BARRIERS TO ACCURATE UNDERSTANDING OF AUTISM

Psychology and tools
When psychology was first established as a science separate from biology and philosophy, an alternative debate over how to describe and explain the human mind and behavior began. The different schools of psychology represent the major theories within psychology.

The first school of thought, structuralism, was advocated by the founder of the first psychology lab, Wilhelm Wundt. Almost immediately, other theories began to emerge and vie for dominance in psychology.
In the past, psychologists often identified themselves exclusively with one single school of thought. Today, most psychologists have an eclectic outlook on psychology. They often draw on ideas and theories from different schools rather than holding to any singular outlook.
The following are some of the major schools of thought that have influenced our knowledge and understanding of psychology:
Structuralism

  • the focus of structuralism was on reducing mental processes to their most basic components and elements

  • techniques such as introspection were used to analyze the inner processes of the human mind

  • major thinkers associated with structuralism include Wilhelm Wundt and Edward Titchener.

Functionalism 

  • was a reaction to the theories of the structuralist school of thought

  • some historians even question whether functionalism should be considered a formal school of psychology at all given its lack of a central leader or formalized set of ideas

  • instead of focusing on the mental processes themselves, functionalist thinkers were instead interested in the role that these processes play

  • heavily influenced by the work of William James and not associated with a single dominant theorist. Instead, there are a number of different functionalist thinkers associated with this outlook including John Dewey, James Rowland Angell, and Harvey Carr.

Gestalt Psychology

  • a school of psychology based upon the idea that we experience things as unified wholes

  • gestalt psychologists believe that you must look at the whole of experience

  • according to the gestalt thinkers, the whole is greater than the sum of its parts

  • the whole (a picture, a car) carries a different and altogether greater meaning than its individual components (paint, canvas, brush; or tire, paint, metal, respectively). In viewing the "whole," a cognitive process takes place – the mind makes a leap from comprehending the parts to realizing the whole

  • visually and psychologically we attempt to make order out of chaos, to create harmony or structure from seemingly disconnected bits of information

  • is also known as the "Law of Simplicity" or the "Law of Pragnanz" (the entire figure or configuration), which states that every stimulus is perceived in its most simple form.

  • prominent founders of Gestalt theory are Max Wertheimer, Wolfgang Kohler, and Kurt Koffka.

Behaviourism

  • all behavior can be explained by environmental causes rather than by internal forces

  • focuses on observable behavior

  • theories of learning including classical conditioning and operant conditioning were the focus of a great deal of research

  • behavioral training, token economies, aversion therapy and other techniques are frequently used in psychotherapy and behavior modification programs

  • a dominant school of thought during the 1950s, based upon the work of thinkers such as John B. Watson, Ivan Pavlov, B. F. Skinner

Psychoanalysis

  • emphasized the influence of the unconscious mind on behavior

  • believed that the human mind was composed of three elements: the id, the ego and the superego. The id is composed of primal urges, while the ego is the component of personality charged with dealing with reality. The superego is the part of personality that holds all of the ideals and values we internalize from our parents and culture.

  • alternate terms for id, ego and superego are instinct, reason, emotion, intuition and socialisation which are the defining elements of this theory

  • believes that the interaction of the three elements (id, ego, superego) was what led to all of the complex human behaviors.

  • was enormously influential, but also generated a great deal of controversy. This controversy existed not only in Freud’s time, but also in modern discussions of his theories.

  • a school of psychology founded by Sigmund Freud. Other major psychoanalytic thinkers include Anna Freud, Carl Jung and Erik Erikson.

Humanistic Psychology

  • developed as a response to psychoanalysis and behaviourism

  • focused on individual free will, personal growth and the concept of self-actualization

  • early schools of thought were largely centered on abnormal human behavior, while humanistic psychology differed considerably in its emphasis on helping people achieve and fulfill their potential.

  • has a major influence on other areas of psychology including positive psychology. This particular branch of psychology is centered on helping people living happier, more fulfilling lives.

  • Major humanist thinkers include Abraham Maslow, Carl Rogers

Cognitive Psychology

  • studies mental processes including how people think, perceive, remember and learn

  • related to other disciplines including neuroscience, philosophy and linguistics

  • began to emerge during the 1950s, partly as a response to behaviourism. Critics of behaviourism noted that it failed to account for how internal processes impacted behavior

  • this period of time is sometimes referred to as the "cognitive revolution" as a wealth of research on topics such as information processing, language, memory and perception began to emerge.

  • one of the most influential theories from this school of thought was the stages of cognitive development theory proposed by Jean Piaget.

Considering the wide scope of these theories it can be concluded that a variety of the principles can be easily applied to resolving what is are large problems concerning the accurate identification, diagnosis and definition of autism spectrum disorder.

Autism is a broad umbrella covering many aspects of the disorder as defined by DSM V and Nimh.
The aspects defined cover High functioning autism (previously known as Asperger’s syndrome), Classical autism, and Kanner’s autism.

Alternative descriptors for Hfa and ASD:

  • Non-specific or not otherwise specified, pervasive developmental disorder (NOS-PDD)

  • Non-specified personality disorder

  • Childhood Disintegrative Disorder

  • Personality Disorder

  • Borderline Personality Disorder

  • Schizoid conditions

Within these widely based disorders there are co-occurring subsets of symptoms:

  • Attention deficit hyperactive disorder (ADHD)

  • Attention deficit disorder (ADD)

  • Retts Syndrome

  • Tourette’s syndrome

  • Epilepsy

  • Obsessive Compulsive Disorder (OCD)

  • Narcissism

  • Dyslexia

  • Dyspraxia

  • Alexithymia

  • Depression

  • Anxiety

The study of autism in all its complexities should embrace many tools for defining and making sense of the disorder, bearing in mind the disorder itself is a barrier to study because of, amongst other deficits, lack of Theory of Own Mind and lack of ability to generalise learning which render the subject unable to participate fully in their own examination. It is imperative that those who know the subject best, the family members and spouses, are involved in any diagnosis or study regarding the circumstances of an adult on the autism spectrum.
There needs to be a broad cross-section of research styles and techniques drawn from the vast bounty of psychological theories when deciding how to describe and explain the human mind and behavior:

  • the role that mental processes play in the lives of the subject

  • that the normal experience is to perceive our world as a unified whole

  • reducing mental processes to their most basic elements changes the essence of the whole

  • that subjects attempt to make order out of chaos, to create harmony or structure from seemingly disconnected bits of information to make meaning of their world

  • a focus on observable behavior gives the viewer an alternative understanding from the perceived reality of the subject

  • theories of learning, including higher order thinking and learning…the how and why; how people think, perceive, remember and learn…can be used to define and make sense of the human condition in some aspects

  • that everything is part of, not separate from

  • using knowledge and understanding gained by observation and interpretation to assist in helping people achieve and fulfill their potential

  • stages of cognitive development theory puts into focus the question of the ability and/or willingness of the subject to be able to participate or not in any therapy or research

  • ideals and values we internalize from our parents and culture will drive and create a bias in our understanding of psychological processes

  • neuroscience can provide cold physical evidence, yet not explain the true nature of the metaphysical experience of humanity

An eclectic approach to research tools, with a flexible, open mind of the researcher, is the only possible way to begin to unravel further truth of the complex umbrella of autism.

A single minded approach to diagnosing the disorder will continue to cause a disservice to those with the condition and to the families who struggle to make sense of and understand their loved ones’ circumstances when there is no accurate diagnosis. Cherry picking subsets and failing to see the inter-connection between overall elements and consequential behaviours will not serve as an ethical response for vulnerable people.

The individual jigsaw pieces of autism are being defined very well currently, yet failure to see the alternative descriptors and subsets as a whole is what is stalling any further progress in finding answers to the real how and why of this condition and its impact on the person with the disorder and on those who are in intimate contact with the person with Hfa.

The alternative descriptors are a piecemeal approach to research and understanding. The use of these vague terms is also part of what is causing a bottle neck in understanding Hfa. These descriptors create a restriction on moving to a more accurate diagnosis and recognition for individuals.

Identification and diagnosis of Hfa is being made more complex than it needs to be. The spouses and partners of those with Hfa are well equipped through observation, constant proximity and experience to contribute and describe accurately the connections between the various aspects of Hfa which are currently described and treated in isolation. An umbrella approach to collecting and containing all the information in a central picture is what’s needed. This is the picture which spouses, partners and family members have clearly learned from their daily interactions with the adult with Hfa. They can provide valuable input.

A whole of life investigation, if possible, is sometimes also essential when diagnosing adults with Hfa as their skills in navigating society and relationships appears to be relatively normal to the outsider or diagnostician who does not experience daily interaction with them.

Currently the experiences of spouses and other family members who live with someone with Hfa is mostly ignored or denied. This is a major flaw in data gathering about Hfa as it fails to take into consideration the Gestalt notion of whole, rather than components.

Autism Spectrum Disorder is a complex mix of neuro developmental, biological and physical conditions, each of which cannot be considered in isolation or as separate conditions, thus a wide variety of approaches and sources of data must be utilised to fully and accurately explain Hfa.