Given the plethora of publications on autism, any addition needs to state a very specific intent. This books looks at recent research linking behaviours (mind) in autism to brain abnormalities. Several key themes are examined through cutting-edge research from three continents. Their seemingly logical progression probably owes as to much to editorial art as to nature.
One of the themes explored is the drawback of characterising autism in behavioural terms, starting with the intriguing possibility that the disorder bearing Hans Asperger's name might not be the one he described. Tager-Flusberg and Joseph echo the importance of characterising the ‘endophenotype’ of autism in terms of neurocognitive deficits linked to neuropathology. Another study of congenitally blind children elegantly cleaves the social effects of visual impairment from the deficits in reciprocal engagement that characterise both visually normal and impaired people with autism.
This decanting of ‘core deficits’ from the various trajectories that may lead to autism remains the Holy Grail of autism research, which will enable a more informed study of the aetiology, natural history and treatments for autism.
The neurophysiological basis of one of these core deficits, ‘shared communicative reference’, is explored in the articles on joint attention, reflexive visual orienting and eye tracking. The idea that brain development itself may be influenced by aberrant brain process deriving from a primary deficit is a fascinating perspective on the plasticity of neurodevelopmental disorder.
Klin and others suggest that there are cognitive deficits in assigning salience, which leave a person ill-equipped to set priorities and learn from experience. This has a significant bearing on any educational or therapeutic interventions.
The overarching cognitive theories are discussed in terms of experimental paradigms in an attempt to establish whether there may be a ‘cognitive style’ unique to autism. The fact of ‘weak coherence’ (Frith), seemingly at odds with the ‘empathizing-systemizing’ theory (Baron-Cohen), emphasises the need for more studies on the neurobiological hard-wiring underpinning deficits.
The importance of the five interconnected systems constituting the ‘social brain’, and the identification of fusiform face area as a possible ‘neurofunctional marker’ are exciting. They need to be balanced against the study of the amygdala which cautions that structural abnormalities may not always be reflected in physiological dysfunction. The use of non-verbal paradigms such as movement disorders and crossovers from non-autistic populations illustrate the many ways of skinning the neurobiological cat.
For me, this book has been as much an exploration of the mind of the researchers as of people with autism. It will probably age with grace in an electronic world and be of interest to clinicians and specialists in autism, given the range of disciplines represented, the international tenor and the evolving nature of the issues themselves. The glossary of acronyms at the end of each chapter was the only minor distraction in an interesting and instructive read.
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