A ti d T l t?A ti d T l t?Autism and Talent?Autism and Talent?

Francesca HappFrancesca Happéé

MRC SMRC Social, ocial, GGenetic and enetic and DDevelopmental evelopmental PPsychiatry Centresychiatry CentrePPsychiatry Centre sychiatry Centre

Institute of Psychiatry, Institute of Psychiatry, King’s College LondonKing’s College Londong gg g

http://www.jessicapark.com/

OverviewOverview• Autism spectrum disorders and talent• Autism spectrum disorders and talent• The ‘fractionable triad’• Current cognitive accounts: talent-engines?

– Mind-blindness?Mind-blindness?– Executive dysfunction?

il f d i bi– Detail-focused processing bias?• Data on behavioural association• Conclusions

Autism: Background factsAutism: Background factsDi i i i S i l i i• Diagnostic criteria: Social impairment,

Communicative impairment, Ri id/ i i b h i d i

Evident by 3yrsRigid/repetitive behaviour and interests

1% f l i h i di d• 1% of population may have an autism spectrum disorder (ASD): includes autism, atypical autism, Asperger’s syndromesyndrome

• Males out-number females low IQ and epilepsy commonMales out number females, low IQ and epilepsy common

• Increase in numbers probably due to better recognitionIncrease in numbers probably due to better recognition, widening criteria, etc

D i bThe puzzle of autistic talent

Drawings by Nadia,

a 3-year-old with severe autismautism

Not only product, but process, oftenNot only product, but process, often extraordinary

Stephen Wiltshire draws Tokyo, from memory, after a brief helicopter ride

Talents most common in circumscribed areas: Music, Art, calculation, memory…

The puzzle of superior performance inThe puzzle of superior performance in autism spectrum disorders (ASD)

People with ASD show ‘savant skills’ at much higher rates than other groups (10-30%)rates than other groups (10 30%)

In addition, uneven cognitive profile is typical, g p yp

Al i hAlmost every person with ASD is surprisingly good at something…

e g distress at tiny changese.g. distress at tiny changes

Autism spectrum disorders: the diagnostic triadAutism spectrum disorders: the diagnostic triad

Social Social impairmentsimpairmentsKanner:

‘insistence on

Unitary explanation?

sameness’ + ‘ i i

Or

‘fractionable triad’?‘autistic aloneness’

C i tiC i tiCommunication Communication impairments impairments

Restricted/ Repetitive Restricted/ Repetitive Behaviours & Behaviours &

InterestsInterestsInterestsInterests

Correlations between triad traits in a population-based sample

Social Social rph= phenotypic N>6800 twinsimpairmentsimpairments

ph p e o yp ccorrelation

Males/ femalesMales/ females

N>6800 twinsAged 8 yrsCAST t t Males/ femalesMales/ females

r = 31/ 21rr = 46/ 34= 46/ 34

CAST parent report

rph = .31/.21rrph ph = .46/.34= .46/.34

C i tiC i tiCommunication Communication impairments impairments

Restricted/ Repetitive Restricted/ Repetitive Behaviours & Behaviours &

InterestsInterestsr = 41/ 32 InterestsInterestsrph = .41/.32

Ronald, Happé & Plomin (2005) Dev. Science; Ronald et al. (2006) JAACAP

Shared or distinct genetic influences?Shared or distinct genetic influences?Social Social rg= genetic N>6800 twins

impairmentsimpairmentsg ge e c

correlation

Males/ femalesMales/ females

N>6800 twinsAged 8 yrsCAST t t Males/ femalesMales/ femalesCAST parent report

r = 39/ 29 rg = .31/.18rg = .39/.29 rg .31/.18

C i tiC i tiCommunication Communication impairments impairments

Restricted/ Repetitive Restricted/ Repetitive Behaviours & Behaviours &

InterestsInterestsrg = .50/.42 InterestsInterests

Ronald, Happé & Plomin (2005) Dev. Science; Ronald et al. (2006) JAACAP

Th ‘F ti bl t i d’?The ‘Fractionable triad’?All three core impairments required for diagnosisAll three core impairments required for diagnosis,

but…• ASD-like traits in 3 areas correlate only moderately• genetic effects on each part largely distinctgenetic effects on each part largely distinct• isolated impairments can be seen in relatives• children exist with single impairment (i.e. just social,

just Communication, or just restricted/repetitive behaviour)(see e.g. Ronald et al’06 JAACAP; Happé et al ’06 Nat Neurosc)

Q. what aspect of ASD predisposes to talent?

The triad: No single cognitive explanation?The triad: No single cognitive explanation?Social Social

impairmentsimpairments“Theory of mind”

“Executive functions”

Problems recognising

Problems generating

mind” functions”

recognising thoughts and feelings?

generating, planning, monitoring?

C i tiC i ti

feelings? monitoring?

Communication Communication impairments impairments

Restricted/ Repetitive Restricted/ Repetitive Behaviours & Behaviours &

InterestsInterests“weak coherence” InterestsInterestsDetail-focused cognitive style?

“weak coherence”

‘Mind blindness’ as a ‘talent engine’?Most people with autism fail

Mind-blindness as a talent-engine ?Most people with autism fail

‘theory of mind’ testse g attributing a false beliefe.g. attributing a false belief

In everyday life, ASD social and communicative difficulties fit a patterncommunicative difficulties fit a pattern of ‘mind-blindness’, e.g. don’t lie

Mindblindness alters the

Neurotypicals learn through social interactionlearning environmentNeu o yp c s e oug soc e c o• orient to others’ eye gaze, pointing, etc• interested in what others find interesting• infer thoughts/feelings behind actions• imitate others’ actionsObligatory attention to/learning from others?Obligatory attention to/learning from others?

People with ASD are typically less interested p yp yin others• may look less at faces/eyes

i t t d i h t h fi d i t ti• interested in what they find interesting• not motivated by social rewards• interaction may be puzzling/frighteninginteraction may be puzzling/frightening‘Free’ to pursue own focus of attention?

‘N t i l ’ lik h t th lik‘Neurotypicals’ like what others like

Shutts, Banaji & Spelke, 2009, Dev Sci3 ld h t f d l th d d b•3-yr-olds choose toys, foods, games, clothes endorsed by peer

•Are apparently unaware of the source of their preference‘Herd effects’ (see Raafat, Chater & Frith, 2009, TICS)

pp y p

3 ways that mindblindness may3 ways that mindblindness may enhance talent?

1. No ‘blinkers’ from shared thoughts?

2. Don’t spend time/neural pspace on social ‘savant’ skills?skills?

3. Better able to achieve unself-conscious (i li i ?) f ‘fl ’?(implicit?) performance… ‘flow’?

Some thingsSome things are better

done without too much self-

reflection?reflection?

Note: imaginative pretence may require mentalising, ti it d tcreativity does not

Drawing by Gilles Trehin http://urvillecity.free.fr/

i d f i l iExecutive dysfunction as a talent-engine?

Pl i C t l G ti

Executive Functions

Planning& Monitoring

Control& Flexibility

Generating& manipulating ideas

• Problems of ‘cognitive inflexibility’ linked to RRBIs

• Snyder’s account suggests reduced top-down inhibitory effects ‘release’ talent in autisminhibitory effects release talent in autism

‘Released’ talents in frontotemporal dementia?Released talents in frontotemporal dementia?

• Anne Adams, atrophy of left frontal regionsAnne Adams, atrophy of left frontal regions (and loss of speech), increasing artistic productionproduction

… repetition isn’t necessarily the enemy of creativity

• Does degree of EF impairment predict probability of special skills? Generativity better in talent domainGenerativity better in talent domain

• Do other groups with EF deficits show raised incidence of talents?

DetailDetail--focused processing bias (‘weak coherence’)focused processing bias (‘weak coherence’)as a talentas a talent--engine?engine?as a talentas a talent engine?engine?

‘‘inability to experience wholes without inability to experience wholes without full attention to the constituentfull attention to the constituentfull attention to the constituent full attention to the constituent partsparts……A situation, a performance, a A situation, a performance, a sentence is not regarded as complete if sentence is not regarded as complete if

d f l hd f l hit is not made up of exactly the same it is not made up of exactly the same elements that were present at the time elements that were present at the time the child was first confronted with it Ifthe child was first confronted with it Ifthe child was first confronted with it. If the child was first confronted with it. If the slightest ingredient is altered or the slightest ingredient is altered or removed, the total situation is no longer removed, the total situation is no longer the same and therefore is not accepted the same and therefore is not accepted as suchas such…’…’ Kanner, 1943Kanner, 1943

‘‘persistent preoccupation with parts of persistent preoccupation with parts of objectsobjects’’ is a diagnostic criterion (DSMis a diagnostic criterion (DSM--objectsobjects is a diagnostic criterion (DSMis a diagnostic criterion (DSMIV, APA 1994). IV, APA 1994).

Extraordinary eye for detail in ASDExtraordinary eye for detail in ASDExtraordinary eye for detail in ASDExtraordinary eye for detail in ASD

Can you spot the differences?Can you spot the differences?

Alternative accounts of detailAlternative accounts of detail--focusfocus

•• ‘Enhanced perceptual functioning’‘Enhanced perceptual functioning’Mottron & Burack, 2001Mottron & Burack, 2001

•• Enhanced ability to discriminate highly similarEnhanced ability to discriminate highly similarEnhanced ability to discriminate highly similar Enhanced ability to discriminate highly similar stimuli, reduced ability to generalisestimuli, reduced ability to generalise

Pl i d 2001Pl i d 2001Plaisted, 2001Plaisted, 2001

•• Superior ‘systemising’ in the ‘extreme male brain’Superior ‘systemising’ in the ‘extreme male brain’Superior systemising in the extreme male brain Superior systemising in the extreme male brain BaronBaron--Cohen, 2002Cohen, 2002

Embedded Figures TestEmbedded Figures Testeasier if easier if eithereither gestalt weakened, or gestalt weakened, or target part enhancedtarget part enhancedtarget part enhancedtarget part enhanced

LocalLocal GlobalGlobal

Evidence of superior local and reduced global processing in ASD: v de ce o supe o oc d educed g ob p ocess g S :Scheurich, Fellgiebel, Muller, Poustka & Bolte, 2010

Detail-focus can also i i i hgive new insights…

…a different view of th ldthe world….

Weak Central Coherence and Savant Skills

Image from www.autisminfo.com Image from whyfiles.org/209autism/

How does detail-focus spark talent?How does detail-focus spark talent?Exemplar-based memory advantageous for some areas of p y g

mastery– Music: Absolute pitch is present in all musical savants, p p ,

involves memory for exact note not relations between notes (melody)

– Art: bottom-up approach, ignoring known gestalt, is suggested for accurate drawing

– Calendrical calculation can begin through discovery of small regularities

N.B. Top-down global processing may need to be inhibited in TD (not in ASD?) Ss – Snyder’s TMS studies

Example of drawing starting with a detailExample of drawing starting with a detail

Note that the finished house Note that the finished house i ‘ h t’ d it l li ‘ h t’ d it l l 20

25

30

deta

ilde

tail

is ‘coherent’, despite local is ‘coherent’, despite local biasbias

10

15

20tin

g w

ith

ting

with

0

5

ASD ADHD TD% s

tart

% s

tart

Booth et al, 2003

R l ti ASD lik t it d T l tRelating ASD-like traits and TalentTEDS G l l ti l• TEDS General population sample of 8-yr-old twins y

• After exclusion criteria, and random selection,After exclusion criteria, and random selection, N = 6,426

( ) i i f– 82 (1.3%) meet DAWBA criteria for ASD• Parental reportParental report

– of ASD-like traits (CAST: social, communication, RRBI Qs)

f i l ift– of special gifts Pedro Vital et al 2009, JCPP

Skills & Gifts QuestionsSkills & Gifts QuestionsD /h di l t iki kill d t– Does s/he display a striking skill, compared to her/his general ability level?

– Does s/he display a striking skill, when compared to other children her or his age?to other children her or his age?

– Does s/he display a special gift, when comparedDoes s/he display a special gift, when compared to children even much older?

Tick box: Maths Music Art Memory [Other]

ASD Like Traits by Special abilityASD-Like Traits by Special ability

0.3

0.35 Social CAST

0.25

0.3

CommunicationCAST

0.15

0.2ion CAST

RRBI CAST

0.1

0 5

0

0.05

No Special Ability Special Ability

Parentally reported incidence of SpecialParentally reported incidence of Special Abilities

Math 6% 63%! Soc" Com" RRBI " "

Memory 7% 55%! Soc" Com" RRBI " "y ! " " " "

!Music 3% 42%! Socns Com" RRBI " "

Art 6% 43%! Socns Com" RRBI " "

!=more ASD-like

Association with Special skills +/ ASDAssociation with Special skills +/- ASD070.60.7

SocialCAST

0.40.5

CommunicationCAST

020.3

tion CAST

RRBI CAST0.10.2 RRBI CAST

0TD TD

(SpecialASD ASD

(Special( pAbility)

( pAbility)

What element of RRBI is linked with Talent?

“St t d M t M i ” (f DSM IV)• “Stereotyped Motor Mannerisms” (from DSM-IV)• “Unusual and Intense Interests”• “Rigidity and Insistence on Sameness” • “Persistent Preoccupation with Parts of Objects”Persistent Preoccupation with Parts of Objects

(Detail-focus)Does s/he appear to notice unusual details that– Does s/he appear to notice unusual details that others miss? D /h t h l f– Does s/he appear to have an unusual memory for details?

Special Gift No reported S i l Gift

Effect SiSpecial Gift Size

N (%) 1075 (16 7) 5351 (83 3)N (%) 1075 (16.7) 5351 (83.3)

Stereotypies 0.09 (0.29) 0.06 (0.24) 0.11

Detail-focus 0.71 ** (0.36) 0.45 (0.41) 0.67

Special Interests

0.15 ** (0.27) 0.09 (0.21) 0.25

Insistence on Sameness

0.21 ** (0.30) 0.14 (0.26) 0.25

**p<.001

Cross-twin cross-trait correlations reveal shared

rc = .93/.92

genetic/environmental factors

rg = 44/ 46

ACE ECA

63/ 7702/ 02 49/ 6748/ 30

rg = .44/.46

35/ 21 03/ 03

S i lrph = .37/.34

.63/.77.02/.02 .49/.67.48/.30.35/.21 .03/.03

RRBI Special Gift

Relating ASD like traits and Talent: S mmarRelating ASD-like traits and Talent: Summary

P t l t f i l ift l t ith• Parental report of special gifts correlates with report of ASD-like traits

• Gifts relate primarily to rigid & repetitive traits• Gifts relate primarily to rigid & repetitive traits, especially eye for detail

• Link between these two aspects of individual pdifferences largely mediated by genetic influences

Other evidence linking detail-focusOther evidence linking detail-focus and talent

Repetitive behaviour and preoccupations are common to savants +/- ASD (e g O’Connor &common to savants +/- ASD (e.g. O Connor & Hermelin, 1991; Young, 1995)

Musicians with Absolute Pitch (AP) show more ASD-like traits than musicians without APASD like traits than musicians without AP (Brown et al., 2003)

Artists, and people with ASD, show good block design skill (Pring, Hermelin & Heavey, 1995)design skill (Pring, Hermelin & Heavey, 1995)

ConclusionsConclusions• May not be autism per se, but specific aspects of y p , p p

autism that predispose to talent• Mindblindness may enhance but unlikely to instigateMindblindness may enhance, but unlikely to instigate

talents?• Detail focused processing bias may be starter motor• Detail-focused processing bias may be starter motor

for talentP li i id f b h i l d i• Preliminary evidence of behavioural and genetic association between special abilities and eye for detail

• You don’t have to have autism to be talented… but it (i.e. detail-focus) helps!

• Implications for education and fostering talent in ASD

Thanks toThanks to• All the participants with ASD and p p

without• Angelica Ronaldg• Pedro Vital• Rhonda BoothRhonda Booth• Robert Plomin and the TEDS team• Emma Colvert Emma Woodcock Victoria Hallett and• Emma Colvert, Emma Woodcock, Victoria Hallett and

all the SRS team• MRC Wellcome Trust Autism Speaks ESRC• MRC, Wellcome Trust, Autism Speaks, ESRC• Neil O’Connor & Ate Hermelin’s original inspiration

Ut F ith• Uta Frith

Anne Adams Pebbles http://memory.ucsf.edu/Art/

Exploring fragments of ASD?G f hild d fi d b i i lik iGroups of children defined by autistic-like traits

‘impaired’= Scoring in top 95% of a

SocSoc RRBRRBp g p

subscale

II3% 4%0.4%

0 7%0.6% 0.9%

0.7%

3%87%ComCom

3%87%No deficits

N predicted by chance:1 deficit: 5%2 d fi it 0 25%2 deficits:0.25%3 deficits: 0.0125%

Detail-focus in Anorexia Holliday, Dannhorn, Tchanturia & the Eating Disorder Team IoP

R lt f TD F l d CA & IQ t h d A i

1.4

Results for TD Females and CA & IQ matched Anorexia vs. Controls

1

1.28 to 10 yrs TD

0.8

111 to 13 yrs TD

14 to 16 yrs TD

mpl

etio

ns

0.4

0.6y

17 to 25 yrs TD

Anorexia (n=18loca

l com

0

0.2Anorexia (n=18

Controls (n=18)

N l

0Anorexia group respond well to ‘weak coherence’ intervention

Specific RRBIs?Specific RRBIs?DSM-IV defined RRBI types with CAST items

• Stereotyped Motor Mannerisms (Stereotypies)• Stereotyped Motor Mannerisms (Stereotypies)– Does s/he have any unusual and repetitive movements?

• Unusual and Intense Interests (Special interests)• Unusual and Intense Interests (Special interests)– Does s/he mostly have the same interests as her/his peers?

– Does s/he have an interest which takes up so much time that s/he does little else?p

• Rigidity and Insistence on Sameness (Insistence on sameness)– Does s/he like to do things over and over again in the same way all the time?

– Does s/he try to impose routines on him/herself, or on others, in a such a way that it causes problems?

• Persistent Preoccupation with Parts of Objects (Detail focus)• Persistent Preoccupation with Parts of Objects (Detail-focus)

– Does s/he appears to notice unusual details that others miss?

Does s/he appear to have an unusual memory for details?– Does s/he appear to have an unusual memory for details?

Math Talent Music Talent Art Talent Memory Talent

Yes No Yes No Yes No Yes No

N 407 6019 173 6253 410 6016 441 5985 (93%)N(%)

407 (6%)

6019 (94%)

173 (3%)

6253 (97%)

410 (6%)

6016 (94%)

441 (7%)

5985 (93%)

" 255 2898 72 3081 177 2976 243 2910 (45%)"(%) (63%) (48%) (42%) (48%) (43%) (47%) (55%)

( )

Social 2.10 1.63 1.70 1.66 1.74 1.66 1.97 1.64 CAST (1.50) (1.61) (1.40) (1.61) (1.50) (1.61) (1.74) (1.60)

p<.001; d=0.30 ns ns p<.001; d=0.21

ComCAST

2.35 (2.02)

2.10 (1.94)

2.64 (2.11)

2.10 (1.94)

2.40 (2.03)

2.10 (1.94)

2.65 (2.20)

2.10 (1.92)

p< 005; d=0 13 p< 001; d=0 27 p< 005; d=0 15 p< 001; d=0 27p<.005; d=0.13 p<.001; d=0.27 p<.005; d=0.15 p<.001; d=0.27

RRBICAST

2.11 (1.30)

1.51 (1.30)

2.29 (1.40)

1.53 (1.30)

2.15 (1.27)

1.51 (1.30)

2.65 (1.23)

1.50 (1.30)( ) ( ) ( ) ( ) ( ) ( ) ( ) ( )

p<.001; d=0.46 p<.001; d=0.56 p<.001; d=0.50 p<.001; d=0.43