside world, and eventually to have joint attention or shared attention, requires affective interest in the world outside one’s own body—in sights, sounds, and movements.  …An early and continuing component of shared attention involves attending to the world outside one’s own body with rhythmic, affectively-mediated perceptual motor patterns.

    …Soon they begin integrating what they hear and see.   By four to five months, one can readily observe synchronous movement in rhythm with mother’s affective communication via her voice, facial expressions, or body movements.   As development proceeds, reciprocal gestural, vocal, and verbal communication generally occurs in an interactive rhythm.

  • Falling in Love:  …The second functional developmental capacity is engagement.   For an infant to engage with a caregiver requires joy and pleasure in that relationship. When that’s not present, children can withdraw and become self-absorbed. For children who have processing problems, it may be much harder to pull them into that joyful relationship.

  • Becoming an Intentional Two-Way Communicator:  …The third functional developmental capacity is two-way purposeful communication.  Two-way communication and affective reciprocity obviously requires affect to provide the “intent.”  When an infant reaches for Daddy to take the rattle off his head or hand it back to him, or gets into a back-and-forth smiling game, one clearly sees affect (intent) guiding the interaction (i.e., the infant wants that rattle).  Piaget thought means-ends relationships occurred at nine months with motor behavior (i.e., an infant reaching and pulling a string to ring a bell).  But Piaget missed the role of affect.

    The baby’s affective probe occurs much earlier than the motor probe. Causal affective behavior occurs earlier than causal large muscle motor behavior.   First we see a smile begetting a smile, a frown begetting a frown.  Later on, we see the baby reach for and give back objects. At this stage as well, the affect diathesis is occurring, now transforming relating into two-way, affective communication (rather than just joyful interest in the caregiver).

  • Learning to Interact to Solve problems and Discover a Sense of Self:  The fourth level of transformation occurs between 10 months and 18 months. It involves the development of a range of new capacities, all related to the … ability to engage in longer sequences of affective reciprocal interactions with clear intent or problem-solving goals and the ability to perceive and interact in these larger patterns.  This transformation enables the …[child/Student] to form a more integrated sense of self, integrate affective polarities, social problem-solve, and broaden visual-spatial and auditory processing abilities.

    As indicated earlier, during this stage we often start seeing differences with some of the children who will be diagnosed with autistic spectrum disorders.   Many of the children have relative degrees of mastery of the first three stages, but the fourth stage is more difficult.   Now, the infant has to connect his affect to his motor planning and sequencing, as well as his emerging symbol formation.

    …As a child begins to imitate words (“Mom,” “Dad,” “go,” “door”), those symbols or words have to be invested with affect to have meaning.  The word “juice” only has meaning to the degree the child can invest the words with the many affective experiences that come to mean “juice,” including the pleasure and image of drinking the juice.

    Even grammar, which Chomsky and other linguists have assumed is innate, depends on affect and affective interactions to become functional. Children with autistic spectrum disorders frequently verbalize nouns in a repetitious way (“Door, door.”).  If the intervention can get them affectively interactive, however, they can often learn to use proper grammar. For example, a child is opening and closing a door. We get stuck behind the door. If they push us away, they are becoming purposeful. Purposeful, affectively-mediated behavior creates a foundation for the purposeful and meaningful use of words…The affect, by providing intent, enables the components of language to align (e.g., “open door” versus “door, door, door.”).   Many investigators may have missed the importance of affective reciprocity because it occurs routinely with most infants and toddlers and their caregivers.

    …In this fourth stage, the child is also beginning to integrate affective polarities.   Early on, infants tend to have extreme affect states—all happy or gleeful or all sad— but by 18 to 19 months we see children begin to shift affect states more readily and actually integrate affect states such as happiness and sadness, anger and closeness.  They can be angry and then seem to want forgiveness and make up. When playing with a 13-month-old child, it feels like if he were angry and had a gun, he very well might pull the trigger.  With the 18-month-old, it feels like he integrates his caring and anger. He
    might look mad and feel connected and warm at the same time. One can often feel the quality of these affect states when playing with infants and toddlers at different ages.

    Complex affective patterns emerging during this fourth transformation lead to patterns of affective expectations. A toddler purposefully behaves cooperatively, hams it up and acts funny, or becomes mischievous, all in relation to specific internal states. A child also anticipates what Daddy’s going to do next when he comes home. He looks at his face and if it’s angry, he hides behind the door. If he looks like he’s feeling warm and will be nice, the toddler will run up and flirt with him.  The toddler can anticipate the “other” as well as the “self” in terms of affects and behaviors.  This capacity sets the stage for … ‘theory of mind’ tasks that Simon Baron-Cohen describes.

  • Creating Ideas: At the fifth level, transformations involve the affect system investing ideas.  For example, in pretend play, affects or desires drive the theme (dolls hugging or kissing) as well as functional language (“I’m hungry,” “I’m angry,” “Give me that.” “Look! I want to show you something.”). Functional language, whether it’s on a need basis (Give me juice.”), or at a collaborative “show you this or that,” or sharing opinions

    “I didn’t like that” basis, is very different from simply labeling objects or pictures. Here is also where IQ tests fall down.  IQ tests don’t discriminate well enough between the different uses of ideas and language, such as between pragmatic language or creative and abstract thinking and simply using language to label objects or for rote, memory-based problems.

  • Building Bridges Between Ideas: At the sixth level of transformation, a child builds bridges between affectively meaningful ideas. Establishing reality-testing, a symbolic sense of self, and moving back and forth between fantasy to reality depends on reaching this next level.  For example, critical to establishing reality-testing (which is the basis for later abstract thinking) is an affective “me” intending to do something with an affective “other.”There has to be an interaction involving affect between the “me” and the “other” to establish a psychological boundary (i.e., an affective sense of what’s “me” and an affective sense of what’s “outside me”).  That boundary doesn’t come out of reading books or out of doing puzzles. It comes from interactions involving the exchange of affective gestures and symbols. It comes out of interactions such as “I want this.” “No, you can’t have it,” or “Yes, you can.” In addition, these interactions must be part of a continuous flow of back-and-forth affective gestures.  Islands of affective interactions followed by self-absorption leads to an “in and out” affective probe or rhythm with the external world (reality). A stable sense of reality requires a continuous interactive relationship to the significant “others” in our lives. Abstract and inferential thinking grows from a solid reality boundary.A stable reality boundary also allows empathy to develop. A child can project a “me” into a “you” and figure out how “you’re” feeling to the degree that a child has established a separate sense of “me.”

    In this context, abstract thinking, empathy and theory of mind tasks are extensions of the stage of building bridges between affective ideas.  In addition to affective interactions, the child’s individual differences in processing capacities (i.e., visual-spatial processing, motor planning, auditory processing) will contribute to these advanced mental capacities and they have to be taken into account in considering these capacities.

Contributions to the Understanding of Autism from Gutstein and Sheely

Drs. Steven Gutstein and Rachelle Sheely are the co-authors of the RDI or Relationship Development Intervention approach.  RDI has two components, much like the relationship between DIR (theory/core deficit model) and Floortime (the intervention) described above.  The [latest] RDI Book is one of the best, most accessible and important books on autism there is – another MUST READ.

While these authors don’t bifurcate their writing into separate theoretical bases and intervention components (at least not named as such), they have a very well articulated version of both.  The theoretical basis, like Greenspan, takes a neuroscientific and developmental psychopathology approach, and from that describe a series of core deficits as well (below).  These core deficits are not in contrast to Greenspan’s DIR, they complement it and offer another way to look at the same thing.

Gutstein and Sheely’s theoretical model centers around core deficits of relating that emanate [cascade] from neurological deficits related to neural coherence deficits (as the DIR Model does) and that lead to a breakdown in the “Guided Participation Relationship or ‘GPR’ as they call it.”  Intervention largely represents restoring the GPR, both by helping parents develop proper scaffolding and support techniques, and by facilitating the child’s ability to engage in and benefit from the GPR.

Primary Deficit: Experience Sharing

Even the highest functioning individuals with an Autism Spectrum Disorder (including Asperger’s Syndrome) remain locked in the realm of Instrumental competence (below), limited to acquiring the skills for the sole reason of getting their needs met.

Related Deficit: Intention-Sharing

Borrowing from the work of researchers Andrew Meltzoff (Psychology; Primatology), Alan Fogel (Systems Theory); Michael Tomasello (Neuroscience and Attachment), Alan Sroufe (Emotional Development); Daniel Stern (Infant Mental Health), Peter Hobson (Psychiatry), Barbara Rogoff (Anthropology) and various authors referring to Neural Coherence Theory; Central Coherence Theories of Autism and others, Gutstein and Sheely point to documented deficits in abilities that underlie the ability to fully share experiences with others. (Sponderworks’ theories and methods draw heavily on these sources as well)

Beginning at birth, the human brain contains a mechanism for both observing and executing what others
do.  “Imitation is the bud, and empathy and moral sentiments are the ripened fruit, born from years of interaction with other people already recognized to be ‘like me…’” (Meltzoff, A.N.; 2005)[2]

Meltzoff proposed the following epistemology relative to the development of perspective/ intention sharing:

Table: Meltzoff’s Epistemology for the development of Imitation and Emotion/Intention/Perspective Sharing

Imitation

Intrinsic connection
between observed and executed acts, as manifest by newborn

imitation (Meltzoff &
Moore, 1997).

First-person experience

Infants experience the
regular relationship between their own acts and underlying

mental states.

Understanding Other
Minds

Others who act “like
me” have internal states “like me.”

Aspects of the ability to understand another person’s behavior mature in typical development long before real perspective taking and theory of mind develop.  These abilities have to do with not only being observant of another person’s actions, but of being able to deduce and identify with a person’s intention from watching it.  This ability has been identified as “intention sharing” by primatologists and investigators of human emotional development.[3]  Intention-sharing is defined as…

…the ability to participate with others in collaborative activities with shared goals and intentions: shared intentionality. Participation in such activities requires not only especially powerful forms of intention reading and cultural learning, but also a unique motivation to share psychological states with others and unique forms of cognitive representation for doing so. The result of participating in these activities is species-unique forms of cultural cognition and evolution, enabling everything from the creation and use of linguistic symbols to the construction of social norms and individual beliefs to the establishment of social institutions.[4]

After observing and experimenting with primates and children (neurotypical and with autism), Hobson hypothesized…

  • that individuals with autism have a specific disability in perceiving, responding to, and identifying with the attitudes rather than the actions of other people (e.g., Moore, Hobson, & Lee, 1997); and that they are less likely to ‘pick up’ and imitate another person’s bodily expressions and expressive gestures that are incidental to achieving goals.
  • that as a further manifestation of their limited propensity to identify with other people, individuals with autism fail to move into the psychological position of the other, and therefore fail to adopt the self-orientation of actions.

Researchers have identified three levels of imitation, some of which can develop in individuals with ASD with or without intervention, and some that that typically do not (and can be considered pathognomic to autism):

Emulation

Emulation learning, as it is referred to in primatology refers to imitation that “…in response to a demonstration, apes tend to reproduce the result in the environment (emulation learning) and pay very little attention to the actual intentional actions of the demonstrator.”[5]

Many children with autism can learn to do this – some with training, and some on their own.  Emulation refers to simple
copying of actions.  This type of imitation has been referred to as “blind mimicry.”  The animal or infant simply imitates the actions of the other.  The imitator understands the topographical details of the behavior and the simple goal of the demonstrator, but may miss the stylistic details of the act, and, since the person may not understand the motivation of the demonstrator, may fail to invent new means of accomplishing the same goal.

Imitation

Here, the individual attends to the non-essential details of the act.  These might include the emotional expressions and gestures, the stylistic differences, etc.  Some individuals with autism can perceive these details, but they’re very limited in comparison to neurotypical children.  They have difficulty perceiving whether something was “easy” or “difficult,” “enjoyable” or not, etc. for the demonstrator.  Imitation at this level requires some ability to reference not only the physical actions of the demonstrator, but their attitudes towards the action.

Identification

Identification involves the referencing of the demonstrator’s intentions, rather than just observable aspects of the action like topography and style.  The observer references the goal of the person, and not necessarily just the action.  This allows a perception to develop new means (not demonstrated by action), to accomplish the same goal.

Inability to Manage Uncertainty

This problem stems from very early issues with management of sensory input and motor output.  A typical development of the symptoms leads to a cascade of other developmental events that resulted in the syndrome of autism.

What the authors mean by an “inability to manage uncertainty,” is that there are going to be limits in the Student’s ability to adapt his or her behavior in response to the environment.  They attribute this problem to the failure to acquire skills are necessary to function in fluid and dynamic social situations.

The behavior of people with neuroregulatory disorders tends to be morecircularthan continuous.  That is, behavioral sequences of these children tend to be repeated in behavioral “loops,” rather than being governed by continuous and flexible adaptation to external circumstances.

These loops can be small (e.g., repeatedly spinning an object; opening and closing a door; turning the lights on and off watching a ceiling fan, etc.), which is actually characteristic of the “circular” actions described by Piaget in Sensorimotor Stage III.

Behavioral loops can also be large and complex (e.g. elaborate scripts; elaborate conversational routines [asking questions in which they already know the answer]; perseverative topics and interests, etc.).  Since “thinking” is the internalization of past, present, and future actions (without the actual motor implementation of the “thoughts”), the complex behavioral loops seen in higher functioning individuals are actually patterns of thinking (see Cognitive Fluidity, below).

When other people and/or the environment interpose upon these behavioral loops, the Student’s typical reaction is defensive.
Using a systems theory perspective, the authors describe these loops as “static systems.”  As described below, variations are considered violations in static systems, and the system adapts by reestablishing rules.

Impairment of Cognitive Fluidity

Autism is seen as a cognitive information processing disorder. By describing it in this way, the Gutstein and Sheely point to the neurological deficits that lead to the inability to manage uncertainty.

This is very consistent with the SCS theory of autism as described here, which concerns the integration of multiple and various neural processors.  Integration problems cause a bottleneck in information processing, so instead of being continuous, neural messages tend to loop. 

Deficits in Episodic Memory

This is based on research showing deficits in episodic memory among people with autism.

Episodic Memory refers to the autobiographical account of one’s experiences.  It has a huge role in “thinking about” and recalling events voluntarily (explicit), but also exists on a subconscious level (implicit).

What a person remembers about any event has mainly to do with how the brain’s various systems record events into [unified/amalgamated] perceptions and memories.

Each of us has had the experience of going through an event with another person and then finding out that the other person remembered the event in a much different way than you did.  Some people remember what they saw better than what they heard, and for other people, it could be the other way around.  For some events, the smell or the taste of the event is the most salient feature.  People tend to favor their most efficient memory systems, but emotions usually determine the meaning of events.  Therefore emotions have a large role in what features of the event were the most meaningful.

It is very significant that emotions play the largest role in what aspects of the event were best remembered.  Even though each sensory modality (along with somatic/interoceptive input” is at first initially processed by separate memory systems — there is tremendous feedback between the systems.  Therefore, the relative efficiency of one system over another will also have a role in what the person eventually determines as meaningful.

Tendency to engage in “Instrumental” rather than “Experience Sharing” interactions

“Instrumental social behaviors are a means to achieving an end; they have little to do with the specific person with whom we interact. Experience Sharing on the other hand, has as its focal point, the pleasure derived from specific social encounters as a unique end in itself.  At first glance, the differences appear simple and straightforward.  However, upon closer inspection, distinguishing between these two forms of interaction is not as easy as expected.

Instrumental Interactions and Experience Sharing are similar in five ways:

The same behavior can be used for both purposes.

The same activity can have both Instrumental and Experience Sharing goals.

The purpose of Student’s play can be either Instrumental or Experience Sharing.

Both types of behavior can produce emotional reactions.

Conversational formats can be used for both types of interactions.

… How, then, can we reliably distinguish Instrumental interactions from two Experience Sharing behavior?… 

The predictability of the end product: We engage in Instrumental interactions with a clear goal in mind.  There is something very specific we expect to receive by taking certain actions with another person.  Furthermore, we become quite
disappointed if we take the requisite actions and do not receive the expected result.  In contrast, Experience Sharing
occurs for no particular reason.  It is undertaken without any clear objective, except the enjoyment or positive feelings we derived from the interaction.

The relationship of the partner to the goal: In the Instrumental encounters, we engage other people because there is something we wish to obtain from them — information, an object, or participation in an activity.  Other people are agents, perceived as necessary only to deliver the product to us.  If we can achieve our goal without interaction, we will do so….

The interchangeability of partners: Any partner who knows the right rules and possess the necessary knowledge or skill will serve in an Instrumental encounter.  In this respect, partners are fairly interchangeable.  Furthermore, we may
quickly — and in a decidedly detached manner — exchange of partner with whom we have shared experiences for a new inexperienced partner, if the new partner is more willing to provide us with what we seek out of the interaction.  In contrast, memories of shared experience with a particular person greatly enhance the pleasure of Experience Sharing.  Our relationships are strengthened by the perception of a shared past and potential common future.  In addition, we learn that
partners who are aware of each other’s unique ways of relating have an easier time maintaining the relationship.

Reliance on scripts and rules: Instrumental interactions follow highly predictable scripts and roles enacted in a specific order.  Once the scripts and roles are learned and can be performed on cue, participants believe that they should be successful most of the time in achieving their objectives.  It’s like playing the same videotape over and over.  In contrast, Experience Sharing depends upon partners constantly evaluating the degree to which there is a “match” between their experience and that of their partner(s).

The need for emotional communication: People may have emotional reactions while engaged in, or as a result of Instrumental interactions, but emotional communication is not necessary for success.  Participants can largely ignore each other’s emotional reactions and still attain their desired objectives.[6]

Instrumental v. Experience Sharing Interactions

Instrumental interaction is task oriented and hence is the typical language of task performance.  Interaction is conducted to obtain something that is wanted or needed from another person.  If either communication partner can obtain the information
without interacting, he or she will, and we often see people with autism doing exactly that.   Here are some typical characteristics of instrumental (static)  interaction and communication….

There is a maximum of predictability and minimum of uncertainty.  There is a heavy reliance on rigid scripts, rules, and role actions.  There is an expectation of highly predictable sequences of actions taken by both partners and highly specific, predictable end products.  Failure to reach the expected end point can leads to frustration and/or anger.

Despite shared history, partners are interchangeable so long as they possess requisite skills and knowledge.  Partners are essentially interchangeable.

Experience Sharing interaction is quite different.  The excitement of unplanned results is a critical reason to engage in the interaction.  We interact for novel experience.   Interaction is conducted mainly to create a unique, shared experience with a partner that cannot be duplicated through individual actions.  Prior history with partners makes future interactions more satisfying.  Partners are highly valued for prior shared emotional experiences.   Experience Sharing interaction is only partially reliant on rules and role actions.  Mostly rely on both partners’ ongoing observations and actions to maintain mutual understanding and coordination.

Static v. Dynamic Systems

Characteristics of Dynamic Systems
  • A dynamic system is fluid – it is marked by continuous and spontaneous change
  • A dynamic system is constructed to manage a great deal of novel information
  • Novel information is produced through the interaction of the elements (participants)
  • Cannot be overly restrictive -  the system is regulated and maintained only partially through its structural elements
  • No specific end product to guide behavior.
  • Participants cannot count on a specific chain of actions to provide predictability.

What then keeps the system from degenerating into chaos?

Ongoing co-regulatory actions are employed in place of specific structural elements.  Participants reference the emotional reactions of their partner(s) on a moment to moment basis and use the information to determine whether they should increase, or decrease, the level of variation – in other words, they exhibit emotional coordination.

Characteristics of Static Systems

A static system is mostly unchanging.  It is marked by predictability and stable outcomes.

  • Created to limit the flow of new information into the system
  • System members are assured of highly predictable outcomes.
  • Critical for many of our society social functions

Static Systems rely on:

  • Specific rules
  • Repeatable sequences of actions
  • Clear outcomes
  • As a result, static systems are relatively simple to teach in a scripted manner
  • They require little ongoing maintenance actions by system members
  • People are relatively interchangeable – as long as they follow the prescribed rules and scripts
  • As opposed to fluid systems, adding novel information or attempting to vary the structure in a static system is viewed as disruptive.  System members typically try to sanction or exclude people who persist in such actions.

We note here that the above sets of skills comprise the vast  majority if not entire curriculum of most conventional ABA curricula!

Management of Anxiety/Distress

In the face of anxiety or uncertainty, one’s choices are…

To close the system and seek more control

Static systems lower anxiety because they are predictable
Withdrawing and isolating our ways of forming a static system
Becoming rigid and controlling is another defense mechanism to manage anxiety

To open the system: seek dynamic information

Understanding the other person’s point of view can reduce anxiety
Understanding the feelings and intentions of others can also reduce anxiety
Sharing one’s own point of view influences others in the same way

Difficulty managing uncertainty – or the lack of dynamic thinking and processing skills required to do so, explains the need for defensive reactions from children with neuroregulatory disorders.  The common terms we use such as “rigidity,” and “desire for sameness” merely describe defensive behaviors.  Defensive behaviors can come in many forms, but are usually described by people as passive (e.g., ignoring; withdrawing; helplessness; purposeful forgetting, etc.) or active forms (e.g. protesting; aggression, etc.) of resistance.

Communication Dysfunction

Communication dysfunction should be considered as a secondary deficit (this is not necessarily Gutstein’s or Sheely’s view).
I maintain that social communication evolved and evolves to support interaction.  Because Experience Sharing is typically not a goal in the interactions of people with autism, there is little impetus to develop what is called “Declarative” forms of
communication.

Declarative vs. Imperative Communication

Imperatives are statements made when a definite response is in mind.  They include communication with the function of directing, questioning, requesting, demanding, prompting, and other forms that refer to specific, right or wrong responses

Declaratives on the other hand are statements meant to simply share observations, feelings, and emotions.  These would include comments, observations, declarations, reflections, etc., that do not require (but usually evoke much better than imperatives) responses.  Declaratives are not necessarily right or wrong.  There can be many right answers.

Typical communication contains 80% declarative communication, and 20% imperative communication. Studies with people who have autism show that less than 1% of communication used is declarative.

Using declarative communication can make a dramatic difference. Declarative communication removes the pressure off of the Student to perform and provide the right answer. Declaratives are invitations to interact, while questions are typically cues to provide a right answer.

Declarative communication is more than just a way of talking. It is a way of interacting/being with another person. It is taking a side by side position with another person, where you look out at the world together.

Declarative communication uses language forms that involve relative thinking processes — they imply that between two speakers there can be different views of reality. Examples of declarative language include invitations (“Let’s play with cars”), declamations (“I’m tired of playing with cars!”), self-narratives (“I’m walking over to the table to pick up some cars.), indirect prompts (“Now is a good time to decide which car you want to play with”), celebrations (We did it!), etc.

It is common belief that ASD children suffer from processing disorders. It seems to me that the common practice, however, is to use the ‘inverted funnel’ approach. They can process less, so we, in error, pour in more. Further, we become entrenched in testing/probing for signs of knowledge I ask and they give the correct answer, then they ‘know.’ If indeed their pathways are more restricted it would seem that we would be very judicious in communicative approaches. Ironically, whether we are Guides, Specialists, Teachers… we simply use imperatives FAR more frequently with fragile children than we do with typically-developing children.

We are bothered by the lack of communicative initiation of spectrum children and go to great lengths to hear them speak. However, setting them up in roles of Responder for the vast majority of the time will likely only encourage their isolation, their lack of self and their lack of initiative.

Imperative v. Declarative communication

Imperative communication is preferred by people with autism spectrum and related disorders because it is the language of predictable responding, whereas declarative communication comprises about 80% of the utterances for the rest of us.

Imperative language is the language used most in static systems, whereas declarative language is the language used mostly in dynamic, experience-sharing systems.

Imperative language functions and forms usually require a “right or wrong” or yes/no answer (digital); is used to obtain an answer or (functional) information, and;  is the kind of language that often can be replaced by a computer.

Imperative forms of relating and communicating are the most common skills taught to individuals with autism.  This is because it plays into their autistic strengths of rote memorization and responding – hence, they are simply easier to teach.  They can be rehearsed and there is usually a limited set of correct responses to memorize.

They are not necessarily the most important or “applied” skills as they tend to promote terse and instrumental relating.

Imperative language tends to shorten and shut down interactions.  They can put people on the defensive or make them feel pressured to produce a correct response.  Monologues are forms of static systems often observed in speakers who have autism.  They are not open or they do not require adjustment to incoming information and they require little referencing of the listener.

Declarative language is the language used in dynamic systems.  It is used primarily for the purposes of sharing experiences, information, feelings, ideas, perceptions, memories, etc.  This enables true dialogues, but they require complex and multi-layered processing of incoming information for meaning, and for formulating responses (based on the meaning of incoming information).  It requires anticipating various (rather than singular, right or wrong) consequences of the responses.

 

 

 

 

 

 

 




[1]     The information from authors Steven Gutstein and Rachelle Sheely Ph.D.s is best described in their book “The RDI Book

[2] Meltzoff, A. N.; 2005; Imitation and other minds: The “Like Me” hypothesis. In S. Hurley & N. Chapter (Eds.), Perspectives on imitation: From cognitive neuroscience to social science (pp. 55-77). Cambridge: MIT Press.

Meltzoff, A. N.; 2002; Imitation as a mechanism of social cognition: Origins of empathy, theory of mind, and the representation of action. In U. Goswami (Ed.), Handbook of childhood cognitive development (pp. 6-25). Oxford: Blackwell Publishers.

Meltzoff, A. N., & Moore, M. K.; 1997; Explaining facial imitation: A theoretical model. Early Development and Parenting, 6, 179-192.

[3] Hobson, R. P., Lee, A.; May 24th, 2000; Clinical reports of abnormalities in autism; Paper presented to the Conference:
Perspectives on Imitation; Royaumont, Abbey, France

Tomasello, M., Carpenter, M., Carpenter, M., Call, J., Behne, T., Henrike, M.; 2004; Understanding and sharing intentions: The origins of cultural cognition; Behavioral and Brain Sciences; Cambridge University

Hobson, R.P. and Lee, A. (1999); Imitation and identification in autism; Journal of Child Psychology and Psychiatry, 40, 649-659.

Moore, D.G., Hobson, R.P., & Lee, A.; 1997; Components of person-perception: An investigation with autistic, non-autistic retarded and typically developing children and adolescents. British Journal of Developmental Psychology, 15, 401-423

[4] Tomasello, M., Carpenter, M., Carpenter, M., Call, J., Behne, T., Henrike, M.; 2004; Understanding and sharing intentions: The origins of cultural cognition; Behavioral and Brain Sciences;CambridgeUniversity

[5] Tomasello, et al. 2004

[6] Steven Gutstein; Rachelle Sheely Ph.D.s; 2000; “Solving The Relationship Puzzle; Future Horizons pp. 7-9.