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Autism

Kids With Autism Live in an Intense World

Contrary to appearances. people with autism may be overloaded by sensation.

Adam, a boy with an Autism Spectrum Disorder (ASD), is at the playground with his mother and a friend of his mother’s. It’s a typical scene – some adults playing basketball and racquetball, a group of moms pushing strollers, and younger children running around giggling and yelling. A Little League practice is going on, a breeze is blowing and, just outside the playground, there’s plenty of traffic.

In the midst of all this, Adam is in his own world. Suddenly he excitedly shrieks and points in the direction of the traffic. His mom’s friend manages to catch the words “white police truck” being said again and again. He stops, listens carefully and hears a far-away siren. In the midst of the playground commotion, Adam has evidently tuned out all of it in order to concentrate on (and isolate) a sound that must initially have been many blocks away. His mother couldn’t hear it, and her friend just barely could.

This anecdote is instructive of what may be happening in cases of ASD – particularly instances where the child or adult in question has a more severe form of the condition. People who seem to be ‘tuned out’ of social interaction may, counter-intuitively, have become that way not because they have a deficit of empathy or mental/social apparatus, but because they have fled from too much sensory or emotional input.

This is known as the “intense world” theory, and it’s the brainchild of Henry Markram, director of the Brain Mind Center at the Swiss Federal Institute of Technology, his wife, researcher Kamila Markram, and their former associate, Tania Rinaldi Barkat. The theory emerged out of years of frustration with the Markrams’ son, Kai (who is now 20). The concept they hit upon is described most eloquently by Maia Szalavitz in her article “The Boy Whose Brain Could Unlock Autism.” She writes:

"Consider what it might feel like to be a baby in a world of relentless and unpredictable sensation. An overwhelmed infant might, not surprisingly, attempt to escape. Kamila [Markram] compares it to being sleepless, jetlagged, and hung over, all at once. 'If you don’t sleep for a night or two, everything hurts. The lights hurt. The noises hurt. You withdraw,' she says. Unlike adults, however, babies can’t flee. All they can do is cry and rock, and, later, try to avoid touch, eye contact, and other powerful experiences. Autistic children might revel in patterns and predictability just to make sense of the chaos."

The intense world theory presumes that the world autistic people perceive is one of constant sensory overload. This is because their brains are hyper-connected. Rather than one cell having connections to ten other cells, it might be linked to 20. So the world is experienced as “a barrage of chaotic, indecipherable input, a cacophony of raw, unfilterable data.” Szalavitz continues:

"Just to survive, you’d need to be excellent at detecting any pattern you could find in the frightful and oppressive noise. To stay sane, you’d have to control as much as possible, developing a rigid focus on detail, routine and repetition. Systems in which specific inputs produce predictable outputs would be far more attractive than human beings, with their mystifying and inconsistent demands and their haphazard behavior."

Recall, in my last post, the findings presented at the International Meeting for Autism Research (IMFAR), indicating that the brains of kids with ASD register individual sensations normally but overreact to sensations occurring at the same time. This seems consistent with the intense world presumption: the more stimuli, the more information is shared by neural connections, and the more reaction is ratcheted up. Now, think back to Adam in the playground. He blocked out everything else so he could concentrate on one sound – a far off police siren. No doubt this strategy succeeds in protecting the autistic child from an overload of stimuli. But it comes at a significant cost – and not just in lost ‘face time’ with other children and adults around him. There are critical stages in neural development when certain kinds of external input are essential for the growing brain. If the opportunities for interaction with the outside world are minimized during these periods, social and language impairments may arise. Thus, in seeking a measure of comfort and predictability in his environment, the infant who was initially prone to autism may well cement it by unwittingly sabotaging his social, linguistic and emotional skills.

Yes, emotion is a big part of the equation. The IMFAR study found that the amygdala – the brain’s emotional ‘sentinel’ – is one of the regions that reacts strongly to concurrent stimuli. If the amygdala reacts this way to a sound or a texture, imagine how it would react to a yelp of pain, a gasp of surprise, or a pointed accusation. The intense world view posits that people with ASD dial themselves down in the face of a barrage of feelings – their own and others’. Again, this is counter-intuitive. But one mother is quoted in the Szalavitz article as stating that her autistic child is actually the most empathetic of her three kids. And Kai Markram, when asked if he sees things differently than others do, responds emphatically “I feel them different.”

While the title of this blog is “Feeling Too Much,” I have to admit I wasn’t mindful of autism when I came up with that name.

In my next post, we’ll look at why people with ASD tend to be male…and why sensory sensitivity could quite possibly have its roots in the womb.

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