MRI Scans and Asperger's - New Research

The online journal Autism Research published a new study today on how MRI scans of brain circuitry might help us understand how the brains of people with HFA differ from the brains of people without spectrum disorders.

Researchers were able to measure six physical differences of microscopic fibers in the brains of 30 males with confirmed high-functioning autism and 30 males without autism. How these findings might relate to adults with Asperger's is unknown. The scans helped researchers identify adults in the study with HFA with over 90% accuracy. While the study was small, the progress is promising, as researchers are increasingly in search of definitive evidence of brain differences related to autism. Identifying such differences may serve to clarify diagnosis, which is a largely subjective process at present.

While the study authors find the results promising, MRI scanning for diagnostic purposes is a long way from becoming a widely used tool.

Using the MRI, the study authors measured how the water in the brain flows along the axons or nerve fibers in the parts of the brain that control language, social and emotional functioning. The scans revealed that the wiring of the brains of those with autism was disorganized compared with the brains of a typical person without autism.

Such results are important for adults with Asperger's to consider, and important for their partners to consider. The communication difficulties which can cause immense frustration for the partner of an adults with AS are understood today, with increasing clarity, to result from neurological brain differences.

Currently there is no biologic test for autism; clinicians working with adults must gather information about current and past functioning to piece together a clinical picture. This process can be tricky, as adults have often adapted to social rules and settings, making what might be more easily identifiable "Aspie" behaviors difficult to see. Often family members are the true observers of these behaviors, but are left without a framework with which to understand them.

Adults with Asperger's - The Eyes Have It

Researchers in 1997 (Baren-Cohen) found that adults with Asperger’s have difficulty reading mental states by looking at a person’s eyes – not only the expressions of the eyes, but the location of their gaze. These findings were expanded upon in 2002 (Rutherford), when researchers found that adults with AS have difficulty extrapolating people’s mental states from their vocalizations.

Take just a minute to imagine some of the implications.

• You might miss the message of a potential friend who uses vocal inflection to communicate her irritation with your long story; her social rejection results

• You might not see that the person gazing past you is no longer interested in your words; when he abruptly walks away, you’re left confused and mid-sentence

• You might not notice the heavy-lidded, far-away gaze of your partner, which implies her deep thought; when you interrupt her, her anger seems “out of the blue”

• You might not see the knowing glance between party goers when you introduce a boring topic; when you proceed to elaborate, group members leave

• You might miss the sarcasm of a coworker when he shares that a secret is “common knowledge”; when you mention it to a coworker the next day, you’ve unwittingly committed a serious social blunder

We constantly use our flexible and dynamic ability to read and react to myriad social cues to avoid social disasters. Adults with AS who may not have this luxury are left trying to navigate the social landscape with no real map. The negative reactions, indifference and subtle (or not-so-subtle) rejection they deal with can lead to social anxiety, confusion, avoidance, isolation, even depression.

You can cut some slack for those who struggle to keep up with an ever-changing social context by resisting the urge to expel them from the group. You can resist the urge to mock or embarrass. If you have social gifts, you can share them. Remember, adults with AS are often developing the computer programs you work with and performing the neurosurgery you may benefit from.

Asperger's: Standing Face and Zero Order Skills

Soft signs is a term used to refer to "soft neurological symptoms", or differences in skills involving coordination.

The symptoms are observable when tested for (usually by a neurologist), and are often evaluated with diagnostic activities such as "touch your finger to your nose". The child with difficulties with such tasks exhibits "soft signs", behaviors which are expected to mature with age.

Back in 2006, researchers at the University of Helsinki and the Hospital for Children and Adolescents in Finland looked at soft signs in adults with Asperger's, and found that they persisted through adolescence and adulthood.

As typical children age, these soft signs often diminish, and evolve into Zero Order Skills. This set of skills is described by Richard Lavoie, M.A. as "skills that are only significant when they fail to exist". He describes a common soft sign as a child's inability to track with his eyes without moving his head. Seems like no big deal, right?

But imagine the behavior of the adult who does not possess this Zero Order Skill. Out with a group at a bar, he does not make eye contact with each person he speaks with. Instead of moving his head slightly and moving his eyes to meet the gaze of his conversation partners, he keeps his eyes in a fixed position, and moves his head in order to maintain eye contact. How does it come off? Robotic.

The ability to track during a conversation, then, is an example of a Zero Order Skill. This skill is not a social asset - no one wins praise for this skill - rather, it is an expected skill, necessary for others' comfort during conversation.

The adult with a deficit in Zero Order Skills will suffer resulting social effects. Yet Zero Order Skills can be taught, learned and mastered.

One Zero Order Skill which may be missing in the skill set of the adult with Asperger Syndrome is his or her STANDING FACE. The standing face is our most basic, relaxed and frequently adopted facial expression - the neutral expression we use when reading or watching TV. It may be worth your time to look in the mirror and taking a look at what yours looks like. You may also want to ask a trusted loved one or professional for their feedback.

Often adults with Asperger's find their "game face" is slack, open-mouthed, stern-looking or comes across as aloof. This is just fine if you're intending to send messages of boredom, superiority or anger (and who isn't, from time to time?). But if you'd like to come across as open and interested, these expressions can be obstacles.

The goal may not be to adopt an artificial wardrobe of empty smiles (see cartoon above), but to master the facial posture of someone who comes across as engaged and relaxed. This can involve "cocking" the head to the side to convey interest, making 8-second interval eye contact, changing physical position (such as leaning slightly forward), gestures of approval such as sporadic smiles, nods, and "aha" looks, and non-verbal cues ("hmmmm", "uh-huh" and "ah").

With practice, your standing face can communicate warmth and openness, and your demeanor can give others clear indications of how you feel. These skills can be mastered with practice, practice, practice. And I encourage you to do just that.

Asperger's: Are You Thinking What I'm Thinking??

"It just doesn't FEEL like you GET how I'm feeling..."

Have you ever heard this from a loved one?

Adults with Asperger's in relationships often hear similar complaints from their partners. Yet highly intelligent Aspies often find ways around this effect in work and other settings. What is it about intimate relationships which magnifies this effect, and what can Aspies do about it?

Adults with Asperger Syndrome are well known to have challenges with social interaction. Often, even long after the obvious signs of these challenges are gone, the adult Aspie often continues to "feel different". But they may be missing their own successes by focusing on the differences, rather than the similarities, between theirs and the social interaction outcomes of NTs.

It's often thought that these typical "social deficit symptoms" stem from so-called "mind-blindness" -- an inability to express a "theory of mind", or to grasp what other people may be thinking, feeling and intending. Yet did you know that adults with Asperger's, who are often highly intelligent, routinely pass tests designed to evaluate theory of mind?

In 2009 a team led by Uta Frith, of University College, London, and Atsushi Senju, of Birkbeck College, London, tracked the eyes of people with Asperger's while they took part in a standard test of theory of mind. The results were surprising.

The test, known as the Sally-Anne False Belief Task, works like this:

One character, Sally, places a marble in a basket and leaves the room. In her absence, another character, Anne, moves the marble to a box. When Sally returns, children are asked where she will look for her marble. If children understand that Sally's actions will be based on what she believes to be true, rather than the actual state of affairs, they should answer that she will look in the basket, rather than the box. This correct answer requires the child to predict Sally's behavior based on her now false belief.

Neurotypical children aged 4, and children with Down's syndrome, pass this test, while children and adults with autism spectrum disorders generally do not. Adults with Asperger's pass it -- but Professor Frith's study shows that their success may be due to a very different mechanism.

The team asked adults with Asperger's, and neurotypical (NT) adults, to take the Sally-Anne task while their eye movements were tracked. Both groups got the task right when assessed verbally, but their eye movements told a different story.

The NTadults generally took their first glance towards the correct place -- the basket where Sally thinks her marble is -- in anticipation that that is where she will look. However, members of the Asperger's group looked equally often at both the box and the basket before making their choice. They did not seem to have a spontaneous understanding of the right answer -- the direction of their first glance was a matter of chance.

The implications of this are fascinating. It may be that people with Asperger's do have difficulties with theory of mind: unlike those with NT brains, they lack the ability to jump straight to the right decision, almost as a matter of instinct. What they seem to do instead is to work out other people's beliefs and intentions by means of logical reasoning.

The finding is also encouraging news for therapy. Theory of mind in itself, it seems, can be learned. That is, the same results can be attained via "intuition" AND logic.

Adults with Asperger's may arrive at social conclusions via logic, but feel exhausted after their success. It may be true that social interactions never do take on the intuitive, fluid quality many adults enjoy when communicating.

Perhaps when it comes to the social interactions of adults with Asperger's the most important part may not be the means, it may be the end itself. If you have Asperger's, you may benefit from focusing less on how you operate differently, and more on the results you achieve or want to achieve.

Chances are you're not coming across as poorly as you think.