I think I might have been wrong...

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You are absolutely right. But, if you want me to go through the official diagnostic criteria, I could do that too. I'm not going to do that just yet, though. First, let's take an example of something that happened today.

During lunch at school, I sat down outside on a bench. There was nobody around, and I was sitting comfortably in the shade. I pulled out my chemistry book and started copying the lab procedures for tonight's class. Then a bunch of freshman girls start running around screaming near me. I looked up at them and shook my head in disgust, but refused to say anything in fear of being rude. Can't they see that I desire peace and quiet as I'm trying to accomplish something? After a few minutes, they ran off. Then 3 of the same girls came back. They stood in front of me for several seconds before attempting to ask me what my name is. I ignored them, and thought that they would get a clue that I'm clearly not interested in starting a conversation. It took them a while, but after a minute or so, they gave up and left me alone, just as I had wanted. I managed to copy down everything for the pre-lab, and now I have time to chill out and relax before class in two hours.

So what will lab class be like? I can't predict the future, but based on how the previous labs have gone, it wont be a problem. I am quite capable of working in a group when I need to. Last time, I recorded all the data into our notebooks, while the other two lab partners did all the measurements. I was able to helpfully answer any of their questions regarding the material. One of my lab partners was frustratingly clueless as to how to measure things and do extremely basic calculations, but I was still nice and polite. I received a few comments at the end of the lab. Firstly, I was complimented on my intelligence. "Oh, you're so smart, you know all of this stuff. I'm really bad at chemistry, but I guess you're really good at it." In an attempt to be polite, I replied that while I'm good at chemistry, I nearly failed biology and other non-mathematically based classes. The second comment I received was in reference to my extremely deep voice. I shrugged it off and said that "I know, I get that comment a lot." There were no conflicts over anything; it all went smoothly. There were no problems with misinterpreting body language. I maintained eye contact well enough. I did not misinterpret any directions.

So what do you think? In the first example, is that a good description of the "active but odd" person with Asperger's, or is that someone who simply would rather get some work done than engage in pointless chit-chat? Yes, this is a rhetorical question. There is no right answer, and that's my whole point.

In the second example, does that seem like someone who is socially impaired? It's once again possible to answer both yes and no. On one hand, everything went smoothly. On the other, I was working with people who are at least 10 years older than me, and far more mature. I'll never really know what they thought of me.

Does this exclude me from having AS? Absolutely not. But, is it possible that AS isn't actually what I'm dealing with? Absolutely.

I could drive myself nuts thinking about this endlessly. But I'm not going to. It's a combination of both giftedness and AS, end of story. Saying that I'm not gifted makes as much sense as saying the grass is blue and the sky is green. Saying that I'm not at least somewhat autistic is also kinda fruitless, as I do have awkward body language, alexithymia, extreme introversion, empathy for inanimate objects, etc. Obviously I must be somewhat autistic, or I wouldn't be on WP at all.

Completely false. The traits must have been there all along. They didn't have to cause huge challenges in childhood, but they needed to be there. There's a reason that even in diagnosing AS in adults they try to talk to the person's parents - because what they were like as a child is NECESSARY to diagnose them with a PDD.

I think most aspies do, it's just weird. I don't like Family Guy but I love old cartoons, bad puns/anti-jokes and surreal/awkward situations in comedies (like Borat, which I think is tied with Airplane! as the funniest movie ever made).

Your hypothesis is interesting. I have above average intelligence but not to the point where that alone would have caused me to have had huge social difficulties my entire life. Still, I think I understand where you're coming from. I remember the valedictorian of my HS: he skipped 2 grades, got a perfect ACT score, and was ambitious, but no one seemed to like him because he came across as arrogant. He made eye contact well and never really said anything that awkward, but people tended to avoid him. I think he's at Yale now.

I agree. It's an odd thing. You can have the greatest sense of humor in the world but if nobody else shares it (or you're too depressed) it doesn't matter. When I'm happy I laugh at almost anything, and people find my observations hilarious. Trouble is, I'm seldom happy.

Though the question of whether someone qualified for diagnosis in early childhood doesn't quite point out two matters of consequence:

1. present symptoms need to be observed and identified as abnormal behaviours in order to (later) be recognised as "prevalent"
2. a child's impairments become noticeable only if impaired abilities are required to be used, certain behaviours are requested/demanded and requests/demands are not met by the child or not met as consistently as expected at that age.

One might assume that pretty much all parents are capable of noticing symptoms commonly known as "red flags" and capable of providing a fairly normal environment in which impairments are noticed but there's still a disturbing amount of parents who fail at this to some extent.

This would be an interesting research idea: Can one not have the "nonverbal impairments," i.e. intuitively experience theory of mind and be on the spectrum?
In other words is it possible to be on the spectrum, and not have one iota of trouble reading the non verbal, and communicating with the eyes- to naturally communicate with others this way?

Apparently, the way the DSM is laid out, allows a diagnoses without ToM impairements: - you don't have to have "non verbal impairements" to get a DX. ToM and body language, to me, are inextricably linked.

Maybe this would be PDD, then?

Thoughts?

I think you mean PPD-NOS. PPD by itself refers to the whole spectrum.

But, anyway, I actually am not sure if I have nonverbal impairments at all. Sometimes, after group discussions, I'll find that I was usually totally clueless as to what was really going on. It's not uncommon for me to be eavesdropping later only to hear "I think so-and-so was being a jerk today" and think to myself, "what the heck, I didn't think so at all." That sounds like it could be autism, right? But, now consider that I wasn't really even paying attention. My mind is often elsewhere. I don't generally pick up on this kind of stuff because I'm almost not even there. I'll listen occasionally and maybe nod my head to pretend that I'm listening, but I'm actually not. I have much more mentally stimulating things I could be thinking about. If I am actually genuinely listening, I can read people (or, at least, I think I can).

Online quizzes are hit and miss. Some I've done average on, some below average, and some far below average. There are explanations for this, other than ToM deficits. One, not knowing what the words mean on some of the answers, and two, a limited short term memory capacity.

And then there's child development. When I was very young, I was obsessed with specific topics, such as cars and trains. I could be left by myself for hours with a few toys and not ever complain. I was both extremely curious and creative. Although I wouldn't always reciprocate in conversations (even at the age of 3 I didn't understand why I should say "hello"), I never had any problems making eye contact or with the whole mirror neuron thing. I was usually a very calm child. I could sit in a car for a whole day on a road trip without having my parents need to calm me down. I always seemed to be able to entertain myself.

I also tended to withhold information, and that still hasn't changed much to this day. For example, when I would get home from school, my mom would ask me how my day was. I never knew what to say. She thought I was being stubborn, but she told me a few months ago she thinks this was because of AS. What goes on in my head is similar to this: what did I really do today? ...and why do you need to know that? Is this an example of an inability to communicate like autism suggests? No, not really. I just don't see it as necessary. If anything, it's a result of too much empathy. I don't like listening to people talk about their day, so why would I blabber on about mine and put someone else through that frustration? This is why I don't mind doing it on the internet. Nobody is forced to read what I type here, so I can freely go on for as long as I like.

And then, to make a long story short, puberty hit and it was like running face first into a thick concrete wall at mach 3.



Finally someone understands what I'm getting at here.

Last edited by SammichEater on 01 Sep 2011, 1:02 pm, edited 2 times in total.

Interesting question to bring up. I would say no. I think intuitive ToM should rule out the possibility of ASD. Very significant deficits in or lack of neurotypical/plethistic ToM is fundamental to autism. When someone smiles in a certain way that everyone else intuitively understands, without thinking, as "She is mocking you", all I see is a smile on a face, and I don't wonder what it means, and I don't remember that such things have meanings at all. Not everyone on the spectrum is like me. Someone else may not look at the face to see the smile. Another may remember that the smile has a meaning and wonder what it is and come up with the wrong one. Yet another may get it right, but only after thinking about it for awhile or years later. There may even be someone who gets it right away, but only because they have systemized social interactions/non-verbal cues/theory of mind very well. Now think of the vast number of situations like this in everyday life. Most are far more complex than a mocking smile. In the ToM area, very high-functioning, very gifted autistics who are actually interested in social interaction may get these messages as fast, accurately, and in all their complexity as any random neurotypical the minority of the time. Passing the mocking smile might go along with failing the flirtatious laugh, and let's not even talk about more complex mindgames or power play in a group. Ack! Let's also not talk about what the heck we are supposed to do in response to any messages that we have non-intuitively figured out.

In terms of the DSM criteria, I think ToM deficits would also show up as deficits in social-emotional reciprocity and relationships appropriate to developmental level. ToM deficits underlie more than the one criteria of non-verbal communication impairments.

A 40-year-old adult who has systemized ToM and is able to apply it in real-time could have lacked ToM completely as a 10-year-old child.

I think you missed my point.

My point is:

Say if a person HAD been evaluated as a child (theoretically speaking, not they actually WERE evaluated), if they absolutely could NOT qualify as a person with ASD, then they CANNOT qualify as an adult. No amount of loopholes will make it so. If a person is NT as a child, then a person is NT as an adult.

Also, I am not referring to people who are misdiagnosed with another condition that is similar to an ASD in some regards. That is simply a misdiagnosis that can be fixed later on. I mean, if a person simply CANNOT under any circumstances qualify for an ASD as a child (if they had been evaluated under good circumstances), then it is impossible for them to have one as an adult.

Like I said, there is really no way around it. You cannot develop a pervasive developmental disorder in adulthood. It just does not happen.

That's where I landed myself with "ToM"-- central, "fundamental." The two, having ToM, and having autism together are mutually exclusive, but: Is it possible the criteria excluded this part ("body language") as mandatory due to this "learned affect?" It'd sure complicate things this way.

Could it be possible the DSM architecture allows a compromised "ToM", as in a lack 'in arousal' to form relationships, thus meeting enough of the other criteria, e.g. "narrow interests," etc? In other words, appear schizoid, but rigid with routines and interests @ the expense of "relationships" -- "a rare bird"-- but not clinically schizoid-- but a developmental disorder, none the less. You'd read or "intuit" the "signs" but they don't affect you.

All speculation until such a rare bird is seen. I'd be interested to know why the criteria appears to be split or "allows" this split, as in the above scenarios.

Thoughts?

I just want to point out that in the study in which Simon Baron-Cohen claimed that impaired theory of mind was a core deficit in autism, only 80% of the children he tested actually showed any such impairments.

Also, whenever autistic people pass theory of mind tests, they make the tests increasingly complex until they outstrip the ability to hold all the information in working memory - which is usually less than what a neurotypical can manage, and when they finally get failures on these complex social scenarios, they say "See? Still impaired."

I guess what I am saying is not that there is no ToM impairment involved, as I know I have issues there, as do others. But more that I am not certain it is a core, required deficit for autism.

I think it's possible to have significant ToM deficits without meeting the non-verbal communication criterion. Most likely, such a person would meet either the "social-emotional reciprocity" criterion, the "relationships" criterion, or both.

The relationship between non-verbal communication and mentalizing seems more complicated than apparent from the diagnostic criteria. It's not just the amount of facial expressions/body language/gestures that matters, but what they mean in a social-emotional context. What I mean is that NTs recognize a standard set of non-verbal cues and know what states of mind they imply for other NTs. An autistic person could display the same facial expressions and body language, but these non-verbal cues wouldn't imply the equivalent NT states of mind in the mind of the autistic person.

For example, whenever I am interrupted while hyperfocusing, I feel like I am being hanged, drawn, and quartered. So, barring a nukular meltdown, I look at the interrupter in a certain way, using a certain facial expression that means "Please go away and leave me alone, stat!". This non-verbal cue has never worked to produce the desired effect, because the interrupters always interpret it as "Please stay and talk to me". No matter how I hard I lase this look at them, they stay and appear extra eager to strike up conversations with me, while I am screaming inside my mind, "Go away! Go away! Go away!" Recently, I figured out why this is. It's because the look on my face when I am wishing them away is the exact same look as that on the face of an NT who wishes to be social. In these situations, I look at the person's face, including their eyes, and I hold eye contact with them, when I usually don't but instead shift my eyes all over the room. In this moment when I would like nothing more than for the interrupter to disapparate in a puff of smoke, I look like I am particularly social and friendly, much more so than I normally look, when I am more open to social interaction, but look either aloof, daydreamy, or "not all there" to them.

During diagnosis, what I think is happening is that some autistics with ToM deficits, or should I say ToM differences from NTs, are not meeting the non-verbal communication criterion, when the headshrinker sees that they express some amount of unblunted affect. But a non-verbal cue coming from an autistic person may mean something completely different than the same cue from an NT. NT headshrinkers can't help interpreting the cues the NT way, because their brains do it automatically, and they can't control the process. Some cues from autistics mean nothing at all in a social-emotional context, or are not even directed towards other people, but they are still interpeted in these ways by the social-emotional auto-interpreters. So I think the criterion should instead be, "Do you use non-verbal communications, and if so, do they have social-emotional meanings, and if so, do they have the same social-emotional meanings as the standard ones correlated with those particular cues?"



I think the difference between us and them is that we have hold these things in working memory to work out all the steps through conscious analysis. NTs don't even need the working memory. They've got their automatic process at work.

The above is in reference to real-life and real-time, of course. I've found that ToM tests are very difficult to correlate to anything that happens in actual human-to-human interactions. Any test that involves intellectual analysis of what George and Martha are doing in some picture story, analogous to watching TV and figuring out the mentalizings of the characters, is pretty far removed from being inside the interaction oneself. The core ToM deficits of autism will pop out and very obviously in actual interactions, even if they don't on tests that are testing something or other that may or may not be related to intuitive ToM.

In a paper I read in which RMET was used to compare autistics vs. schizophrenics vs. normals, there was a small paragraph reporting that RMET performance did not vary amongst the three groups, but was strongly correlated with IQ. The sample size was small, and there was not much detail beyond that one statement, but I was not at all surprised by the result.

I thought of some more Krap(TM) while taking a shower. Y'all know how there are "Reading People" courses to teach people how to read facial expressions and body language better? Those are for NTs to consciously recognize microexpressions and use them to mentalize people to get more specific results than the general idea they get about someone's state of mind or personality when their brains do their intuitive ToM thing without their conscious participation. Normally, they might get the idea that someone is a an untrustworthy sleazeball after first meeting them, but nothing more specific than that. By learning to analyze microexpressions in real-time, they'd be able to tell exactly when the sleazeball was lying and exactly what the sleazeball was lying about. Like the eyes/nose/mouth would display the "lying predator" microexpressions at the same time that the sleazeball said, "I'll get you a record contract if you come to my studio in the abandoned warehouse by the East River". In this case, NTs would be doing what autistics have to do to read people, but they've got a foundation to build on, while we have no idea that the person is even an untrustworthy sleazeball. OK, I admit that the East River example is too obvious, but substitute a more subtle lie there.

Could autistics benefit from the same courses? I don't see why not, but maybe take some basic courses on linking states of mind with non-verbal communications in different social-emotional contexts. <---Does this sound as difficult to others as it does to me? Because it sounds really difficult to me. Imagine that someone systemized all this info for you. Would you be able to apply it in real-time group interactions? I think that I could learn the info easily, but I don't think that I could use it to read several people in a group, then write myself out in a way that would be read by those people to mean what I had intended to mean. There are just way too many things, and way too many possible things, going on to keep track of it completely consciously.

So the question boils down to this: Does any human have enough working memory to engage in complex social cognition through entirely conscious processes? I can't say for sure, but my gut feeling tells me that the answer is "Hell no!"

BTW, I've already forgotten what this thread was originally about. My working memory has failed me there. Or is that long-term memory? No, it's working memory, because I can't write a post and know what the thread is about at the same time.

Is this known for sure? If you give an NT the information in a complex theory of mind task, wouldn't they need to hold the information in their working memory? If I create a social chain of 5-6 people and ask what one or two people in this chain know about the situation, isn't it possible for an NT to be confused by the sheer volume of information?

I am not sure that theory of mind is all that well understood among NTs, let alone autistics.



I would really like to see something that establishes ToM is a core deficit in autism, rather than a possible (and perhaps likely) deficit. Uneven development and skills is a classic autistic pattern, but this one thing is true for everyone? Doesn't that seem a bit odd? It seems to me that social deficits are centralized by NTs because to many of them being social is central to being human.



I think there have other studies that found similar. Basically, RMET isn't indicative of autism or not.

I got a hunch that the "rare bird" is out there. This bird can fly with ToM , just as any NT; can intuit into the social sphere as good as any NT, but nonetheless is biased for "his/her own world." Not Schizoid though, but as meeting enough of the other 299.80 DSM. Not Autistic per say, as in ToM, but a type of PDD.

The way the architecture is laid out in the DSM, if such a person exhibited the natural ability of ToM , as actually having "it," but met the other parts of "significant impairment," would the good doctor say," sir, after many hours of sitting with you, you get jokes, you know how to intuit my mind of what I'm thinking, easily; it flows like Niagara Falls, in fact. You though, are significantly impaired with your routines, 'rigid,' and don't show the 'usual interest in people.' You don't meet the schizoid criterion-- you don't fear 'intimacy' as schizoids do."

"There is nothing I can do for you as in meeting this 299.80, because you can be as socially competent as the next guy, though significantly impaired with all the other."

Could this scenario exist within those guidelines? Or is such a neurological composition impossible, or exist enough in numbers, to be known clinically?
Has this passed through the doctors' door?

Try ODing on marijuana.

Now try ODing on aspirin.

As usual, it's...everybody, now: not that simple.