Wednesday, November 5, 2014

The Intense World Theory of Autism and Daniel

Since learning my older son, Daniel, has autism, I have spent a great deal of time reading about it. With my undergraduate degree and two years of graduate school in molecular biology, the things I typically read are on the molecular biology and neurobiology of autism. Since I can understand the most recent research, that's what I prefer to read.

My interest in the brain precedes my even having children, as my dissertation, Evolutionary Aesthetics, shows. In my dissertation I review some of the neurological underpinnings of artistic production and creation, with a focus on language and literature. Since then, I have mostly published, though, on self-organizing scale-free network processes -- including spontaneous orders -- in which negative and positive feedback is present. When such a system is dominated by negative feedback, the system tends toward equilibrium. When such a system is dominated by positive feedback, you get regular cycles -- booms and busts, in economic terms. When such a system has both positive and negative feedback present at the same time, you have what is called a biotic system -- such systems are complex and creative. Spontaneous orders are biotic systems -- especially in combination with other spontaneous orders, other scale free networks, etc.

All of this leads me to something I read on the Intense World Theory of autism. It seems that the main complaint about this theory is that it does not explain all forms of autism. Given a recent metastudy suggesting there are at least three different kinds of autism, I would hardly think this is in fact a real a problem of the theory. In fact, this is good news, since we will begin to understand more clearly why some things work for some autistic children, but not for others. If they don't actually have the same syndrome, you wouldn't expect the same things to work for everyone. That being said, the Intense World Theory, as described in the above linked article, makes a lot of sense to me -- in no small part because of what it says about the parents.

But first, the similarities between Kai Markram (the son of the neuroscientist who developed the IWT of autism) and Daniel are remarkable. Both were precocious babies. Daniel is a bundle of energy. Daniel also alternates between social anxiety around strangers and just running up and hugging strangers. There are the tantrums -- which in Daniel's case, are fortunately getting better over time, as we continue to expose him to social situations. Daniel also on occasion lines things up. And he is sometimes very sensitive to sounds -- he will sometimes turn off the radio, and he is bothered by applause. We also noticed that if we hugged Daniel when he is most upset, he has calmed down. In no small part, I came up with this idea after I read that autistic children who are given nasal injections of oxytocin became more social for a while. Since oxytocin is made naturally in response to skin-on-skin touch, I began making sure I held and hugged him more -- which has had a remarkably positive effect. We have been fortunate that Daniel is apparently better with the food than Kai was, though. He'll try most foods, but when he's made up his mind he likes or dislikes something, that's the end of it.

Given these similarities, what Henry Markram concluded was very interesting to me. The conclusion that "autistic people take in too much and learn too fast" fits well what I know about Daniel. For example, Daniel, since age 4, understands cause-and-effect and can therefore engage in deductive reasoning. One day, when Daniel was 4, as we were driving to the local grocery store, we drove by a restaurant with a large number of cars in the parking lot, and Daniel said, "Look, Daddy! They have lots of customers!" We then went to the grocery store, and when we came out, as I was putting Daniel in his car seat, he said to me, "Daddy, we were customers, weren't we?" My wife, who teaches 1st grade, says her 6-7 year old students cannot do that.

But this is what really spoke to me, what made me understand that, at least in the case of Daniel, IWT explains a great deal:
The more he [Henry Markram] investigated the idea of autism not as a deficit of memory, emotion and sensation, but an excess, the more he realized how much he himself had in common with his seemingly alien son.
Like Henry Markram, as a small child I wanted to know everything (that hasn't changed). I did a little better in high school than he did, but not by much, and it was not until my Senior year that I turned things around. Oh, and one of the main predictors of someone having a child with autism? Having a Ph.D.

Henry Markram and his wife discovered that in the mouse models they were studying, the inhibitory cells (negative feedback) worked normally, but the excitatory cells (positive feedback) "responded nearly twice as strongly as normal—and they were hyper-connected," and "were hyperactive, which isn’t necessarily a defect: A more responsive, better-connected network learns faster." In other words, autistic people with hyper-connected, hyperactive excitatory cells learn too quickly, and they learn irreversibly. Which can be a problem -- especially when what they are learning is a fear response.

They also discovered that autistic brains have more minicolumns, "which can be seen as the brain’s microprocessors." Coincidentally, "extra minicolumns have been found in autopsies of scientists who were not known to be autistic, suggesting that this brain organization can appear without social problems and alongside exceptional intelligence." This suggests a kind of continuum. It seems that your "average" extremely smart person has enough extra minicolumns, enough of a ramped-up brain, to become a scientists (and, likely, an artist, inventor, etc.). Slightly more, and you might develop Asperger's Syndrome. Slightly more, and you develop autism. This would suggest, as the article does, that brilliance in those autistics who are also savants is a feature, not a bug. Many autistics develop very advanced cognitive abilities, including those necessary to be good at math, music, and science. In fact, "Mathematics, musical virtuosity, and scientific achievement all require understanding and playing with systems, patterns, and structure. Both autistic people and their family members are over-represented in these fields, which suggests genetic influences." My own proclivities are in "understanding and playing with systems, patterns, and structure" in my scholarly work (on complex network processes) and poetry (formal verse -- patterns and structure).

What this suggests is that Daniel is an even more intense version of me. I have many social difficulties precisely because I "feel too much and sense too much." I am deeply empathetic, and my intensity of feeling is what led to my becoming an artist. I am sensitive to fabrics, to anything touching my wrists or neck, to the textures of foods (spaghetti and fettuccini both taste very different to me because of their very different textures). I experience the world very intensely, and it can be too much at times. If this is my experience, and Daniel is (if Asperger's is one level, and autism is two) two levels more intense in his feelings and senses, his behaviors make a great deal of sense to me.

More than this, the fact that it is excitatory neurons that are working more also explains quite a bit, if we take a complex systems view. As I mention above, complex systems like the brain have both positive and negative feedback working simultaneously. That is a normal brain. In a brain in which the inhibitory neurons were more active, we would expect to see a brain moving more toward equilibrium -- low activity. In a brain in which the excitatory neurons were more active, though, we would expect to see cyclical activity -- periods of hyperactivity and mania followed by low energy and depression. Many autistics are also diagnosed with bipolar disorder. Though undiagnosed, I am almost certainly at least mildly bipolar. I have seen Daniel have very low energy and cry and "be sad" for no reason at all; at other times, Daniel is extremely hyper. Fortunately, Daniel rarely crashes into the really sad depressive mode, but he does cycle between low and high energy. This would make perfect sense if his brain were dominated by positive feedback, as the Intense World Theory suggests.

However, this aspect is nowhere mentioned in the article. It seems an important thing to consider, though. But to understand this means one has to take a complex systems perspective. Perhaps further research will show others have in fact made this connection -- but if not, I think it's an important insight that needs to be investigated further.

The good news is that many of Daniel's social anxieties and repetitive behaviors seem to have been decreasing over time. And his language skills have been improving. Fortunately, while he is clearly autistic, his symptoms could have been much worse. Based on the article, it seems his social anxieties are not even as bad as Kai's, whose symptoms do not sound all that bad compared to others I have read about. And Daniel is more likely in recent months to look at you when you talk to him. Much of this improvement has been since I read about how autistic children have low oxytocin levels and that increased levels of oxytocin help with these behaviors. Since skin-on-skin touch increases oxytocin, I have made sure to hug Daniel more and to make sure there is skin-on-skin contact. I am convinced this has helped. I have seen the behavioral changes. He will always have them to a certain degree, but if Daniel can overcome some of these social issues, while retaining the benefits of autism, Daniel should have a great life.

1 comment :

  1. Interesting article. Thank you for your thoughts on this subject. Excellent.