Mar 09

Cart Before the Horse Research: Multisensory Integration in Autism

A short article appeared on the ScienceDaily website a few weeks back, reporting on a piece of research published in The Journal of Neuroscience, January 15, 2014. The title of the research study was not given, but a link brings one to “Multisensory Temporal Integration in Autism Spectrum Disorders.”

The brief summary of the research is problematic for me from beginning to end, because it is an (altogether too common) example of research that starts with a false premise and then proceeds to offer advice to “treat” a problem that may not exist in the first place.

The major false premise, common to much autism research, is that autism is a “disorder” rather than a difference. When a researcher starts from that premise, they will be looking for “causes” of the “defect” rather than for an understanding of the source, function, and consequences of the difference.

In the study, Vanderbilt researchers compared 32 typically developing children ages 6-18 years old with 32 high-functioning children with autism, matching the groups in virtually every possible way including IQ.

This highlights a potentially major problem in research about autistic children (and very little has been done using adults, so research on children accounts for the preponderance of “findings” about autism). Autism is generally acknowledged to be a developmental difference, with some skills developing more rapidly and some more slowly compared with neurotypical (NT) children. So, age-matching is going to distort the results. There might be a very marked difference in ability in childhood, but that difference might disappear by the time people reach adulthood. This needs to be accounted for, in my opinion, but it seldom (if ever) is, in the research I have read.

“Children with autism have difficulty processing simultaneous input from audio and visual channels. That is, they have trouble integrating simultaneous information from their eyes and their ears,” said co-author Stephen Camarata, Ph.D., professor of Hearing and Speech Sciences. “It is like they are watching a foreign movie that was badly dubbed, the auditory and visual signals do not match in their brains.”

Okay, so we “have difficulty” and “the auditory and visual signals do not match in [our] brains” — that does not mean we can’t integrate the two, it’s just slower. This is consistent with the Intense World Theory of Autism.

“One of the classic pictures of children with autism is they have their hands over their ears,” Wallace said. “We believe that one reason for this may be that they are trying to compensate for their changes in sensory function by simply looking at one sense at a time. This may be a strategy to minimize the confusion between the senses.”

Hmmh — “We believe…” and “This may be…” — I wonder if it ever occurred to him to ask any autistic people to comment on that. This is a common arrogance, that NT scientists somehow mysteriously know more about what it’s like to be autistic than do autistic people. Bizarre.

Wallace noted that the recently-released Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5), which serves as a universal authority for psychiatric diagnosis, now acknowledges sensory processing as a core deficit in autism.

Perhaps needless to say, I don’t believe that autism belongs in the DSM, any more than homosexuality did. It’s a difference, not a “psychiatric diagnosis.” And I think Wallace has distorted the role of sensory processing in autism. It’s not a “deficit” but one of the differences that presents many challenges in a world that was designed by and for NTs.

“There is a huge amount of effort and energy going into the treatment of children with autism, virtually none of it is based on a strong empirical foundation tied to sensory function,” Wallace said. “If we can fix this deficit in early sensory function then maybe we can see benefits in language and communication and social interactions.”

Given all the problems in this write-up, I can’t imagine that this research has any value at all. One can’t “fix” a “deficit” that doesn’t exist, and autism does not need “treatment.” It’s very discouraging to think of all the effort that goes into demeaning autistic people instead of trying to help them deal with an unfriendly world.

A couple of caveats:

  1. My comments here are based only on the description linked to here, which in turn seems to have been taken from the press release put out by Vanderbilt University Medical Center. I did not read the original article, which is copyrighted and behind a pay wall, and there is no contact information given for the authors. So much for the free and open flow of scientific ideas and information.
  2. I do not have any training in the field of neuroscience or any related area. My background is in financial economics, and my interest is a personal one. That said, I have learned much and formed many opinions over the past few years.


1 ping

  1. Michael Forbes Wilcox

    Follow-up comment: there is an abstract of the paper available at http://www.jneurosci.org/content/34/3/691

    I’m having a little trouble integrating their meaning here. If I’m understanding it properly, it seems that they are saying they were able to measure a time-lapse for autistic kids in perceiving auditory and visual speech signals. But I’m not sure they tried to figure out if that resulted in diminished comprehension. Having a sensory difference is not the same thing as having a functional deficit.

    1. Lucy Moore

      When I was a kid, did have some trouble processing certain kinds of speech, particularly certain kinds of emotion-heavy speech in movies. I cannot explain how the tonality of the speakers has obscured the meaning of the words from me, just that it did (the tones vary). Now that I’m older, however, I have found that this happens far less often; when I have watched the same movies and heard the phrase that was once unintelligible, I now understand the actual phrase (i.e. in Aladdin, when Iago gets the door slammed on him, he says something in a ragged tone of voice that, as a kid, I thought was “Al-a-vart” or something like that, but when I watched it again, as an adult, I realized that Iago was saying, “Ow, that hurt!”). Such mistakes in processing make sense as people who are hard-of hearing do the same thing. It’s sort of like having a hearing impairment that is selective for speech. I suspect that mine was extremely mild, and for others, even normal speech may be very difficult to process, and they may also have trouble understanding who is talking. I also understand that this is not the precise ability being discussed here, as I was able to visually process the speech/speaker connection just fine; however, this is an example of a “deficit” lessening with age, as many normal childhood “deficits” do.
      As a graduate student in biology who has worked in a science lab before, I can assure you that you did understand it properly; they did not really test the link between multisensory processing and functional language deficits, they merely extrapolated. Scientists do do that, but they indicate that that is what it is by saying a link is, for instance, “suggested” rather than “found”. If they had actually found a direct link between ability to process language and multisensory processing delay, they would said it was found, rather than strongly suggested.

  2. Michael Forbes Wilcox

    Thank you for your comment. Although I wrote this piece nearly two years ago, I have not calmed down all that much when it comes to being annoyed at this kind of depiction of autism. I’m working on a larger essay on “The Language of Autism” in which I suggest ways to avoid using pathologizing language.

    That larger issue aside, I found your comments on comprehending speech to be consistent with my experience. I think there is a limit, however, to how much improvement can come with maturation, training, and practice. I’m still a bit puzzled by the role executive function plays in this (and other) issues that I face. Part of it is that working memory plays a role in processing speech, I’m sure, but why I am not able to improve that ability is a mystery.

    Unlike the claim in the paper I picked on, I find that I am better able to process oral speech when I have visual cues. Telephone calls and messages are nearly impossible for me to understand; so much so that I generally refuse to use the telephone. But personal meetings are okay for me. I still have to concentrate very hard to avoid having my mind wander down endless related pathways, but I can usually do pretty well. Written words are best.

    Part of the explanation is, I think, that I do not naturally think in words, so when I hear words, I have to translate them into concepts that I can integrate into my database of life experiences and learnings. And when I speak, I have to translate all of that into clumsy words that capture only a small part of my rich inner life.

    Again, I appreciate your commentary; my thoughts here were not so much a direct response as they were things brought to the surface of my consciousness by your words.

  1. If We Didn’t Have a Hammer « Susan's Blog

    […] latest blog post of Michael’s was particularly interesting to me because he takes a new bit of autism research done by Vanderbilt University, and he points out flaws in the study that the general public may not notice. Because Vanderbilt […]

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>