9 months ago



Justin 41 Another

Justin 41 Another important part of executive function is the ability to generate a novel response spontaneously. To perform any new action, such as walking through the kitchen, we need to inhibit previously learned responses and generate a novel response to environmental stimuli and situations. In other words, we need to be able to take into account everything that is going on and relevant right now to decide how to behave as we walk through the kitchen. If on one occasion a child touched the stove on his way through the kitchen, deficits in executive function would make it difficult to inhibit that touching behavior each time the child walked through the kitchen. Perhaps a child with autism is unable to stop touching the stove because he cannot generate a novel response. That stimulus (the stove) always elicits the same response (touching). There is a subtle difference between inhibiting a previous behavior and generating a new one. In either case, however, spontaneity would be impaired, the ability to adapt to changing circumstances, to apply something learned in one setting to another context. As a result, the same set of behaviors would be seen over and over, and the ability to be creative and flexible in different situations would be lost. We can see this vividly when we teach social skills to children with autism by helping them to learn certain rules (see Chapter 5). The child can memorize these rules and can then demonstrate appropriate application of these social skills in the laboratory. But the same child will not necessarily be able to use those skills consistently in everyday interaction in the schoolyard. It is almost as if she cannot incorporate what she has learned into real-time social situations. Perhaps that is why the social mannerisms of people with autism often seem so formal and pedantic. They look like they are acting, like they are applying memorized rules; the spontaneity of social chitchat is absent. There must be a neurobiology of spontaneity just like there is a neurobiology of boredom. Perhaps the circuits in the brain overlap. The central coherence and executive function hypotheses can explain the fact that the behaviors occur frequently and in the same way, but the essential element missing in all these hypotheses is why engaging in the activity is so pleasurable. It is also hard to explain fully the social and communication difficulties experienced by people with ASD on the basis of weak central coherence or executive function. This is more easily explained by the idea that people with autism, and to some extent with AS, lack a theory of mind, discussed in depth in Chapter 5. The pleasure felt by Justin and Chris when engaging in their repetitive behaviors is palpable. Listening to thunder and watching the trees is fun,

42 A MIND APART even if they do it over and over. Of that there is no doubt. Why should it give them so much pleasure? These fascinations and circumscribed interests are almost like an addiction, but an addiction to perception, to detail, to pattern and rhythm. In some sense, form, line, color, repetition, and movement are addictive for the person with autism and AS, but not addictive in the same way that other people become addicted to alcohol or certain drugs. That is the key mystery that resists explanation and, I suspect, will do so until we have a better understanding of the brain systems involved and the connection between the frontal lobes and the reward center of the brain. * * * I remember having a free afternoon in San Francisco some years ago and deciding to visit the art gallery. There was an exhibition featuring Robert Ryman, an artist who paints in the minimalist tradition. I had never heard of him, but with nothing better to do, I ventured inside. I was soon completely dismayed. The entire show consisted of hundreds of white paintings: big white paintings, small white paintings, nothing but white paint. This is ridiculous, I thought. This guy is pulling my leg. White paintings indeed! Modern art at its worst. Anybody could do this. I soon noticed, though, that each painting was in fact subtly different. The size of the paintings ranged from quite large to quite small, but the brushwork also varied from painting to painting. Sometimes a large brush was used, sometimes a small one. Sometimes you could see the canvas showing through; at other times the entire surface was covered. Sometimes there were fasteners, or bits of white tape adhering to the picture; at other times the paintings seemed to hang in the air by themselves. Sometimes the paint was thickly laid on, sometimes only very thinly. In fact, once I paid attention to these details, the paintings displayed an almost infinite variety of aspects. It soon became fun to see all the ways the painter could vary the same details and what effect he could achieve in doing so. After a while I became amazed at the extraordinary richness of the paintings and stood in wonder before his achievement! What a paradox, hundreds of white paintings, each one very different. Obviously this artist was never bored with painting white. It was the physicality of the paint he was interested in, its thickness, the brush strokes, the texture, the size of the canvas, and so on. There was no figure and ground as there is with most paintings, no near and far, no