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Empathizing, systemizing and autism Simon Baron-Cohen Autism Research Centre Cambridge University.

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1 Empathizing, systemizing and autism Simon Baron-Cohen Autism Research Centre Cambridge University

2 Collaborators Androgens: Androgens:  Gerald Hackett, Kevin Taylor, Rebecca Knickmeyer, Bonnie Auyeung, Emma Chapman, Svetlana Lutchmaya, Melissa Hines, Ieaun Hughes Genetics: Genetics:  Lindsey Kent, Bhismadev Chakrabarti, Grant Hill-Cawthorne, Frank Dudbridge, Patrick Chinnery, Sally Wheelwright, Alex Pollitt, Carrie Allison Neuroimaging Neuroimaging  Ed Bullmore, Howard Ring, Lloyd Gregory, Xavier Chitnis, Steve Williams, Mick Brammer, Chris Ashwin

3 Autism Social and communication difficulties Social and communication difficulties narrow interests/obsessions/routines narrow interests/obsessions/routines Classic autism: 4:1 (male:female) Classic autism: 4:1 (male:female) Asperger Syndrome: 9:1 Asperger Syndrome: 9:1

4 Hans Asperger (1944) “The autistic personality is an extreme variant of male intelligence… In the autistic individual the male pattern is exaggerated to the extreme”

5 Boys > girls: Toy vehicles, constructional toys, and mechanical toys Girls > boys: Dolls, enacting social and emotional themes “systemizing” “empathizing”

6 Males > females: maths, computing, physics, engineering, tool-making Females > males: Primary school teaching, nursing, social work, counselling “systemizing” “empathizing”

7 Empathizing and Systemizing Empathizing (E) Empathizing (E)  identify another person’s thoughts and feelings,  respond to these with an appropriate emotion Systemizing (S) Systemizing (S)  analyse or build a system  mechanical, natural, abstract, collectible

8 Different profiles S > E : more common in males? S > E : more common in males? E > S : more common in females? E > S : more common in females? S >> E : more common in autism? S >> E : more common in autism?

9 Empathizing

10 Systemizing

11 sarcasticstern suspiciousdispirited

12 preoccupied insisting imploring grateful

13 Eyes Test (max = 25) xsd Males Females AS Fathers Mothers BC et al (1997) JCPP

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16 Finding the target (speed) xsd Males Females AS Fathers Mothers Jolliffe & BC (1997) JCPP

17 The Empathy Quotient: examples I really enjoy caring for people I really enjoy caring for people People often tell me I went too far in driving my point home in a discussion People often tell me I went too far in driving my point home in a discussion I often find it difficult to judge if something is rude or polite I often find it difficult to judge if something is rude or polite

18 The Empathy Quotient (max = 80) meansd Males Females AS BC & Wheelwright (2004) JADD

19 The Systemizing Quotient: some examples When I listen to a piece of music, I always notice the way it’s structured When I listen to a piece of music, I always notice the way it’s structured If I were buying a car, I would want to obtain specific information about its engine capacity If I were buying a car, I would want to obtain specific information about its engine capacity If there was a problem with the electrical wiring in my home, I’d be able to fix it myself If there was a problem with the electrical wiring in my home, I’d be able to fix it myself

20 The Systemizing Quotient (SQ) (max = 80) meansd Males Females AS BC et al (2003) Proc Royal Soc

21 Empathizing Systemizing Extreme S Type B Type E Type S Extreme E E-S Model

22 Look at individuals, not their sex Plotting EQ against SQ (sex-blind) shows distribution is not random Goldenfeld et al (2006) Int J. Clin Neuropsych

23 Look at individuals, not their sex Plotting SQ and EQ (not sex blind or diagnosis blind) showing the Difference (D) score

24 Plotting individuals by brain-type

25 DiffMenWomenAS E > S femalebrain17441 E = S balanced23367 S > E malebrain % showing each brain type Goldenfeld et al (2006)

26 MenWomenAS E >>S extremefemale040 S>>Eextrememale6065 % showing each brain type Goldenfeld et al (2006)

27 Eye contact at months old mean sd Boys Girls Autism Lutchmaya & BC (2001) Infant Behavior and Dev.

28 Testing sex differences in newborns

29 % of babies showing a looking preference FaceMobileEqual Boys Girls Connellan et al (2000) Infant Behavior and Dev

30 Amniocentesis: a window on foetal testosterone (FT) FT surge: weeks nmol/L in males nmol/L in females d = 2, p < 0.001

31 Foetal testosterone (FT) FT masculinizes brain and behaviour   Injection of FT masculinizes female rat brain and behaviour   Produced by testes and adrenal glands   Crosses blood brain barrier, passes through cell membrane and enters cytoplasm FT binds to androgen receptors in cytoplasm   in sexually dimorphic brain areas   Passes into cell nucleus, binds to DNA and affects transcription   alters neural connectivity, modulates serotonin and GABA transmission and prevents apoptosis

32 FT predicts eye contact at 12m Infant Behav. & Dev FT Linear regression: Both sexes B = -2.1, SE = 0.7, p < Boys alone B = -2.5, SE = 1.0, p < 0.02

33 FT predicts vocabulary at 24m Infant Behav. & Dev Both sexes, linear reg B = 58.9, SE = 29.6, p < 0.05

34 FT predicts Children’s Communication Checklist (CCC) at 48m Quality of social relationships Quality of social relationships  B = -1.63, SE = 0.61, p < Restricted interests Restricted interests  B = 1.73, SE = 0.069, p < JCPP, 2005

35 FT predicts Empathy Quotient (EQ) at age 6-9 yrs old. (Chapman et al) n = 100 boys, 93 girls r = -0.28, p < 0.01

36 FT predicts Eyes Test at 6-9 years old (Chapman et al) r = -0.43, p < 0.01

37 FT predicts CAST score: autistic traits at age 6-9 yrs old Linear regr B = 0.66, SE = 0.18, p < Auyeung et al (submitted) CAST score

38 Other clues for the androgen (FT) theory of autism Girls with Congenital Adrenal Hyperplasia (CAH) have a higher AQ score (Knickmeyer et al, in press) Girls with Congenital Adrenal Hyperplasia (CAH) have a higher AQ score (Knickmeyer et al, in press) Early puberty in boys with autism (Tordjeman et al, 1997) Early puberty in boys with autism (Tordjeman et al, 1997) Delayed menarche and elevated rates of PCOS in women with AS (Ingudomnukul et al, submitted) Delayed menarche and elevated rates of PCOS in women with AS (Ingudomnukul et al, submitted) Low 2D:4D ratio in autism (Manning et al, 2001) Low 2D:4D ratio in autism (Manning et al, 2001)

39 The extreme male brain theory: the neurological level Amygdala size: autism > typical boys > girls Amygdala size: autism > typical boys > girls (Sparks et al 2002) Long range connectivity: Long range connectivity:  Typical females > males > autism (Welchew et al, 2005) Head size: Autism > typical males > females Head size: Autism > typical males > females (Courchesne et al, 2004) (Courchesne et al, 2004) BC et al (2005) Science

40 Ultimate causes: Genetics Twin studies Twin studies Sibling risk rates Sibling risk rates The ‘broader phenotype’ The ‘broader phenotype’

41 Clues for ‘assortative mating’ of parents Both parents faster on the Embedded Figures Test Both parents faster on the Embedded Figures Test Both parents score slightly lower on the Eyes Test Both parents score slightly lower on the Eyes Test Both parents have a higher AQ (Bishop et al, 2005) and SRS (Constantino et al 2004) Both parents have a higher AQ (Bishop et al, 2005) and SRS (Constantino et al 2004)

42 Assortative mating: Grandfathers’ occupations EngineeringSocial Work (%)(%) Autism Downs Autism, 1997

43 bilateral inferior frontal Eyes Task Assortative mating: The Eyes Test Brain and Cog, in press

44 EFT left fusiform & visual cortex Assortative mating: EFT BC et al (in press) Brain and Cog red: left blue: right visual cortex

45 Summary: Triad of strengths Islets ofobsessionsrepetitive abilitywith systemsbehaviour Systemizing

46 Summary: Triad of difficulties SocialCommunicationImagining others minds Empathizing

47 For more information, visit Thanks to: The Nancy Lurie Marks Family Foundation Medical Research Council UK Target Autism Genome

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