Integration problems in high functioning autism

Dorit Ben Shalom, Zlotowski Centre for Neuroscience, Ben Gurion

University of the Negev

An under researched problem

By informal estimate, only 10% of people with high functioning ASD have the severe form

Researchers have no idea what to look for

My main interest is in the severe form, because so much more is known about the less severe forms

The medial prefrontal cortex and integration in autism

Ben Shalom, 2009

Ben Shalom, D. (2009). "The Medial Prefrontal Cortex and Integration in Autism." Neuroscientist:

Level 3• Logical processing• Conscious

• Integration• Pre-conscious

• Animal processing• Unconscious

Level 2

Level 1

Emotion

the theory of mind hypothesis(Baron-Cohen et al., 1985, Frith & Happe,

1994)

Baron-Cohen, S., A. M. Leslie, et al. (1985). "Does the autistic child have a "theory of mind" ?" Cognition 21 (1): 37-46.Frith, U. (1994). "Autism and theory of mind in everyday life." Social Development 3(2): 108-124.

Level 3

Level 2

Level 1

Conscious logical processing of emotions

Pre-conscious integration of emotional states

The animal level of emotion

NeurotypicalAutistic

spectrum disorder

emotion

an atypicality at the integrative level could lead to atypical emotional s tates , and to a

lack of common experiences with other people

Emotion

Memory

episodic (Bowler et al., 2000) or ‘complex’ memory atypicalities

(Minshew and Williams, 2007)

Bowler, D. M., J. M. Gardiner, et al. (2000). "Episodic Memory and Remembering in Adults with Asperger Syndrome." Journal of Autism and Developmental Disorders 30 (4): 295-304Minshew, N. J. and D. L. Williams (2007). "The new neurobiology of autism: cortex, connectivity, and neuronal organization." Archives of neurology 64 (7): 945-950.

L evel 3

L evel 2

L evel 1

C onscious logical process ing of emotions

P re-conscious integration of memory epis odes

T he animal level of memory

NeurotypicalAutistic

spectrum disorder

memory

one reason for atypical episodic or 'complex' memory in AS D could be

atypical intergration of memory episodes

Memory

Perception

the weak coherence hypothesis (Frith, 1989, Happe & Frith, 2006) (emphasis on

atypical top down processing)

the enhanced perceptual functioning hypothesis (Mottron et al., 2006)

(emphasis on enhanced bottom up processing)

L evel 3

L evel 2

L evel 1

C onscious logical process ing of emotions

P re-conscious integration of perc eptual objec ts

T he animal level of perception

NeurotypicalAutistic

spectrum disorder

perception

a lack of perceptual objects could reduce top down process ing and encourage

bottom up process ing

Perception

Motor

dyspraxia (difficulty in planning complex movements) is more general in ASD, going

beyond imitation (mostofsky et al., 2006)

Level 3

Level 2

Level 1

Conscious logical processing of emotions

Pre-conscious integration of motor actions

The animal level of motor behavior

NeurotypicalAutistic

spectrum disorder

motor

a difficulty formulating motor actions could lead to a difficulty in motor planning

Motor

perception

memory

emotion

motor

JS (Smith, 2006)

“I have a hard time localizing pain [. . .]. I have a very hard time explaining where aches are located when my doctors ask”

who after 4 repetitions of 8 word pairs with phonological interference knew only 2

Unrelated JS (Ben Shalom, Faran, & Boucher, 2010)

“When I was 7 I got a doll's house [. . .]. I picked it up [. . .] in my mouth [. . .]. I later moved onto the series of flattened white blocks [. . .] before stacking them in piles according to size. [. . .] I saw no doll's house”

Donna Williams (Williams, 2003)

Ido Kedar (Kedar, 2010)

“It was my good fortune that I was able to learn to communicate on letter board or computer with my one finger. Thanks to that, my education is possible”