The Empathy Imbalance Hypothesis of Autism: A Theoretical Approach to Cognitive and Emotional Empathy in Autistic Development

There has been a widely held belief that people with autism spectrum disorders lack empathy. This article examines the empathy imbalance hypothesis (EIH) of autism. According to this account, people with autism have a deficit of cognitive empathy but a surfeit of emotional empathy. The behavioral characteristics of autism might be generated by this imbalance and a susceptibility to empathic overarousal. The EIH builds on the theory of mind account and provides an alternative to the extreme-male-brain theory of autism. Empathy surfeit is a recurrent theme in autistic narratives, and empirical evidence for the EIH is growing. A modification of the pictorial emotional Stroop paradigm could facilitate an experimental test of the EIH

Electrophysiological markers of predictive coding in multisensory integration and autism spectrum disorder

Publiekssamenvatting De manier waarop we de wereld om ons heen waarnemen is niet alleen gebaseerd op informatie die we via onze zintuigen ontvangen, maar wordt ook gevormd door onze ervaringen uit het verleden. Een recent geïntroduceerde theorie over de verwerking en integratie van sensorische informatie en eerdere ervaringen, de zogeheten predictive coding theorie, gaat ervan uit dat ons brein continu een intern predictiemodel van de wereld om ons heen genereert op basis van informatie die we ontvangen via onze zintuigen en gebeurtenissen die we in het verleden hebben meegemaakt. Het kunnen voorspellen wat we in bepaalde situaties zullen gaan zien, horen, voelen, ruiken en proeven, stelt ons in staat om te anticiperen op sensorische prikkels. Om deze reden reageren we vaak sneller en accurater op voorspelbare sensorische signalen. Op neuraal niveau zijn er ook aanwijzingen gevonden voor de aanwezigheid van een intern predictiemodel. Na het horen van een geluid, bijvoorbeeld van de claxon van een auto, genereert ons brein automatisch elektrische activiteit die met behulp van elektro-encefalografie (EEG) te meten is. Wanneer we datzelfde geluid zelf initiëren, door bijvoorbeeld zelf op de claxon te drukken, kunnen we beter voorspellen wanneer het geluid optreedt en hoe dit ongeveer zal klinken. Deze toename in voorspelbaarheid van het geluid is terug te zien in een vermindering van het EEG signaal. Wanneer we luisteren naar een reeks voorspelbare geluiden waarin onverwacht een geluid wordt weggelaten genereert het brein ook een duidelijk elektrisch signaal, een zogeheten predictie error, dat kan worden gemeten met behulp van EEG. De sterkte van dit signaal wordt verondersteld samen te hangen met de hoeveelheid cognitieve vermogens die aan de onverwachtse verstoring van de voorspelling worden toegewezen. De bevindingen beschreven in dit proefschrift laten zien dat het zelf initiëren van een geluid bij mensen met autisme spectrum stoornis (ASS) niet automatisch resulteert in een afname in elektrische hersenactiviteit. Ook is gevonden dat een plotselinge verstoring in sensorische stimulatie bij mensen met ASS kan resulteren in verhoogde elektrische hersenactiviteit. Deze bevindingen suggereren dat mensen met ASS minder goed in staat lijken te zijn om te anticiperen op sensorische prikkels, en mogelijk meer moeite hebben met de verwerking van onverwachtse verstoringen in sensorische stimulatie. Een verminderd vermogen om te kunnen anticiperen op sensorische prikkels en omgaan met onverwachtse verstoringen in sensorische stimulatie kan niet alleen leiden tot atypische gedragsreacties, waaronder onder- en overgevoeligheid voor sensorische prikkels (symptomen die veel voorkomen bij ASS), maar heeft mogelijk ook gevolgen voor de sociale cognitieve vaardigheden. In sociale situaties is het kunnen anticiperen op hetgeen een ander zegt of doet van cruciaal belang. Het begrijpen van sarcasme vereist bijvoorbeeld de integratie van subtiele verschillen in auditieve (toonhoogte en prosodie) en visuele informatie (gezichtsuitdrukkingen, lichaamstaal). Het juist interpreteren van dergelijke dubbelzinnige sociale signalen is vaak lastig voor mensen met ASS. De bevindingen beschreven in dit proefschrift suggereren dat de oorzaak hiervoor mogelijk ligt in verstoringen in het vermogen om te kunnen anticiperen op sensorische prikkels. Toekomstig onderzoek moet uitwijzen of mensen met ASS ook meer moeite hebben met het anticiperen op sensorische prikkels en verwerken van onverwachtse verstoringen in andere sensorische domeinen. Naast het vergroten van wetenschappelijke kennis over de sensorische informatieverwerking in ASS kan verder onderzoek naar de neurale mechanismen van sensorische anticipatie potentieel leiden tot een elektrofysiologische marker voor ASS die kan worden toegepast als diagnostisch hulpmiddel. Met name voor mensen waarbij de gedragskenmerken niet altijd goed te beoordelen zijn kan een dergelijke biomarker mogelijk als objectief meetinstrument worden ingezet in de klinische praktijk

Neural Dynamics of Autistic Behaviors: Cognitive, Emotional, and Timing Substrates

What brain mechanisms underlie autism and how do they give rise to autistic behavioral symptoms? This article describes a neural model, called the iSTART model, which proposes how cognitive, emotional, timing, and motor processes may interact together to create and perpetuate autistic symptoms. These model processes were originally developed to explain data concerning how the brain controls normal behaviors. The iSTART model shows how autistic behavioral symptoms may arise from prescribed breakdowns in these brain processes.Air Force Office of Scientific Research (F49620-01-1-0397); Office of Naval Research (N00014-01-1-0624

Sensory processing in autism across exteroceptive and interoceptive domains

Objective: The current article discusses recent literature on perceptual processing in autism and aims to provide a critical review of existing theories of autistic perception and suggestions for future work. Method: We review findings detailing exteroceptive and interoceptive processing in autism and discuss their neurobiological basis as well as potential links and analogies between sensory domains. Results: Many atypicalities of autistic perception described in the literature can be explained either by weak neural synchronization or by atypical perceptual inference. Evidence for both mechanisms is found across the different sensory domains considered in this review. Conclusions: We argue that weak neural synchronization and atypical perceptual inference might be complementary neural mechanisms that describe the complex bottom-up and top-down differences of autistic perception, respectively. Future work should be sensitive to individual differences to determine if divergent patterns of sensory processing are observed within individuals, rather than looking for global changes at a group level. Determining whether divergent patterns of exteroceptive and interoceptive sensory processing may contribute to prototypical social and cognitive characteristics of autism may drive new directions in our conceptualization of autis

Sensory processing in autism across exteroceptive and interoceptive domains

Objective: The current article discusses recent literature on perceptual processing in autism and aims to provide a critical review of existing theories of autistic perception and suggestions for future work. Method: We review findings detailing exteroceptive and interoceptive processing in autism and discuss their neurobiological basis as well as potential links and analogies between sensory domains. Results: Many atypicalities of autistic perception described in the literature can be explained either by weak neural synchronization or by atypical perceptual inference. Evidence for both mechanisms is found across the different sensory domains considered in this review. Conclusions: We argue that weak neural synchronization and atypical perceptual inference might be complementary neural mechanisms that describe the complex bottom-up and top-down differences of autistic perception, respectively. Future work should be sensitive to individual differences to determine if divergent patterns of sensory processing are observed within individuals, rather than looking for global changes at a group level. Determining whether divergent patterns of exteroceptive and interoceptive sensory processing may contribute to prototypical social and cognitive characteristics of autism may drive new directions in our conceptualization of autism

The cerebellum and motor dysfunction in neuropsychiatric disorders

The cerebellum is densely interconnected with sensory-motor areas of the cerebral cortex, and in man, the great expansion of the association areas of cerebral cortex is also paralleled by an expansion of the lateral cerebellar hemispheres. It is therefore likely that these circuits contribute to non-motor cognitive functions, but this is still a controversial issue. One approach is to examine evidence from neuropsychiatric disorders of cerebellar involvement. In this review, we narrow this search to test whether there is evidence of motor dysfunction associated with neuropsychiatric disorders consistent with disruption of cerebellar motor function. While we do find such evidence, especially in autism, schizophrenia and dyslexia, we caution that the restricted set of motor symptoms does not suggest global cerebellar dysfunction. Moreover, these symptoms may also reflect involvement of other, extra-cerebellar circuits and detailed examination of specific sub groups of individuals within each disorder may help to relate such motor symptoms to cerebellar morphology

Enactivism, other minds, and mental disorders

Although enactive approaches to cognition vary in terms of their character and scope, all endorse several core claims. The first is that cognition is tied to action. The second is that cognition is composed of more than just in-the-head processes; cognitive activities are externalized via features of our embodiment and in our ecological dealings with the people and things around us. I appeal to these two enactive claims to consider a view called “direct social perception” : the idea that we can sometimes perceive features of other minds directly in the character of their embodiment and environmental interactions. I argue that if DSP is true, we can probably also perceive certain features of mental disorders as well. I draw upon the developmental psychologist Daniel Stern’s notion of “forms of vitality”—largely overlooked in these debates—to develop this idea, and I use autism as a case study. I argue further that an enactive approach to DSP can clarify some ways we play a regulative role in shaping the temporal and phenomenal character of the disorder in question, and it may therefore have practical significance for both the clinical and therapeutic encounter

How the Attitude of Acceptance, Enthusiasm and Learning through Motivation Affects Brain Development in Children with Autism: A Literature Review

Research on the autism spectrum (AS) has expanded tremendously over the last two decades with exciting insights into underlying neurobiology. Neuroplasticity, the remarkable ability of the brain to form new connections as a result of experience, is not limited to specific parts of the brain nor does it have a time limit meaning that growth and learning are on-going processes. In this review we explore the impact of the attitude of acceptance, enthusiasm and learning through motivation on brain development in children on the AS. The first part of the review focusses on the impact of attitude on social, emotional and cognitive development, while the second part focusses on the impact of attitude on brain biology

Individual differences in sensory sensitivity: a synthesising framework and evidence from normal variation and developmental conditions

For some people, simple sensory stimuli (e.g., noises, patterns) may reliably evoke intense and aversive reactions. This is common in certain clinical groups (e.g., autism) and varies greatly in the neurotypical population. This paper critically evaluates the concept of individual differences in sensory sensitivity, explores its possible underlying neurobiological basis, and presents a roadmap for future research in this area. A distinction is made between subjective sensory sensitivity (self-reported symptoms); neural sensory sensitivity (the degree of neural activity induced by sensory stimuli); and behavioral sensory sensitivity (detection and discrimination of sensory stimuli). Whereas increased subjective and neural sensory sensitivity are assumed to increase together, the status of behavioral sensory sensitivity depends on the extent to which the increased neural activity is linked to signal or noise. A signal detection framework is presented that offers a unifying framework for exploring sensory sensitivity across different conditions. The framework is discussed, in more concrete terms, by linking it to four existing theoretical accounts of atypical sensory sensitivity (not necessarily mutually exclusive): increased excitation-to-inhibition ratio; predictive coding; increased neural noise; and atypical brain connectivity