Is Autism a “Deficit” or a Super Sensitivity?


Salon has reprinted an excerpt from a book by University of California cognitive neuroscientist Gregory Hickok, in which Hickok argues that common diagnostic tests are prejudicing psychiatrists to think of autism as a social and mental “deficit” rather than as a “hypersensitivity.”

“There is a widespread view that autistic individuals are less sensitive to pain because their reactions to painful events, such as a blood draw, are often less dramatic than a typical child’s,” writes Hickok. He then describes a study that looked beyond obvious physical reactions. “The team also measured the children’s heart rate and blood serum levels of a stress hormone (β-endorphin). Autistic subjects showed a greater heart-rate response to the needle prick and had a higher concentration of β-endorphin than controls.”

Many tests measure children’s abilities to imitate actions, and these usually determine that autistic children have less ability. Hickok points out that many of these tests ask children to repeat “meaningless” actions, whereas other tests show that autistic children do better than non-autistic children on identifying and repeating meaningful actions.

Based on this alternative theory, Hickok then discusses different neuroscientific explanations for autism. “It turns out that rats who are exposed prenatally to valproic acid—a compound used in human medications to control seizures and bipolar disorders—develop some key features of autism both neurally and behaviorally, including loss of cerebellar neurons, abnormalities in the serotonergic system, decreased social interactions, increased repetitive behaviors, enhanced anxiety, motor abnormalities, and sensory hypersensitivity,” writes Hickok. “Curiously, the prevalence of autism in humans who are prenatally exposed to valproic acid through maternal use of the medication is substantially higher (one estimate is 11–100 times) than in the general population.”

We might have autism backwards: What “broken mirror” and “broken mentalizing” theories could have wrong (Salon, September 1, 2014.)