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Ped Med: Autism As Extreme Maleness

Posted on: Friday, 9 February 2007, 18:00 CST

By LIDIA WASOWICZ

While among reported cases, autism appears gender-related, affecting some four times as many boys as girls, some scientists go so far as to argue the disorder is nothing more than an exaggerated version of the male profile.

They say the neurodevelopmental condition's behavioral symptoms are a magnification of men's proclivities, such as making lists, and peculiarities, such as resisting feelings.

In general, men are sadly shortchanged on empathy, lacking the intuitive feminine knack to pick up cues to people's state of mind and heart and pick out the appropriate emotional response to it, proposes Simon Baron-Cohen, director of the Autism Research Centre at Cambridge University in England and author of The Essential Difference: Men, Women and the Extreme Male Brain (Penguin, 2003).

Rather, on average, they excel at what he calls systemizing -- the organizing, analyzing and constructing of rule-based systems and figuring out the mechanics of how they work.

Autism overemphasizes these male traits, Baron-Cohen wrote in Science, the prestigious, peer-reviewed journal published by the American Association for the Advancement of Science.

Here, nature has a definite hand, he said. Even on the first day of life, boys and girls already start going their separate gender-paved ways.

As one example, a mere 24 hours after coming into the world, the majority of male newborns will look at a mechanical mobile suspended above them whereas the females, on average, will prefer staring at a human face, Baron-Cohen said.

Individuals, of course, will vary in personality, but for the most part, baby boys will not be as likely as little girls to respond to the distress in others or to make eye contact with them -- setting a lifelong pattern of behavior, he said.

Toddler boys tend to start talking later than girls and to make slower progress in expanding their verbal repertoire, some studies suggest.

Baron-Cohen blames biology -- namely, the male hormone testosterone.

Research indicates the amount of prenatal testosterone, produced by the fetus and present in the amniotic fluid that bathes the baby in the womb, can predict a child's sociability, Baron-Cohen said.

As a rule of thumb, the higher the male-hormone level, the less eye contact and the slower the language development. Surges of testosterone and other male hormones may be propelling the autistic brain to develop beyond the typical male blueprint, Baron-Cohen contended.

On a neuroanatomical level, he noted, studies using scanning technologies show males generally have greater and faster early growth of certain regions of the brain but less bridging of its two hemispheres than is true for females.

For example, the average man's cerebrum -- an area in the front of the brain related to higher thinking -- is 9 percent larger than the average woman's. The same holds true for the amygdala, where fear and emotion are processed, Baron-Cohen said.

Men also outpace women in the number of nerve cells in their body, he said. Whether bigger is better -- or even whether size matters at all -- in these instances remains to be determined.

Where women have a heads-up is in the thickness of connective tissue that perhaps facilitates communication between the brain's hemispheres, Baron-Cohen said.

The left section is thought to be the analytical side, responsible for measurement, logic, math and analysis, he said.

The right regulates creativity, art, intuition and lexicon. Conventional -- and controversial -- wisdom claims the left side rules in men, the right in women, Baron-Cohen said.

This may explain a Yale University finding that when performing language tasks, women are likely to activate both hemispheres, but men tend to rely only on the left one, he added.

Autism amplifies these variations, Baron-Cohen and colleagues contended.

In children with the disorder, brain growth is more extreme than in a typical male, and the amygdala is abnormally large in toddlers with autism, they pointed out. Here, too, testosterone and other male hormones appear to interfere, Baron-Cohen proposed.

In keeping with the theory, adults with autistic disorders matched the high end of the male profile on psychological tests, scoring big points in the systemized brain category, he said.

That's also where 54 percent of non-autistic men but a mere 17 percent of women answering the same questionnaire got their high marks, Baron-Cohen said.

The theory can explain numerous symptoms of autism, Baron-Cohen said, from social disability to the occasional extraordinary talent in math or music or drawing -- all skills that benefit from the organizational mindset typified by males -- to obsessive, repetitive behaviors, such as spinning or lining up of objects, a manifestation of an intensified version of man's drive for systemic order.

Baron-Cohen offered four pieces of evidence to support his proposition that autism is the genetic result of ''assortative mating'' between two strong systemizers:

-- Mothers and fathers of children with autism both complete a so-called embedded figures test -- in which geometric shapes are hidden in a complex design -- faster than men and women in the general population.

-- Both parents are more likely to have fathers who are talented systemizers, e.g., engineers.

-- Magnetic resonance imaging screens reveal unlike most couples who exhibit definite gender differences, both moms and dads of autistic children show strong male patterns of brain activity while performing tasks that call for empathizing or systemizing.

-- Both parents score high on tests for autistic traits.

As a central theme to his controversial model, Baron-Cohen emphasizes the need for increased tolerance and understanding of autistic behaviors and validates the contention of some mildly autistic adults and parents of children with the less severe type of the disorder that it is their brain -- and not everyone else's -- that is normal or even gifted.

While the premise of autism as exaggerated maleness arouses rigorous debate, the call for greater acceptance attracts more uniform support.

(Note: In this multi-part installment, based on dozens of reports, conferences and interviews, Ped Med is keeping an eye on autism, taking a backward glance at its history and surrounding controversies, facing facts revealed by research and looking forward to treatment enhancements and expansions. Wasowicz is the author of the new book, Suffer the Child: How the Healthcare System Is Failing Our Future, published by Capital Books.)

Next: Call for greater acceptance

-- UPI Consumer Health welcomes comments on this column. E-mail: lwasowicz@upi.com

Source: United Press International

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