Abstract
The 6-year-old boy ran into my office and immediately, without making eye contact and without showing any interest in the examiner, rushed for the small objects on the table and began quickly but carefully carrying them to another slightly smaller table on an adjoining wall, one by one. Finished, he carried them back to the table, one by one, in exactly the same order.
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Notes
- 1.
I will return to this example in Chap. 10.
- 2.
Kanner published his article in 1943; Asperger submitted his work as his doctoral thesis also in 1943, and it was published in 1944.
- 3.
Moreover, they both borrowed this title from Bleuler’s term autism, which designates the core deficit in schizophrenia—loss of contact with reality. In schizophrenia, autism is accompanied by autistic thinking. Both Kanner and Asperger indicated that the entity described by them is not characterized by autistic thinking.
- 4.
In this book, the term autism includes low functioning autism (LFA), high functioning autism (HFA) and Asperger syndrome (AS). The term AS is not used by itself, it is included into the category of HFA. I did not use the umbrella term Autistic Spectrum Disorder (ASD) common in the recent literature because it is still not uniformly defined. For example, some authors include in it Pervasive Developmental Disorder Not Otherwise Specified (PDD NOS) (Akshoomoff, 2006), while others distinguish four subgroups within ASD: Asperger syndrome, high, medium, and low functioning autism (Baron-Cohen et al., 20024), etc.
- 5.
The behavioral approach uses mathematical methods to determine the statistical significance (or lack thereof) of separately observed features of a particular clinical group (study population). There is nothing wrong with such detailed descriptions. Indeed they are very important and give invaluable information. What is wrong, or at least incomplete, is treating the observation and mathematical description of behaviors as a goal. Behavioral manifestations may or may not adequately reflect altered subjective experience. Jaspers (1968, 1997) warned that a claim to be concerned with objective data only has a natural consequence: it will be psychiatry without psyche—elimination of everything that can be called mental or psychic.
- 6.
Autism and schizophrenia are very different disorders. Strikingly, as in autism, neuroimaging and morphological studies of schizophrenia have similarly confusing results: findings are perplexingly heterogenous, “global” but variable, not consistent and non-specific, overlapping with those in the normal population. This rings the bell that we are dealing with artifacts. Standard neuropsychological tests and in particular neurocognitive tasks that are used in fMRI studies are based on our knowledge about localization of cortical functions. These tests are designed to diagnose focal brain lesions. However, we know now that neither schizophrenia nor autism are focal brain disorders. Therefore, a standard neuropsychological approach is not adequate to autism.
- 7.
It is interesting to note that no other neurodevelopmental condition gets “assigned” with so many “unscientific” epithets such as “mysterious,” “enigmatic,” “puzzling,” “fascinating,” “paradoxical,” as does autism. This is in contradiction to the rather “boring” behavioral cliché it represents, the lack of imagination described in autistic children—their literal, “unstrange” mind. It seems to me that this paradox reflects “the shock which the course of our comprehension receives in the face of the incomprehensible” in Jaspers’ terms.
- 8.
The synonymous terms “proprioceptive” and “kinesthetic” will herein be used interchangeably.
- 9.
Contrast this to the cerebellum–midbrain level where the proprioceptive–vestibular input comes from the trunk and head, constructing the body as a weight in the gravitation field.
- 10.
The term “working memory” is misleading since the frontal lobe does not store information. Information is stored where it is spatially organized, i.e., in the posterior brain. Furthermore, “working memory” is in reality not a term, but a metaphor, given that “working” and “memory” are not compatible semantically.
- 11.
The following parameters are usually used to distinguish one cytoarchitectural field from another: the layering in depth of the cortical sheet and, within each layer, cell characteristics—cell type ratio, cell size and number, cell density, cell spatial distribution, and their connections.
- 12.
For example, the border between the primary visual cortex BA17 and the secondary visual cortex BA18 is characterized by an abrupt change in lamina IV, which is broad and subdivided into sublaminae in BA17 and a thinner and less well differentiated lamina IV in BA18 (Schleicher et al., 2009).
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Glezerman, T.B. (2013). Introduction. In: Autism and the Brain. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4112-0_1
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