THE HUMAN NATURE OF AUTISM
MIKAEL VILLALOBOS: WE’RE GOING TO GET STARTED. THANKS TO ALL OF YOU FOR COMING. I
CHAIR THE CAMPUS COMMUNITY BOOK PROJECT. AND BEFORE I INTRODUCE OUR SPEAKER TODAY, I
WANT TO BRING YOUR ATTENTION TO A COUPLE THINGS ON YOUR CHAIRS. THE EVALUATION FORM. IF
YOU CAN MAKE SURE TO FILL IT OUT AFTER THE EVENT AND LEAVE IT ON THE CHAIR AND I WILL PICK IT UP
AFTERWARDS. AND ALSO YOU HAVE THE BROCHURE WHICH HAS ALL OF THEE EVENTS ASSOCIATED WITH
THE PROJECT. WE HAVE A JAM PACKED WEEK. TOMORROW AND ALSO ON THURSDAY. AND OF COURSE,
TEMPLE GRANDIN WILL BE HERE ON CAMPUS TO SPEAK ON FEBRUARY 10TH. LET ME INTRODUCE OUR
SPEAKER,
THE TITLE OF TODAY’S PRESENTATION IS LISTED. HELP ME WELCOME PETER MUNDY.
PETER MUNDY: IT’S GREAT TO BE HERE. I’M GOING TO TRY TO COVER THIS AGENDA AND COVER IT
IN ABOUT AN HOUR AND HOPEFULLY, TIME FOR DISCUSSION QUESTIONS AND ANSWERS. IT IS SMALL
ENOUGH, IF SOMETHING IS CONFUSING AND I HAVE NOT MADE MYSELF CLEAR, LET ME KNOW AND WE CAN
TAKE QUESTIONS DURING THE DISCUSSION.
THIS IS A REALLY INTERESTING PROGRAM OF STUDIES, WHERE WE HAVE TEMPLE GRANDIN COMING
IN FEBRUARY. SHE IS PROBABLY THE MOST FAMOUS PERSON WITH AUTISM, AND THERE ARE A LOT OF
FAMOUS PEOPLE WITH AUTISM NOW. I THOUGHT WE WOULD TALK A LITTLE BIT ABOUT THE HISTORY HERE
AND EMBED WHAT I’M GOING TO TALK ABOUT IN THE HISTORY. AND IT WILL BE EMBEDDED THROUGHOUT.
AND PRIMARILY, I’M GOING TO TALK ABOUT ONE DIMENSION OF THIS THING THAT WE CALL AUTISM,
THAT IS IMPORTANT TO UNDERSTAND. NO ONE UNDERSTANDS AUTISM IN ITS ENTIRETY. NO ONE
UNDERSTAND AUTISM IN THEIR ONE SINGLE DIMENSION THAT THEY HAVE BEEN STUDYING. YOU HAVE TO
TAKE THAT INTO CONSIDERATION WHEN YOU HEAR ANYONE TALK ABOUT ANY DISABILITY, REALLY,
BECAUSE THESE ARE VERY COMPLEX THINGS AND ARE PART OF HUMAN NATURE AND HUMAN NATURE IS
VERY COMPLICATED. HUMAN NATURE IS VARIED AND THE DIFFERENCES ARE ALSO VARIED.
WHEN WE START TALKING ABOUT CATEGORIES OF DISABILITIES, WE HAVE TO THINK OF THEM AS
BEING, “FUZZY” CATEGORIES. THAT IS WHERE THERE IS NOTHING SPECIFIC THAT DEFINES THE NATURE
OF CATEGORY. TAKE THE CATEGORY OF TALL, WHAT IS THE DEFINING FEATURE? IT IS ALL RELATIVE TO
OTHER PEOPLE'S HEIGHT OR GROUPS OF PEOPLE. THE SAME WITH THE DISABILITIES. THEY ARE ALL
RELATIVE TO WHAT HAPPENS FOR MOST PEOPLE. THEY TEND TO BE EXTREMES, BUT THEY DON’T
NECESSARILY MEAN THAT THEY ARE ABNORMAL OR NOT PART OF HUMAN NATURE. THEY ARE ALL PART
OF HUMAN NATURE AND WE’RE GOING TO TALK ABOUT THAT AS WE GO THROUGH TODAY.
FIRST I THOUGHT WE WOULD MEET A COUPLE PEOPLE WITH AUTISM. THAT IS IMPORTANT. MANY OF
YOU PROBABLY KNOW PEOPLE THAT ARE AFFECTED BY AUTISM. IN ORDER TO UNDERSTAND HOW
VARIABLE IT IS, IT IS USEFUL TO SEE A COUPLE EXAMPLES.
(VIDEO)
>> WE’RE PARENTS OF AN AUTISTIC 16-YEAR-OLD TEENAGER, WHO IS CONSIDERED HIGH
FUNCTIONING IN TODAY’S WORLD OF AUTISM. HE HAS BEEN A JOY TO OUR FAMILY, IT WAS TOUGH IN THE
BEGINNING.
>> WHEN I WAS A SMALL CHILD, I WAS BITING PEOPLES’ FINGERS, PULLING THEIR HAIR. I BANGED
MY HEAD AGAINST THE WALL AND I MADE VERY LOUD NOISES.
>> HE IS A VERY DETERMINED CHILD. HE IS NOW IN AN HONORS CLASSROOM, A 96.2 AVERAGE.
AND HE WAS CONCURRED GETTING HIS DRIVER’S PERMIT, WHICH IS UNHEARD OF.
>> THIS YEAR, ONE OF MY SUGGESTIONS IS TRIGONOMETRY AND I HAVE A LITTLE – I MEAN, I HAVE
A – SOME PROBLEMS WITH IT, BUT IT IS A LITTLE TRICKY, I HAVE TO LEARN BACK FROM ALGEBRA.
>> SO YOU SEE A LOT OF FAMILIES BEING TORN APART FROM IT AND THAT IS A MAJOR ASPECT OF
AUTISM, IT DOES DESTROY FAMILY LIFE. IN OUR CASE, WE TOOK JOEY AND WE WERE DETERMINED TO
MAKE HIM BECOME FUNCTIONING AND WE WERE NOT GOING TO INSTITUTIONALIZE HIM, BUT IT WAS NOT
EASY.
>> LIFE IS NOT FAIR, YOU SEE, I SHALL NEVER BE KING, AND YOU SHALL NEVER SEE ANOTHER DAY,
AND I…
>> IF YOU GO WITH THE OUTLOOK THAT I WILL HELP YOU AND YOU CAN HELP ME, NOT, “I KNOW IT
ALL” YOU WILL SEE TREMENDOUS PROGRESS BECAUSE THEY TAKE PRIDE IN BEING A TEACHER. AND WE
TAKE PRIDE IN BEING A PARENT.
>> I MADE HIGH STARS THIS YEAR IN HIGH SCHOOL BECAUSE I KEPT WORKING HARD ON MY
SUBJECTS AND I MADE STRAIGHT A’S.
>> THEY GAVE JOEY A CHANCE. UNTIL TODAY, THERE ARE STILL SOME TEACHERS, JUST FOR
EXAMPLE, HE IS IN 10TH GRADE AND THE TEACHER DID NOT WANT HIM IN CLASSROOM BECAUSE HE WAS
AFRAID OF THE IDEA THAT HE WAS AUTISTIC AND WOULD HAVE TO BE IN THERE WITH AN AIDE. AND HE
CAME TO ME LAST WEEK AND SAID HE WAS THE MOST WONDERFUL STUDENT HE HAD AND I LEARNED A
LOT. YOU CAN’T UNDERESTIMATE THE ABILITY OF THOSE CHILDREN. THEY NEED A CHANCE AND THE
TEACHERS ARE WHERE IT STARTS BECAUSE THEY DEAL WITH THEM 8 HOURS A DAY. THEY HAVE TO BE
CONSISTENT AND THEY JUST NEED A CHANCE TO BECOME THE BEST HUMAN BEING THEY CAN BECOME.
YOU KNOW. ITS TOUGH.
(END)
PETER MUNDY: ONE OF THE VERY INTERESTING THINGS ABOUT WHAT IS NOW CALLED AUTISM
SPECTRUM DISORDERS, MOST OFTEN, MOST CHILDREN HAD NO OPPORTUNITY FOR PUBLIC EDUCATION
UNTIL THE LATE 80S, EARLY 90S. IN 1990, AUTISM WAS ADOPTED INTO THE FEDERAL LEGISLATION THAT
PROVIDES FOR EDUCATION FOR ALL PEOPLE WITH DISABILITIES. BUT AUTISM DID NOT EXIST IN THAT
GROUPING UNTIL 1990. THIS VIDEO WAS ABOUT LATE 90S, SO WHEN THE MOM SAID IT IS UNHEARD OF
THAT HE WAS ABLE TO DO X, THAT WAS THE CASE FOR A LONG TIME. PEOPLE WITH AUTISM DID NOT
SHOW AS MUCH PROGRESS AS THEY WERE CAPABLE OF BECAUSE IT WAS THE MIND SET THAT IT WAS
NOT A DIFFERENCE THAT WAS AMENABLE TO INTERVENTION AND WE’RE GOING TO TALK ABOUT HOW
THAT WAS ONE OF THE MOST MISGUIDED THOUGHTS THAT WE’VE HAD IN THE FIELD.
SO JOE WOULD BE CALLED IN TODAY’S WORLD, JUST A PERSON WITH AUTISM. SOMEBODY MIGHT
SAY HE IS A HIGH-FUNCTIONING. AND THERE IS THIS OTHER TERM, ASPERGER. AND TEMPLE GRANDIN
USES ASPIE AND IT IS A TERM I WANT US TO BE CLEAR ON.
HERE IS A YOUNG MAN WHO PROBABLY WOULD HAVE MET CRITERIA FOR WHAT PEOPLE CALL
ASPERGER.
(VIDEO)
>> I’M KAREN WOODINGS, I HAVE A 13-YEAR-OLD SON WHO WAS DIAGNOSED ON THE AUTISM
SPECTRUM.
>> HELLO, MY NAME IS MICKEY WOODINGS, OR KW.
>> NICK PROCESSES INFORMATION AND IT IS FASCINATING TO WATCH IT, REALLY. YOU CAN SPEAK
TO HIM AND HE WILL UNDERSTAND YOU. BUT FOR HIM TO TRULY PROCESS IT AND UNDERSTAND IT, AND
THEN ACT ON IT COULD BE WEEKS LATER.
>> SO, NOW, WHAT MAKES YOU UNIQUE AT SCHOOL?
>> WHAT MAKES ME UNIQUE AT SCHOOL IS THAT I LIKE TO CALL – USE MYSELF IN THE THIRD
PERSON AND I OFTEN REFER TO MYSELF AND USE MY INITIALS AND I HOPE YOU ARE NOT OFFENDED BY
THAT.
>> NOT AT ALL. WHAT MAKES YOU WANT TO DO THAT, DO YOU KNOW?
>> YOU KNOW MOM, I’M SORRY, I DO NOT KNOW. I’VE DONE IT FOR A COUPLE YEARS NOW AND I
STILL HAVEN’T FIGURED OR GIVEN IT MUCH THOUGHT AS TO WHY.
>> HE IS A NICE GUY AND HE WILL GROW UP TO BE A NICE GUY, BUT HE WILL BE A VERY QUIRKY
GUY. AND IT AFFECTS EVERYTHING. IT AFFECTS NOT NECESSARILY HIS ABILITY TO HAVE FRIENDSHIPS,
BUT IT DOESN’T MEAN THE SAME THING TO HIM. HE WANTS TO HAVE FRIENDS, HE JUST DOESN’T ALWAYS
KNOW HOW TO BE A FRIEND. HE WANTS TO BE SMART, BUT HE DOESN’T NECESSARILY HAVE THE SKILLS.
THE EDUCATIONAL ORGANIZATIONAL SKILLS TO STUDY AND BECOME SMART.
>> I HYPOTHESIZED THAT AUTISM MAY HAVE DIFFERENT EFFECTS.
>> I THINK IT IS TRUE.
>> I THINK I MAY BE ONE OF THE LUCKIEST PEOPLE.
>> WHY IS THAT?
>> BECAUSE I’M – HOW SHOULD I PUT THIS? BECAUSE I HARDLY GET SICK. AND IT IS RARE. AND
UM, WELL, I GUESS THE ONLY ONE BAD THING ABOUT IT, I HAVE VIDEO GAME AND COMPUTER GAME
ADDICTION FROM IT.
(LAUGHER)
>> HE WILL BE ALL OVER THAT SPECTRUM ON ANY GIVEN DAY. THEY LOOK AT HIM AND SPEAK TO
HIM AND HERE IS A KID WHO IS FUNCTIONING PRETTY WELL. IF HE GETS UPSET, HE CAN BE AT THE OTHER
END OF THE SPECTRUM WHERE HE SIMPLY CANNOT VERBALIZE ANYTHING, OR IT WOULD BE
INAPPROPRIATE. IT IS NOT AS SIMPLE AS SAYING, OH, HE IS DOING THIS AND WE HAVE TO STOP IT. BUT
WHY HE IS DOING THAT AND SOMETIMES YOU HAVE TO LOOK A LITTLE BIT DEEPER WITH OUR KIDS THAN
YOU WOULD WITH ANY OTHER TYPICAL KID IN YOUR CLASS.
(END)
PETER MUNDY: SO, WE HAVE TWO DIFFERENT PRESENTATIONS THERE. ONE, JOE, WHO WAS 16, HE
HAS A LITTLE BIT OF STRUGGLE TO SPEAK. HE WAS NOT INN ARTICULATE, BUT HE WAS AN EFFORTS. HE
HAD A HISTORY OF BITE AND IT WAS IDENTIFIED EARLIER IN LIFE. HE SHOWED BEHAVIORS THAT WERE
THE CLASSIC PROTOTYPE OF AUTISM.
SECOND YOUNG MAN, 13, DIDN’T REALLY SHOW THE CLASSIC PROFILE. HE WANTED TO INTERACT WITH
HIS MOM AND PROBABLY WANTS TO INTERACT WITH A LOT OF PEOPLE AT SCHOOL. THE IDEA OF
WITHDRAWN, AVOIDANCE BEHAVIOR OF AUTISM, WHICH WAS THE PRIMARY MODEL EARLY ON WAS
PRETTY MUCH WRONG. AND WE KIND OF KNEW IT WAS WRONG IN 1977, BUT IT TOOK 30 YEARS TO PROVE
IT THAT IT WAS WRONG. HE IS THE TYPE OF CHILD THAT WE CALL ASPERGER’S. WE NO LONGER MAKE
THAT DISTINCTION, AND THERE ARE A LOT OF PEOPLE AFFECTED BY IT, AND IS VARIES, BUT A LOT OF
PEOPLE ARE SMART. NOT AS SMART AS TEMPLE GRANDIN, BUT VERY SMART.
UNLESS YOU CAN EXPLAIN HUMAN NATURE, YOU CAN’T EXPLAIN AUTISM. IT IS AN INTEGRAL PART
OF HUMAN NATURE. WE UNDERSTAND HUMAN NATURE BETTER BY UNDERSTANDING AUTISM. IT IS GIVING
US CLUES AS TO WHAT ARE VERY IMPORTANT COMPONENTS, BUT WE REALLY DON’T UNDERSTAND IT YET;
IT IS JUST TOO COMPLEX.
NOW, IN THE NEXT 100 YEARS, WE ARE ON THE WAY. IT HAS TAKEN 50 YEARS TO BE ON THE WAY,
NOW I THINK WE ARE FOLLOWING PATHS THAT WILL ULTIMATELY LET US KNOW MUCH MORE ABOUT
AUTISM AND MUCH MORE ABOUT HUMAN NATURE.
LET’S GO BACK IN HISTORY, THIS IS SOMETHING THAT HAS EXISTED FOR A LONG TIME. THERE HAVE
BEEN CASED REPORTED BACK AT LEAST 200 YEARS. IT WAS FIRST IDENTIFIED AND SYSTEMATICALLY
DESCRIBED BY TWO PEOPLE, KANNER AND HANS ASPERGER. THE INFORMATION THAT ASPERGER
PROVIDED WAS DELAYED FOR ABOUT 20 YEARS.
WHAT KANNER SAID, THIS IS A BIOLOGICAL-BASED DISTURBANCE. DEFINITELY A BIOLOGICALLYBASED DISTURBANCE. THIS IS A GENETICALLY PREDISPOSED DEVELOPMENT THAT IS PART OF HUMAN
NATURE, BUT IS VERY DIFFERENT.
IT HAS SOMETHING TO DO WITH AFFECTIVE CONTENT, MAYBE THAT IS
TRUE AND WE’LL TALK ABOUT THAT.
TEMPLE GRANDIN WAS BORN IN 1947 AND HER PARENTS, BEING SMART, MANAGED TO TAKE HER TO
SOMEBODY ELSE WHO WAS VERY SMART, A PEDIATRICIAN, WHO THEN PRETTY MUCH DID THE RIGHT
THING AND SAID YOU HAVE TO GET SOMEBODY TO INTERVENE WITH YOUR DAUGHTER ALL THE TIME. AND
THEY STARTED THAT BY AGE 2 WITH TEMPLE. THAT IS ONE OF THE REASONS THAT WE’RE GOING TO GO
LISTEN TO HER IN FEBRUARY. TURNS OUT THIS EARLY INTERVENTION CAN CHANGE THE PRESENTATION
OF AUTISM FOR A LOT OF PEOPLE. SHE PROBABLY DID NOT RECEIVE THE DIAGNOSIS OF AUTISM IN 1947,
AND I WILL TELL YOU WHY IN A BIT, RIGHT NOW.
IT WAS NOT UNTIL 1980 THAT THAT WAS IN THE DIAGNOSTIC SYSTEM IN THE UNITED STATES, OR IN
THE EUROPEAN SYSTEM, EITHER. IT TOOK A LONG TIME. I THINK IT APPEARED IN THE EUROPEAN SYSTEM
IN 1978 AND HERE IN 1980. WHEN IT DID APPEAR, IT WAS TERRIBLY DEFINED, ONLY 5 CRITERIA. ONE WAY
THAT DESCRIBED WAS A PERVASIVE LACK OF RESPONSE TO OTHERS. IN 32 YEARS, I HAVE NEVER SEEN
THIS, NOT ONE.
AND IT IS BECAUSE PEOPLE DIDN’T REALLY KNOW HOW TO MAKE THAT OBSERVATION. THEY WERE
SO TAKEN ABACK BY THESE KIDS AND IF LEFT WITHOUT INTERVENTION, MANY PEOPLE WITH AUTISM WILL
END UP SHOWING A LOT OF STEREOTYPES. IF PROVIDING WITH INTERVENTION, FEWER PEOPLE SHOW
THIS. NO ONE WAS GETTING INTERVENTION FOR A LONG TIME. IN THE 80S, I WAS WORKING IN ONE OF THE
BEST CLINICS THE WORLD AND PEOPLE WERE BEING TOLD THERE IS NO HOPE AND YOU HAVE TO
INSTITUTIONALIZE YOUR KID. THAT WAS WRONG.
WE HAVE ALL SORTS OF POOR UNDERSTANDING. AT FIRST WE THOUGHT IT WAS A FORM OF
SCHIZOPHRENIA, BUT NOT THE CASE AT ALL.
IN APPEARS THE FEDERAL EDUCATION ACT AND 1994 IS WHEN WE TURNED THE CORNER. IT WAS
NOT UNTIL 1994 THAT WE HAD ANYTHING A APPROACHING A GOOD DESCRIPTION OF AUTISM THAT
ALLOWS US TO RECOGNIZE THIS DIFFERENCE IN NATURE. SAME THING IN EUROPE. THAT IS THE
INTERNATIONAL CLASSIFICATION OF DISEASE AND YOU SEE THE SAME PROGRESSION THERE.
SCIENCE IS POLITICS, SO KANNER HAD A BIOLOGICAL PERSPECTIVE, BUT HE BASICALLY HAD TO
RECANT UNDER PRESSURE FROM THE PSYCHODYNAMIC GROUP AND SAY, NO, IT IS NOT BIOLOGICAL, IT IS
ENVIRONMENTAL AND THE NOTION THAT IT WAS CAUSED BY AN ALOOF PARENTING STYLE EMERGED.
THAT TURNED OUT TO BE ABSOLUTELY INCORRECT, BUT IT HELD SWAY FOR CLOSE TO 20 YEARS. AND
AGAIN, DISRUPTED OUR ABILITY TO UNDERSTAND WHAT THE PROBLEM WAS.
IN THE 60S AND 70S, PEOPLE LOOKED AT IT AS A SENSORY PROCESSING OR PERCEPTION OR
LANGUAGE-BASED DISORDER. THOSE ARE NOT IMPORTANT, BUT ALL OF THEM FUNDAMENTAL. WHAT
HAPPENED, THE PRIMARY SOCIAL CHARACTERISTICS WERE NOT ATTENDED TO AT ALL AND WE MADE
VERY LITTLE PROGRESS THERE. IT WASN’T UNTIL THE 80S THAT WE REALLY STARTED TO MAKE
PROGRESS. LET ME ILLUSTRATE THIS. PAT HOWLIN, AT THE UNIVERSITY OF LONDON, WROTE THE
DEFINITIVE PAPER, IT WAS 7 PAGES LONG AND HAD 39 CITATIONS, 6 WERE EMPIRICAL. THERE WERE NO
OBSERVATIONS OF THE SOCIAL NATURE OF AUTISM PRIOR TO ABOUT 1975.
THEN, WE’VE GOT A SHORT PERIOD OF TIME, 8 YEARS LATER, ALL OF A SUDDEN IT IS 24 PAGES AND
116 CITATIONS. THERE WAS AN EXPLOSION. IT WAS THE APPLICATION OF INFANT DEVELOPMENTAL
SCIENCE TO AUTISM.
BECAUSE PEOPLE RECOGNIZED THAT, HEY, WE KNOW A LOT ABOUT INFANT DEVELOPMENT AND THESE
CHILDREN ARE DEVELOPING EARLY AND AUTISM IS SOMETHING THAT EXPRESSES ITSELF EARLY AND WE
SHOULD USE THE INFANT DEVELOPMENTAL MODELS AND THAT CHANGED HOW WE VIEWED AUTISM.
BECAUSE THERE WAS NOTHING THERE THAT PROVIDED FOR GUIDANCE AND DIAGNOSIS, WE HAD A
LACK OF RERESPONSIVENESS TO OTHERS 1980. THAT LASTED UNTIL 1994.
ONE OF THE THINGS THAT IS VERY IMPORTANT TO UNDERSTAND IS THAT MOST OF US, CORRECTLY
THINK OF AUTISM AS A DISTURBANCE OF SOCIAL INTERACTION. BUT IT IS NOT JUST ONE THING. IT IS
ALSO A DISTURBANCE OF LEARNING. AND TEMPLE GRANDIN TALKED ABOUT ONE ASPECT OF THAT IN HER
BOOK, SHE TALKED ABOUT MANY, BUT THE QUOTE REFERS TO ONE.
THE DIFFICULTY WITH REALLY MAKING LANGUAGE FUNCTIONAL. AND HERE SHE IS TALKING ABOUT
LEARNING TO READ AND SAYING, WHAT I CAN DO WELL, I COULD TAKE MY UNDERSTANDING OF
PHONEMES AND SOUNDS AND MAP THAT ON TO THE WORD. AND IT MADE SOME SENSE WHEN IT WENT TO
NOUNS, BUT BEYOND THAT, IT DID NOT MAKE SENSE. AND THAT TENDS TO BE TYPICAL FOR EVERYONE
WHO IS LEARNING TO READ. MOST PEOPLE LEARN TO READ NOW AND IT IS A LITTLE BIT MORE EASY THAN
VERBS. SHE IS TALKING ABOUT THE LEARNING COMPONENT OF AUTISM. THERE IS SOMETHING THERE
THAT DISRUPTS LEARNING AND IT DISRUPTS IT FROM INFANCY AND CONTINUES TO DISRUPT LEARNING
THROUGHOUT LIFE. THAT DOES NOT MEAN THAT PEOPLE WITH AUTISM DON’T LEARN OR CAN’T LEARN
WELL, IT IS JUST A DIFFERENT WAY OF LEARNING. THEY HAVE TO COME OUT LEARNING FROM A
DIFFERENT SET OF INFORMATION PROCESSES.
IT INVOLVES LEARNING FROM THE GET GO. AND PARTICULARLY LEARNING FROM AND WITH OTHER
PEOPLE. THAT IS ALMOST THE DEFINING NATURE OF AUTISM RIGHT THERE. A DIFFERENCE IN LEARNING
FROM AND WITH OTHER PEOPLE. CERTAINLY INTERVENTIONISTS WOULD SAY, “YES, THAT IS WHAT WE
WORK ON. HOW DO I GET THIS PERSON TO LEARN WITH AND FROM OTHER PEOPLE MORE QUICKLY,
EASILY AND ENJOYABLY?”
IF WE’RE TALKING ABOUT AUTISM AND WE UNDERSTAND THAT IT IS IDENTIFIED IN THE 40S, AND
PEOPLE STARTED TO SAY, “WELL, WE MIGHT NOT UNDERSTAND THIS, BUT WE’VE GOT TO TRY TO DO
INTERVENTION TO HELP PEOPLE AFFECTED WITH THIS DIFFERENCE.” THEN WHAT ARE WE GOING TO USE?
WE ARE GOING TO USE WHAT IS AVAILABLE AT THE TIME, THE BEHAVIORAL APPROACH. PEOPLE
THOUGHT ALL LEARNING COULD BASICALLY BE REDUCED TO BEHAVIOR, REINFORCEMENT AND
LEARNING. AND IT WORKED BEAUTIFULLY, REALLY WELL WITH ANIMAL MODELS, REALLY WELL. AS SOON
AS YOU TRANSITION TO HUMAN BEINGS AND PRIMATES AND DOLPHINS, A WHOLE GROUP OF ANIMALS, IT
DOESN’T WORK SO WELL.
AND THE REASON FOR THAT IS, THAT LEARNING BECOMES MORE COMPLEX. IS MODERATED BY
MORE THINGS IN HUMAN BEINGS THAN IT IS IN MOST ANIMALS. SAME THING FOR SOME OTHER GROUPS.
AND THIS BECAME APPARENT IN THE COGNITIVE REVOLUTION THAT WAS STARTED TO OCCUR IN
THE 50S. MOST OF YOU ARE FAMILIAR WITH CHOMSKY. SKINNER WROTE A BOOK TRYING TO DESCRIBE
ALL OF LANGUAGE LEARNING IN TERMS OF OPERANT PRINCIPLES AND IT HAD MANY LOGICAL ERRORS IN
IT. AND CHOMSKY POINTED THEM OUT AND SAID YOU CAN’T EXPLAIN THIS COMPLEX FORM OF LEARNING
IN TERMS OF OPERANT PRINCIPLES. AND HE PROPOSED THIS THING CALLED THE LANGUAGE ACQUISITION
DEVICE.
PEOPLE WERE TALKING ABOUT MEMORY AND LIMITED CONSTRAINTS OF MEMORY. MEMORY
EXPANDS UNTIL WE GET OLDER AND IT CAN KICK OFF AROUND AGE 5 IN TERMS OF SCHOOL-BASED
LEARNING, BUT THERE IS A CONSTRAINT THERE. PEOPLE BEGAN TO THINK ABOUT, WELL, WE KNOW
ENOUGH ABOUT THE COGNITIVE MEDIATORS OF LEARNING, WE CAN DEVELOP MACHINE LANGUAGE
REPLICATIONS AND TEST WHETHER IT IS REALLY WORKING. THE BEGINNING. SOFTWARE IN THE 50S.
THIS IS THE ONE THAT WE’RE GOING TO TALK ABOUT, BRUNER’S NOTION ABOUT LEARNING. AND
WHAT WAS IMPORTANT AND WHAT WAS MISSING FROM THE OPERANT PRINCIPLES.
AND BASICALLY BRUNER SAID SOMETHING VERY SIMPLE, AND JUST BEAUTIFUL IN A SENSE BECAUSE HE
SAID, “HUMAN LEARNING INVOLVES INDIVIDUAL KNOWLEDGE ACQUISITION, BUT ALSO A SET OF
MECHANISMS THAT ALLOW US TO SHARE A KNOWLEDGE.” AND THAT MUCH OF HUMAN LEARNING IS
BASED ON THE ABILITY TO SHARE KNOWLEDGE. SO IN ANY INSTRUCTIONAL SITUATION, RIGHT, YOU’RE
TRYING TO SHARE KNOWLEDGE WITH SOMEBODY AND PROVIDE THEM WITH THE KNOWLEDGE. AND YOU
AND THAT PERSON OR THAT GROUP OF PEOPLE HAVE TO ENGAGE IN A DYNAMIC COGNITIVE PROCESS
WHERE YOU’RE SHARING INFORMATION BACK AND FORTH.
YOU THINK WE WOULD HAVE RECOGNIZED THAT YEARS EARLIER, BUT BRUNER PUT IT INTO A
PARTICULAR FRAMEWORK THAT WAS VERY, VERY COMPELLING FOR MOST PEOPLE.
HE ALSO SAID THAT CONTRARY TO CHOMSKY, YOU CAN’T EXPLAIN LANGUAGE. HE KNEW THROUGH
OBSERVATIONS, AS DID MANY OTHER PEOPLE, THAT INFANTS ARE COMMUNICATING WELL BEFORE
LANGUAGE. THEY WERE DOING SOMETHING THAT IS IMPORTANT TO LANGUAGE INVESTMENT.
SOMETHING THAT YOU COULDN’T EVEN HAVE LANGUAGE DEVELOPMENT IF THIS WAS NOT EXPRESSING
ITSELF IN INFANTS. THAT IS ONE OF THE THINGS THAT WE’RE GOING TO BE TALKING ABOUT.
SO, PAYING ATTENTION TO WHAT OTHER PEOPLE ATTEND TO IS FUNDAMENTAL TO HUMAN
LEARNING. IF YOU’RE TIRED, IF I’M BORING, IF YOU ALREADY KNOW THIS STUFF AND YOU ARE HAVING A
HARD TIME PAYING ATTENTION IN THIS PARTICULAR DISCUSSION, YOU’RE NOT GOING TO BE ABLE TO
LEARN. IF YOU CAN’T PAY ATTENTION TO WHAT I’M TRYING TO GET YOU TO ATTEND TO, YOUR
ACQUISITION OF INFORMATION IS GOING TO BE LOW. ON THE OTHER HAND, IF YOU CAN PAY ATTENTION
TO WHAT I’M DIRECTING YOUR ATTENTION TO, THE LIKELIHOOD OF YOUR ACQUIRING THE INFORMATION
GOES UP. BEING ABLE TO SHARE ATTENTION WITH SOMEBODY ELSE, COMPLETELY MEDIATED LEARNING
IN INSTRUCTIONAL SITUATIONS. AND WE’RE NOT BORN WITH THAT ABILITY, WE HAVE TO DEVELOP IT. AND
WE DEVELOP IT EFFORT FULLY AND SLOWLY OVER 2, 3, 4, 5, YEARS OF PRESCHOOL DEVELOPMENT.
WE CALL THIS JOINT ATTENTION. AND THE DIFFERENCES THE DEVELOPMENT OF THIS ARE A MAJOR
FEATURE.
SO, THE CRITICAL ARTICLE, I THINK, IN TERMS OF OUR UNDERSTANDING OF HOW IMPORTANT THIS IS, WAS
PUBLISHED IN “NATURE” IN 1975. AND SCAIFE AND BRUNER AT OXFORD UNIVERSITY, PUT CHILDREN IN A
SITUATION THAT IS SIMILAR TO THIS. A TESTER WOULD LOOK LEFT OR RIGHT, DID NOT USE POINTING.
AND THEY FOUND THAT 2 MONTH-OLDS DID NOT RESPOND AT ALL, 4 MONTH-OLDS DID NOT RESPOND AND
6 MONTHS, 25% OF THE BABIES WERE LOOKING IN THE CORRECT DIRECTION. FROM 6 MONTHS ON UP
THROUGH 14 MONTHS, WITH EVERY CHANGE IN AGE, 2 MONTHS IN CHANGE IN AGE, THEY FOUND THAT
MORE AND MORE BABIES WERE FOLLOWING THE TESTER’S LOOKING. UNTIL FINALLY THEY WERE ALL
DOING IT.
NOW IN 1975, THAT WAS IMPOSSIBLE. ABSOLUTELY IMPOSSIBLE, BECAUSE PIAGET SAID THAT
BABIES ARE EGOCENTRIC, THEY CANNOT ADOPT THE VISUAL PERSPECTIVE OF SOMEONE ELSE UNTIL 24
TO 34 MONTHS AND NOBODY LOOKED UNTIL BRUNER AND SCAIFE LOOKED. IT REVEALED THAT THIS
CAPACITY TO FOLLOW PEOPLE’S ATTENTION DEVELOPED EARLY IN LIFE. BY 6, IT IS REALLY STARTING TO
EXPRESS ITSELF.
SO, WITH BRUNER’S PUBLICATION, THERE WAS ALSO ELIZABETH BAITS WAS TALKING ABOUT THE
SAME SORTS OF THINGS. AND VERNER AND KAPLAN IN THE 60S. WITH THAT SEQUENCE OF
PUBLICATIONS, PEOPLE STARTED TO SAY, WELL, THIS COULD BE VERY, VERY IMPORTANT TO ASSESS,
PARTICULARLY FOR THOSE OF US INTERESTED IN WORKING WITH CHILDREN WHO ARE AT RISK FOR NOT
LEARNING SO WELL.
AT THE LINDA RAY INTERVENTION CENTER IN MIAMI, JEFF AND HIS WIFE BEGAN TO OPERATIONALIZE
THIS. AND THEY DEVELOPED THE EARLY COMMUNICATION SKILLS AND I HAPPENED TO BE A GRADUATE
STUDENT WITH THEM. I HAD GONE ON TO DEVELOP THIS IN A DIFFERENT WAY AND THEY ARE NOT
INTERESTED IN THIS WAY ANYMORE. BUT THEIR DEVELOPMENT PAVED THE WAY FOR WHAT I’M GOING TO
TALK ABOUT.
ONE THING, YOU CAN MEASURE THIS THING CALLED RESPONDING TO ATTENTION. BEING ABLE TO
FOLLOW ATTENTION SYSTEMATICALLY, FROM ABOUT AGE 8, USING THIS MEASURE AND FROM ABOUT AGE
2 MONTHS, USING ALTERNATIVE MEASURES. IT IS RELIABLE AND ALMOST ALL 9 MONTH OLDS SHOW THIS
BEHAVIOR.
NOW, HERE IS A DIFFERENT ONE. THIS IS ONE OF THE IMPORTANT THINGS HERE, I DIDN’T LABEL IT,
HERE THE CHILD IS IN A SIGNAL RECEIVER ROLE. YOU ARE DOING SOMETHING AND THEY ARE GETTING
THE MESSAGE AND IT IS AFFECTING THEIR BEHAVIOR. THEY HAVE TO INTERPRET WHAT YOU ARE DOING.
IT IS ALSO THE CASE THAT THE CHILD CAN ADOPT THE SENDER ROLE AND THAT IS IMPORTANT TO
UNDERSTAND. IN THE FIRST TWO YEARS OF LIFE, KIDS ARE PLAYING WITH THE SENDER RECEIVER ROLE
AND SO IMPORTANT IN COMMUNICATION. AND USING THIS TO MAKE REFERENCE. YOU AND I CAN MAKE A
REFERENCE, WHEN YOU REFERENCE SOMETHING, YOU ARE TRYING TO GIVE INFORMATION OR SHARE AN
EXPERIENCE AND THE SAME WITH ME. IT IS A COMPLEX COGNITIVE FACILITY.
AND IT DEVELOPS FIRST IN TERMS OF THIS TYPE OF BEHAVIOR. A CHILD IS LOOKING AT SOMETHING
INTERESTING, A BOUNCING TOY. AND THEY TAKE ATTENTION AWAY FROM THE TOY TO LOOK AT
SOMEBODY ELSE, A STRANGER IN THIS CASE, AND THEN THEY COME BACK. AND THIS IS A 12 MONTH OLD.
HERE WE HAVE AN 8 MONTH OLD DOING THE EXACTLY THE SAME THING. AND WE FOUND THAT THIS
IS VERY EASILY MEASURED. AND THIS IS VERY RELIABLE. THAT BY 8 MONTHS, KIDS ARE PLAYING
AROUND WITH THE SENDER AND RECEIVER ROLE IN COMMUNICATIVE INTERACTIONS WELL BEFORE
LANGUAGE. AND THEY ARE ENGAGING IN REFERENCE. THEY ARE MAKING REFERENCE TO THINGS WITH
GESTURES AND RESPONDING WHEN OTHER PEOPLE MAKE REFERENCE.
SO, AFTER DEVELOPING THAT AT THE UNIVERSITY OF MIAMI, RIGHT BEFORE WE DEVELOPED IT,
ACTUALLY, THIS GUY NAMED FRANK CURCIO, IN BOSTON WENT INTO A CLASSROOM WITH CHILDREN WITH
AUTISM, THEY WERE OLDER, 16, 17, AND HE DID OBSERVATIONS AND HE FOUND SOMETHING INTERESTING.
THE PEOPLE WITH AUTISM, THE CHILDREN WITH AUTISM MADE A LOT OF EYE CONTACT. THEY WERE
MAKING A LOT OF EYE CONTACT WITH OTHER PEOPLE. THEY WERE ALSO USING GESTURES AND
COMMUNICATIVE BITS TO REQUEST THINGS AS FREQUENTLY AS THE OTHER CHILDREN, WHO ALSO HAD
DEVELOPMENTAL DISABILITY IN THIS CLASSROOM. NO DIFFERENCES IN EYE CONTACT OR GESTURAL
COMMUNICATION.
WHERE THERE WAS A BIG DIFFERENCE WAS THAT THE CHILDREN WITH AUTISM WERE NOT USING
GESTURES AND EYE CONTACT TO SPONTANEOUSLY SHARE AN EXPERIENCE, SHARE A TOY OR POINT.
THAT IS WHERE THEY DID NOT DO TOO MUCH WITH THAT. THAT WAS A VERY IMPORTANT STUDY. IT DID
NOT HAVE A CONTROL GROUP AND IT WAS AN OBSERVATION STUDY. A SEQUENCE OF OTHER STUDIES
CAME OUT. THIS ONE WITH ABOUT 4 CHILDREN. THIS LOOKING AT 1 OR 2 BEHAVIORS AND WORKING WITH
SIGMAN AT UCLA, WE USED THE SCALES AND MEASURED A WHOLE BUNCH OF DIFFERENT TYPES OF
BEHAVIORS AND FOUND THAT THAT JOINT ATTENTION DISTURBANCE WAS THE DIFFERENCE THAT
DISCRIMINATED CHILDREN WITH AUTISM, THESE ARE 4 TO 6-YEAR-OLDS, FROM OTHER CHILDREN WITH
OTHER DEVELOPMENTAL DISABILITIES AND OTHER CHILDREN WITH TYPICAL DEVELOPMENT.
THIS INITIATING BEHAVIOR, DISCRIMINATED 96% OF THE AUTISM GROUP FROM 96% OF THE OTHER
TWO GROUPS COMBINED. IT WAS A VERY POWERFUL BEHAVIOR. AND 20 YEARS LATER, A STUDY WITH
TYPICAL CHILDREN SHOWED THIS TYPE OF BEHAVIOR IS REALLY THERE BY 9 MONTHS. VERY FREQUENT,
HIGH FREQUENT BEHAVIOR AT 9 MONTHS. THIS IS SOMETHING THAT IS DEVELOPING PRETTY EARLY IN
INFANCY.
SO, REMEMBER THAT THE DIAGNOSTIC IN THE 80S, DESCRIPTION, AND THE PROTOTYPE THAT
ALMOST EVERYBODY HAD WHO WAS TRAINED IN THE 7S 0 AND 80S AND EVEN IN THE 90S WAS A
PERSPECTIVE LACK OF RESPONSE TO OTHERS. AND CHILDREN WITH AUTISM DISPLAY ATTACHMENT TO
THEIR PARENTS AS CLEAR AS ANY OTHER CHILD, WELL, THAT IS AN EXAGGERATION: MANY CHILDREN, IF
YOU IMITATE A CHILD WITH AUTISM, THEY BECOME AWARE OF IT PRETTY QUICKLY AND THEIR BEHAVIOR
SLOWS DOWN AND THEY START PAYING MORE ATTENTION TO YOU.
SOME CHILDREN WITH AUTISM DISPLAY EYE CONTACT, BUT ALSO SOCIAL LEARNING AND THEY
RESPOND TO IMITATION. THERE WAS LOTS OF DATA BY 1989 TO INDICATE THAT A PERVASIVE LACK OF
RESPONSIVENESS WAS NOT CORRECT. NOT ONLY WRONG, BUT MISLEADING. MOST CHILDREN WITH
AUTISM WERE NOT SHOWING THIS LACK OF RESPONSIVENESS TO OTHERS.
SO, BY 1994, WE HAD A VERY DIFFERENT DIAGNOSTIC SYSTEM. COUPLE OTHER CHANGES CAME UP,
TOO, BUT WE HAD A VERY DIFFERENT DIAGNOSTIC SYSTEM. AND ONE OF THE MAIN FEATURES WAS A
LACK OF SPONTANEOUSLY SHARING AND ENJOYING AN INTEREST. LET’S SEE IF THIS STUFF WILL WORK.
LET’S SEE WHAT TYPICAL SPONTANEOUS SHARING OF EXPERIENCE LOOKS LIKE IN A 12 MONTH OLD.
(VIDEO)
THAT IS PRETTY SOPHISTICATED. THAT IS NOT JUST SAYING, “I SEE THAT” IT IS I SEE THAT IT AND IS
WIGGLING AND I CAN WIGGLE JUST LIKE THAT. THAT IS VERY SOPHISTICATED AND COMPLICATED.
HERE IS A CHILD WITH DOWN’S SYNDROME AND THIS IS 18 MONTHS FOR THIS YOUNG MAN.
SO HE IS SHARING IT, -- THIS IS ME, BY THE WAY AND THAT IS A LONG TIME AGO. HE SHARED IT WITH ME
AND HE SHARED WITH HIS PARENTS BEHIND HIM. HE LOOKED AT ME AND THEN TURNED AROUND.
WHAT MOTIVATES SOMEBODY TO DO THAT? I DON’T HAVE AN ANSWER TO THAT QUESTION AND I’VE
BEEN ASKING THAT FOR 30 YEARS. HERE IS THIS TOY BOUNCING AROUND, WHY TAKE YOUR EYES OFF
AND LOOK AT YOUR PARENTS BECAUSE THEN IT HAS STOPPED.
HERE IS A CHILD WITH AUTISM. IT IS BOUNCING AROUND, HE IS SMILE, AND ENGAGED. HIS MOM IS
MOVING AROUND. VERY ENGAGED WITH IT. NOT LIKE HE IS NOT ATTENDING OR DOES NOT ENJOY IT, BUT
HE DOES NOT LOOK UP, SPONTANEOUSLY SHARE IT. ON THE OTHER HAND, LET’S LOOK AT WHAT
HAPPENS WITH THE SAME AGE CHILD, NOT THE SAME CHILD, UNFORTUNATELY, WHERE THERE IS
ANOTHER TYPE OF GAME CALLED THE SOCIAL INTERACTION GAME WHERE YOU REACH ACROSS AND
TICKLE THE CHILD AND THEN STOP AND SEE IF THE CHILD SAYS, YES, DO THAT AGAIN. THE PROTOTYPE
OF THE CHILD WITH AUTISM IS EITHER THAT THEY ARE NOT GOING TO NOTICE YOU DOING IT OR THEY WILL
NOT REQUEST IT AGAIN.
HE REACHES OUT AND WIGGLES HIS FINGERS AND SAYS, DO IT AGAIN, AND DOES THAT OVER AND
OVER AGAIN. THAT IS NOT A NONRESPONSIVE CHILD. BUT NOT A CHILD WHO WOULD ENGAGE IN THIS
ONE TYPE OF BEHAVIOR.
THEN WE HAD PRETTY MUCH A WHOLESALE CHANGE IN THE DIAGNOSTIC SYSTEM. SO ONE OF THE
THINGS THAT WAS ONE OF THOSE MISTAKEN IDEAS WAS THAT, THIS IS A QUOTE FROM MICHAEL RUTTER
AND SCHOPLER.
(READING TEXT) SO THAT IS 1987, 75% OF CHILDREN WITH AUTISM ARE THOUGHT TO HAVE INTELLECTUAL
DISABILITIES.
THE DIAGNOSTIC METHODS WERE POOR AND THE ESTIMATED PREVALENCE WAS 2 TO 3 PER 10,000.
IN 1990S, NIH ASKED A GROUP OF PEOPLE, PRIMARILY, CATHY AND MICHAEL AND OTHERS TO DEVELOP
STANDARDIZED MEASURES OF AUTISM FOR DIAGNOSTIC PURPOSES. THE FIRST CAME OUT IN THE
ULTIMATE FORM IN 1994, AS IDI AND THE SECOND IN THE ULTIMATE FORM, NOT QUITE THE ULTIMATE
FORM, SAME OUT IN 2000, THE AUTISM DIAGNOSTIC OBSERVATION SCHEDULE.
NOW, WITH THOSE MUCH BETTER MEASURES AND I WILL TELL YOU ABOUT THE MEASURES IN A
MINUTE, WE SEE ONE IN 65 PEOPLE. NOW, IF YOU EVER LOOK AT THE DATA FOR THIS, YOU KNOW THAT 1
IN 65 IS AN ESTIMATE BASED ON HUGE DIFFERENCES ACROSS STATES. SO IT IS LIKELY NOT TO BE SO
ACCURATE. IT IS PROBABLY MORE LIKE 1 IN 100 AND IT IS GOING TO VACILLATE BACK AND FORTH. MIGHT
BE 1 IN 65, BUT THERE IS A LOT OF ERROR, BUT NOT SO MUCH THAT WE THINK IT IS MORE THAN 1 IN 100.
BUT THERE IS A LOT OF ERROR IN THAT RIGHT NOW.
WHAT THERE IS NOT A LOT OF ERROR IN ACROSS THE STATES, THIS IS COMING FROM 11 DIFFERENT
STATES AND 300,000 CHILDREN. ONLY 30% OF CHILDREN WITH AUTISM IN THE SECOND GRADE HAVE
INTELLECTUAL DISABILITIES. 30%, NOT 75%, 30%. THAT IS ONE OF THE REASONS THAT WE COULDN’T
MAKE THE DIAGNOSIS OF CHILDREN WITH AUTISM. IN THE 90S, WE THOUGHT IT WAS TIED TO
INTELLECTUAL DISABILITY. IN IS ONLY TIED IN SYNDROMES LIKE FRAGILE X. IT IS SEPARATE FROM
INTELLECTUAL DISABILITY AND WHAT IS CALLED IDIOPATHIC AUTISM. THERE ARE A LOT OF CHILDREN
AFFECTED BY INTELLECTUAL AUTISM, MORE THAN OTHER POPULATIONS, BUT IT IS NOT STRONGLY TIED
TO INTELLECTUAL DISABILITY.
WHEN WE LOOK AT THE REVISED GOLD STANDARD THING, THE ADOS, WE CAN SEE THAT WE ARE
MEASURING A LOT OF JOINT ATTENTION BEHAVIORS. JOINT ATTENTION HAS BECOME PART OF THE
DIAGNOSTIC SYSTEM.
THIS IS MORE EXPRESSIVE. HERE WE HAVE 134 NURSES AT 49 CLINICS WHO ARE SCREENING 4,000 30
MONTH OLD AND 45 RECEIVE AUTISM BASED ON THE SCALE. THIS IS IT. IT HAS THREE JOINT ATTENTION
ITEMS THAT NURSES USE, RESPONDING TO NAME, WHICH IS AN INTERESTING ITEM. AND PRETEND PLAY
ITEM. AND NURSES ARE ABLE TO IDENTIFY AUTISM NOW JUST ON THE BASIS OF THOSE FIVE
OBSERVATIONS. THESE ARE THE THREE JOINT ATTENTION ITEMS ON THE SCALE AND THAT PLAYS A
MAJOR ROLE IN OUR ABILITY TO SEE THIS PROBLEM OR DIFFERENCE AMONG CHILDREN.
HERE WE HAVE 8 MONTH OLDS. ONE OF THE THINGS THAT WE LOOK AT NOW ARE THE INFANT
SIBLINGS OF CHILDREN WITH AUTISM. SO A FAMILY HAS A CHILD WITH AUTISM AND THEY HAVE ANOTHER
CHILD AND SOMETIMES THEY ARE RECRUITED INTO A STUDY AND WE CAN SEE HOW THAT CHILD
DEVELOPS AND ALSO TO SEE IF WE CAN DETECT AUTISM EARLIER AND EARLIER.
IN THIS PARTICULAR STUDY THAT CAME OUT OF THE GROUP IN MIAMI THAT I WORKED WITH FOR A
LONG TIME, THEY WERE ABLE TO DETECT AUTISM AT 8 MONTHS ON THE BASIS OF INITIATING JOINT
ATTENTION. THOSE THAT RECEIVED THE DIAGNOSIS AT 36 MONTHS, SHOWED THIS BEHAVIOR. PEOPLE
LONG THOUGHT IT WAS BECAUSE OF AFFECTIVE. BUT THIS DOES NOT PREDICT THE DIAGNOSIS AS WELL
AS THE NON-AFFECTIVE. IT ENDED UP BEING A PRETTY IMPORTANT DETAIL.
JOINT ATTENTION IS NOT JUST AN INFANT BEHAVIOR, WE’RE ENGAGED IN JOINT ATTENTION RIGHT
NOW. WHEN I LOOK AT PEOPLE AND YOU MAKE EYE CONTACT WITH ME AND YOU LOOK BACK UP HERE,
THAT MAKING OF EYE CONTACT HAS A VERY IMPORTANT AFFECT. IT ACTUALLY CHANGES YOUR
INFORMATION PROCESSING FOR A FEW SECONDS. IT INCREASES IT, RIGHT?
AND IT IS PART OF THE JOINT ATTENTION PROCESS. WHEN WE ENGAGE IN JOINT ATTENTION WITH
OTHER PEOPLE, WE ACTUALLY DO BETTER INFORMATION PROCESSING WHEN WE ARE NOT ENGAGED IN
JOINT ATTENTION. THAT IS ONE OF THE THINGS THAT CONTINUES INTO ADULTHOOD. JOINT ATTENTION IN
INFANCY IS RELATED TO THE DEVELOPMENT OF SOCIAL COGNITION AND SPONTANEOUSLY SHARING
EXPERIENCE WITH OTHERS, AN IMPORTANT SOCIAL BEHAVIOR. AND ALSO RELATED TO THIS THING
CALLED REFERENCE, OR DEIXIS. BRUNER WAS WILD ABOUT THIS AND RECOGNIZED THAT JOINT
ATTENTION IS ALL ABOUT REFERENCE. AND IT IS DENOTING WHAT IS IMPORTANT IN THE WORLD TO PAY
ATTENTION TO. AND THAT IS REALLY THE ESSENCE OF IT. IT ALSO HAPPENS TO BE SOMETHING THAT IS
VERY IMPORTANT TO LANGUAGE DEVELOPMENT.
BUT THIS IS BETTER. ALL THAT’S KIND OF INTERESTING, BUT LET’S HEAR AN ANECDOTE FROM
ANOTHER HIGH-FUNCTIONING PERSON WITH AUTISM. TIM PAGE, NOW AT USC. AND THE STORY THAT HE
TELLS IS THAT HE WAS IN CLASS, I THINK IT WAS EITHER SECOND OR FOURTH GRADE. AND THEY ARE IN A
TOWN OUTSIDE OF BOSTON AND GOING TO GO INTO BOSTON TO GO TO A MUSEUM. AND THE TEACHER
SAYS WE’RE GOING TO GO IN TODAY AND YOUR ASSIGNMENT IS TO WRITE ABOUT THE TRIP. AND SHE
USED THOSE TWO PHRASES, ACCORDING TO TIM. WHAT TIM DID WAS WRITE ABOUT THE TRIP.
(READING TEXT)
YOU CAN READ THE REST OF THAT. HOW DO YOU THINK THE TEACHER RESPONDED TO THAT? TIM SAYS
SHE TOOK A RED PENCIL AND WAS SO AGGRAVATED, RIPPED THROUGH THE PAGE AND SAID, “STOP
MESSING AROUND IN MY CLASSROOM!” TIM GOES ON TO SAY, “IT WAS UNCONVENTIONAL, BUT IT WAS
NOT, NOT ACCURATE. I COULD NEVER GET THE POINT OR ADOPT A COMMON PERSPECTIVE OF WHAT THE
TEACHER WANTED AND WHAT I WAS INTERESTED IN.” AND THAT IS THE ESSENCE OF AUTISM FOR HIGHER
FUNCTIONING PEOPLE. JUST LIKE TEMPLE. TEMPLE HAD GOTTEN MUCH BETTER, BUT SHE HAS AN
INTEREST, A LIMITED INTEREST, WHAT SHE IS INTERESTED IN AND SHE HAS BEEN ABLE TO MAKE A
CAREER OUT OF IT. BUT GETTING HER TO SHIFT FROM THAT INTEREST TO OTHER PEOPLE’S INTEREST IS A
DIFFICULT THING. SHE IS NOW 67, AS WE GET OLDER ALL SORTS OF THINGS HAPPEN. THIS IS HER
EXPERIENCE IN HIGH SCHOOL, TOO. WRITING ABOUT SOMETHING THAT DID NOT MATCH UP WITH THE
ASSIGNMENT WAS IT WAS OF INTEREST TO THEM AND NOT CLEAR WHAT THE POINT OF REFERENCE WAS
BY THE TEACHER. JOINT ATTENTION IS PLAYING A ROLE IN THAT.
I THINK I WILL JUST GO OVER THE INTERVENTION STUFF AND THEN WE’LL HAVE QUESTIONS. IF YOU
DON’T HAVE QUESTIONS AND YOU WANT TO STAY, I WILL TALK ABOUT NEURO DEVELOPMENT.
INTERVENTION, THIS IS THE MOST IMPORTANT AND PRETTY WONDERFUL STORY ON RESEARCH IN
AUTISM. IT DOES NOT GET NEARLY AS MUCH PLAY AS OTHER THINGS DO, BUT IT IS REALLY, REALLY,
GOOD NEWS.
AS WE MOVED FROM THE 1980S MODEL OF AUTISM, THIS DSM-5, SAYS SOCIAL COMMUNICATION AND
VARIABILITY IN EXPRESSIVE LANGUAGE MODERATES HOW EXPENSE THE AUTISM IS. IF YOU HAVE GOOD
LANGUAGE, THE INTENSITY IS LESS AND THE EFFECT ON THE QUALITY OF LIFE IS LESS. IF YOU HAVE NO
LANGUAGE, THE EFFECT IS GREATER. 30% OF CHILDREN WITH AUTISM REMAIN MINIMALLY VERBAL INTO
THE SCHOOL YEAR PERIOD. AND WE’RE STRUGGLING HOW TO INTERVENTION WITH THEM. BUT 70% HAVE
SUFFICIENT LANGUAGE THAT THEIR POTENTIAL IS PRETTY STRONG OR RELATIVELY STRONG IN SCHOOL
NOW.
SO WE’VE ALREADY TALKED ABOUT THIS. I HAVE NO IDEA WHY THAT IS THERE AGAIN. BUT THIS IS
WHAT I REALLY WANTED TO SAY. NOW WE KNOW THAT IT IS REALLY HARD TO DETECT AUTISM IN THE
FIRST 6 MONTHS OF LIFE, BUT WE’RE RIGHT ON THE CUSP OF PEOPLE ABLE TO DETECT IT BETWEEN 8 AND
18 MONTHS WITH SOME RELIABILITY. WE ALL THINK, MOST OF US DOING THE WORK THINK WE WILL NEVER
BE ABLE TO DETECT ALL OF THE KIDS IN THAT PERIOD OF TIME, BUT WHEN WE DO SEE IT, WE’LL BE
ACCURATE.
AND WE UNDERSTAND IT AS A DISTURBANCE OF LEARNING FROM OTHERS AS WELL AS SOCIAL
RELATIONS. AND THIS HYPERRESPONSIVENESS, REPETITIVE BEHAVIOR, IS A MAJOR PART OF THE AUTISM
SPECTRUM DEVELOPMENT OR DISORDER, WHAT THEY ARE CALLING IT IN THE UK IS AUTISM SPECTRUM
CONDITIONS. THIS IS THERE, BUT IT IS NOT REALLY CONNECTED TO THESE. THESE TWO ARE FAR BETTER
CONNECTED THAN THIS IS.
WHEN WE LOOK AT THE RESEARCH ON JOINT ATTENTION, WE CAN SEE THAT IT REALLY PREDICTS
HERE AT 4 YEARS, HERE AT YEARS, OUT TO LANGUAGE. THERE IS A TIGHT ASSOCIATION BETWEEN JOINT
ATTENTION DEVELOPMENT AND LANGUAGE DEVELOPMENT. VERY TIGHT. WE AGAIN AND AGAIN SEE THAT
JOINT ATTENTION IS VERY IMPORTANT TO LANGUAGE. IN FACT, WHEN PEOPLE DO COMPUTATIONAL
MODELING, THEY ARE IMPROVED IF THEY CAN MODEL JOINT ATTENTION.
WHY IS THAT?
WELL, NO ONE TEACHES YOU LANGUAGE. YOU LEARN LANGUAGE IN INCIDENTAL SITUATIONS. AND THE
EXAMPLE THAT I GIVE THAT I’M TIRED OF AND YOU HAVEN’T HEARD IT, IS, NO ONE TOOK YOU INTO THE
KITCHEN AND TAUGHT YOU ALL THE NAMES FOR CUTLERY. WE DIDN’T HAVE FORK DAY, MAYBE YOU DID
AT YOUR HOUSE, BUT NOT AT MINE. I WISH WE DID BECAUSE I GET CONFUSED. WE PICK THINGS UP
INCIDENTALLY. AND THAT IS A REALLY IMPORTANT THING TO THINK ABOUT. IF WE DO IT INCIDENTALLY,
HOW THE HECK DO WE DO THAT?
THE EXAMPLE IS, THIS IS FROM 1995 AND I HAVE NO IDEA WHY THIS IS JIGGLING AROUND SO MUCH.
BABIES PICK UP WORDS IN OPPORTUNISTIC SITUATIONS WHERE A NEW OBJECT IS LABELED AND THE
CHILD HAS TO FIGURE OUT THE CORRECT MAPPING BETWEEN THE LABEL AND THE OBJECT. IT IS CALLED
A REFERENTIAL MAPPING PROBLEM. AND MANY CHILDREN HAVE REFERENTIAL MAPPING ERRORS
BECAUSE THEY CAN’T FIGURE IT OUT.
THAT NARROWS DOWN THE ENVIRONMENT AND THEY ARE MORE LIKELY TO MAP THE RIGHT WORD
ON THE RIGHT OBJECT AND JOINT ATTENTION ACTS AS A MECHANISM FOR LANGUAGE AND OTHER
ASPECTS OF LEARNING AS WELL. IF THIS IS GOOD, WHEN YOU FOLLOW SOMEBODY’S ATTENTION,
IMAGINE HOW GOOD IT IS WHEN YOU POINT SOMETHING OUT TO SOMEBODY. WHEN YOU SAY, (POINTING)
AND SOMEBODY SAYS PROJECTOR, IT SAYS, I’M INTERESTED IN THAT AND YOU ARE READY TO TAKE
INFORMATION, AND IF YOU GIVE ME A LABEL, I’M LIKELY TO MATCH IT TO THE REFERENCE. EVEN MORE
LIKELY WHEN I INITIATE THE REFERENCE. IJA IS EQUALLY IMPORTANT, IF NOT MORE IMPORTANT TO
LANGUAGE DEVELOPMENT.
LET’S GO BACK AND THINK ABOUT THE BEHAVIORAL APPROACH TO LEARNING AND THE IDEA THAT
THAT’S GOING TO BE VERY USEFUL TO GUIDE INTERVENTION FOR CHILDREN WITH AUTISM. LOBAS IN 1987
PUBLISHED THE FIRST PAPER INDICATING THAT A BEHAVIORAL LEARNING APPROACH HAS A STRONG
IMPACT. HIS STUDENT, TRIS SMITH, HAS CONTINUED THAT WORK AND DONE THINGS THAT ARE MORE
PRECISE AND RIGOROUS WITH THIS PARTICULAR METHOD. NOT ONLY HAS HE DEVELOPED THE
BEHAVIORAL METHODS, HE ALSO DEVELOPED THE RESEARCH TO REALLY SHOW WHETHER OR NOT IT HAS
EFFICACY.
AND HERE IS A VERY GOOD STUDY, 42 CHILDREN, SOME ARE IN EARLY INTENSIVE BEHAVIORAL
INTERVENTION, WHICH IS USING BEHAVIORAL PRINCIPLES AND 21 CHILDREN ARE IN A CURRICULUM IN THE
COMMUNITY THAT IS NOT USING THAT. IT IS CALLED DISCRETE TRIAL, ADULT DIRECTED INSTRUCTION AND
YOU GET 50 MINUTES PER HOUR OF THE ADULT DIRECTING THE ATTENTION OF THE CHILD AND TRYING TO
IMPART INFORMATION TO THE CHILD. THEY HAVE TO ENGAGE IN JOINT ATTENTION, BUT IT IS ALL ADULTDIRECTED JOINT ATTENTION.
AND YOU KNOW, IT WORKS. IT REALLY WORKS. SO HERE, LET’S LOOK AT THAT QUADRANT RIGHT
HERE. THIS IS AN I.Q. MEASURE AND THIS AS WELL. THE GROUPS START OUT VERY SIMILAR. OVER THE
COURSE OF INTERVENTION AND FOLLOW UP, THE GROUP THAT IS GETTING THE BEHAVIORAL, THE
LEARNING, THE OPERANT-BASED DOES BETTER. HERE, THE GROUP IS RIGHT AT THE MEAN IS RIGHT AT
THE LEVEL FOR INTELLECTUAL DISABILITIES AND HALF THE GROUP REMAIN BELOW.
SO THIS IS JUST ONE OF ABOUT 8 OR 9 VERY WELL DONE STUDIES THAT INDICATE THAT
BEHAVIORAL APPROACHES HAVE A VERY IMPACT ON CHILDREN AND LEARNING.
THEN WE HAD THIS IDEA THAT WE HAVE TO CAPITALIZE OF THE FUNCTIONS OF HUMAN MINDS IN
ORDER TO REALLY IMPACT LEARNING AS WELL AS POSSIBLE. SO, IN THE 80S, A GUY NAMED MICHAEL
TOMISELLO, NOTICED THAT PARENTS COULD DO ONE OF TWO THINGS; FOLLOW THE ATTENTION OF THEIR
CHILD AND GIVE THE CHILD INFORMATION IN THE CONTEXT OF THEIR EXPRESSED OR MANIFEST INTEREST,
OR THEY COULD REDIRECT THE ATTENTION OF THEIR BABY AND GIVE THEM INFORMATION ABOUT SOME
OBJECT THAT THEY WERE NOT PAYING ATTENTION TO, TO BEGIN WITH. IF YOU FOLLOW THE ATTENTION
OF CHILDREN AND PROVIDE INFORMATION, IT SLIGHTLY BETTER AND IT IMPROVES LANGUAGE BETTER
THAN IF YOU ARE CONSTANTLY REDIRECTING.
MARIAN AND MIKE DID A STUDY LIKE THIS OF CHILDREN WITH AUTISM AND THEY FOUND EXACTLY
THE SAME THING. IF YOU FOLLOW THE GAZE OF THE CHILD WITH AUTISM, THEY ARE MORE LIKELY TO PICK
THINGS UP RATHER THAN IF YOU REDIRECT.
THAT HAS LED TO A NEW TYPE OF INTERVENTION THAT IS NOT SO BEHAVIORAL. INSTEAD, IT IS
BASED ON THE IDEA THAT YOU FOLLOW THE ATTENTION OF YOUR CHILD AND YOU PRESENT INFORMATION
IN THE CONTEXT OF THAT. IT IS CALLED INCIDENTAL LEARNING OPPORTUNITIES. BUT IT GIVES THE CHILD
CONTROL. SO THIS IS CALLED A CHILD-CONTROL VERSUS ADULT-CONTROL INTERVENTION. I SHOULD SAY
THIS TYPE OF INTERVENTION USES BOTH, BOTH TYPES. BUT THEY INCREASE THE NUMBER OF THE
INCIDENTAL TRIALS IN ORDER TO GET THE BENEFITS OF THE CHILD DIRECTING ATTENTION AND THEN
GETTING INFORMATION.
THEY ARE NOT AS INTENSIVE. YOU DON’T NEED SO MANY HOURS OF INTERVENTION. AND THEY ARE
JUST AS EFFECTIVE. SO THIS, BY USING THE INCIDENTAL FOLLOWING OF THE CHILD’S ATTENTION, SALLY
ROGERS, IN PARTICULAR, SHE HAD BEEN DEVELOPING THAT METHOD FROM THE LATE 70S. AND SHE WAS
REALLY THE PERSON THAT DEVELOPED IT AND IT IS A VERY EFFECTIVE METHOD. AND IT IS PROBABLY
MORE EFFICIENT THAN THE BEHAVIORAL ONLY APPROACH. AND YOU CAN SEE HERE, THAT THE RESULTS
ON AN I.Q. MEASURE ARE PRETTY MUCH THE SAME AS TRIS SAW WITH THE OPERANT APPROACH, ONLY
THIS TOOK LESS TIME.
BUT NOW WE COME TO THIS IDEA OF SAYING, OKAY, BUT IF WE UNDERSTAND LEARNING FROM A
COGNITIVE PERSPECTIVE, AND WE THINK JOINT ATTENTION IS THE CRITICAL THING, OR A CRITICAL POINT
THERE, LET’S TARGET JOINT ATTENTION AND DEVELOP TARGETED TREATMENTS FOR JOINT ATTENTION.
AND NOT MANY PEOPLE KNOW THIS. WHEN NIH STARTED FUNDING THESE LARGE, NATIONAL RESEARCH
SYSTEMS, CPEA, START NOW, THE AUTISM CENTERS OF EXCELLENCE, THE FIRST INTERVENTION PROJECT
THAT THEY FUNDED WAS TARGETED JOINT ATTENTION. IT GOES BACK TO 1997.
CONNIE’S PROJECT, NOW HAS DEVELOPED A MAJOR LITERATURE THAT SHOWS THAT YOU CAN TARGET
JOINT ATTENTION. AND YOU CAN DO IT IN TERMS OF 5 TO 6 WEEKS OF 30 MINUTES A DAY OF JOINT
ATTENTION TARGETED INTERVENTION. SO YOU CAN DO IT IN THE CONTEXT OF ANY OTHER INTERVENTION.
HER STUDIES ARE PROVIDING THAT 5 WEEKS, BOOSTER OF JOINT ATTENTION IN THE CONTEXT OF THE 50
MINUTES PER HOUR, TWO YEARS OF BEHAVIORAL INTERVENTION. AND WHAT SHE FINDS IS THE CHILDREN
WHO GET THE JOINT ATTENTION INTERVENTION END UP DOING MUCH BETTER ON LANGUAGE THAN THE
GROUP OF KIDS WHO ARE IMPROVING ON THE BEHAVIORAL INTERVENTION AND IMPROVING ON
SOMETHING CALLED THE SYMBOLIC PLAY. BUT THE JOINT ATTENTION WAS THE STRONGEST
INTERVENTION BECAUSE IT TARGETS A LEARNING MECHANISM. IT TARGETS A HUMAN LEARNING
MECHANISM THAT IS IMPORTANT TO LANGUAGE LEARNING AND OTHER FORMS OF LEARNING.
SHE ALSO FOUND THAT JOINT ATTENTION MEASURES PREDICT FOLLOW UP LANGUAGE AND
COGNITION, 4 YEARS LATER. AND PREDICTS REDUCTION IN SYMPTOM PRESENTATION AND THE MOST
IMPORTANT THING IS, THAT INTERVENTION WORKED BEST FOR THE CHILDREN WITH THE LOWEST INITIAL
IJA. THAT IS IMPORTANT BECAUSE CONNIE HAS GONE ON TO PUBLISH A STUDY THAT SHOWS THAT JOINT
ATTENTION IN COMBINATION WITH COMPUTER-BASED COMMUNICATION DEVICES, CAN ACTUALLY BENEFIT
CHILDREN WHO ARE MINIMALLY VERBAL, WHO ARE IN THE FIRST AND SECOND GRADE. MAYBE IT WAS
KINDERGARTEN OR FIRST.
THE REASON THAT NEURO DEVELOPMENT IS IMPORTANT BECAUSE WHEN YOU ARE TRYING TO
UNDERSTAND SOMETHING LIKE AUTISM, THE FIRST THING IS IDENTIFICATION. THE SECOND THING IS
INTERVENTION, MAKING IT BETTER, YOU HAVE TO IDENTIFY KIDS BEFORE YOU CAN DO INTERVENTION.
WHEN WE WERE NOT IDENTIFYING KIDS, NOBODY WAS DOING INTERVENTION. WE’VE GOTTEN BETTER AT
IDENTIFYING AND NOW BETTER AT INTERVENTION, NOT PERFECT, IT HELPS ONLY 60% OF THE CHILDREN
WHO FLOW INTO THEM. THE OTHER THING IS THE NEURO DEVELOPMENT. AND THE SHORT EXPLANATION
HERE IS WE CAN ACTUALLY BEGIN TO SEE THE DEVELOPMENT OF JOINT ATTENTION AT 5 TO 6 MONTHS
USING DIFFERENT IMAGING TECHNIQUES, IN TYPICAL CHILDREN. THAT IS PROBABLY GOING TO HELP US
IDENTIFY WHAT IS GOING ON EARLIER IN KIDS WITH AUTISM. WE LOOK AT ADULTS AFFECTED BY AUTISM
AND WE LOOK AT THEIR IMAGING STUDIES, WE SEE THIS CLEAR PATTERN OF THE FRONTAL AND THE
PARIETAL PART OF THE BRAIN WORKING TOGETHER IN PEOPLE WITHOUT AUTISM. IN PEOPLE WITH
AUTISM, THEY ARE ABLE TO DO THE JOINT ATTENTION, BUT THERE IS NO PART OF THE BRAIN THAT IS
WORKING FOR ALL PEOPLE WITH AUTISM, THE BRAINS ARE ATTACKING THE PROBLEM WITH ALL SORTS
OF DIFFERENT REGIONS. IT IS LIKE THERE IS NO SYSTEMATIC DEVELOPMENT OF A JOINT ATTENTION
SYSTEM, EVEN THOUGH THEY ARE ABLE TO DO JOINT ATTENTION. THAT IS NOT SPECIFIC TO AUTISM; WE
SEE THAT A LOT. WE SEE THAT THEY ARE CAPABLE OF DOING THINGS, BUT THE WAY THEY’RE DOING IT, IT
IS VERY DIFFERENT FROM OTHER PEOPLE.
AGAIN, I THINK THAT YOU KNOW, THIS IS ONE SLICE, IT IS NOT EXPLAINING EMPATHY. IT IS NOT
EXPLAINING THE SENSORY PROBLEMS THAT THE CHILDREN HAVE. IT IS NOT EXPLAINING WHY SOME
CHILDREN – THE BIG THING, IT IS NOT EXPLAINING WHY SOME CHILDREN END UP HAVING INTELLECTUAL
DISABILITIES AND OTHERS DON’T. IT IS NOT EXPLAINING WHY WHEN KIDS DO WELL IN SCHOOL AND THEY
PRETTY MUCH DO, THEY DON’T DO WELL WITHOUT THE STRUCTURE OF SCHOOL. BUT IT DOES EXPLAIN
SOME THINGS; WERE WE’RE ABLE TO BETTER IDENTIFY CHILDREN AND SOME ASPECTS OF WHY WE’RE
BETTER ABLE TO INTERVENE.
>> IN YOUR RESEARCH, DO YOU COME ACROSS CHILDREN WHO ARE ALSO ON THE SPECTRUM, BUT
HAVE HEARING OR VISION LOSSES?
PETER MUNDY: ABSOLUTELY, AUTISM IS PART OF HUMAN NATURE AND IT EXPRESSES WITH
SENSORY PROBLEMS. ANYTHING THAT CAN BE EXPRESSED IN HUMAN NATURE CAN BE EXPRESSED IN
COMBINATION WITH AUTISM. IT IS PARTICULARLY HARD, THOUGH, YOU ARE RIGHT, WHEN VISION
PROBLEMS, HEARING, SENSORY PROBLEMS, SEIZURE DISORDERS ARE COMBINED WITH AUTISM. THAT IS
A HARD THING FOR ANYONE TO DO.
>> WHAT CAN YOU DO FOR JOINT ATTENTION LEARNING ISSUES FOR A CHILD WHO IS DIAGNOSED
LATER, AROUND SECOND OR THIRD GRADE?
PETER MUNDY: THAT IS USUALLY A CHILD WHO IS A FAIRLY BRIGHT CHILD. THAT IS ONE OF THE
REASONS A WE DO THE EPIDEMIOLOGY IS IN ORDER TO CAPTURE ALL THOSE CHILDREN. WE DON’T HAVE
A COMPLETE UNDERSTANDING YET. MOST OF THE RESEARCH IS DONE WITH PRESCHOOL CHILDREN.
WHAT I TALK TO PARENTS ABOUT IS JOINT ACTIVITY AND COLLABORATIVE FIST. THEY BOTH PUT A HIGH
DEMAND. IF YOU CAN ENGAGE IN AN ACTIVITY THAT A CHILD LIKES AND ARE MOTIVATED BY, YOU CAN
GET THEM TO PAY MORE ATTENTION AND SHARE THE EXPERIENCE WITH OTHER PEOPLE. IT IS THE
PIVOTAL PLATFORM IN WHICH YOU DO THAT.
MANY PEOPLE PAY A LOT OF ATTENTION TO WHERE OTHER PEOPLE ARE LOOKING TO GET A CLUE
TO WHAT THEY ARE THINKING OR WHAT THEY’VE JUST EXPERIENCED. SO LET’S PLAY AROUND WITH THAT
TODAY AS WE WALK AROUND. LET’S LOOK AT PEOPLE AND LOOK AT WHAT THEY’RE LOOKING AT AND
SEE IF WE CAN THINK ABOUT WHAT THEY MIGHT BE SEEING AND FEELING AND JUST GET PEOPLE TO
EXPLAIN IT AND PRACTICE IT. BUT NOBODY’S DEVELOPED, OUTSIDE OF CONNIE, OR MINIMALLY VERBAL
CHILDREN, AND YOU SHOULD LOOK UP CONNIE KASARI, NOBODY HAS DEVELOPED THIS TYPE OF
PACKAGE YET. MAINLY BECAUSE THIS IS AN INFANT PEOPLE.
>> I HAVE A COUPLE QUESTIONS, ONE IS, HOW COMMON IS THIS JOINT ATTENTION TYPE OF
INTERVENTION IN PRACTICE RIGHT NOW WITH PARENTS? AND NUMBER TWO, I’M REALLY INTERESTED IN
BILINGUAL HOUSEHOLDS AND HOW THAT PLAYS A ROLE IN LANGUAGE DEVELOP. IS THERE A BENEFIT,
WHAT TYPES OF ADVISE OR WHAT CAN YOU SAY ABOUT THAT?
PETER MUNDY: LET’S GO TO THE FIRST QUESTION. I ACTUALLY DON’T KNOW HOW MANY PARENTS
NATIONWIDE HAVE THESE KINDS OF INTERVENTIONS AVAILABLE TO THEM. I WOULD SAY THAT EITHER
THE BEHAVIORAL, SOMETHING LIKE THE EARLY STAR DENVER MODEL OR TARGETED JOINT ATTENTION IS
AVAILABILITY IN ALMOST ANY UNIVERSITY CENTER THAT FOCUSES ON AUTISM. BUT THOSE ARE THE
PLACES THAT ARE LIKELY TO LET PARENTS BENEFIT FROM THEM.
BACK IN 1994, JERRI DAWSON AND HER STUDENT MADE A VERY IMPORTANT OBSERVATION; THERE
HAD BEEN A COUPLE STUDIES SHOWED THAT CHILDREN WITH AUTISM RESPOND TO BEING IMITATED,
YOUNG. IT WAS SHOWN THIS ACTUALLY BOOSTS. MANY INTERVENTIONISTS NOW USE IMITATING
CHILDREN WITH AUTISM AS A WAY TO GET THE CHILD TO BE MORE AWARE OF OTHER PEOPLE, AND THE
SYNCHRONY OF BEHAVIOR BETWEEN OTHER PEOPLE AND THAT BEGINS TO FACILITATE JOINT ATTENTION.
IN THAT SENSE, MANY EARLY INTERVENTION PROGRAMS HAVE A COMPONENT THAT TARGETS JOINT
ATTENTION. CONNIE’S GOING BEYOND THAT, BY USING IMITATION AND NOT TOO MANY PEOPLE OUTSIDE
OF LOS ANGELES ARE GETTING THAT.
BILINGUALISM. DOES IT FACILITATE LANGUAGE DEVELOPMENT IN ALL CHILDREN OR SPECIFICALLY
ABOUT CHILDREN WITH ASD?
>> BOTH. I FIGURED THERE IS PROBABLY MORE KNOWN ABOUT TYPICAL DEVELOPMENT, BUT I
DON’T KNOW.
PETER MUNDY: NOT MUCH WITH RESPECT TO JOINT ATTENTION. THERE IS A FACULTY MEMBER AT
SANTA CRUZ WHO HAS SHOWN THAT THE TENDENCY TO ENGAGE IN JOINT ATTENTION MIGHT BE SLIGHTLY
DIFFERENT ACROSS CULTURES. BUT KNOWN ONE HAS SHOWN THAT IT IS DIFFERENT IN TERMS OF ITS
IMPACT ON LANGUAGE DEVELOPMENT. AND WE SEE IT IN CHINA. IT IS LIKELY THAT REGARDLESS OF THE
LANGUAGE AND BILINGUALISM, YOU HAVE TO ENGAGE IN JOINT ATTENTION. IT IS ADOPTING A COMMON
POINT OF REFERENCE. IF YOU DON’T ADOPT THE POINT OF REFERENCE, IT IS HARD TO LEARN LANGUAGE.
BILINGUALISM PROBABLY DOES FACILITATE IT IN SOME WAYS, BUT THE LITTLE I KNOW IS THAT YOUNG
CHILDREN TEND TO STORE THE LEXICONS IN TWO DIFFERENT LANGUAGES SO THEY DON’T GET A HUGE
BENEFIT IN ONE LANGUAGE OR ANOTHER. BUT ULTIMATELY, THERE IS EVIDENCE THAT IT IS BENEFICIAL
TO BEING ABLE TO PICK UP OTHER LANGUAGE AND BEING ABLE TO THINK IN TWO LANGUAGES. AMONG
CHILDREN WITH AUTISM, I DON’T KNOW OF ANY STUDIES THAT HAVE TACKLED THAT ISSUE. I DON’T THINK
WE’RE DOING AS WELL AS WE COULD IN FULLY PENETRATING INTO ALL COMMUNITIES TERMS OF
DIAGNOSIS, FOR ONE. AND TWO, WE’RE HARD-PRESSED TO FIGURE THIS OUT IN GENERAL, LET ALONE
TRYING TO FIGURE OUT THE BILINGUALS. BUT SALARY ROGERS MAY KNOW MORE ABOUT THAT AND YOU
CAN E-MAIL HER. AS WELL AS CONNIE.
>> CAN EARLY INTERVENTION REVERSE AN AUTISM DIAGNOSIS? IF SO, DOES THAT AFFECT OUR
UNDERSTANDING OF AUTISM?
PETER MUNDY: IT IS NOT CLEAR, NO ONE HAS FOLLOWED ENOUGH CHILDREN WHO ARE GETTING
EARLY INTERVENTION OR WHERE WE KNEW EXACTLY WHAT THE EARLIER INTERVENTION WAS TO SAY
THAT IT LED TO A CHILD MOVING FROM THE DIAGNOSTIC CATEGORY OUT. HOWEVER, PEOPLE HAVE
FOLLOWED CHILDREN WITH AUTISM AND FOUND THAT A PROPORTION DO SEEM TO MOVE FROM THE
CATEGORY OUT OF THE CATEGORY.
WHICH WOULD BE EXPECTED YOU TAKE THIS IDEA OF A RELATIVE OR FUZZY CATEGORY WHERE
YOU ARE IN THE CATEGORY. IF YOU ARE EXTREME ON A SET OF DIMENSIONS, BUT LESS EXTREME OVER
TIME AND THEREFORE, MOVE OUT OF THE CATEGORY. THAT IS ALSO A HINT THAT IT PROBABLY WOULD
BE BIOLOGICAL. IT WITH MOVE ACROSS PRESENTATION OF ANY SORT OF BIOLOGICAL – LANGUAGE IS
BIOLOGICALLY BASED. I’M NOT SURE WE WOULD SAY IT IS BIOLOGICALLY-BASED TO SEE THAT, BUT WE
DO SEE THAT, OR AT LEAST SOME RESEARCH GROUPS CLAIM TO SEE PEOPLE TRANSITIONING OUT.
>> AS A COMMENT, THIS IS PERPETUAL AMONG COLLEAGUES IN THE FIELD. A SENSE OF
REMISSION OR CURE OR WERE THEY NOT EXACTLY DIAGNOSED IN THE FIRST PLACE OR MORE OF A
LANGUAGE DELAY. WHAT WE ALSO TEND TO SEE ARE “MIRACLE” BABIES WHO GO FROM FAIRLY
INTENSIVE NEEDS VERY YOUNG TO VERY FUNCTIONAL YOUNG ADULTS. IT IS A GREAT DISCUSSION AND
DEBATE.
PETER MUNDY: THE CHILD JOE THAT WE WERE LOOKING AT LOOKED VERY SEVERELY IMPAIRED.
THERE IS SOMETHING CALLED THE REACTION RANGE AND WE ALL HAVE THAT ON ANY OF THE
DIMENSIONS WHERE IN THE RIGHT ENVIRONMENT, WE CAN BE AT THE TOP OR THE BOTTOM OF THE
REACTION RANGE. IT MAKES PERFECT SENSE THAT SOME PEOPLE WITH AUTISM CAN MOVE TO THE TOP
OF WHATEVER THE REACTION RANGE IS. FOR SOME PEOPLE, THAT MAY APPEAR TO BE OUT OF THE
DIAGNOSTIC CATEGORY. TIM PAGE WAS THE CLASSICAL MUSIC REVIEWER FOR THE WASHINGTON POST.
HE IS A VERY GOOD WRITER AND VERY GOOD WITH MUSIC. HE HAS AN ADAPTIVE LIFE. HE IS NOW AT THE
COMMUNICATION SCHOOL AT USC AND A FACULTY MEMBER. IF YOU TALK TO TIM, HE WOULD NOT SAY
THAT HE’S NOT AFFECTED BY AUTISM ANYMORE. BUT IF I WERE TO LOOK AT TIM, I WOULD SAY, HE MIGHT
NOT BE AFFECTED BY AUTISM ANYMORE. CONVERSELY, SOMEBODY WHO IS ON THE SPECTRUM MIGHT
SAY, I AM NOT AFFECTED BY AUTISM ANYMORE. BUT SOMETHING LOOKING AT THEM MIGHT SAY THEY
ARE. IT IS A VERY CONFUSING PICTURE AND ONE THAT IS PROBABLY INSOLUBLE GIVEN THE
HETEROGENEITY OF THE PRESENTATION. IT IS CLEAR THAT SOME PEOPLE SHOW REALLY DRAMATIC
GROWTH, SO DRAMATIC THAT THEY MAY STILL BE AFFECTED, BUT IT DOESN’T APPEAR THAT WAY TO
OTHER PEOPLE. WHEN YOU SEE TEMPLE GRANDIN, YOU PROBABLY WON’T SEE SOMEBODY THAT YOU
SAY, OH, THAT PERSON IS NO LONGER AFFECTED BY AUTISM. SHE’S VERY HIGH FUNCTION AND VERY
SMART, BUT STILL CLEARLY AFFECTED.
>> IS THERE ANY RELATIONSHIP BETWEEN SENSOR AND INTELLECTUAL DISABILITIES
PETER MUNDY: I DON’T KNOW, I DON’T THINK SO. I DO KNOW THAT SENSORY PROBLEMS ARE AN
INTERESTING ONE. WHEN WE LOOKED AT THOSE TWO EXAMPLES, WE HAD SOMEBODY WHO WAS
WITHDRAWN AND ALOOF AND SOMEBODY WHO WAS ACTIVE AND ENGAGED. WITH SENSORY PROBLEMS,
MOST PEOPLE THINK IT IS HYPERRESPONSIVE. BUT IT IS NOT, IT IS HYPO RESPONSIVENESS. AND THAT
TENDS TO BE THE MORE CHRONIC PROBLEM. THE HYPERRESPONSIVENESS REDUCES OVER TIME AND
MOST PEOPLE ARE SHOWING HYPORESPONSIVENESS IF THEY SHOW ANY SORT OF ABNORMALITY AT ALL.
AND THE HYPO RESPONSIVENESS IS SHOWN IN MANY PEOPLE WITH LANGUAGE. BUT I DON’T HAVE A
STUDY IN MIND FOR THAT PARTICULAR PROBLEM. ANY OTHER QUESTIONS?
GREAT, IT’S BEEN A PLEASURE TALKING TO YOU ALL.
(APPLAUSE)