AUTISM AND THE MOTOR THEORY OF LANGUAGE

Autism is a puzzling and distressing state which affects a considerable number of children world-wide. Autistic children display a range of deficiencies and often present bizarre patterns of behaviour. There is no consensus about the causes or treatment of autism. There may be a genetic element and autism may be a manifestation of errors in the programming of neural development pre- and post-natally. One of the central and most discussed aspects of autism is deficiencies in speech development; absence or distortion of the use of words and of syntax make communication difficult for autistic children. Coupled with their notable lack of social empathy, this intensifies the isolation from which the children suffer. No clearly successful treatment for their language or other difficulties has as yet emerged. Given this, it seems desirable to examine whether the different ideas about the origin and functioning of language offered by the motor theory may be relevant in understanding the nature of autism or suggesting ways in which these unfortunate children might be helped, in tackling their language deficiencies or more widely.

The motivation for this paper came from seeing what a significant part language deficiency and language peculiarities play in the development of autistic children, particularly as illustrated by that very careful and perceptive book The Siege (Clara Claiborne Park 1967). This led to a closer examination of the specific features of the autistic language deficiency: the difficulty in acquiring words, the peculiar misuse of pronouns, defects in pronunciation, formality of syntax, as described by many authors in a surprisingly uniform way. Other deficiencies in autistic children, in movement, gesture, pointing, go along with the deficiencies in language. Autism in children is a distressing and strange experience both for the child and for the parent. It seems as though there is something which has gone wrong - and that what is wrong is not necessarily irretrievable. There is a question how far all the deficiencies may be the result of a single developmental fault. A tremendous amount of work is currently done to help autistic children and their parents. Many different forms of treatment and many different theories of what is wrong in autistic children have been tried - none has proved remarkably successful. Because of the major part played by language-deficiency in autism, and because defects in language have such a crippling effect on the life of the autistic child, it seems right to see whether the different approach to the origin and nature of language proposed in the motor theory might have some relevance for the origin or possible treatment of autism. Are there any practical conclusions both for the nature of the autistic syndrome and for the treatment of autistic children ?

What is autism?

The short answer is : no one really knows but there have been many excellent accounts of manifestations of autism in children by experts such as Lorna Wing, Frances Tustin, Uta Frith, Patricia Howlin and many others. The following account draws directly upon their descriptions of autism and upon the summary of the features of autism by the National Autistic Society.
Autism is a disorder affecting cognition and language development. They have problems in understanding and using any form of communication, non-verbal as well as verbal. Some autistic children do not develop any useful language at all or else use only stereotyped words or phrases that have little or no meaning. There are also cognitive difficulties. Although they can remember experiences, autistic children seem unable to imbue them with significance beyond the immediate, literal meaning, or to classify such events so that they fit into a gradually developing, coherent mental picture of the world. There is a strange combination of marked abnormality and yet relatively intact abilities together with normal physiognomy and an apparently intelligent expression. The highly unusual patterning of skills and deficits has given rise to the notion that, somehow, if only the right key could be found, the solution to all the child's handicaps could be discovered but no such key has been found.
The autistic child has no sense of 'me' and 'not-me' except in fleeting moments of awareness. Such a child lives mostly in terms of the outlines of shapes. Touch seems to be the predominant mode of experience and seeing, hearing and even smelling are felt to be tactile experiences. People are treated as things which are extensions of the child's own bodily 'things'. The handicap is in its nature more similar to blindness or deafness than to, say, shyness. Autistic children have an obsessive desire for sameness.
Bizarre behaviours appear in a child who looks perfectly normal, physically attractive, unusually serious. The many strange aspects of behaviour include abnormal bodily movements, such as grimacing, arm flapping, jumping and springing back and forth, one foot to another. There are abnormalities of visual inspection and eye contact. They use peripheral rather than central visual fields (responding to movement and outline rather than to details), looking past rather than at people and things; looking at people and things with brief rapid glances rather than a steady gaze. They may show a lack of dizziness after spinning round. There will be problems of motor imitation: difficulty in copying skilled movements (the child learns best if his limbs are moved through the necessary motions). Autistic children are unable to use gesture, miming, facial expression, vocal intonation, bodily posture etc. to convey information; the only gesture may be grabbing someone's hand and pulling them towards a desired object) using the adult or an adult's hands as a tool. Expressive gesture of the kind that accompanies speech is lacking. With this lack of gesturing by the children goes poor comprehension of the information conveyed by gesture, miming, facial expression, bodily posture, vocal intonation, etc. They may become insistent that other people take part in their routines. For example, they may try to insist that everyone in a group of adults sit with their feet pointing in a particular direction.
Perhaps more difficult to explain are the unusual responses to sensory stimuli. Oversensitivity to certain sounds, fascination with bright lights or objects that spin, and indifference to pain, heat or cold may all occur in young autistic children. The way these children cover their ears to shut out or modify sound is often remarked upon. Often there are paradoxical responses to sensations (e.g. covering eyes in response to a sound, or ears in response to a visual stimulus). Play is ritualistic and lacking in imagination, most noticeably in those autistic children with the most severe language impairments.
Autistic children are incapable of understanding emotion in others. All autistic children suffer a severe lack of empathy - the ability to put themselves in the place of another person. They are indifferent to others' distress. They seem to lack the normal child's awareness of other human beings.