Social deviance in autism: a central integrative failure as a model for social nonengagement.
Clinically, adult autistic and PDD individuals appear to have an uneasy relationship with their social environment no matter how much developmental progress they make. Many can work at modest jobs, many more do not, and even fewer are interested enough in the human environment to cohabitate and/or marry. A conversation with a young autistic man of 20 about a trip to visit a relative focuses more on the time the train left and how late it was in hypermnestic detail, including all details except the affective environment or the relationships to human beings. This is the human significance of the term autism. Autistics can speak and reference, but they seem not to understand the social requirements of a human interchange. If they do know it, they know it in a fragmentary or rudimentary way devoid of subtlety or nuance. Whatever we mean by social intercourse and whatever functions subsume it, they seem to emerge in interaction with cognition and language. They develop apace as human traverse those first 3 years of life and as they reach social maturity in adolescence. Autistic children appear not to integrate their knowledge of things in a representation that includes emotional and cognitive elements. They do not seem to understand that words necessarily refer to things of this world that others are also referencing in their words and sentences--shared reference is not natural to them. Intersubjectivity as a feature of common code use is not tacit or explicit in their behavior. They similarly do not use social referencing in the way in which normals do, and although they show some attachment to people, they seem to do so without benefit of affective display leading to reciprocity. There is little notion of the external that makes another human being distinguishable from a thing. Their treasured objects in early childhood are hard and lack comforting proximal receptor attractiveness as in normals. Hobson's extensive studies have elaborated a notion about the autistic child's knowledge of person. He comments on the lack of integration of the verbal and visual situational ties in which affective expression emerges and functions. He also comments on the deictic inabilities, inferring that the "I," "you," and "he" references do not have any significance for such children. We would like to note that while Vygotsky and others have observed that speech comes from the world of people, language comes from the maturing organism as an innate propensity.(ABSTRACT TRUNCATED AT 400 WORDS)
Shapiro
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Child and Adolescent Psychiatry, Payne Whitney Clinic, Cornell University Medical College, New York, New York.
Hertzig
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D000339:Affect; D001321:Autistic Disorder / Q000175:diagnosis / Q000523:psychology*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000523:psychology*; D003142:Communication; D006801:Humans; D007398:Interpersonal Relations; D007805:Language Development Disorders / Q000175:diagnosis / Q000523:psychology; D010553:Personality Development