Richard Howlin PhD

Using the Foundations of Mindfulness & Neuropsychology in Supporting Individuals of all ages.

 

Shared Meanings & Autistic Behavior

Richard Howlin

 

When facing a child’s learning difficulties, there is a natural desire for parents to do all that is possible to understand and help their child’s situation.  I am always moved by the dedication of parents and the sacrifices that are made day to day to help the development journey unfold.  Children diagnosed within the autism spectrum are a particularly complex and unique group of individuals and it is this complexity that can sometime prove both confusing and exhausting. From my own clinical experience I have found that pursuing  clarity within broad brush strokes of terms such as ASD or Asperger Syndrome is usually rewarded. Gauging the child’s underlying processing issues and their subsequent behavioral expression can serve to inform accommodation and remediation at each phase of development. This attempt at conceptual and strategic clarity is the central idea  of the practical discussion that follows. Yet, in my work with autism I am always reminded of one of my favorite quotes by the philosopher Martin Buber. 

Every person born into this world represents something new, something unique, something that never existed before...it is the responsibility of each one of us to understand this...

The ramifications of this thought places us into the deeply spiritual essence of what it means to be a child and what it means to be a parent. It was Plato who in his Symposium so eloquently stated that parents are also midwifes to the unique soul of the child, to that child’s essence. Thus beyond the reality of expectations, diagnostic discussions and the plans and agendas that can overwhelm us, I feel it is essential that parents (and others) keep site of this truth. That your child is something God is doing in the world, and that he or she may command their own agenda. If we keep site of this unfolding mystery, we are, as the Irish so beautifully say: “On our way”.            

The Emergence of Shared Meaning in Early Childhood

The broadness of variability with the autism spectrum is daunting. This heterogeneity becomes most evident when considering those individuals within the higher functioning or Asperger Syndrome subgroup. The impressive variability of many of these children presents a diagnostic challenge even to the seasoned clinician.  Within this group certain children may experience significant improvement in their symptoms during early development while for others the progress is more slow and uncertain.  In some cases, we may find ourselves questioning whether or not the autistic like behaviors of some of these children  merely reflect a particular style or divergent way of being in the world . Yet I would suggest that the one underlying common thread that characterizes all of these children is the presence of significant social learning difficulties. Alongside the talents, individual temperament and unique spirit of each child, the social dyslexia of ASD forms a predictable and often resistant pattern. Early difficulties in processing social gestures parallel problems in social reasoning and ultimately, the acquisition of meaning.  It is in autism that we find ourselves most directly confronted with the social foundation of mind and the fact that ongoing social participation provides a key frame of reference for the emergence of identity. 

As previously discussed in the area of reading comprehension, we find that many developmental tasks of childhood and adolescence are embedded in shared meanings (Howlin, 2013). As the term suggests, shared meanings are common understandings and rituals embedded in social culture. They reflect Piaget’s earlier idea of infant “schemes” (Piaget-1 ) which described cognitive/affective neural dispositions that are primed to engage with the material and social world. Neurotypical children acquire social-psychological understanding through biologically rooted neural networks that respond naturally to facial expression and social gestures.  As development proceeds, common understandings are accumulated and continuously refined.  By the time a typical child reaches Kindergarten, regardless of ability level or background, they implicitly understand the shared meaning of teacher pleasing behavior and similarly have the inner maps that allow the anticipation of pleasure in joining with other students at play.                                              

ASD children may find themselves lost and at odds in much of the “assumptive world” of classroom expectations and routines. For example, the introduction of group learning projects or reading circles can generate distress and confusion in many ASD children. In social situations, the young ASD student has acquired few reliable memories or maps to draw from.  In addition, they are faced with the ongoing difficulty in deciphering the non-verbal cues of “live” social behavior. It is understandable how such struggles reading and inferring meaning socially can result in negative interactions for the ASD child.  Studies have shown that young autistic children experience significantly heightened cortisol levels, a key indicator of distress arousal, in typical social situations throughout the school day (Corbett, 2013).                                                                                                                                                                                   

Shared Meaning and Behavior 

Difficulties in social understanding and experiencing shared meanings often translate into the everyday social hiccups and idiosyncratic behavior seen in autism. Typical social learning subsumes the experience of other people’s emotions and thinking. Conceptual maps are continuously formed which in turn facilitate greater flexibility and perspective in thinking and behavior. As we have seen, this socially mediated learning of meaning does not occur naturally in autism.  It follows that behavioral rigidity and insular idiosyncratic pursuits are common features in ASD.  At the age of 15, Jonathan’s preoccupation with maps of the London Underground revealed a natural fascination and interest. Yet due to his ASD, this interest and meaning is for him alone, it is not shared by others.  Furthermore, he is not able to place this interest in “context” or perspective within the world of his peers.  Once while visiting his school in Hillingdon, I made the grave mistake of asking his help on finding the best way to reach Paddington Station in central London (I explained to him that I was running late and needed to catch a flight).  The flood gates of information opened and I found myself in a confusing sea of well-intentioned advice. Jonathan was not able to gauge my situation and access the socially derived common sense that one would typically and instinctively apply in such situations.  I ultimately left hurriedly for a cab feeling more confused than before with a kindly and verbose Jon following me out of the building.         
 
Underlying Neurobiological Processes

Various neurobiological processes have been associated with the interpersonal difficulties found in autism. Studies have revealed abnormalities at both the perceptual-sensory and deeper affective processing levels. Many ASD students demonstrate markedly atypical visual attention patterns when processing human facial expression. In addition, it has been found that ASD children’s emotional responses to social encounters are different.  Imaging studies have documented atypical patterns in the amygdale region, which plays a key role in relaying such information.  As a vital component of the greater limbic system, the amygdala provides the affective response and thus the “felt sense” of social interactions, including the processing of the human face. This affective component is a key ingredient in acquiring meaning and facilitating social motivation (Grellotti, et.al  2002). 

Thinking Patterns

As we can see, the difficulties found in ASD appear to originate from a partial disruption to this delicately evolving social maturation program.  Already in early childhood, these affective/cognitive neuroatypicalties begin to merge into a familiar and idiosyncratic processing style in many children with ASD.  School aged children with autism generally display a fairly rigid thinking style which favors local over global coherence. That is, ASD children tend to direct their attention toward the (sometimes insignificant) details of the immediate environment and neglect the wider context of meaning.  Integrated brain functioning typically utilizes both local and global perspectives in a flexible manner. This literal autistic learning characteristic also influences the preference for inanimate objects over social interaction. Charles Fernyhough (1993) once described this autistic thinking style as binary or “monologic” verses “dialogic”. Dialogic describes a flexible thinking process that stems from the capacity to bring alternative perspectives in relationship to one and other. Social situations are dynamic and complex, necessitating such a wider and inclusive perspective. As discussed this ability hinges on the formation of inner maps and meanings derived largely from imagining the minds of others. In contrast, objects, numbers, blocks and the majority of computer games are predictable entities, more easily allowing for control and one-sided manipulation.  Ultimately the autistic child’s mind is unprepared for the dynamic nature of human interaction and it thus offers far less of the positive emotional quality that motivates neurotypical children to engage and explore.

Providing Developmental Bridges

Viewing autism through the lens of neuropsychological understanding allows us to consider the remedial strategies that may help facilitate behavioral and neural growth.  This initially involves mapping the processing characteristics of the individual child in terms of their developmental strengths and challenges. Ultimately, we are seeking a coherent formulation n how a student understands their world at each stage of development. In ASD identifying and modifying factors that create confusion and distress is key. From this point of departure, parents and educators can plan effective social interventions. By gauging the students sensory and processing challenges, social learning situations can be structured in ways that do not overwhelm the more fragile processing characteristics of the child.

Facilitating Shared Meaning: Floor Time

Engaging the social networks of the brain is a key foundation of the therapeutic work in autism.  The intervention that perhaps best exemplifies this principle is “Floor Time” which was introduced by Stanley Greenspan at Georgetown University.   The typical  “Floor Time” scenario involves one adult actively engaging  with a toddler in a play situation on a floor mat. The key is active engagement, catching the socially reluctant toddler’s gaze, using exaggerated emotional responses and seizing upon moments of joint attention during motivating unstructured play activities. The adult “pushes” themselves so to speak, into the foreground of the otherwise isolative play pattern, creating a shared and social experience.  I remember discussing Floor Time with Greenspan in the 1990’s and relayed how this principle of engagement appeared also suited to older children and even adults in the ASD spectrum. In my work, I had found myself creating age-specific modifications of the approach to facilitate motivated participation in therapy. It seemed that this modified “Floor Time” process could enhance interpersonal involvement in various ways.  Greenspan wholeheartedly and graciously agreed with the idea.
 
Facilitating Shared Meaning: Floor Time

Engaging the social networks of the brain is a key foundation of the therapeutic work in autism.  The intervention that perhaps best exemplifies this principle is “Floor Time” which was introduced by Stanley Greenspan at Georgetown University.   The typical  “Floor Time” scenario involves one adult actively engaging  with a toddler in a play situation on a floor mat. The key is active engagement, catching the socially reluctant toddler’s gaze, using exaggerated emotional responses and seizing upon moments of joint attention during motivating unstructured play activities. The adult “pushes” themselves so to speak, into the foreground of the otherwise isolative play pattern, creating a shared and social experience.  I remember discussing Floor Time with Greenspan in the 1990’s and relayed how this principle of engagement appeared also suited to older children and even adults in the ASD spectrum. In my work, I had found myself creating age-specific modifications of the approach to facilitate motivated participation in therapy. It seemed that this modified “Floor Time” process could enhance interpersonal involvement in various ways.  Greenspan wholeheartedly and graciously agreed with the idea.