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In 2006 your lab published a paper in Nature Neuroscience linking a mirror neuron dysfunction to autism. How might reduced mirror neuron activity explain the symptoms of autism?

Reduced mirror neuron activity obviously weakens the ability of these patients to experience immediately and effortlessly what other people are experiencing, thus making social interactions particularly difficult for these patients. Patients with autism have also often motor problems and language problems. It turns out that a deficit in mirror neurons can in principle explain also these other major symptoms. The motor deficits in autism can be easily explained because mirror neurons are just special types of premotor neurons, brain cells essential for planning and selecting actions. It has been also hypothesized that mirror neurons may be important in language evolution and language acquisition.

Thus, a deficit in mirror neurons can in principle account for three major symptoms of autism, the social, motor and language problems.

There is convincing behavioral evidence linking media violence with imitative violence. Mirror neurons provide a plausible neurobiological mechanism that explains why being exposed to media violence leads to imitative violence.

I think there are two key points to keep in mind. The first one is the one we started with: mirror neurons are brain cells specialized for actions. They are obviously critical cells for social interactions but they can’t explain non-social cognition. The second point to keep in mind is that every brain cell and every neural system does not operate in a vacuum. Everything in the brain is interconnected, so that the activity of each cell reflects the dynamic interactions with other brain cells and other neural systems.

all the success stories related inside the pages of EPSS are accompanied by fortuitous exposure to various forms of structured material, clearly marking out the most promising path for autistic development and growth.

And of course these discussions fly in the face of the current clamor for early intervention in autism, where it would seem the goal is always to yank the autistic child away as early as possible from his or her preferred method of engaging the world, and substitute instead an intense bombardment of socially based indoctrination, hoping to turn the child around while there is still time for the “malleable” brain to be re-molded.

In my opinion, it is no mere coincidence that the very same elements that stand at the core of the Mottron team's affirmative description of autistic perception and cognition are also the very same elements that stand at the core of humanity’s sudden departure off the savannah and leap into the modern world.

Admittedly, a thorough discussion of such a topic would be much too large for inclusion in an academic research paper such as EPSS, but the fact that the Mottron team does not mention, or even hint at, the connection between the features of autistic perception and the features of human cognitive history leave it unclear whether the team has ever considered such a connection.

At this point in time, the Mottron team seems to be the only autism research team heading in a positive and enlightening direction—a direction that is constructive for autistic individuals everywhere—and I look forward to all their future contributions.

Savant skills included more fully developed talents, such as being able to name the elevation of both the sun and the moon at any time of day, on any specified date; being able to name the day of the week for any date in the distant past or future (a talent known as calendrical calculation) and perfect pitch. Importantly, the abilities and the skills had to be exceptional by the standards of the general population, but also well above the individual's overall level of ability. In total, roughly 30 per cent had some kind of special ability (Philosophical Transactions of the Royal Society B, vol 364, p 1359).

For musical savants like Paravicini, Happé suggests that a bias towards small details might have led their developing brains to focus more on the exact notes than the overall melody, leading to perfect pitch and an exceptional musical memory. In art, a focus on small regions of a picture could lead to accurate perspective drawing.

Most people find this harder when they are shown an unsegmented version of the pattern versus a segmented one, but people with autism don't have this preference, demonstrating their skill at seeing a whole in terms of its parts even if there are no obvious dividing lines (see diagram). "It shows they are able to do the segmentation in their minds," says Winner. The precocious realists did not have this preference either, indicating a talent for realistic drawing may arise from this isolated trait commonly found in autism (Philosophical Transactions of the Royal Society B, vol 364, p 1449).

Although these results help to pinpoint exactly what it is about autism that predisposes people to talent, it's still not clear why an eye for detail is more common in autistic people in the first place. Clues might lie in the work of Simon Baron-Cohen from the University of Cambridge, which suggests that people with autism are "hypersensitive" to sensory information

Daniel Tammet, a prodigious savant who has memorised pi to 22,514 digits, believes his own talents have arisen from a special ability to connect different pieces of information together. "Savant abilities are linked to a highly associative type of thinking, an extreme form of a kind that everyone does - examples would include daydreaming, puns and the use of metaphors," he says.

The few studies of savant brains certainly suggest they are physically different from the average brain. For example, when Happé and Wallace studied the brain of a savant gifted at art, calendrical calculation and memory, they found his cortex was thicker in the areas associated with visuospatial processing and calculation and thinner in other regions associated with social cognition, compared with people who were neither savants nor autistic. But whether these differences were innate or grew with lifelong practice was still unclear.

The answer to that question may come from an unlikely source - a study of London taxi drivers who have acquired an encyclopedic memory of the streets of London known as "the Knowledge". Given that taxi drivers must remember the layout of 25,000 streets and the location of thousands of places of interest, and retrieve the information instantaneously, some researchers like Happé believe the Knowledge qualifies as a savant-like skill.

Eleanor Maguire and colleagues at the Institute of Neurology at University College London and colleagues found that drivers with the Knowledge have a bigger rear hippocampus than bus drivers and adults who do not drive taxis. In addition, the hippocampus appears to be larger the longer a taxi driver has been working, and shrinks once they retire (Philosophical Transactions of the Royal Society B, DOI: 10.1098/rstb.2008.0288).

In fact, it seems the remaining mystery is not so much how savants achieve their talents, but what drives them in the first place. "Motivation is a big unknown," says Wallace. "It's an enormous driving force in giftedness and in savants, but we don't know a lot about it."

One person who has something of an inside view on what contributes to savant ability is Paravicini's mentor, Adam Ockelford, a professor of music at Roehampton University in London who has watched Paravicini's talent blossom since the age of 4. When they first met, Paravicini was entirely self-taught and bashed at his plastic keyboard with his fists and elbows to reproduce the sounds he was hearing. It was only after years of practice that his technical skills developed.

But as researchers like Wallace have suggested, Paravicini seemed motivated way beyond the average music student. In fact, he seemed to be playing as if his life depended on it, and Ockelford thinks it's this that truly sets savants apart from their peers. "The survival instinct gets turned with extraordinary force into something else - in Derek's case music," says Ockelford. "When people see Derek, they think it is amazing, almost religious. But to me, it's mainly just hard work."

Thompson (1993) describes facilitated communication as a classic example of the self-fulfilling prophecy. The facilitator wants to believe that the person with a severe cognitive and language disability is actually of normal to superior intellectual ability. Parents especially want to believe that a way has been found to finally unlock the door to their real son or daughter.

In short, people want facilitated communication to work.

Advocates of facilitated communication often respond to naysayers, "It can't hurt to try it." Biklen agrees, "It is not harmful to teach people to communicate through pointing." However, he qualifies his claim with the caveat that "it can be harmful if the facilitator over interprets, does not monitor the person's eyes, facilitates when the person is looking away, is not sensitive to the possibility of guiding the person, and asks leading rather than clarifying questions."

Some argue that "false communication" may distort beliefs, understanding, and rehabilitative approaches to persons with autism and other developmental disabilities.

There are at least 50 legal cases in the U.S. involving allegations of sexual abuse produced through facilitated communication (Berger, 1994). Several such cases have already occurred in Australia, and some have arisen in Europe (Green, 1992).

Additionally, facilitated communication in the past few years has been the source of many contested abuse allegations, usually allegedly reported by an individual with very limited unassisted communication skills against a family caregiver or caregivers.

With the exception of three empirical studies (Intellectual Disability Review Panel, 1989; Calculator and Singer, 1992; and Velazquez (in press)) which provide preliminary validation of facilitated communication, most of the support for the validity of facilitated communication is based on anecdotal reports.

Unfortunately, validity questions surround anecdotal reports of facilitated communication. In general, these reports lack the controls necessary to rule out experimenter biases, reliability concerns, and threats to validity (Cummins and Prior, 1992; Jacobsen, Eberlin, Mulick, Schwartz, Szempruch, and Wheeler, 1994).

Although Biklen (1990) admits that facilitator influence is a real possibility, facilitated communications are typically reported as though they are the words of the person with a disability.

Without exception, these empirical studies have questioned the authenticity of the communication as truly coming from the individual versus the facilitator.

Interdisciplinary Party Report (1988) and the Intellectual Disability Review Panel (1989) both of which examined the source of facilitated communications produced by persons in Australia, and found strong evidence that responses obtained through facilitation were influenced by the facilitator.

Gina Green, Director of Research for the New England Center for Autism and Associate Scientist for the E.K. Shriver Center for Mental Retardation, Inc., has reviewed over 150 cases where empirical testing was performed and cites 15 independent conduct evaluations involving 136 individuals with autism and/or mental retardatiion who were alleged to have been taught to communicate via facilitated communication. In none of the cases were investigators able to confirm facilitated communication by the 136 individuals.

Einstein researchers contend that scientific evidence directly points to the locus coeruleus–noradrenergic (LC-NA) system as being involved in autism. “The LC-NA system is the only brain system involved both in producing fever and controlling behavior,” says co-author Dominick P. Purpura, M.D., dean emeritus and distinguished professor of neuroscience at Einstein.

The locus coeruleus has widespread connections to brain regions that process sensory information.

It is also involved in a variety of complex behaviors, such as attentional focusing (the ability to concentrate attention on environmental cues relevant to the task in hand, or to switch attention from one task to another).

“What is unique about the locus coeruleus is that it activates almost all higher-order brain centers that are involved in complex cognitive tasks,” says Dr. Mehler.

Drs. Purpura and Mehler hypothesize that in autism, the LC-NA system is dysregulated by the interplay of environment, genetic, and epigenetic factors (chemical substances both within as well as outside the genome that regulate the expression of genes). They believe that stress plays a central role in dysregulation of the LC-NA system, especially in the latter stages of prenatal development when the fetal brain is particularly vulnerable.

Drs. Purpura and Mehler believe that, in autistic children, fever stimulates the LC-NA system, temporarily restoring its normal regulatory function.

the future of autism treatment probably lies in drugs that selectively target certain types of noradrenergic brain receptors or, more likely, in epigenetic therapies targeting genes of the LC-NA system.

“You can’t take a complex neuropsychiatric disease that has escaped our understanding for 50 years and in one fell swoop have a therapy that is going to reverse it — that’s folly. On the other hand, we now have clues to the neurobiology, the genetics, and the epigenetics of autism. To move forward, we need to invest more money in basic science to look at the genome and the epigenome in a more focused way.”

This study documented that autistic children experience behavior changes during fever.

Einstein researchers contend that scientific evidence directly points to the locus coeruleus–noradrenergic (LC-NA) system as being involved in autism. "The LC-NA system is the only brain system involved both in producing fever and controlling behavior," says co-author Dominick P. Purpura, M.D., dean emeritus and distinguished professor of neuroscience at Einstein.

The locus coeruleus has widespread connections to brain regions that process sensory information. It secretes most of the brain's noradrenaline, a neurotransmitter that plays a key role in arousal mechanisms, such as the "fight or flight" response. It is also involved in a variety of complex behaviors, such as attentional focusing (the ability to concentrate attention on environmental cues relevant to the task in hand, or to switch attention from one task to another). Poor attentional focusing is a defining characteristic of autism.

"What is unique about the locus coeruleus is that it activates almost all higher-order brain centers that are involved in complex cognitive tasks," says Dr. Mehler.

autism, the LC-NA system is dysregulated by the interplay of environment, genetic, and epigenetic factors

They believe that stress plays a central role in dysregulation of the LC-NA system, especially in the latter stages of prenatal development when the fetal brain is particularly vulnerable.

a higher incidence of autism among children whose mothers had been exposed to hurricanes and tropical storms during pregnancy.

autistic children, fever stimulates the LC-NA system, temporarily restoring its normal regulatory function. "This could not happen if autism was caused by a lesion or some structural abnormality of the brain," says Dr. Purpura.

future of autism treatment probably lies in drugs that selectively target certain types of noradrenergic brain receptors or, more likely, in epigenetic therapies targeting genes of the LC-NA system.

If the locus coeruleus is impaired in autism, it is probably because tens or hundreds, maybe even thousands, of genes are dysregulated in subtle and complex ways," says Dr. Mehler. "The only way you can reverse this process is with epigenetic therapies, which, we are beginning to learn, have the ability to coordinate very large integrated gene networks."

"You can't take a complex neuropsychiatric disease that has escaped our understanding for 50 years and in one fell swoop have a therapy that is going to reverse it — that's folly. On the other hand, we now have clues to the neurobiology, the genetics, and the epigenetics of autism. To move forward, we need to invest more money in basic science to look at the genome and the epigenome in a more focused way."

Look at the content of any intelligence test—language, arithmetic, patterns, designs. What we measure with the aid of those I.Q. booklets are not the abilities we inherited from out our animal past, but instead their exact counterpart; we measure only those skills the species has been adding throughout all its history since. In some sense, an intelligence test measures the modernness of an individual; an intelligence test measures an individual’s ability to appropriate for himself the same set of skills the species has been appropriating as a whole—skills that do not find their origin in our biological nature, but instead owe their existence to the strange, brewing mixture of non-biological pattern, structure and form that has been rapidly taking shape all around us.

The unusual characteristics of humanity’s transformational individuals are not the result of their genius, they are genius’s prerequisite

But counter to prevailing wisdom, there are many autistic individuals—most likely a majority—who do make substantial progress by means of an alternative perceptual course, a course that allows them not only to navigate meaningfully their surrounding world, but also to assimilate, if somewhat awkwardly and belatedly, to the human species itself (and thereby explaining how autism, estimated to be present in nearly one percent of the human population, could go entirely unrecognized until as recently as sixty-five years ago).

all autistic individuals must crystallize their existence by means of this alternative perceptual course—it becomes, in essence, autism’s most salient feature.

The unusual behaviors and interests of autistic children—lining up toys, staring at ceiling fans, twirling, flapping hands repeatedly, fascination with knobs, buttons, switches, letters, shapes and digits, watching the same video again and again, singing the same song over and over—these activities betray a form of perception completely unlike that of most other children, a perception noticeably absent in social and biological focus, but also noticeably drawn to symmetry, repetition and pattern.

The unusual routines of autistic children are the natural, indeed the expected, mode of expression for a form of perception engaged primarily by the structural aspects of the non-social, non-biological world.

Autistic individuals would have been the first to notice the inherent structure contained in the natural world—the geometry of plants, the isomorphisms of natural objects, the logic of the celestial seasons—only they would have had motivation to embrace such form, only they would have had the need to perceive nature’s symmetry, repetition and pattern in order to form their cognitive grounding.

We know only bits and pieces about the four Greeks on Professor Flynn’s list, but filling in with the traits from the list’s more modern members, we can reasonably summarize all the unifying characteristics: late- or strange-talking, socially awkward, irascible, obsessed with structure, compelled by form, unusually—not necessarily greatly—intelligent.

The continuing medicalization of autism, the insistent demonization of autism’s spontaneous effect—these carry the danger of an unforeseen consequence. For the cure of autism will not be the end of a tragic brain disorder; autism’s eradication will not see the passing of a troubling mental disease. The removal of autism from the entire human species will produce only an ironic solution to the mystery of our expanding human intelligence, it will produce the ignoble end to the Flynn effect.

When confronted by data that runs counter to our accustomed way of seeing things, we as humans have but two choices: we can try to explain the results away, or we can adjust our perception of the experienced world. The former choice paves the all-too-common road of modern academic science; the latter, as described above, walks the more promising path of genius.

Autism is not a mental illness, not a brain disorder, it is instead the source of humanity’s changing perception of its experienced world; it is, with care and understanding, genius’s fertile soil.