Abstract
While restricted repetitive and stereotyped patterns of behavior, interests and activities are united into one domain in behavioral classification (DSM-IV, the American Psychiatric Association), these phenomena represent a heterogeneous group of behaviors that stem from different hierarchical levels and areas in the autist’s brain. Both stereotypical behavior and an autist’s preoccupation with parts of objects (so-called “restricted interests”) contribute to the working hypothesis of this book, i.e., prevalence and exposure of the right-hemispheric sensory-motor and thalamic levels. Thus both phenomena will be discussed in this chapter and their significance for the autistic clinical-brain pattern explored.
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Notes
- 1.
This is the thalamic level at which nothing is known about the outside world; this level’s focus is singularly that of one’s own body.
- 2.
There are various terms for these motor patterns in the literature, which I will use, such as ready-made patterns, cliché, behavioral macro or “chunk,” automatic and pre-set packages of behavior.
- 3.
I had a patient in whom a medication that decreases dopamine in the brain was tapered off too quickly. This patient had quite significant frontal lobe dysfunction, and thus weakened control of subcortical levels, at baseline. He developed an acute stereotypical reaction, which I called a “Sisyphean toil.” He would spend hours rapidly performing and then repeating motor sequences. For example, he was constantly arranging and re-arranging his slippers into a line at the foot of his bed. He also spent hours taking change out of his purse, arranging it on his night table, putting it back in his purse, and then taking it out again and so on, until he was exhausted. He gave the impression of being under some imperative to continue these movements, ceaselessly. He was also unable to stop, even when aware of wanting to stop. He was able to respond to questions, but would quickly be distracted and look away. This stereotypical behavior was decreased and disappeared when he was given a powerful medication that decreased dopamine in the brain.
- 4.
Interestingly, Bernstein noted that in evolution of the animal world, songs and dance only emerge when the striatal level is well developed, namely, in birds.
- 5.
The same objects were enumerated in Chap. 3 as inducing an intense fear in a child with autism.
- 6.
The following example of the experience of a patient with damage to the RH might be an illustration of fixation on the object, analogous to what is observed in autists:
If he looked out of the window at such moments [his disorder was intermittent], pedestrians in the outermost field of vision seemed to be moving at a speed of about 30 mph and cars would ‘shoot by’. At the same time, if he fixated on any of the pedestrians, they appeared to be moving along ‘as in a funeral procession’ [Hoff and Potzl (1938) cited from Cutting (1997), p. 208].
Is this the explanation for the autist’s peripheral gaze? Is it the RH’s way of looking?
- 7.
We may recollect here Temple Grandin’s report about her childhood when she could sit hours on the beach “studying” each individual grain of sand as it flowed between her fingers. “As I scrutinized their shapes and contours, I went into a trance which cut me off from the sights and sounds around me” (p. 44; see also Chap. 3).
- 8.
RH BA37 is put in parenthesis here to emphasize RH PC’s larger contribution to this network.
- 9.
BA39 and BA40 will be discussed in detail in the next chapter.
- 10.
Here we can think about an increased awareness of both the internal space of the thalamic level and the external space of the sensory-motor level.
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Glezerman, T.B. (2013). How Autistic Persons Act in the World (Cerebral Organization of Movements and Autism). In: Autism and the Brain. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4112-0_5
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