Men, Empathy, and Autism

A British researcher offers a new theory about the developmental disorder that has skyrocketed among children

By David Cohen. Thanks to Beth Sigall
Cambridge, England On a first meeting in his office here at the
University of Cambridge, Simon Baron-Cohen comes off as a poster boy for the empathetic scholar. He pulls a chair close, looks directly into his visitor’s eyes with a steady gaze, and pays close attention to the ensuing conversation, not only to the actual words spoken but also to the body language that can reveal so much. His own voice is soft and easy, conveying
a deep understanding that has helped make him one of his country’s most
listened-to autism researchers over the past 20 years.

Last summer Mr. Baron-Cohen’s words struck a chord much farther
afield, crossing the ocean and penetrating scholarly stateside barriers
where resistance was expected, and some still remains. As well as being a
reminder of the fast-growing international nature of autism research, his
newfound recognition coincides with an American-government effort to
investigate the condition and why the number of children diagnosed with
autism has skyrocketed in recent years.

The 45-year-old professor of developmental psychopathology’s
photogenic face and media-savvy style haven’t exactly impeded his growing
recognition either. His crossover appeal has been likened to that of Steven
Pinker, the Harvard psychologist and best-selling author who is, as it
happens, an old chum, and whose words of praise (“one of the most brilliant
research psychologists of his generation”) adorn the jacket of Mr.
Baron-Cohen’s latest book. “They’re both handsome guys who know how to
articulate very complex ideas in a way that’s very appealing to the public,”
says Helen Tager-Flusberg, a neurobiologist who has worked with both men.

It is Mr. Baron-Cohen’s theory about empathy, in particular, that is
generating a buzz among researchers and the public alike. His new work, The
Essential Difference: The Truth About the Male and Female Brain (Perseus
Publishing, 2003), suggests that the capacity for empathy is the critical
cognitive difference between men and women. He goes on to speculate that the empathy gap between genders could provide a key for understanding autism, which afflicts one in every 250 American children — the vast majority of them boys, including this reporter’s 4-year-old son.

A Guy Thing?
Some parents of autists have charged that mercury-containing vaccines
caused their children’s disorder, but most researchers, including Mr.
Baron-Cohen and others here at Cambridge’s Autism Research Center, discount that theory. Scholars have reached no consensus on the condition’s likely cause, let alone what could be its most effective treatment or possible
cure, which is another of the reasons Mr. Baron-Cohen finds himself playing
to an attentive audience these days.

The Cambridge scholar identifies empathy as “the drive to identify
another person’s emotions and thoughts, and to respond to them with an
appropriate emotion.” At the core of his thesis, he postulates that the
natural wiring of the human brain tends either toward a capacity for empathy
or toward one for understanding systems. He labels them E-type and S-type

Although the scholar’s office is small, he draws his chair a bit
closer to allow for a clearer look at a little chart he uses to explain the
scoring on questionnaires that the center gives to subjects. One corner of
the frame shades into deep blue, the other into pink.

“We find,” he explains, “that women on average tend to score in this
light blue area, so their empathy is better than average. But their
systematizing is not as strong as their empathy.” Moving a finger across the
frame, he continues: “Now here. Men on average are in the pink range —
they’re interested in how things work, in systems, and less interested in
talking about, say, emotional problems.”

The final point of the demonstration, and the book’s clincher, is that
autism represents nothing less (or more) than an “extreme version” of the
male brain. As Mr. Baron-Cohen tells it, it’s almost like an exaggerated guy
thing, a disorder in which autists tend to be more male than most men.
But he takes pains to distance his work from the “Mars and Venus”
tradition. Imagining that “men are from Mars and woman are from Venus,” is
not helpful scientifically, writes Mr. Baron-Cohen, “and distracts us from
the serious fact that both sexes have evolved on the same planet.” Not to
mention any autistic offspring they may have.

An ‘Extreme Aloneness’
Childhood autism was first described in 1943 by Leo Kanner, a child
psychiatrist at the Johns Hopkins University, who spent five years studying
11 children possessed with an “extreme aloneness from the beginning of
life.” He borrowed the word “autism,” derived from the Greek autos, meaning
“self,” from the Swiss researcher Eugen Bleuler, who had used it in another
context some three decades earlier. Unbeknown to Kanner or any of his
American colleagues, the same condition was being studied simultaneously in
Europe. It was identified with the same name only a year later, by a
pediatrician in Vienna named Hans Asperger, after whom a high-functioning
version of autism is named.

No two young autists are the same. Some will manage to lead relatively
ordinary, even intellectually exceptional, lives, while others may need to
be institutionalized. But what such youngsters share, both men saw, is an
iron-walled detachment from the physical environment and an indifference to
other people, along with profound difficulties with communication and
imaginative play.

Among the behaviors most linked to the disorder are poor language and
social skills, and a propensity for repetitive, frequently obsessional
behavior, including hand-flapping, toe-walking, and self-injury. Autistic
kids will often repeat the same words or phrases over and over, or immerse
themselves in weirdly narrow interests, spinning to the sound of a rock
album until they drop or else, perhaps, staring at a leaf on a tree until
the sun goes down.

Clinicians since Kanner have debated the degree of conventional
intelligence possessed by autists, with the usual assumption being that most
of them exhibit some mental retardation.

One of the implications of Mr. Baron-Cohen’s paradigm is that the
opposite could be true, at least insofar as the “extreme” brain can be taken
to mean one possessed of an extreme intelligence.

This is one of a number of areas where Mr. Baron-Cohen’s current
findings dovetail with some of his previous work. He has argued that a
number of great scholars — both men and women — may themselves have
possessed such a highly intelligent, “extreme” brain. One of the latest
book’s case studies involves an award-winning Cambridge scholar who, in a
typical autistic touch, is terrified of talking on the telephone.

Mr. Baron-Cohen, along with the mathematician Ioan M. James of the
University of Oxford, recently made scientific headlines by arguing that at
least three of the well-known personality traits of Einstein and Newton —
obsessive interests, difficulty in social relationships, and profound
communication problems — suggested that these men were autistic. He even
has his suspicions about the philosopher Ludwig Wittgenstein. And why not?
Academe is a place “of strong and narrow interests, even obsessions,” he
says with a shrug.

The Testosterone Theory
Mr. Baron-Cohen’s latest findings in the psychological realm also fit
with his continuing work on autism’s biological roots. His next book,
scheduled for publication this summer, looks at amniotic testosterone
levels, which go to the heart — or brain — of his overriding theory on the

Testosterone, he proposes, is the biological basis for the prenatal
development of the autistic child. It starts in the womb, where some
individuals receive an exceptionally high dose of the hormone, leading to
the “extreme maleness” of the condition. Based on their study of thousands
of samples of amniotic fluid, Mr. Baron-Cohen and his colleagues at the
autism center have documented that children who experienced high-prenatal
testosterone levels make less eye contact as toddlers and have lower
communication skills at age 4, though he admits the evidence for any
relationship between fetal testosterone and autism has yet to be

In different studies, Mr. Baron-Cohen’s group is using scanning
techniques to examine how the brains of autists respond to different social
and emotional situations. They are also examining the genetics of the
syndrome and developing new diagnostic tests.

If further research substantiates Mr. Baron-Cohen’s testosterone
hypothesis, he says, it would revolutionize the way in which autism is
understood and initially diagnosed, possibly opening the door to far earlier
intervention with intensive behavioral therapies. But it would also “open up
an ethical can of worms with regard to terminations of pregnancy as well.
… I mean, what would be lost, as well as gained, by that?” he asks.
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