What is autism

Autism is a developmental condition that affects how individuals perceive the world and interact with others, rather than being a disease that can be caught or cured. It influences brain development from an early age and persists throughout a person's life.

This condition impacts approximately 700,000 people in the UK, which equates to more than 1 in 100 individuals. Autism is more common in boys than in girls, with research consistently showing a higher proportion of males affected. A review by Fombonne et al. (2011) reported an average of 5.5 males to every 1 female across multiple studies.

Key characteristics of autism

People with autism often experience challenges in social interaction, communication, and behaviour, which can make everyday situations difficult. These characteristics typically appear in early childhood and affect how individuals form relationships and respond to their environment.

Main features of autism

• Social interaction difficulties - Individuals may show a lack of responsiveness to others, struggling to form attachments, even with close family members like parents. They often find it hard to understand others' mental states, emotions, or perspectives, leading to atypical social behaviours.
• Communication challenges - There is frequently difficulty communicating.
• Repetitive behaviours - This includes repeating certain words, actions, or routines in a rigid, rule-based way.
• Preference for order and resistance to change - There is often a preference for order and organisation and resistance to change.

Extreme male brain theory

One biological explanation for autism suggests it arises from differences in brain development influenced by hormones during prenatal stages. This theory, proposed by researcher Simon Baron-Cohen, views autism as an extreme version of typical male brain patterns.

Baron-Cohen identifies three main brain types based on strengths in empathising and systemising:

• Type E (female brain) - Stronger in empathising, which involves intuitively understanding and responding to others' feelings with care and sensitivity, but weaker in systemising.
• Type S (male brain) - Stronger in systemising, which means intuitively figuring out how things work or identifying underlying rules in systems, but weaker in empathising.
• Balanced brain - Equal strengths in both empathising and systemising.

On average, more males have Type S brains, while more females have Type E brains. Autism is theorised to be an extreme form of the Type S brain, exaggerating systemising abilities while minimising empathising skills.

Role of testosterone in brain development

This brain difference is linked to the male hormone testosterone, released by the male foetus around eight weeks of development. Testosterone shapes the brain towards male-typical patterns, which are distinct from female-typical ones.

Evidence linking to autism characteristics

Autism's higher prevalence in males aligns with this theory, as does the condition's association with strong systemising (e.g., preference for order) and weak empathising (e.g., difficulty understanding emotions). Research shows autistic individuals often excel at tasks requiring systemising, such as those involving patterns or rules, outperforming even typical males.

Research supporting extreme male brain theory

Several studies provide evidence for the extreme male brain theory by comparing performance on tasks that highlight differences in empathising and systemising.

Baron-Cohen (2003) study on empathy and systemising

• Aim - Baron-Cohen conducted a self-report questionnaire study to measure empathising and systemising tendencies.

• Method - Participants completed a questionnaire with questions assessing empathy (e.g., understanding others' feelings) and systemising (e.g., analysing how systems work).

• Results - Females generally scored higher on empathy questions, while males scored higher on systemising questions, supporting the idea of distinct brain types.

Falter (2008) study on cognitive tasks

• Aim - Falter compared autistic and non-autistic children on tasks typically associated with male brain strengths.

• Participants - 28 children with autism and 31 typically developing children.

• Method - Children completed mental rotation tasks and figure-disembedding tasks.

• Results - Autistic children outperformed the typically developing children on both tasks.

Theory of mind explanation

An alternative, non-biological explanation for autism focuses on social cognition. Theory of mind refers to the innate ability to understand that others have their own thoughts, beliefs, plans, and points of view, allowing us to empathise and predict behaviour.

People with autism often lack a fully developed theory of mind, sometimes called 'mind blindness'. This means they struggle to see the world from another person's perspective or comprehend that others might hold different beliefs or emotions. For example, they may not realise when someone else lacks knowledge about something, leading to frustration in interactions. This deficit has major implications for social skills, as it hinders forming relationships and interpreting social cues.

The Sally-Anne task

To test theory of mind in autism, Baron-Cohen (1985) developed the Sally-Anne task, a false-belief experiment using dolls to assess if children can understand others' perspectives.

Participants

• 20 children with autism (average age 12 years).
• 14 children with Down's syndrome (average age 11 years).
• 27 typically developing children (average age four years).

Procedure

Children were asked three questions during the task:

1. Belief question: "Where will Sally look for her ball?"
2. Naming question: "Which doll is Sally and which is Anne?"
3. Reality question: "Where is the ball really?"

Results

• All groups answered control questions (naming and reality) correctly.
• 85% of children with Down's syndrome and typically developing children answered the belief question correctly.
• Only 20% of autistic children answered correctly.

Conclusions

The results suggest autistic children have not developed theory of mind.