Monday, November 3, 2008

Inside the mind of a crackpot autism theorist

Psychologists say we're biased towards the perception that other people are more biased than we are.
--Today's Phildelphia Inquirer Science Section.

Perhaps that explains my reaction to the latest Grand Theory of Autism that's crossed my desk: the Binaural Phase Shift Theory. This theory, which, so far as I know, has one acolyte (whom I'll refer to as "BPST") holds that the language deficit in autism is caused by out of sync processing of auditory information from right and left ears. It's like seeing double, except that it's hearing double.

When BPST emailed me about his theory two days ago, it was my first time being directly contacted by a Grand Theorist. And, since I have a deaf, autistic son with a cochlear implant who hears only out of one ear, I was tempted to reply:
As I understand it, your theory is based on phrase disynchronicity in
*binaural* hearing. This assumes that binaural hearing exists in a given
child in the first place.

My favorite theory of autism, because it fits *my* son so well, is the
Theory of Mind/Extreme Maleness theory. It explains why he's so unusually
good at math, so good at visual reasoning, and so unusually physically
strong.

But, since autism is such an extremely heterogeneous condition, it would
be in appropriate for me to assume that this theory applies to autistic
children in general.
This, of course, led to a more extensive exchange, which I excerpt here:
BPST: And exactly how profound is profoundly deaf. Most autistic children are not profoundly deaf.

Lefty: Yes, indeed: no surprise there. Most autistic children aren't deaf at all.

BPST: Many autistic children will be missing or reduced certain segments of their hearing bandwith like the lower frequencies

Lefty: Actually, it's typically the higher frequencies that are missing in deafness. That's why many deaf people use low-frequency doorbells, for example.

BPST: I believe that lower frequencies with longer bandwidths are the easiest to synchronize and are heard in the womb by the placenta [sic].

Lefty: "I believe" isn't an argument.

BPST: I know a profoundly autistic adult with right ear has normal hearing at all frequencies but her left ear has lost all frequencies except the midrange. As a newborn she never was able to synchronize low range and gradually progress to synchronizing the mid range. At her cortex the left midrange frequencies appear out of phase with right midrange frequencies. The left midrange frequencies reach the cortex out of phase with the right midrange. Voices that have midrange are profoundly blurred and she has no functional use of speech.

Lefty: Nor is one anecdote.

BPST: Are you saying that before the unilateral implant the BAER were totally flat? Did you see the BAER? I bet you did not.

Lefty: That's rather presumptuous of you. Yes, I did see the BAER. No evidence of hearing at any level.

BPST: I am no implant expert but I sincerely doubt that an implant can produce anywhere near the complex signal discrimination and resolution of a single normal auditory system. I would not expect a unilateral cochlear implant to provide the resolution of ordinary unilateral hearing.

Lefty: He can discriminate all speech sounds, as can most kids implanted before 2 years of age.

BPST: Unless a unilateral side is completely wiped out with no BAER signal at any frequency, I would assume that binaural traces from the weak ear still reach cortex and could interfere with auditory resolution from the strong ear.

Lefty: Such an assumption isn't warranted in my son's case.

BPST: I am no expert on the theory of the mind although I read and forgot it briefly. However autistics need simultaneous attention of same abstract issue to develop vocabulary [nouns] of abstract things.

Lefty: My son has an excellent vocabulary of nouns (not to mention verbs, prepositions, and function words), and of abstract things in general. (What's the connection between "abstract things" and binaural phase shift???)

BPST: It is difficult for autistics to follow the rapid verbal thought processing of the nonautistic and for them to precisely follow what abstract thing is being named.

Lefty: My son has no trouble with abstraction. Many people underestimate the capacity of autistic children for abstraction.

BPST: As for " extreme maleness" the median age that boys learn speech occurs after girls. Your son does not have more testosterone than other boys unless he has a hormone problem.

Lefty: Do you have actual evidence against Baron-Cohen's findings on the testosterone connection?

BPST: The "extreme male mind theory" has its roots in cultural bias that accepts delayed verbal and enchanced math skills in males vs females.

Lefty: Do you have actual evidence against Baron-Cohen's findings on this? Remember, Baron-Cohen's findings relate to statistical tendencies, not absolutes.

BPST: If [your son's] cortex is so excellent at conscious reasoning [association patterns] then why can't he form association pattens for auditory input? Ask your self why his auditory association patterns fail to meet the performance standard of the visual association areas. [there are many questions you can't approach]

Lefty: What makes you think he can't form association patterns for auditory input? In fact, he does so all the time. You don't know him, and you shouldn't be diagnosing him at a distance.

BPST: [The Binaural Phase Shift Theory] likely applies to a large subset of autistic children but not all.

Lefty: "likely?" "large subset"? I would not presume this of my pet theory.

BPST: You fail to understand the significance of simultaneous cortical synchronization.

Lefty: Peer reviewed articles?

BPST: I can sense your bias against it, and to accept it would fundamentally change your belief system. Your mind is controlled by what you heard in the past. There is simply too much programming in your head to change. But I suspect I was right about your son and his ability puzzles. A lot of people thought their were weapons of mass destruction in Iraq in March 2003. You have believed a lot a things that were wrong. So would it even matter if you were wrong about this?

Lefty: And you? And the vaccine theorists, the Diet Theorists, the Interactive Metronome Theorists, the Mozart Effect theorists, the Floor Time theorists? I've been in this business for over 10 years, and when it comes to "causes" and "cures," I've heard it all. But I'm always open to actual evidence, as opposed to beliefs, assumptions, anecdotes, and wishful thinking.
Arguably, BPST isn't worth two seconds of my time. But he claims to be an MD, and claims to be surgically inserting "unilateral large tympanostomy tubes" (ear tubes) to reduce hearing in one ear as a "treatment" for autism.

And he's actively recruiting young children as subjects.

And I worry that he'll find a way divert funding towards his practices and away from (what I consider to be) more promising areas of research and treatment.

4 comments:

Mrs. C said...

Bleh. How about we start funding autism treatments just like other medical conditions rather than lumping it in with "mental health" crap and letting insurance companies keep getting away with giving nothing??

PS. I rather doubt the vaccines caused my childrens' autism, but now that I know about thimerosol and some of the other stuff in vaccines even now, I am more cautious about vaccines. I think it's an overall plus but of course if we keep getting ONLY focus on vaccines we're going nowhere.

Liz Ditz said...

You were far more patient than I.

Isn't it malpractice, what the doctor is doing?

eddy jon said...

you mention the Interactive Metronome Theorists... i am not familiar with whats being said about IM/ASD and would like to know more.

lefty said...

Here's a link promoting the Interactive Metronome for autism:
http://autism.healingthresholds.com/news/interactive-metronome-therapy-he

So far as I can tell, no controlled studies show it effective in treating autism.