1. What makes us tick and what makes us stick? Timing and inertia in ASD

2. Outline Neuroanatomy What makes us tick? –Intervals –Time and the (autistic) brain –Time and autistic traits (break) What makes us stick? –What is inertia? –What isn’t inertia? –Executive function –Attention –Catatonia –Strategies

3. Neuroanatomy Pre-frontal cortex Cerebellum Basal ganglia

4. Timing Introduction Intervals –Circadian: about 24 hours –Interval: a few seconds to minutes –Millisecond: less than 2 seconds Time and the brain Time and autistic traits

5. Circadian LengthAbout 24 hours FunctionsSleep/wake cycles Eating BrainSuprachiasmatic nucleus AutismDelayed sleep phase syndrome Less pronounced rhythms Sleep disturbance

6. Interval LengthA few seconds to minutes or longer FunctionsPassage of time Memory BrainBasal ganglia Pre-frontal cortex AutismStructuring memory Prospective memory (remembering to do something in the future) Understanding change over time

7. Millisecond LengthLess than 3 seconds FunctionsMotor coordination Language BrainCerebellum AutismClumsiness Language delay and language perception problems Social timing

8. Time and the (autistic) brain Suprachiasmatic nucleus (SCN) Basal ganglia Cerebellum Clock genes

9. Time and autistic traits Movement Language Change resistance Social timing Memory Task switching

10. Summary Timing is important for many things from language perception to movements to changes Time perception helps give the world structure and helps us interact with it effectively Timing helps us to predict what is coming next and respond at the right time.

11. Outline Neuroanatomy What makes us tick? –Intervals –Time and the (autistic) brain –Time and autistic traits (break) What makes us stick? –What is inertia? –What isn’t inertia? –Executive function –Attention –Catatonia –Strategies

12. Introduction What is inertia? What isn’t inertia? Executive function Attention Catatonia Strategies

13. What is inertia An object in motion tends to stay in motion and an object at rest tends to stay at rest. Starting, stopping & changing of activities and focus

14. What isn’t inertia? Lack of motivation Depression Fatigue (though it can cause sleep deprivation) Procrastination or avoidance Laziness!

15. Executive function (EF) The mind’s ‘boss’ or director –EF is what stops an automatic response when a non-automatic response is wanted Includes: –planning, organising, sequencing, monitoring, inhibition, initiative One sign of impaired EF is perseveration Autistic people do not usually have a problem with inhibition, but ADHDers do. Lacking initiative = what we call ‘inertia’

16. Attention Slow attention shifting (see timing) Missing cues Slower to orient and respond Things that are easy to do and instant rewards (computers)

17. Catatonia Physically ‘stuck’ May be related to or similar to Parkinson’s Disease Caused or made worse by anti- psychotic medication? Passive interaction style Could inertia be a very mild version?

18. Strategies Reminders Shock The ‘do it now’ principle Routines –Inertia applies to routine instead of task –Attaching new task before an automatic one Perceptual patterns to follow - ‘flow’ Make it as easy as possible

19. Inertia summary Inertia is the inability to start, stop or change what you’re doing Inertia has a neurological basis and is not willful Executive function and attention switching may play a part and catatonia may be related Sometimes there are things we can do to make it easier.