What is Autism?

How Autism Affects Development

Diverse Contributing Factors Producing a Common Outcome

Researchers have concluded that they are unlikely to find a single factor that explains the autistic infant’s failure to become active participants in their social engagements as well as explaining the other early impairments that predict a later diagnosis. They are gradually forming a consensus understanding of the process that may lead to a common pathogenesis.

Elsabbagh and colleagues. (Elsabbagh et al. 2012) reflect an emerging consensus, when they suggest that development of infants later diagnosed with autism can best be understood by considering the potential for multiple risk factors:

“Where the presence and the severity of each risk factor, as well as the interaction between these, explains the resulting clinical picture.” Henderson & Mundy (2013) have described [autism] as a disorder where multiple etiologies lead to a shared impairment in effectively learning from others experience.  Jones and colleagues (Jones et al. 2014) have posited that [autism] likely emerges from a “complex interaction between pre-existing vulnerabilities and the child’s experience, which compromises the infant’s ability to take advantage of learning opportunities available in their environment. “

Vulnerabilities Lead to a “Tipping Point”

The prevailing view is that each infant that will be diagnosed with autism may be born with a unique profile of vulnerabilities, whose cumulative impact surpasses a “Tipping Point’ leading to the infants’ difficulties regulating their social engagement with parents. This in turn negatively impacts the quality of the parent-infant relationship and thus the ability of the relationship to provide the rich developmental arena that it does for neurotypically developing infants.

Our primary hypothesis is that autistic infants’ diverse vulnerabilities leads to their failure to surpass the positive threshold required to for their Growth-Seeking drive to emerge. Thus they continue to be dominated by the need for Stability-Maintaining which remains their sole motivating force.

Autistic infants do not develop a perception of themselves as active agents. They do not perceive that they can maintain their overall internal cognitive organization in the face of novel, incongruent disorganizing information. They do not experience their capacity for emotion mediation. Autistic infants do not form and are unable to access to strong emotional memories supporting their engagement with parent guides as providing a safe route to increased personal agency. The absence of, this “shared relationship history” may be the most important difference between future Autistic and non-autistic infants.

As a consequence, autistic infants form generalized expectations that attempting to engage with novelty, incongruity and situations producing uncertainty will have catastrophic consequences. In stark contrast to the autonomous growth-seeking efforts of their neurotypically-developing peers, the autistic infant attempts to limit input and output transactions with their social and non-social environment to a narrow range that avoids their unmanageable feelings of internal disorganization and distress.

Autistic infants fail to take advantage of growth-promoting opportunities with parents. They restrict their autonomous actions to engaging in largely non-meaningful object exploration and unproductive repetitive behaviors. Unfortunately, this also serves to cut off almost all opportunities for mental and self-growth.

Consequences of Lack of Growth-Seeking

Lack of Motivation for Growth-Promoting Social Engagement

Many of the same indicators that failed to differentiate autistic from non-autistic infants at 6-7 months now distinguish the two groups. The most powerful differences are those related to the degree to which infants become active participants in their social interactions. While their non-autistic peers are becoming active partners, initiating, co-regulating & repairing their interactions with parents, autistic infants appear ‘frozen’ in an earlier, passive style of relating. Unlike their neurotypically developing peers, they do not become active partners in responding to parent communication and in maintaining their engagements.

Lack of Desire to Participate in Parent-Guided Joint Play

Parents spend many hours engaged in simple activities with their neurotypically-developing infants and toddlers, preparing them to participate with social peers. The few studies that have been conducted with autistic infants and toddlers, clearly demonstrate that they do not take advantage of available support, to learn to function in a more coordinated and collaborative manner.

Lack of Experience-Sharing Initiation

As researchers study autistic infant development over the course of their second year, the most documented sign of their divergence as well as their ongoing social passivity, is their failure to initiate and actively maintain Experience-Sharing interactions (also referred to as ‘Joint Attention) with parents and family members.

Researchers have found that differences in the initiation of experience-sharing become increasingly magnified over the course of the second year. For example, a number of groups studying the factors during infancy that best predict a future autism diagnosis, have noted that the failure to initiate experience-sharing between ages 12-18 months, is the best single discriminator of a future autism diagnosis (Barbaro & Dissanayake, 2012; Charman, 2014; Mundy & Thorpe, 2007).

Lack of Experience-Sharing Growth

Of special concern is that while infants who go on to be diagnosed with other developmental delays appear to ‘catch up’ with neurotypically developing peers by the end of their second year, autistic infant’s do not, clearly indicating that unlike developmentally disabled peers, autistic infants are not suffering from a delay but rather a clear divergence in their developmental path (Barbaro & Dissanayake, 2012; Charman, 2014; Jones et al. 2014; Macari et al. 2012; Mundy & Thorpe, 2007; Watson, et al. 2013).

In contrast to their neurotypically developing and developmentally delayed peers, whose communication growth during the second year is primarily due to an expansion of their Experience-Sharing repertoire, autistic infant communication growth is limited almost exclusively to ‘instrumental’ communication (communicating to obtain something from the other person).  For example, Shumway & Wetherby (2009) concluded that, “Young children with [autism] do communicate, but communicate predominately for behavior regulation rather than for the purpose of commenting or sharing attention about an object or event of interest.”  Similarly, Barbaro & Dissanayake (2012) concluded that “Once [autistic] infants acquire the ability to communicate, they limit communication primarily for the purpose of requesting rather than sharing experiences.

Next: Disruption of the Parent/Child Relationship in autism

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