Look Into My Eyes
Contributed by Rachel Hopf, M.A., SLP-CF and
Kristie Brown Lofland, MS, CCC-A
Our biological make-up encourages humans to connect with others. Recent research has shown that there are parts of our brains that require us to be empathetic, human, and humane (Perry& Szalavitz, 2006). In Matthew Lieberman’s book, Social: Why Our Brains Are Wired to Connect, the author emphasizes that our entire lives are motivated by social connections. Likewise, according to Dr. Ami Klin, a well-known researcher in the early diagnosis of autism spectrum disorders and the director of the Marcus Autism Center, the eyes are the window of other people’s experiences.
Babies are born in a state of fragility and are dependent on their caregivers for survival. In order to survive, nature promotes that babies will orient to their caregivers. Research shows that infants prefer to listen to sounds made by people rather than to sounds made by things. They prefer to look at people rather than just objects. When infants look, they prefer to look at people’s eyes-especially their gaze and to respond by looking back at them. Babies learn very quickly that attention is important, and that they can shift that attention in order to get what they want. Over time, they also learn to follow someone else’s gaze, because they realize whatever people are looking at is also what they are thinking about. Soon after, they begin to learn about the meaning of things; because if someone is pointing to, or looking at something, babies aren’t just receiving a directional cue. They are also receiving a label and the other person’s intent behind that cue. This is how infants begin to build a body of meanings and shared experiences. It is this mutual choreography that is crucial to the social brain and fosters social connections.
Some believe that autism originates at the beginning of life. Therefore, if what these authors and researchers are saying is true—that humans are born to socially orient and to have reciprocal social interaction and to be empathetic, human and humane beginning at birth—what happens in the brains of individuals with autism?
There is a relatively new theory suggesting that children on the autism spectrum may be failing to receive the necessary input for social and language growth due to sensory dysfunction (under or over stimulated) during critical periods of development. The “intense world theory” proposes social and language delays in autism do not stem from inherent differences in the social brain. Rather, sensory issues early in life lead to social and language delays in autism.
The “intense world theory” was conceived by Swiss researchers Kamilia and Henry Markram. Henry’s son was diagnosed with high functioning autism, and his son’s overwhelming experiences of fear led them to formulate this theory.
The Markrams and a colleague, Tania Rinaldi, backed up their theory by studying rats exposed as fetuses to the anti-epileptic drug valproic acid ( brand name: Depakote). These “VPA rats” had symptoms that were reminiscent of autism. The VPA rats were more fearful overall and were oversensitive to things like noise and light. They avoided other rats and showed repetitive behaviors. When the researchers examined the brains of these rats, they found their brains had more groups of cells in the cortex serving as the sensory processing units, and that these units were better connected to one another. Together, these characteristics were thought to intensify sensory experiences and intelligence.
Early on, it was believed that individuals with ASD were less emotionally sensitive due to diminished amygdala sensitivity. Today, we are beginning to understand things differently. The amygdala is a small structure in the brain that responds to, and codes for, the emotional intensity of events in our environment. In humans, the amygdala is responsive to social inputs, such as other people’s emotional expressions. It primarily registers fear and anxiety. Young children with autism have a larger amygdala than typically developing children. For children with ASD, this means more anxiety and increased threat detection. These children will be more overcome by their environment and more fearful of people, places, and things. For young children with ASD, looking into the eyes of another person triggers a powerful fear response. In fact, increased volume in the amygdala at age three is predictive of poorer social adjustment at age six (Lieberman, 2013). To compound matters, the visual pathways that feed threat information to the amygdala show hyperactivity in individuals with autism, causing more sensitivity to sound, touch, and visual input.
If what these researchers have found is what is truly happening, then the social deficits and problems with language development in individuals with ASD could be secondary to heightened fear and sensory issues and not a sign of inherent problems with the social regions of the brain (Perry & Szalavita, 2010). The authors of the book Born to Love theorize that children with autism might develop repetitive behaviors in a manner similar to children who have been neglected as a way of coping with stress. And perhaps as a way to deal with sensory overload, they withdraw within themselves. Therefore, the initial cause of social problems would be from extreme patterns of stress response system activation and a lack of appropriate stimulation at the right time. This same lack of relevant stimulation could also be responsible for early problems with language development in young children with autism.
We need to positively influence, understand, validate, treat, and support individuals with ASD. So what do we do with this information? We can recognize that sensory issues for these individuals can prevent their social, behavioral, and emotional development. In the field of autism, there is a lot of emphasis on perspective taking. However, educators and caregivers should also be challenged to expand their own social cognition, to look into the eyes of individuals with ASD and attempt to understand the world as they see it. For a moment, try to imagine the world from the perspective of a child with ASD.
Frequently, s/he is flooded with overwhelming amounts of sensory input and information, and has little ability to express the problem that perhaps leads them to retreat or act out behaviorally. It is not surprising that s/he would have repetitive behavior or crave routine. At least then, they can have predictability and alleviate some of the fear that comes from living in an overwhelming world.
Too many times when developing treatment or education plans for children with ASD, sensory issues are the last to be addressed when they should be the first to be recognized, evaluated, and supported.
Perry, B. & Szalavitz, M. (2010). Born for love. New York, NY: Harper Collins Publishers.
Lieberman, M. (2013). Social: Why our brains are wired to connect. New York, NY: Broadway Books.
Perry, B. & Szalavitz, M. (2006). The boy who was raised as a dog. New York, NY: Basic Books.
Klin, A. (2013). A new way to diagnose autism. Retrieved from: https://www.youtube.com/watch?v=b-J8d1zfRIM
Hopf, R. & Lofland, K. (2016). Look into my eyes. The Reporter, 21 (5). Retrieved from https://www.iidc.indiana.edu/pages/look-into-my-eyes.