Temple Grandin’s theories on autism

As you probably know, the Temple Grandin biopic, starring Claire Danes, is showing this Saturday evening.  Here is Temple on the movie.  Grandin has done a great deal to benefit animals, by designing more humane slaughterhouses, stockyards, and encouraging other innovations.  She also has promoted the idea of talented autistics and helped raise that notion to a very high profile.  I have enormous respect for what she has done and I would gladly see her win a Nobel Prize if the appropriate category for such a prize existed.

That said, researchers disagree with Grandin's theories on autism in a number of ways and my own reading leads me to side with the researchers on some issues.  Many non-autistics defer to Grandin on autism because of her life story, her remarkable achievements, and yes because of her autism.  I thought it would be useful to offer a more skeptical view of a few of her claims:

1. Autistic individuals do not in general "think in pictures," though some autistics offer this self-description.  Grandin repeatedly refers to herself in this context.  I don't read her as claiming this tendency is universal or even the general rule, but the disclaimers aren't as evident as I would like them to be. 

2. There is little evidence to support her view that autistics "think like animals."  Here is one published critique of her theory: "We argue that the extraordinary cognitive feats shown by some animal species can be better understood as adaptive specialisations that bear little, if any, relationship to the unusual skills shown by savants."  You'll find a response by Grandin at that same link.  I'm not totally on board with the critique either (how well do we understand savants anyway?), but at the very least Grandin's claim is an unsupported hypothesis.

3. Grandin tends to brusquely classify autistic children into different groups.  She will speak of "the nerds who will do just fine" (see the eBook linked to below) as opposed to the "severely autistic," who require that someone take control of their lives and pound a bit of the autism out of them.  There's a great deal of diversity among autistics, and autistic outcomes, but I don't see that as the most useful way of expressing those differences.   Autism diagnoses are often unstable at young ages, there is not any useful or commonly accepted measure of "autistic severity," her description perpetuates stereotypes, and Grandin herself as a child would have met criteria for "severely autistic" and yet she did fine through parental love and attention, which helped her realize rather than overturn her basic nature.  That's not even a complete list of my worries on this point; for more see my Create Your Own Economy.

4. Grandin supports some varieties of intensive behavioral therapy for autistics.  Many research papers support those same therapies but those papers do not generally conduct an RCT and furthermore many of the said researchers have a commercial stake in what they are studying and promoting.  In my view we don't know "what works" but my (non-RCT-tested) opinion is that giving autistic children a lot of fun things to do — fun by their standards — and a lot of information to study and manipulate, gives the best chance of good outcomes.  (In any case "spontaneous improvement" is considerable, so anecdotally many therapies will appear to work when they do not; nor is there a common control for placebos.)  Many of the behavioral therapies seem quite oppressive to me and if we don't know they work I am worried that they are being overpromoted.  Grandin has in some ways the intellectual temperament of an engineer and I am worried that she has not absorbed the lessons of Hayek's The Counterrevolution of Science.

5. Grandin refers to herself as more interested in tangible results and less interested in emotions.  She is entitled to that self-description, but it is worth noting that most individuals in the "autism community" would not consider this a good presentation of their attitude toward emotions.

There is a recent eBook (selling for only $4.00), consisting of a dialogue between myself and Grandin, mostly on autism and talented autistics but not just.  For instance we also talk about our favorite TV shows, including a discussion of Lost, and there is a segment on science fiction and the future of humanity.  I try to draw her out on autism, cognitive anthromorphizing, and attitudes toward religion, but she is reluctant to offer her opinions on that important topic.  I would describe the eBook as a good introduction to her thought on autism and society, while also giving an idea of how someone else (me) might differ from some of her basic attitudes.

Comments

are you familiar with stephen w. porges' autism research?

very interesting stuff.

"but I don't see that as the most useful way of expressing those differences"

Please tell us what the most useful way is.

The only (extremely small) existing RCT of ABA-based autism interventions, in 49 years of published research, was a failure in the area of language, and in adaptive abilities (Smith et al., 2000, 2001--don't forget to read the authors' errata).

Also, this one solitary RCT was based on the manual Lovaas published in 1981, as are other popularly-cited recently-published very small nonrandomized ABA trials. This raises the question of what is meant by "contemporary teaching methods." Remove the controlled trials based on a 1981 manual and the already thin, poor-quality evidence, which features many ABA group children with very poor outcomes, thins out even more.

After 49 years of research into ABA-based autism interventions, there is still no published evidence, involving something approaching an experimental design, for their long-term benefits and harms. The best autistic adult outcomes in the scientific literature are so far not associated with ABA-based interventions. They are associated with the "severest" autism diagnostic criteria ever applied.

IQ and language abilities have not consistently predicted outcomes across different follow-up studies, and low-IQ children have been excluded from popularly-cited ABA trials. Also, there is no consensus as to how to accurately measure autistics' intelligence (or verbal abilities for that matter): scores vary dramatically according to test used and also across time in the same individual.

I don't think it's "evil" to report the state of the science, accurately, and to raise concerns that automatically would be raised--if the population targeted for intervention weren't autistic and weren't so prone to being prejudicially written off.

To some extent I would say that the 'intellectual temperament of an engineer' would be a subset of most the people I have met who are autistic. Just like the Asperger Type found so often among radio professionals.

I didn't use the word "cure." Currently there is no evidence whatsoever for any ABA-based approach to autism that does *not* have as its goal a child who is as measureably nonautistic as possible. There is no manual for such an intervention and no study of any quality.

As I wrote above, there is only one existing extremely small RCT of early intensive ABA-based interventions (in 49 years of published research), and this had largely poor results, particularly for children with the specific diagnosis of autism. See Smith et al. (2000, 2001), as in my previous comment. To verify this point, read the literature.

DawsonG et al. (2010) is not a study of an early intensive ABA-based intervention, at least not with respect to the experimental group. It involves a non-intensive novel "eclectic" intervention, and at best it is a small pilot study with major weaknesses and mixed results. Also, behaviour analysts have extensively claimed that such "eclectic" approaches to autism are ineffective, and this ineffectiveness has in fact been reported in popularly-cited small poor-quality trials.

The harms of ABA-based autism interventions have been ignored in the literature. This does not mean they do not exist. Many autistics are reported to have extremely poor outcomes in these interventions even by the usual standards, including autistics who fail so badly they cannot continue (see, e.g., Howard et al., 2005). The assumption that no harm is done or can be done is unfounded.

Those pushing chelation (etc) are also brimming with wonderful-seeming anecdotes and have claimed that depriving an autistic of chelation is child abuse. This is why I prefer the scientific literature, wherein the Koegels have yet to publish a fair test of their approach.

My view is that autistics deserve the benefit and protection of recognized standards of science and ethics. Those are the standards that automatically protect and benefit nonautistics and without which they couldn't walk around safely much less have a good outcome.

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I can't tell you how many people over the years have asked me if my daughter, Paige, is like the character in Rain Man. In fact, that film was my first exposure to autism, too. I never mind the question; it seems to come from a place of genuine caring and curiosity. But Paige is very different--starting with the fact that she neither speaks nor reads!

Errata:

Hmmm, that is an unfortunate typo...it should have said:

The one severely autistic person I know still lives with his parents and is completely dependent on them NOT because his parents did not provide him with love and support. They provide incredible amounts.

The research on Autism Spectrum Disorders points to the highly individualized nature of both the disorder and best treatments. However, best-practice treatments are generally considered (at least by Birth-3 organizations, universities, etc) in line with ABA. This is not, early 1980s or punishment focused ABA, but function-based, positive and socially-relevant approach.

Much of the confusion on this subject is due to the individualized nature of every child diagnosed and the huge amount of opinion being offered in society, with little research publicized to the same affect. The scientific community needs to be more proactive by actively educating the public and policy regarding findings, but also, those who do not fully immerse themselves in the research, enough to be considered an expert, should withhold from offering (well meaning) opinions. I think this includes the author here (though I generally LOVE your thoughtful comments, opinions, etc.) and even those commenting.

Oh, and probably the first step to becoming a knowledgeable student of the subject is adopting person-first language, which is standard in schools and the field as whole. It should be person/child/student with autism, not autistic person.

I Wonder?

I have built on the work of Temple Grandin, (as more like me have) once we add to her still and motion picture thoughts as she describes, with Projection thoughts, picture-in-picture thoughts, and 3 and 4 layer thoughts and learn to use those and keep our optic and brain generated vision seperate; normal thoughts are the result.

Suddenly everything Autism and Psychology fits, the debate of picture and non picture thinkers has an expalantion. The aminal instinct, The Savant , The Einstein as well as the next 1000 chapters in psychology will be obvious, suddenly if our Picutre thoughts were known in total form. Even Parriots talk with the same internal thought process we do.

Of Course, man hardly admits to Temple's thought process let alone those of us build on it but that is beacuse Man in genral thinks in Shortcuts all the time. The Shortcuts are what he knows as normal thoughts. The Long hand verson of the thoughts are atusim thoughts that take place during the lack of eye contact.

If you don't think you think (as a normal thinker) in Picutres have you ever been stunned and had to stop a conversation and been forced to say "I can Picutre Him" but can't place the name? Then your Minds Eye displays a Thought only you see that turns off the optic vision? If so you just witnessed a picutre thought you don't know you have that runs below the surface of the mind all the time. I see 100's of those below the surface thoughts all the time and they make me Einstein at time and a fool at others. Streamline them and figure out how to use them and they make me 'normal'. If science could hook monitors to our Brains (everyones) I predict it would be nothing more than a big photo album that talks. Now figure the Psychology into that mold and everything psychology has a explanation that fits. Autism is just as much mr/dd as it is Einstein. Personality Issues and Even stuttering and Dyslexia have explanations.

Rich Shull

I'm Inventor of the Turing Motor named for Autistic Hero Alan Turing (1912-1954) he was WWII hero and Father of the Computer. The Turing Motor is triple Hybird ,green and run on one Central spinning cylinder. It is powerdd by compressed air ,gas and Electric. Thundering Acceleration and green MPG in one package.

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