Okay, I’m Superman

It pains me to write these comments, critical of one of my favorite neuroscience writers, but it must be done.

V.S. Ramachandran has just published an online article that has taken an enormous amount of flak on Twitter, some of that from me. Also, the very first comment to the article cites a study that seems to indicate his claims are questionable at best.

UPDATE 4/19: One of my tweeps told me that the link just given was a transcript of an old interview, so he had complained. Evidently, the editor took it down. I’m not sure why, since as far as I know, it still represents Ramachandran’s point of view. The text of the interview appears here, but seems also to have generated some controversy on that site, so it could be removed from there as well, I suppose.

UPDATE 12/9/14: I notice it was indeed taken down, so I’ve put a copy on my own site, of the original post I saw and also a plain text version (not edited, so it may be a bit confusing, but it has all the words).

His punchline is

So if you make a list of all the properties, emotional empathy, imitation, pretend play and you look at all those functions of mirror neurons and make a tabular column of the functions that are deficient in autism, there’s almost a perfect fit.  This is what led us to suggest over 10 years ago that mirror neuron dysfunction might be the basis of autism, it might be one of the major causes of autism.

Really? A “cause” of autism? Based on my own experience, I can see that, having an autistic brain, my mirror neuron functioning might be impaired much in the same way many other brain functions are hindered. Sensory overload. But “dysfunctional” — I don’t think so. And, I think he has his causality backwards.

He then modestly claims that his speculation that “mirror neuron dysfunction might be the basis of autism” is

better than any other theory that’s around regarding autism

Really? Really?

Perhaps he also has a theory regarding lefthandedness.

Based on his descriptions of autism, it seems to me he doesn’t understand what it is like to be autistic. In the article, he says that autistic people

are lacking in empathy, … unable to adopt somebody else’s point of view … [and there is] also a lack of pretend play

These things are all completely untrue, in my experience.

I wrote a post a month or so ago about empathy. There is also a huge catalog of writings on this topic. I don’t know a single autistic person who doesn’t experience empathy (aside, perhaps, from those who are also alexithymic). As I noted in my post, autistic people may have trouble expressing their empathy, and so give the appearance of not being empathic, but that is a communication issue, not one of empathy.

And then there’s the old “theory of mind deficit” myth — these things are pretty much of the same piece.

And lack of pretend play? Not for me, I can assure you! Growing up, I was the oldest of five siblings, and was often the oldest in a group of kids eager to play. They would look to me to decide what we would play that day — would it be Cowboys and Indians? (and who would be which?) or would it be building a fort? or digging a hole to China? I got to decide. And I didn’t need playmates, either. I had plenty of imaginary friends.

According to Ramachandran,

Pretend play by definition in normal children or non-autistic children requires that you put yourself in the shoes of that doll or that action figure.  Pretend you are Superman.  Suspend reality for a short while and pretend you are Superman.  This autistic children are incapable of doing…

Superman was my favorite comic book and TV show when I was young. I didn’t have to pretend to be Superman. I was Superman. I even had a Superman costume, including the cape. I could fly.

All of these myths about autism may have been believed ten years ago, when Ramachandran devised his theory. But, he should know better than anyone that science evolves rapidly, and there are fewer and fewer people who believe them to be so.

Part of the problem, I believe, is that what is in the common wisdom surrounding autism is based in some large measure on ancient studies that were done in the days when autism diagnoses were rare. Only children were diagnosed, and only those who exhibited very noticeable behavioral differences. Kids who couldn’t speak, or who were  aggressive or self-injurious. Many of these children also had intellectual impairment.

It was thought, not too many years ago, that 70% to 80% of autistic kids were also intellectually impaired. Over time, researchers came to realize that the number was probably the reverse of that, and even more recently it has become clear that there is no connection between autism and intellectual or functional capacity.

This, in my opinion, is why we have seen the “explosion” of autism diagnoses. We have been here all along, but there was little awareness that most autistic people had learned to “fit in” and adapt.

I have a lot more to say about all of these things, including mirror neurons, but I’ll leave it at that for now. I simply felt a need to protest the appearance of this antiquated speculation that seems not to be based on our current understanding of autism.

The Ramachandran article, by the way, appears to be a transcript of a video which appears on the same site.

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