A recent paper (March 26, 2009) in the very prestigious journal , Nature (Klin et al. 2009, cited below), gives us an example of the high interest maintained by the neuroscience , developmental psychology, and special education communities in new research developments in autism.
This particular paper is intriguing because it compares the performance of normal toddlers of about 2 years of age, with developmentally delayed toddlers without autism at the same age, and with autistic 2 year olds, on certain visual tasks.
There may still be a substantial remnant of people in the helping professions who, perhaps depending on older literature, tend to lump together the symptomatology of very young autistic and developmentally delayed children as if they always or often shared the same deficits, and these conditions were hard to tell apart at this stage of their young lives.
This paper was, in part, about setting the symptoms and disorders apart.
The Advantage of Preferential Gaze for Normal Motion in Social Learning in Toddlers
Klin et al. explore a fairly striking anomaly, and while others may be inclined to disagree (see Parron et al. 2008, cited below), their work suggests that toddlers with autism do not follow the normal motion of living things preferentially, the way normal toddlers do.
What does this mean?
Recognition and focus on normal, expected biological motion is one of the ways that most infants and certainly all normal children by toddler age, survive.
They learn to recognize a mother or father or sibling in part because the first salient thing they notice is that people are characterized by some degree of motion and certain types of movement, and that some of the movements are particular to family members in dealing with them, while other movements are characteristic of strangers.
This is an evolutionarily important survival skill because it is also related to the detection of danger from living things that are moving at them in unexpected ways. For example, a feral dog coming to attack them, or a horse rearing up to kick them.
Danger awareness is also reinforced by observing the motion of parents or siblings to other moving subjects.
Seeing sibling or parental motions in response to moving threats or opportunities on a repeated basis is one help to toddlers in learning, but only if the toddler is likely to turn its focus on the sequence of action that is pertinent to the threat or opportunity.
In other words, the toddler has to learn to engage in joint visual attention.
Learning appropriate movements and responses from the observation of the movement and response of others is related to, or sometimes used synonymously, with phrases like “Joint Perception & Action Processes, “ or the more colorful “Motor Priming & Contagion.”
Autistic toddlers can certainly see biological motion ----- there are no predictable optically (eyeball anatomy) based visual impairments that are particularly characteristic of autistic toddlers---- but many autistic toddlers do not attribute anything special to either normal or abnormal motion.
But lack of sensitivity to the alarm or exhilaration motions of others short-circuits joint perception and action processing or motor contagion, which eventually leads to a lack of “Social Contagion” the empathetic adoption of mood and actions of people in a group.
It is important to understand that not all autistic children are born equally impaired, and this, along with the kinds of behavioral therapy and family support they get, often explains why some become high functioning, while others cannot progress greatly.
There are widely varying degrees of deficits and different types of coping strategies among autistic individuals, to such a degree that most autistic individuals are now commonly diagnostically categorized as being at some point on a continuum of Autistic Spectrum Disorders, ASDs, that ranges from the mild end of Asperger’s Syndrome to much more profound pervasive developmental disorders.
But for the purposes of this brief survey, and in terms of the paper by Klin et al, 2009, we will use the term autistic without further distinctions, in part because at age two, the degree of lifetime impairment may not be easily determined.
Moving Connect-the-Dots or Point-Light Displays
In the Klin et al. 2009 study, autistic toddlers did not appear to have developed an age-appropriate gazing that is preferentially oriented to recognize and pay closer attention to ordinary biological motion as opposed to abnormal, and somewhat nonsensical motion, under normal circumstances.
But they also found that autistic toddlers might tend to pay special attention more frequently when the viewing of ordinary biological motion is somehow reinforced by another sensory modality.
How were these findings accomplished?
In the Klin study, toddlers were shown what might be called moving Connect-the-Dots figures. These were actually videos of moving people with only certain large bright dots visible on the screen ------the bright dots for example might be placed at the major joints of the body and on the head, limbs and feet.
The “dots” re-enacted child’s games like peek-aboo, pat-a-cake and showed motions like legs and arms moving and hands clapping.
The experimental “shows” of motion involved split screens and a matching sound track that followed one of two motion sequences being simultaneously shown on the split screen.
One half of the screen would be playing the moving dots in normal motion. This was the screen where it was expected that normal children would focus their attention preferentially because the motion of these dots were natural, representing biologically predictable movements, that could be readily perceived as games.
It was not clear whether or not the developmentally delayed or autistic toddlers would do the same.
The other half of the split screen display displayed the same sequence of action but with the moving dots displaying that action upside down.
It was clearly expected that the normal toddlers would avoid gazing at this half of the screen, because its motion was jarring and did not make sense to them.
It was not clear what were the responses of the developmentally delayed and autistics toddlers would be.
In all cases, it was expected that a preferential focus on the dots going through normal motions would be would be reinforced to some degree by the fact that the soundtrack, in all but one of the videos of motions, featured only human voices whose narration matched the normal actions depicted on the screen, but did not match not the upside down ones.
But something unexpected turned up.
While the autistic toddlers were essentially random in which screen they watched, favoring one as much as the other, the developmentally delayed and normal toddlers each showed much more focus and gaze time on the normal , right-side-up movement and sequence of action.
In fact, the response of both of normal and developmentally delayed toddler groups was so alike that it was impossible to determine from performance on this test which toddlers were normal and which were developmentally delayed.
It was however, exceptionally easy to determine which kids were autistic because of this lack of preferential gaze in favor the normal sequence of action.
In fact, this type of screening looks to be a pretty good differential diagnostic tool for autistic toddlers at two years old, especially for sorting them apart from the developmentally delayed at this early age.
The larger implication of this lack of preferential gaze is that it predisposes the autistic toddler to missing out on a whole cascade of motion associated cues that would help them make sense of the world and particularly of human actions and emotions in the world much better.
But there is more to this study.
Serendipitously, during the recording of one of the action sequences, the synchronized sound track actually picked up more than just the human voice narration. The sound track had also picked up and subsequently played back the loud clapping sounds that matched the clapping motions on the screen.
When the autistic toddlers heard the clapping simultaneously with the visual moving connect-the-dots or PLDs of the person clapping, the autistic toddlers paid notably more attention to the half of the split screen that displayed normal motion.
The autistic toddlers did not do as well as normal or the developmentally delayed toddlers , but they certainly did better in attending to the side of the split screen that portrayed normal motions when sound was added as a stimulus at the same time, raising what the researchers referred to as the Audio-Visual Synchrony value of the video show as a whole.
Therapeutically, this suggests that behavioral training with autistic toddlers and children might go better to the degree that it is reinforced with simultaneous additional sensory cues, although other research shows that too many cues, even if intended as reinforcing, may flood the autistic child with “too much information” to focus and interpret.
Mouth Watching, Lip Reading & Being Unfazed by Upside Down
It is clear that autistic toddlers and infants can detect motion as opposed to lack of motion, and may in focus on some particular moving feature of a person, when interacting with them.
For example, some studies show that many autistic children focus intently on the movement of the mouth when someone is speaking to them.
They appear to be like lip-readers, trying to make sense of what is said by comparing what they see in terms of the mouth’s current motions, with their past experience of what those mouth motions seemed to indicate by way of words or outcomes.
Likewise some autistic children have the ability to recognize people despite the image of those people being inverted, with a success rate far beyond normal children, who like this author, get confused when something familiar in its top-down orientation is presented turned upside down.
This appears to be the result of the autistic child focusing only on some key feature that is salient to them, to the exclusion of everything else.
In a sense, the ability of some autistic children to be able to match one pattern with another, works like the FBI’s finger-print matching computer. They resolutely focus on certain features that are fixed in relation to one another, and ignore everything else.
Autistic kids have also been shown in many cases to have better ability to identify pictures when the background is distorted, confusingly camouflaged, or the focus or resolution of the picture may not be optimal.
But these special focusing abilities come at a considerable cost, because, particularly in normal human interactions, the expression of the whole face in terms of the eyes, the nature of the smile or grimace, the accompanying hand gestures and the adjustments to the posture of a person convey as much or even more information about the emotional context of a situation than do just the words or the lip movement alone.
This is a phenomenon that has been exhaustively studies for well over 100 years, including works by Darwin, where he shows that nonverbal dues indicate emotional states and signal action intent, in not only man but in many animals, and as shown in numerous studies by Ekman and others, is universal across human cultures around the world.
Normal, and even developmentally delayed children, seem to be able to take several facial, gestural, and postural cues into account simultaneously, and make a reliable guess as to the mood or underlying message of the person being viewed, ironically even if they cannot identify the person in a subsequent lineup of pictures as well as do some autistic subjects.
In a related phenomena, when other normal viewers would get frightened or upset enough to lose confidence in their ability to make the identification, the autistic viewer has not registered the emotional stressor for either the person being viewed or even of themselves, because they do not process context, and can excel in the identification task.
Autistic children, it seems, are sometimes excellent leaf identifiers, but, sadly, not good at conceptualizing the whole forest of the expressions and emotional states of others.
Or, as some put it, many autistic children have a reduced ability to develop a Theory of (the) Mind (of others.), or an understanding of their mental state.
It is not that autistic toddlers are “obtuse” but rather, that their gaze and focus may be either too “acute” on a fixed circumscribed set of features, or as seen in this study of toddler autistics, so fundamentally indifferent to the motions ----- normal or abnormal, subtle or more striking,------ that it holds them back in the normal progression of learning better to encode context and nuances at the same time as they learn to make identifications later in life, at least when they are without the right kinds and amounts of reinforcing sensory synchrony at an early age.
Tony Stankus tstankus@uark.edu Life Sciences Librarian & Professor
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