Robert McGough, "Scientist's Provocative Theory Explains Puzzling Disorder As Extreme Version of Male Brain" (2003)

WSJE, 16.07.03

Scientist's Provocative Theory Explains Puzzling Disorder As Extreme Version of Male Brain

By Robert McGough

A RESPECTED cognitive scientist at Cambridge University has proposed a provocative theory: Autism can best be understood as an extreme version of the male brain.

Men, he says, traditionally are more interested than women in how things work, and often have more aptitude for mathematics, but are poorer at language skills and in empathizing with other people. That, taken to an extreme, describes many autistic people.

If the scientist, Simon Baron-Cohen, is right, his perspective may lead to new options for detection of autism. It might even lead to efforts at treatment and prevention, though the scientific and ethical hurdles to such efforts would be huge.

There are tantalizing clues that autism is linked to maleness. Among those with classic autism, males outnumber females four to one, and in Asperger's Syndrome, which resembles a type of high-functioning autism, males outnumber females nine or 10 to one.

Still, some researchers think it is an audacious leap to go from maleness to autism. Isabelle Rapin, a professor of neurology and pediatric neurology at New York's Albert Einstein College of Medicine, said she finds Dr. Baron-Cohen's theory "provocative," but "it does not account for some of the many neurological features of the disorder, like the motor symptoms [such as repetitive movements and clumsiness], the sleep problems, or the seizures."

Others, however, think Dr. Baron-Cohen is on to something important. "This theory is ambitious, and it may not explain everything about autism," says Uta Frith, a professor at the Institute of Cognitive Neuroscience at University College London. But there is currently no theory explaining all of autism, she says, and Dr. Baron-Cohen's "has got a handle on one thing that's been noticed for a long time and nobody's dared to deal with it." Moreover, she says, "It does tell us perhaps quite a bit about normal psychology as well."

Still, some worry that the term "extreme male brain" could get misinterpreted. Males are commonly associated with "qualities such as aggression, and they' re stronger" on average than women, says Helen Tager-Flusberg, professor of anatomy and neurobiology at Boston University School of Medicine. "What's dangerous is that's the inference people will make--oh, these are extreme males." .

Dr. Baron-Cohen is defining the "extreme male brain" in a quite different way than being macho. He argues, in a book published recently, "The Essential Difference," that two cognitive characteristics differ measurably in most men and women.

He argues that studies have shown that women, on average, are slightly more empathetic than men-that is, they are more likely to recognize and respond to the emotions of others. "There's a lot of evidence for women being more interested in the emotional lives of people," he says.

In tests, women do better at recognizing the emotions conveyed in photographs of eyes. In a skill related to social interaction, girls tend to develop language abilities and vocabulary faster than boys. Various studies show that women use both sides of their brain for language, devoting much more brain space to the task than men, who use only one side, he says.

Meanwhile, men, he argues, are on average slightly better at what he calls "systemizing," or understanding systems that respond to inputs and outputs in a systematic way. Examples of systems include mathematics, car engines, engineering and carpentry, fields that tend to be dominated by men.

[illustration]
> Clockwise from top left: Sherlock Holmes (Basil Rathbone), Raymond Babbitt (Dustin Hoffman) and Sir Isaac Newton-three faces of autism?<p>

Systemizing, Dr. Baron-Cohen argues, while a good way of interacting with things, isn't a good way of handling the subtleties of social interaction. Humans, he says, are too complex for input-output analysis to work well.

Granted, he says, many women have exceptional skills at systemizing, and individual men can excel at empathy. He worries his theory might be used to pigeonhole men or women, or that he will be disparaged as sexist: "People are ready to accept that sexes differ biologically and physically, but I was concerned it would be seen as discriminatory to claim differences in the mind."

Still, looking at these different skill sets, he sees the autistic person-male or female-as exhibiting an extreme version of the male brain. Autistic people, he says, have no empathizing skills. They perform worse on tests such as recognizing emotions in the photographs of eyes than men. In classic autism, they have significant language, delays.

On the other hand, Dr. Baron-Cohen says a person with autism may have a normal or even extreme ability to systemize. While a nonautistic child might learn the names of a few reptiles, he says, an autistic child might "tell you there are 200 kinds of reptiles and how they differ."

It's all very interesting, but is it true? A freezer in the basement of a laboratory at Cambridge University may hold a vital clue. Inside the freezer are test tubes with samples of amniotic fluid from 3,000 children born in England two to four years ago. That fluid shows how much testosterone the children were exposed to in the fetus.

Already, Dr. Baron-Cohen and colleagues have checked some of those children at ages 12 and 24 months. While autism isn't usually diagnosed so young, the researchers did find that the higher the levels of fetal testosterone, the less the children made eye contact with others. A hallmark of autism is a marked lack of eye contact. Moreover, the children with lower levels of fetal testosterone had larger vocabularies.

Now the team is tracking down children who are diagnosed with autism, Asperger's Syndrome, or related conditions, such as language delay and low social sensitivity and then checking their amniotic fluid for testosterone. The results won't likely be known for another year.