A Thorn in My Pocket: Temple Grandin's Mother Tells the Family Story (26 page)

Her most valuable point, at the heart of her immense research project, is her conviction that there’s a biologic bias in most human brains toward understanding things conceptually and this bias is missing in people with autism.

“For example, you could say to an autistic child ‘Point to the shovel,’ and the child can point to it. But if you say ‘Point to the thing you dig with,’ they may not know what you’re talking about. Whereas a normal toddler, born with the ability to see the world conceptually, may ask before he’s even learned what a shovel is called, ‘Where’s the thing I dig with?’”

“A baby has to begin immediately interpreting things in a meaningful way,” Dr. Minshew says, “Because if he didn’t, and he looked out on the world, he’d have an awful lot of trouble to survive.… And in autism that’s sort of reversed. They get the details, but they don’t get the concept.… There’s a barrier in the brainwiring against understanding things conceptually.”

When children with autism come into this room, “they see three people, but they also see the pictures on the wall, the furniture, the calendar, the books, and they don’t know how to sort it out. They’re overrun with details, and their memory for those is really great. They have all the facts and that all the more confuses the meaning. It’s part of what gives them the oddity.”

Dr. Minshew tells the story of the four-year-old child who, every time he came in to her office, pulled out the same medical book (he knew exactly where it was), turned to the same picture (he knew where that was, too), and asked her the same question. Yet clearly he did not understand the text of the book. When he went home that afternoon, he took the guppies out of the fish bowl and held them in his hand overnight and couldn’t understand why they were dead in the morning. “Something other children would understand automatically, something as simple as you don’t take the fish out of the water. He did twice. It took him twice to figure it out, and then he lost interest in the fish. He said they were broken.”

Since people with autism get the details of what they see, but don’t encode them in the way we do, they have to figure out a concept or pattern through logic and consciously-memorized rules. They’re good at memory. “That part of their brain works really well. But even when they learn the rules, they don’t learn them in enough different ways that they can apply them flexibly. And there are some concepts where there is no rule to figure out. Irony. They just don’t get it. That higher order cognitive ability isn’t there.”

Then there are the very young autistic children: “they don’t even get rules. They don’t get anything, they don’t associate a meaning with anything. They don’t have a word that goes with an object. They don’t have the concept that there is a word that goes with the object. It’s part of the problem.”

A major thrust in Dr. Minshew’s research is to locate this neural brain glitch. “We don’t think about it, but our brain is doing these computations automatically, like a computer. You don’t think about what your computer is doing. In fact, you don’t even look at your fingers when you are typing on your computer. Your thinking has gone into the areas of the brain where it’s no longer conscious.”

A computer. Dr. Minshew’s words set me to analogous thinking. Like an autistic child, a computer functions only on rules and logic. It, too, has facts and memory, it, too, is unable to process concepts. Like the child holding onto the guppies, the computer doesn’t get it, can’t get it, is missing that particular wiring. Instead, the little paper clip man pops up on the computer screen with his oddly imperious and vaguely threatening warning.

“You are committing an illegal operation.”

I am? What have I done? A stab of guilt runs through me, a terrible anxiety that I’ve damaged my expensive computer. I turn it off and rush to call a friend. “Did you type in the wrong e-mail address?” the friend asks. Could have. I turn the machine back on. The warning has vanished. The computer makes no apology and has no remorse. Because it cannot encode something that exists only as a concept, it cannot encode the value difference between typing in the wrong e-mail address and bringing a gun through airport security. It simply sees both as an error.

Autistic children have the same mindset. A leaf blowing from a tree can create as much anxiety as a manhole cover blowing off in the street. Without the ability to conceptualize, all reality comes barreling at an autistic child, all equally important. As Dr. Minshew says, “It’s as if all the planes landed at O’Hare Airport at the same time.”

At the next autism conference Temple and I are both speaking. As I describe Dr. Minshew’s research, I can see Temple sitting among the parents writing it all down. From now on she will call conceptual thinking “thinking in categories.” Not quite the same thing, but a highly workable substitute for what she’s missing.

At last I understand what Temple means when she says she’s like Mr. Spock, that she has no subconscious. It’s not a subconscious she lacks, but Dr. Minshew’s conceptual capacity. Dr. Minshew knows Temple and loves to hear Temple say, “I’ve got that one figured out.”

“She’s learned to do just that. Figure it out.”

“My mind is a series of videos,” Temple announces to her audience. “I scan my videos and pick out the one that answers the problem.” It brings to mind a mother who’s told me about her autistic son who has trouble falling asleep at night.

“I have all these TV sets,” her little boy tells her. “I have to turn them all off before I can sleep.” How exhausting to go through every hour of every day consciously registering and recording what you and I take in at a single glance. However, despite exhaustion, he’s learning to do it, as Temple learned long ago to categorize.

My next step is to find out how he is learning to do it.

I fly to the University of North Carolina in Chapel Hill to talk to Psychologist Gary Mesibov, Ph.D., researcher on autism and the primary organizer of TEACCH,
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a leading therapy technique.

Dr. Mesibov agrees that people with autism lack conceptual thinking, but adds that they also don’t see things in context. “There’s also what you would call a lack of central coherence.”

“If you want to summarize what TEACCH is,” Dr. Mesibov explains, “it’s taking what we know about the brain and presenting the world at the level that autistic children are able to manage and understand … and they understand it by a lot of little bits, not by understanding the overall concept.”

“Are you telling me that these children literally cannot see the forest for the trees?”

Dr. Mesibov nods. “Your daughter is very connected to that; she’s very articulate in describing how she remembers things.”

I think of Temple’s series of videos. I also recall a class of young children that I’d watched recently at the Watson Institute in Sewickley, Pennsylvania,
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where I’d been struck by the variety and ingenuity of its teaching techniques. I call Watson’s director, Marilyn Hoyson, Ph.D., for the secret to the TEACCH system success, and she says that its most important element is its use of visuals.

“Individuals with autism are visual learners, so we employ the TEACCH visual technique of using pictures and objects to explain concepts, ask questions and give directions. It’s using a strength to help them to learn or understand something new.”

Dr. Hoyson then explains that, since no two children are alike, Watson’s teachers and therapists also include other research-based strategies, such as the Picture Exchange System (PECS) and Applied Behavior Analysis (ABA). Dr. Hoyson is eloquent on the importance of using a variety of approaches, also on the importance of teamwork.

“What you were watching appeared to you to be individual work, but behind each child is a carefully developed team collaboration, a pooling of everybody’s insight.” Her point brings to mind Dedham Country Day school’s teamwork help for Temple when she was little, also Hampshire Country School’s teamwork when she was a teenager.

Teaching a child with autism how to do a simple task—pushing a button through a buttonhole or asking for a glass of juice—is not unlike showing him how to put together a Lego figure. His life experience, like a Lego kit, has arrived unassembled, and he has to be shown how to fit each piece of reality onto the next one until the world around him is no longer an unassembled jumble but has taken on a meaningful shape.

For this task, Velcro is indispensable. If a child wants juice, he takes his picture of a glass of juice, sticks it onto his Velcro chart, and brings it to the teacher.

“Oh, you want juice?” the teacher asks. She always speaks the words and, after a bit, the child understands them.

He nods (some autistic children rarely speak).

“Is that all you want?” The child thinks a moment. He’d like crackers to go with his juice. So, now, he must fetch his picture of crackers, stick that onto his Velcro chart beside the juice picture, and bring his Velcro chart back to the teacher.

“Oh, you’d like crackers with your juice?” The child nods. The teacher always makes the child figure out for himself what it is he wants. That’s hard for some of these children, whose thinking is entirely visual and memory-driven. There are those who aren’t even aware that they want something.

Watching the Watson Institute class in action has brought to mind Temple’s nanny teaching Temple long ago how to color pictures: first, pick out the right color to go with the picture; next, keep the crayon within the lines. Only today do I appreciate her gift to Temple and wish she were still alive to enjoy the handiness of Velcro.

Prepositions present another learning hurdle. Since they’re not visual objects, prepositions require an autistic child to make a tiny step into the abstract. First, the teacher demonstrates with a set of cars and roads and bridges what she means by “over.” (The classroom has a whole play area for this lesson). Then she asks the child, “Can you take the yellow truck and make it go
over
the bridge?”

After he learns to do that, she gives him the next bit of Lego instruction.

“OK, now let’s see if you make the blue car go
under
the bridge.” As the child gets the hang of what the teacher is asking him to do, he’s also learning colors.

“Good! Perfect! How about making the orange bus go
around
the bridge.” Slowly, Lego bit by Lego bit, the meaning of prepositions builds up.

Temple often talks about her trouble with prepositions. In the fifties, schools still had air raid drills. Temple says she finally learned “under” by recalling how they all got
under
the school table when the drill bell rang.

Along with “preposition” trouble comes another problem. Though autistic thought is visually-driven, people with autism really don’t want to look you in the eye. Eye contact tells them nothing, it only makes them nervous.

Ami Klin Ph.D., head of the Yale Child Study Center in New Haven, Connecticut, has performed eye tracking tests on young people with autism. He found that when they watch a movie, they don’t maintain eye contact with the actors on the screen, as do most viewers. Instead their eyes rove about the background, picking up irrelevant details: doorways, pictures on the wall, beads around a girl’s neck, etc. Sometimes they watch mouths, which makes sense logically—that’s where the words are coming out—but it’s not where meaning is.

Dr. Klin’s tests have also brought to light the autistic inability to see personality in an animated cartoon of an object. When shown an animation of two little balls chasing each other, the big ball bullying the little ball and shutting it up in a box, people with autism do not see the balls as having personalities nor do they see the box as a lock-up. They see nothing more than two balls and a box. They don’t get the gist of the story. They’re equally baffled by word stories. Whatever the form, stories and imaginative play are often beyond their reach.

Dr. Klin’s clinic works with people with autism, trying to teach them how to recognize eye and face signals: happy, sad, angry, wistful, baffled. He’s found that they can learn to recognize broad emotions like “happy” and “angry,” but more subtle expressions continue to escape them. I think of Dr. Minshew’s observation: “Even when they learn the rules, they don’t learn them in enough different ways that they can apply them flexibly. Then there are times when there’s no rule to figure out. Irony. They just don’t get it.”

Nor do people with autism understand a wink, which is, in essence, a shared joke.

Yet, reading eye signals is in all animal life, along with the instinct to frolic. The other day, I watched the family dog, cat, and bird carry on a wildly funny game of “Watch, Spring, and Pounce.” The bird, bored with whistling in his cage and nobody paying him any attention, flew out the door of his cage and perched on the lampshade above the cat. The cat was instantly alert. Then the dog got up from his corner to watch the cat. When the bird saw that he had everybody’s attention, he swooped across the room. The cat sprang over the furniture after him, and the dog, though he knew he shouldn’t, raced after the cat with a clatter of claws. As soon as the bird had them both in a frenzy, he flew back to his post on the lampshade. The cat returned to his sofa pillow, and the dog, with a sigh, settled back into his corner to watch the cat. As soon as they were both quiet, the bird repeated his game. Over and over the three did this, until, finally, satisfied with the mayhem he’d stirred up, the bird flew back to the boredom of his cage.

It was a game based on eye contact, also involving risk, rules, and some kind of agreed upon trust. Yes, the bird ran a risk, but he knew he could fly out of the cat’s reach, and clearly the sport of the tease made it worthwhile. The dog, adept at eye contact
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and by nature a rule follower, knew he wasn’t supposed to chase the cat, but he also knew that, if the cat broke the chase rule, he could break it too. That was the rule. Each animal kept his eye on the other, and, as long as the rules stayed in place, it was just a game. But what about trust? When the bird flew back to his cage, how did the bird know the cat wouldn’t scramble up the side of the cage and claw him out the open door, as he’d clawed out the baby chipmunks living in the bird house hanging on the garden tree?