While observing in a classroom for children with autism spectrum disorders (ASD), I watched a teacher trying to work with one young boy. She was attempting to get his attention so he would listen to her instructions (e.g., “Tell me your name?”). He looked all around—everywhere but at her. He seemed not to be aware of anything in the classroom; not the other students or teachers, not the toys or pictures on the wall. Nothing.
Finally, his teacher rewarded him for at least sitting in his chair without screaming and throwing things by handing him an iPad. I thought to myself “She’s pretty brave giving him such an expensive 'toy.' I hope he doesn’t break it.” Immediately, he pressed the “on” button, tapped the movies symbol and proceeded to scroll through several selections, found a movie, started it, adjusted the volume and even fast forwarded to a particular spot. His teacher just shook her head and said, “He knows how to use that better than I do.” Just a minute earlier I saw a boy who appeared to have very limited skills and now this gadget opened my eyes to someone with a great deal of promise.
We have long known that people with autism spectrum disorders have difficulty interacting with others and often prefer “things” to people. Recent research on children with ASD and with infants without these disorders may shed some light on this characteristic problem and how it might develop. For example, some research shows that—unlike people without autism—individuals with ASD tend to avoid looking at pictures of faces. One study looked at infants at risk for ASD (those with a family member having ASD) and those not at risk and measured their brain activity to faces. They then followed the children to see who was later diagnosed with ASD at 36 months. The researchers found that those with ASD had different brain responses to faces at 6-10 months than those without ASD. In other words, even before it was clear that an infant had ASD, their social brains were reacting differently.
Obviously, if you are avoiding looking at people, you will be at a major disadvantage when trying to learn communication and social skills. In an important study with typically developing infants, researchers found that in reaction to someone speaking to them at 4 months of age infants look at the speaker’s face. Then, between 4 and 8 months of age they switch their attention from the eyes of the speaker to the mouth to pick up audio visual cues. They then begin a shift back to the eyes at 12 months. What this means is that infants are not just listening to speech but also learn by watching the eyes and mouth of the speaker. Therefore, if infants with ASD are not watching faces they will be at a distinct disadvantage. But why would they avoid looking at faces?
Some have looked at arousal and have theorized that other people make those with ASD anxious—therefore, resulting in avoiding others. But when researchers have looked at arousal, they often get mixed results. A new look at this phenomenon seems the help explain these puzzling results.
Natalia Kleinhans and her colleagues had people with and without ASD look at pictures of faces at two different times. They monitored their brain activity through an fMRI (which assesses brain function). What they found was that the first time they showed the picture of a face both groups had increased arousal in the amygdala (a part of the brain involved with fear and anger). A new, unfamiliar face may be mildly anxiety producing for anyone because of all the new features to consider. However, when they showed the picture a second time, the control group habituated—meaning, they did not have the same hyperarousal response. However, the people with ASD did not habituate, and continued to show hyperarousal. Without getting use to faces, people with ASD may experience stimulus overload each time they see a person. This study may help make sense of why people with ASD avoid faces. And, in turn, may help map the developmental progression of the problems later seen in persons with ASD; including their social impairments and communication difficulties.
Going back to the boy I observed working with and iPad—this research suggests that his difficulties responding to adult-presented requests might have had more to do with facial aversion than an inability to understand complex tasks. We may be able to use this basic research to help children like him learn through technology, but also to perhaps help them reduce their fear reaction to human faces.
Elsabbagh, M., Mercure, E., Hudry, K., Chandler, S., Pasco, G., Charman, T., . . . Johnson, Mark H. (in press). Infant neural sensitivity to dynamic eye gaze is associated with later emerging autism. Current Biology. doi: 10.1016/j.cub.2011.12.056
Elsabbagh, M., Volein, A., Csibra, G., Holmboe, K., Garwood, H., Tucker, L., . . . Johnson, M. H. (2009). Neural correlates of eye gaze processing in the infant broader autism phenotype. Biological Psychiatry, 65(1), 31-38. doi: 10.1016/j.biopsych.2008.09.034
Kleinhans, N. M., Johnson, L. C., Richards, T., Mahurin, R., Greenson, J., Dawson, G., & Aylward, E. (2009). Reduced neural habituation in the amygdala and social impairments in autism spectrum disorders. American Journal of Psychiatry, 166(4), 467.
Lewkowicz, D. J., & Hansen-Tift, A. M. (2012). Infants deploy selective attention to the mouth of a talking face when learning speech. Proceedings of the National Academy of Sciences. doi: 10.1073/pnas.1114783109