Brain Science of Aspergers and Autism Pt. 3: Learned Safety

Eric Kandel, in his book “In Search of Memory”, tells us that positive emotions appear to be processed in a different area of the brain to negative emotions such as fear or anger, which has the effect of inhibiting the amygdala, which is often activated when a child with Aspergers or Autism is having a meltdown or feeling afraid. This could explain why in stressful situations they calm themselves down with certain behaviours, be it repetitive actions, rocking or cuddling a toy.

Kandel’s studies show that by doing something that  is associated with safety, it activates a part of the brain called the striatum, which is involved in positive reinforcement and feeling good. This has the knock-on effect of activating areas in the prefrontal cortex, which inhibits the amygdala, thus inhibiting the anger or fear response.

This seems to me to be a weapon in our arsenal to calm those strong anger or fear responses, whether this is by having a familiar toy to hold onto, or a safe familiar place to retreat to in times of extreme negative emotions.

Brain Science of Aspergers and Autism Pt. 2: Anger and emotion

It is generally accepted that in Aspergers Syndrome and Autism that there is some abnormality in a primitive area of the brain called the amygdala. The name “amygdala” means almond, and there are two almond shaped structures buried deep within the medial temporal lobe. These form part of the “limbic system”, which is responsible for generating and modulating emotions, and laying down long term memories. The role of the amygdala is to coordinate information from different parts of the brain and generate the emotion.

Emotions are a response to bodily changes e.g. feeling hot, tense, sweating, or going red. The amygdala receives sensory information about a situation and the bodily changes from the nervous system, and everyday experience confirms or dismisses the threat accordingly. It is far better to interpret a stick as a snake and respond accordingly only to find out it was really a stick, than for your brain to think about it and get bitten before you realise what is going on.

According to neuroscientist Eric Kandel, emotion, such as fear and anger, has two components, conscious and unconscious. The amygdala receives information from both unconscious and conscious pathways when the brain perceives a threat.

The unconscious component of emotion is the operation of the nervous system. The stimulus is then analysed and an area of the brain called the hypothalamus regulates the emotion.

The conscious component of emotion involves evaluative functions of the cerebral cortex (the area responsible for planning, attention, language and reasoning), and the hippocampus, which is responsible for long term memories and the memory of emotion.

Central to both is the amygdala. According to Kandel, the amygdala is thought to coordinate the conscious experience of feeling and the bodily expression of emotion, particularly fear. It is also the area responsible for triggering the “fight or flight” response.

It seems that in the brain of someone with Aspergers or Autism that the amygdala is triggered on the unconscious component of emotion. It is possible that the brain misinterprets a stimulus as threatening, possibly due to Merzenich’s undifferentiated brain maps. When the person is in this state, logic and reasoning don’t work, and they are not necessarily aware of why they feel so angry or afraid. It appears that something in this system is not working correctly. It is understood that they have an abnormality in their amygdala, but there may also be other factors at work here, such as malfunctions in the pathways to the parts of the brain that analyse the emotion.

Cognitive Behavioural Therapy is often recommended to assist a person with Aspergers or Autism in the controlling of their emotions. Often the therapist will use a visual aid such as a “thermometer” to allow the person to recognise the bodily changes described above, before the amygdala sends the message to release the hormones associated with the fight or flight reflex. It also allows them to consciously analyse their emotions. Tony Attwood has a CBT program that he has developed; further information can be found here.

Once the emotion is triggered, it is impossible to reason with the person with Aspergers, so it is best to leave them to safely calm down, or to distract them. Tony Attwood advises using their special interest as an effective distraction, or maybe giving them a sensory toy to play with.

It seems that traditional methods of meditation and relaxation do not work with someone with Aspergers. Tony Attwood notes that they prefer to be active or physical or to do something repetitive, or even listen to music of their choosing, probably very loudly and over and over again.

References: In search of Memory by Eric Kandel, The Complete Guide to Asperger’s Syndrome by Tony Attwood, The Emotional Brain by Joseph Le Doux

Autism Spectrum Disorder and Fragile X link?

Neurorocker at en.wikipedia

 

When I started to really dig into the genes behind Aspergers and Autism, it seemed that it isn’t as clear cut as I initially thought. After researching the brain science of Fragile X syndrome (and the FMR1 gene) to establish how it could cause Autism and Aspergers, I discovered that that there isn’t just one gene that causes ASD. It seems there may be a range of genes, all of which seem to have similar effects on the developing brain.

In this post I shall discuss the FMR1 gene that causes Fragile X syndrome and its link to Autism.  Fragile X Syndrome is so called because a small section of the genetic code is “repeated on a fragile area of the X chromosome” (source PubMed Health)

According to the National Fragile X Foundation:

“FXS is the most common known cause of autism or “autistic-like” behaviors [sic]”

“Fragile X syndrome can cause a child to have autism or an Autism Spectrum Disorder (ASD) though not all children with fragile X syndrome have autism or an ASD.

  • FACT: For between 2% and 6% of all children diagnosed with autism, the cause is the Fragile X gene mutation.
  • FACT: Approximately one-third of all children diagnosed with fragile X syndrome also have some degree of autism.
  • FACT: Fragile X syndrome is the most common known single gene cause of autism.”

The A.D.A.M. Medical Encyclopedia notes that the symptoms of Fragile X are very similar to those with Autism:

  • “Delay in crawling, walking, or twisting
  • Hand clapping or hand biting
  • Hyperactive or impulsive behavior
  • Mental retardation
  • Speech and language delay
  • Tendency to avoid eye contact”

The reason Fragile X caught my eye is that one of the most common symptoms or signs of Fragile X is the hypersensitivity to sensory stimuli, as outlined by an article in Science Daily:

“New research provides insight into why fragile X syndrome, the most common known cause of autism and mental retardation, is associated with an extreme hypersensitivity to sounds, touch, smells, and visual stimuli that causes sensory overload and results in social withdrawal, hyperarousal, and anxiety. The study, published by Cell Press in the February 11 issue of the journal Neuron, uncovers a previously unknown developmental delay in a critical brain circuit that processes sensory information in a mouse model of fragile X syndrome.”

This is consistent with my view that the majority of symptoms associated with Autism and Aspergers are caused by sensory overload. In response to this article the Shared Attention website notes that: “This seems to support so-called experimental therapies (e.g. sensory integration) that theorize that plasticity in sensory processing can afford lasting positive changes in neurological function and behavioral outcomes. In other words, by using natural interests of the child to harness their attention and engagement, it may be possible to use purposefully engineered activities to modify and naturalize those pathways”.

And it seems that treatment for a child with Fragile X is similar to those with Autism and Aspergers. Source: Medicine.net:

  • Know the learning style of the individual.
  • Develop a consistent daily schedule or routine.
  • Use visual signs (pictures, sign language, logos, words) and concrete examples or materials to present ideas, concepts, steps, etc.
  • Prepare the individual for any changes in routine by explaining them ahead of time, possibly using visual signs.
  • Include functional goals with academic goals; for instance, teaching the individual the names of different pieces of clothing as well as how to dress him/herself.
  • Provide opportunities for the child to be active and move around.
  • Use computers and interactive educational software.
  • Provide a quiet place where the child can retreat and regroup.

So how does the Fragile X gene lead to symptoms similar to Autism?

This from the A.D.A.M. Medical Encyclopedia.

“Normally, the FMR1 gene makes a protein needed for your brain to grow properly. A defect in this gene makes your body produce too little of the protein, or none at all.” The link between the FMR1 gene and the hypersensitivity displayed in Aspergers and Autism has been established (see academic paper)  . The nerve cells in the brain initially grow extra branches, which could explain the hypersensitivity to various sensory stimuli. This could lead to the premature turning off of the “critical period” as discovered by Merzenich. The nerve cells eventually “prune” the branches so that the nerve cells appear normal, but at this stage it could already be too late, as the brain is left with the “undifferentiated brain maps” discovered by Merzenich.

According to the A.D.A.M. Medical Encyclopedia:

“Boys and girls can both be affected, but because boys have only one X chromosome, a single fragile X is likely to affect them more severely. You can have Fragile X syndrome even if your parents do not have it.

Fragile X syndrome can be a cause of autism or related disorders, although not all children with fragile X syndrome have these conditions.”

The symptoms are more likely to be pronounced in boys, girls may only exhibit behaviours such as shyness.

But the FMR1 gene cannot be the only cause of ASD. The main issue with this as an umbrella answer to ASD is that males with Fragile X cannot pass it onto their sons, due to the fact that they only transmit the Y chromosome, and not the X. (source: Autism Help)  But it seems that many boys with Aspergers and Autism have a father who also has it. In addition the IQ of a person with Fragile X Syndrome is highly likely to be below average, although this is not always true for girls. Although the research in this area may be slightly inaccurate, as medicine.net points out:

“Attention disorders, hyperactivity, anxiety, and language processing problems can interfere with test-taking skills and learning. Because many people with Fragile X have these problems, a person with Fragile X may have more capabilities than his or her IQ score suggests”

So the search for the common cause continues…

Academic Papers on Fragile X:

http://www.fragilex.org/pdf/kaufmann-et-al_autismandfragileX.pdf

http://www.ncbi.nlm.nih.gov/pubmed/19441123

Sue Larkey’s tips

Today I signed up to Sue Larkey’s website and received these great tips in my inbox:

10 Essential tips for Understanding Autism Spectrum Disorder

1.      ASD students don’t have to look at you all the time.
o        Reason: They find looking and listening at the same time
hard to do.

2.      Give them time to answer any of your questions.
o            Reason: They have slower processing time. Sometimes it
can take them up to a minute to formulate the answer in the correct
sequence.

3.      If they feel pressured they will answer with stock standard
answers.
o      Reason: They know it will get them out of trouble quickly.
This may include: “I don’t know”, “yes”, “maybe” and often this
isn’t their true answer!!

4.      They often don’t “generalise” information between people
and places.
o          Reason: Homework for teacher ‘x’ is in the yellow basket
but for teacher ‘y’ it’s to be placed in the green basket.

5.      They find organisation of their school equipment very
difficult.
o          Reason: They are best with one folder with everything
inside. Limit the number of pencils, pens etc.

6.      Limit their choices and be very specific with choices.
o          Reason: They find choices overwhelming and are often
concerned with making wrong choice due to their difficulty with
problem solving.

7.      Be as clear, concise and concrete as possible.
o      Reason: People with ASD have difficulty with abstract
thinking.

8.      Avoid verbal overload.
o          Reason: They are visual learners and verbal information
takes them longer to process and retain.

9.      Avoid verbal arguments by redirecting them to what they
should be doing. Eg “Start your work”.
o      Reason: They often enjoy verbal arguments.

10.  Asperger people need positive feedback to know they are on the
right track.
o      Reason: Because of their fear of failure and they want to
be Mr Perfect.

Auditory Processing Disorder

CUTE TODDLER © Beatricekillam | Dreamstime.com

Many people with Aspergers have difficulty with auditory processing, including myself. A child may appear not to hear parts of a conversation or remember instructions, or they may seem to be ignoring someone talking, even if they are close by. They may appear deaf – but this is nothing to do with hearing, and the child may indeed have normal, or even more sensitive than normal, hearing. Difficulties with auditory processing stem from a malfunction in the transfer of audio signals from the ear to the brain. The Listen and Learn Centre in Melbourne define APD as “a problem in the decoding of language”.

www.auditoryprocessing.com.au  defines APD as follows:

“People who have normal hearing actually hear far more than they perceive. Where hearing is a function of the ear, auditory processing – listening – is a function of the brain. Auditory processing describes the way the brain assigns significance and meaning to the sounds in the environment. Effective auditory processing involves a relatively high speed of information transfer. It also requires a good attention span, a well-functioning memory, and sensitivity to the many subtleties of sound. When parts of this complex system break down or don’t operate efficiently, listening is compromised. All the ensuing problems are collectively known as Auditory Processing Disorders (APD).”

It can mean the child doesn’t always register speech, or that they sometimes misunderstand or misremember something that is being said. It can adversely affect their memory of oral information, which can cause frustration as the child is convinced they have remembered something right when it is wrong, or they may have no glimmer of recollection of something they have been told.

APD affects around 5% of school-aged children, and is often worse in loud environments, for instance at school, as the child has difficulty differentiating what is being said from the background noise. This can lead to difficulties with their schoolwork, and their grades may suffer as a result.

The Listen and Learn Centre also note that APD can lead to the “deterioration of behaviour as a result of poor expressive and receptive communication. As children experience the discouragement of being misunderstood and the frustration of misunderstanding others, they become more disconnected from their environment and the people around them”. The child may learn coping strategies such as lip-reading, but this doesn’t always help them in all cases. It could also be the reason why some people with Aspergers may not be able to detect humour. The Neurosensory Unit has this to say:

“It [the central auditory system] helps us to identify the non-linguistic elements of speech and communication, such as rhythm, timing and pitch that assist in interpreting humour and sarcasm, as well as intent of communication.”

APD can be another reason, in addition to sensory overload, that can cause a child to withdraw from social situations. In fact, it seems that sensory overload can also occur with APD, according to the Listen and Learn Centre:

“The term ‘auditory overload’ is often used to describe what happens to people who have APD. Auditory overload is a sense of being overwhelmed and relates to features of the information being received. If information is highly specific, spoken quickly, lacking in contextual cues, described in unfamiliar language or presented in a noisy environment, it will be very difficult for someone with APD to comprehend the message or follow through with instructions.”

Some children with APD may be seem to have very sensitive hearing, and could hear a pin drop in a quiet room. The team at the Listen and Learn Centre have a theory about this:

“Some children are more attentive to bone conducted sounds. They primarily listen with their body instead of with their ears. These individuals have difficulties in dampening the sound intensity and to filter out irrelevant sounds. This may be one of the reasons why individuals are hyper sensitive to sound as they may have lost the ability to focus and tune out extraneous background noise. In this situation, every noise has the same amount of importance. Capturing a word may be difficult as ambient noise distracts from focusing. As a result, the child misses part of the conversation or instruction being given.”

There is no relationship between intelligence and APD; a very bright child may be having difficulty at school and poor marks, which could puzzle parents or teachers.

In this case changes to the teaching style could help, with more emphasis on visual learning strategies.

There is no cure for APD, but it can be treated with speech therapy, reading recovery or through an Auditory Integration Listening Program

kidshealth.org have some tips and strategies for teaching a child with APD: Strategies

Frontiers: Review -The Intense World Theory – A Unifying Theory of the Neurobiology of Autism

Frontiers: Review -The Intense World Theory – A Unifying Theory of the Neurobiology of Autism.

This article outlines the Intense World Theory, which relates to my previous post about empathy, and explains a little about the neuroscience of Aspergers/Autism.

On Empathy

THE COMFORT © Marshhawk | Dreamstime.com

 

I was just about to write a post about my views on empathy, and I came across an article that totally supports my view. Before I share it, I would like to talk about my own experiences, having Aspergers myself. I was thinking about whether my ability to feel empathy was due to a coping mechanism I had developed, but I doubted that this was the case and so I thought back upon my early life… Read more of this post

What is Aspergers?

GENIUS © Slobodan Mračina | Dreamstime.com

 

What is Aspergers? Well, I’ll start by saying what Aspergers isn’t. It isn’t a mental illness, it isn’t a disability. The symptoms of Aspergers are many, complex and varied. Aspergers is a different way of thinking and a different way of seeing the world. An Aspergers child has many unique abilities, acute powers of observation and intense ability to focus. Unfortunately Aspergers is often peppered with social and learning disorders that may make school life difficult or even unbearable for the child. But there is no reason, with the right guidance and interventions, that the Aspie child can’t grow up to be a fully functioning and thriving member of society, having successful social and intimate relationships along the way. Read more of this post