Autism: What have we learnt so far?


Autism is a neurodevelopmental disorder in which individuals have difficulties with social interactions and communication and a reliance for routines and/or repetitive behaviours (Read this NIH fact sheet for more information). Individuals with autism also tend to display sensory seeking behaviour and according to more recent scientific endeavours, experience high rates of gastrointestinal issues.

It’s a disorder which receives much attention in both the press and in research. But research findings, despite advancing at the pace of greyhounds chasing a bunny on the race track, don’t always accompany news stories. The public’s understanding and awareness of this disorder is still work-in-progress, even though local resources for autism has vastly improved.

Research links the use of joint attention — the ability to use gaze and gestures to share attention — to autism, but a recent study points to a more accurate red flag for autism — a social smile during joint attention. This 2014 study observes that infants at 8 months tend to look at an object of interest and then smile at the person they are interacting with, before looking back at the object of interest, during joint attention. In contrast, infants at risk for autism tend not to direct the social smile at the other person in between looking at object and at the other person.

Other research has established that individuals with autism find faces aversive, and as a result have difficulties recognising the emotions of others (more about their difficulties with empathy here). In fact, a hot-off-the-press study finds that individuals with autism focus on areas of contrast and colour of real photographs and the centre of the image, whereas those who don’t have autism look almost exclusively at faces in the same photographs. And this tendency emerges at a young age: a 2014 study observes infants at 6 months to fixate on faces when someone is speaking. In contrast, infants diagnosed with autism later look away from the eyes and mouth when someone is speaking.

Recent research has also identified two other markers useful for screening autism among children aged 9 to 12 months. A 2014 study finds that babies with a head circumference that is at or higher than the 75th percentile at 9 months and infants who fail the tonic neck reflex (also known as the head tilt reflex) are at a higher risk for autism.

With slightly older children, nonverbal screening tools may be useful. A 2015 study proposes a novel way of screening for autism: It turns out that individuals with autism don’t reduce their sniffing of unpleasant smells (and conversely increase their sniffing of pleasant ones). In contrast, their peers who don’t have autism “stop” a wiffy smell in about 305 ms. Another 2015 study finds a higher proportion of children who are subsequently diagnosed with autism among families where parents voiced concerns about their child’s sensory and motor abilities from the age of 6 months, and their child’s language and social communication abilities from the age of 12 to 15 months. So although autism cannot be diagnosed till 2 years of age, there are clear indications and red flags which are proving to be effective for screening autism at a much younger age.

Screening for autism aside, there are still no clear answers to what contributes to autism. Recent research does however indicate differences in brain structure between individuals with autism and peers who don’t have autism. Apart from differences which have been observed in the brain structures which connect the two brain hemispheres to each other, a 2014 study observes a lack of neural pruning — the process by which neural connections which we don’t use are eliminated — among children with autism (for a more in-depth discussion, read this article). Genetic factors are acknowledged to contribute to autism, but environmental factors are also considered to play an important role. Increasing evidence that the composition of gut bacteria differs in individuals with autism from that of their peers who don’t have autism, has led some to suggest that gut bacteria to be a possible contributing factor to autism. While a 2015 study definitively excludes MMR vaccines as a contributing factor to autism (read more about the study here), another 2015 study speculates that other chemicals, such as solvents and pesticides, to which expectant mothers may have exposure, can adversely affect foetal development.

Despite the mixed findings about the cause of autism, more recent research does offer some promising news about effective interventions and strategies found to be useful for helping children and adolescents with autism. Just as children who don’t have autism can be trained to enhance their ability to identify emotional expressions and young preschoolers with autism can be taught social skills, recent research demonstrates that early intervention programmes play an important role in helping children with autism improve their social skills, as well as cognitive and language abilities.

One 2012 study has reported that an intensive programme comprising 20-hours-a-week one-to-one training with interpersonal exchanges over a period of 2 years, yields improved brain responses to faces among infants with autism aged 12 to 30 months. Use of this therapeutic intervention by parents has been shown to be effective on even young infants with autism. In this 2014 study, at-risk 6-month-olds, who showed signs of autism at the start of intervention (e.g., a lack of interest in social interactions and communication), had better cognitive and language skills 12 to 30 months later. In a follow-up study of these infants, further improvements were observed after 2 years of intervention. Infants’ cognitive, communication, and adaptive skills (skills for everyday living) were observed to undergo greater improvement compared to peers with autism who attended a preschool programme and who were given speech therapy.

Other groups of researchers have also shown that parent training is also an effective way to improve the quality of social interactions between parents and infants with autism. A 2014 study has shown that teaching parents to support their children’s learning during everyday activities results in better language and social communication among toddlers with autism. In another recent study, one-year-olds with autism whose parents received coaching on how to attract their infant’s attention and interest their infant in social interaction games produced better outcomes than peers receiving community-based early intervention and monitoring. A separate 2015 study has also shown that the benefits of parent training over a period of 24 weeks to include a reduction in disruptive and aggressive behaviours among children with autism aged 3 to 7 years (Supernanny also some useful tips…). It’s evident that there are various effective therapeutic options available to families of children with autism.

Interventions which reduce the severity of children’s autistic behaviours are important. But support for families are as, if not more, important. This is particularly true for caregivers and parents of children with autism, who experience a high level of caregiving stress on a daily basis and can be at risk for caregiver burn out. Journal writing has been found to help mothers manage their stress levels, while mothers are less likely to experience depression if their partners share the burden of caregiving. But it’s often easier said than done. Respite care — which provides parents and caregivers with time off to take of themselves — can play an important role for helping parents and caregivers manage their stress. And more public awareness won’t do anybody any harm either.

World Autism Awareness Day is a few months away but there’s no time like the present to support a greater public awareness of autism.

Managing personality at the workplace

Are you introverted or extraverted?

Personality is recognized as “a dynamic and organized set of characteristics possessed by a person that uniquely influences his or her cognitions, motivations, and behaviours in various situations” (Krauskopf & Saunders, 1994). Experts recognize five personality dimensions, on each of which each one of us can differ.

These Big 5 personality traits, comprising conscientiousness, agreeableness, neuroticism, extraversion, and openness, are assessed through psychometric tests (test yourself here). And these traits have been found across cultures in numerous industrialized communities.

That’s a somewhat different concept of personality described elsewhere, such as the qualities which characterize the ideal employee. For example, this Forbes article lists among others, intelligence, autonomy (independence), detail orientation, and conscientiousness. Or the five qualities most sought after when hiring employees: professionalism, high-energy, confidence, ability to self-monitor, and intellectual curosity (read that article here).

Psychometric tests can be useful to give employers insight into candidates’ aptitude for particular roles — extroverts are more likely to thrive in jobs which require them to interact regularly with other people (e.g., sales positions) than introverts. Well, that’s not exactly rocket science. People who do not feel energized (and in fact feel overstimulated) by social interactions are less likely to gravitate towards sales or PR jobs (for those not in the know, read this illustrated guide, the “23 Signs You’re Secretly An Introvert“, and the “15 Unmistakable, Outrageously Secret Signs You’re an Extrovert“). No need for a psychometric test.

But these personality assessment tools can provide invaluable insights into employees’ strengths and therefore be useful in working out issues concerning team dynamics and productivity. That would be true, at least if candidates and employees were subjected to a psychometric test shown to test what it aims to test (external validity) and shown to produce results when administered more than once (test-retest reliability). But personality tests commonplace at the workplace may not live up to expectations (read this Guardian article and this academic review).

Assuming conscientious (see, knowing your personality traits can be useful) employers and HR managers implement valid and reliable psychometric tests, there remains the question of how these five dimensions impact the workplace:

1. Conscientiousness
This trait is highly associated with academic success and professional performance (Psychology Today explains why). That hardworking people are more productive at the workplace is both a robust finding and an intuitive one.

2. Agreeableness
While among women, this trait does not have a reliable relationship with employee performance. However, men who say they are less willing to get on with others and who are more willing to be critical of others appear to be more successful career-wise. Getting ahead as a guy therefore appears to be equated to being less “nice” (read this blog and this review). At least in a US corporate setting, according to the research by Judge and colleagues.

3. Neuroticism
It appears that being in a negative emotional state often (individuals who have high neuroticism scores) is associated with lower job satisfaction. Which may explain a lot of things about that co-worker who never seems to be happy about anything.

At the same time, it’s important to get those colleagues who are experiencing emotional distress to get help. And they’re not only in the financial industry.

4. Extraversion
No surprises here: Extroverts are more likely to be in jobs with social interactions. But extroverts are also found to express job satisfaction and associated with leadership positions (but that is not to say it is impossible to find introverts in CEO positions).

5. Openness
Open individuals are associated with positive training outcomes: They are more likely to say that they benefitted from a training course. Which makes sense of course. Being open to new experiences (including new ideas and new ways of doing things) likely makes one more receptive to being trained for new skills or for receiving new knowledge.

Given that personality traits are stable across the lifespan, except neuroticism which on the whole declines as we age (we’re less grumpy as we get older), it pays to get the right employee in the first place. And when working stuck with Disdainful, Disparaging and Derisive, it’s useful to know that it’s probably not about you. It may just be all about them.