To many, Temple Grandin is the public face of autism. Grandin’s story has significantly increased autism awareness around the world, and has increased society’s appreciation of the unique and positive characteristics of the autistic mind. But Grandin is much more than just a label: in addition to being an activist, Grandin is also an author, professor, and highly regarded animal scientist for her innovative methods for handling livestock. Grandin was listed in Time Magazine as one of the 100 most infuential people in the world (in the "Heroes" category), and was also recently played by Claire Danes in the Emmy-winning HBO movie about her life, titled Temple Grandin.

So it's with immense respect and enthusiasm that I asked her a few questions about her new book, The Autistic Brain. I particularly appreciate that she responded to some of the concerns I had with her book (see my critical review).

In your book, you make the case that autism is in the brain and in the genes. On the whole, I felt you downplayed the importance of environmental factors, even though you review evidence in the book suggesting the incredible importance of such factors. For one, you noted that the number of children identified with autism spectrum disorder (ASD) changes dramatically from one community to the next, and one ethnicity to the next. Second, you show how people with autism can show a significant reduction in their symptoms if placed in educational and work contexts well suited to their areas of special interest. Doesn’t this lack of geographical consistency in the identification of ASD and the contextual nature of autism suggest environmental factors also play a huge role?

A fundamental question in brain science is how much of a person’s abilities are due to innate differences in the brain and how much is due to learning and practice. Some people who have read The Autistic Brain feel that I have placed too much emphasis on innate deficits and abilities. I am aware of the many studies that show that therapy and practice can increase brain activity in circuits that are weak, via the mechanisms of brain plasticity. I hypothesize that innate differences in brain circuitry have the greatest effect on the extreme ends of the ability and disability continuum. For example, a few elementary school children have extreme math ability and they can do high school math. An example on the extreme innate disability continuum is a person with autism who never learns to speak after he has had intensive therapy. In my own case, my connective circuit for speaking what I hear had a reduced number of fibers. I had lots of therapy and by age four, I had learned to speak. This may be an example of brain plasticity strengthening a weak circuit. Over the years my public speaking has improved. People tell me that my talks at age 60 were better than my talks at age 50. This shows that with work, I continually improved. However, learning algebra and computer programming was hopeless. I was highly motivated to learn to program a computer but it was impossible. This may be due to a missing circuit. My left parietal area is full of cerebral spinal fluid. Other scans show extensive connections for visual processing. Art was my best subject in elementary school and my career in design of cattle facilities is based on my visual skills. My mother nurtured and helped me develop my artistic abilities. Students with various labels such as autism, dyslexia, learning problems or ADHD tend to have uneven skills. Development of the area of strength must never be scarified by concentrating all teaching resources towards the area of deficit.

I really appreciate your distinction between the “acting self” and the “thinking self.” Or put another way, the difference between what autism looks like on the outside, and what it feels like on the inside. But throughout the book, you seem to be mixing together different levels of understanding what it’s like to be autistic from the inside. While you mention the potential value of self-report— even explicitly arguing that we need to appreciate individual interests, strengths, and hopes— it seems like you ultimately advocate for “Throw ‘em both [a non-autistic and autistic individual] in a scanner and let's see what lights up.”

Do you think that methodology alone can ever fully reveal what it really feels like to have autism from the inside, or give a complete picture of the individual’s interests, strengths, and hopes?

I think autism may be two different conditions on opposite ends of a continuum. At one end of the spectrum, the person is completely non-verbal and may have severe behavior problems. At the other end of the spectrum, the person has fluent speech but is socially awkward. In my book I profiled Tito and Carly. Both of them are totally non-verbal and they are able to type independently. They both describe a confusing sensory world. Carly reported that it is very difficult to control her body movements. She may be a normal teenager trapped inside a dysfunctional sensory system along with uncontrollable movement. She seems to be more socially normal.

On the other end of the continuum where speech is fluent, autism may be primarily a condition where brain circuits that are involved in social communications are abnormal. Sensory jumbling and confusion would be lessened. Brain scanning would be very useful to research the different sensory and social brain circuits in fully verbal and non-verbal individuals.

You raise the intriguing suggestion that people with autism may be more engaged in the world than they seem to be. Could you please elaborate on that idea?

People with autism are always taking in information. I have an insatiable desire to read and read to get more information. A non-verbal person may appear totally disengaged but he may be taking in lots of information. Since I am a bottom up thinker, I have the urge to fill up my database to get a better understanding of the world. To understand a social situation that is happening now, I have to logically figure out the best behavior to use. I do this by “searching” my “database.” In my twenties, I was an avid reader of Dear Abby in the newspaper to get advice on proper social interactions. Both reading and actual experiences continually add information to my database. Increasing the amount of information in my data improved my responses.

What’s the difference between spatial and object visualizers?

I am an object visualizer. When I think about anything, all my thoughts are in specific photo realistic pictures. If you say the word “cell phone tower” I see specific ones that I see on the way to the airport. They pop up in my imagination as a sequence of still pictures. They are specific such as the cell phone transmitters on the roof of a local hotel, a fake silo, and a fake windmill with transmitters. A spatial visualizer thinks more in patterns and spatial location. Spatial visualizers do really well on the Mental Rotation Test. People who are spatial visualizers are often good at math and they usually see less distinct pictures when asked about common objects. Object and spatial visualization activate different circuits in the brain. Some people like me are high in object visualization skills and others in spatial visualization. I have observed by talking to many people, that object visualizers like me are often really good at art/design. Algebra is difficult for many object visualizers. The spatial visualizers excel in math, engineering, and computer programming. The Autistic Brain has numerous scientific references on the two types of visualizers. Many people have mixtures of object and spatial visualization.

I love this sentiment: “Obsessions, in fact, can be great motivators.” You also argue that not all obsessions are created equal. Could you please elaborate what you mean by that?

My obsession with cattle chutes served as a motivatior for me to start my business designing systems for handling cattle. When one of my professors did not approve of my master’s thesis on cattle chutes, my obsession motivated me to continue my studies on cattle chutes. I found another professor to head my thesis committee. My obsession with cattle chutes turned into a successful career designing cattle handling facilities. I tell parents and teachers to tap into child’s obsessions and special interests and use them to motivate. If a child is obsessed with Ford cars, then use Ford cars to motivate schoolwork. Use Ford cars in math problems and have the child read about the history of the For Motor Company. Interests and abilities in art, math or writing should always be encouraged. In elementary school, I obsessively drew horse heads over and over but I was encouraged to expand my art ability into other subjects. If a child has ability in math, he/she should be allowed to do more difficult math. A child will turn into a behavior problem if he/she is not challenged. Obsessions, when properly directed, can lead some children into a successful career.

You argue that it’s important to get people with autism out into the world. Can you elaborate what you mean by this? Also, how can parents and educators help with that?

I am seeing too many individuals with autism who are not getting out into the world. Kids on the spectrum have to be “stretched” to try new things. Parents and teachers should provide choices, but staying home all day should not be one of the choices. When I was fifteen, I had the opportunity to visit my aunt’s ranch. I was afraid to go. Mother gave me a choice of going for a week or all summer. I ended up loving the ranch and staying all summer. There are too many kids with many different kinds of labels who are not learning basic skills. They do not know how to shake hands or order food in a restaurant. They need to be taken to the restaurant when it is not busy and learn to order food. After several trips they can be taken to the restaurant when it is busy. When tasks are taught, a teacher or parent needs to demonstrate it. I am seeing too many individuals becoming recluses in their room. Due to high anxiety, I had a tendency to be reclusive when I was a teenager. This was absolutely not allowed. I had to be at meals on time and get up in the morning. Anxiety in new situations can be reduced by gradually introducing the person to them.

In your view, what are the top priorities for autism research?

My top priority for autism research is sensory problems. For many individuals on the autism spectrum, sensory over sensitivity may make it extremely difficult to tolerate normal environments such as restaurants, supermarkets or sporting events. This is a problem for both fully verbal and non-verbal individuals. Sensory over sensitivity is highly variable. One person may have visual over sensitivity to fluorescent lights and another may be overly sensitive to loud noise. In order to study these problems, subjects will need to be placed in studies based on their particular sensory problem. The use of an autism diagnosis alone will not work because both “apples” and “oranges” from a sensory standpoint will be mixed together. A therapy designed for auditory over sensitivity will probably not be helpful to a person who has visual over sensitivity. Treatment for sensory over sensitivity will make it easier for many individuals to participate in a wide variety of activities.

© 2013 Scott Barry Kaufman, All Rights Reserved