Autism as a Model of Abnormal Emotional Development

Abstract

The compilation of a multilevel picture of impairments secondary to anomalies in mental development requires differentiation of all pathological structures from the standpoint of the mechanisms underlying their genesis. Vygotsky (1983) criticized a linear model of organization of pathological syndromes such as that characteristic of the clinical descriptive method. He proposed instead a hierarchical model that required identification of the primary defect directly responsible for the disorder in the morpho-physiological substrate and of secondary and tertiary structures, some of which are a consequence of the primary defect, others are formed indirectly, and still others are a response of the personality to the defect. The advantage of this approach is that it enables one to establish cause-and-effect relations among pathological symptoms of varying complexity and to focus psychotherapeutic and remedial interventions on the appropriate level of the disorder.The productiveness of Vygotsky's idea was borne out by the whole of our practice of the science of defectology (Dyachenko, 1965). However, in child psychiatry, in which G.E. Sukhareva (1930) put forth similar positions, they did not receive sufficient support. The reasons for this will be discussed on the basis of the early infantile autism syndrome. L. Kanner (1985) was the first to describe the syndrome of early infantile autism. The principal indicators of this syndrome are a marked insufficiency or total absence of contact with adults and other children, fear of novelty and of any change in the environment, monotonous, manipulative play, and impairment of the communicative aspect of speech to the point of mutism.The infantile autism syndrome is manifested most distinctly between the ages of two and five, although specific attributes of it are noticeable at an earlier age: in particular, absence or weakness of the intimation complex, delayed recognition of the mother, the relatively unformed nature of eye contact, coldness or, on the contrary, a symbiotic bond, the presence of motor stereotypes (rocking in the cradle, monotonic turns of the head), and a relatively low level of cooing and babbling (Lebedinskaya, and Nikol'skaia, 1991). In psycho-physiological and clinical studies, the emergence of infantile autism is linked to disorders in mental tone (Mnukhin, and Isaev, 1969) and in the level of waking (Rimland, 1964) and to a low sensory threshold (Ornitz, and Ritvo, 1968). It is hypothesized that when sensitivity is extremely high (hypersensitivity), stimuli are inadequately filtered, and a hyper-compensatory defense mechanism sets in that produces a deficit of information and, as a result, maladjusted behavior.Psychoanalysis sees autism as a result of disorders in child-parent relations: emotional deprivation provokes depression, fear, and other symptoms of distress (Bettelheim, 1967).Psychological studies of autism are basically concerned with cognitive processes. Descriptions of speech disorders (dysphasias in Weber's classification) and related difficulties in operating with signs and symbols (Hermelin, and O'Connor, 1970; Rutter, 1978; Rutter, and Schopler, 1988) occupy a central place in such studies. Recently, a large number of studies have appeared on the difficulties encountered in trying to teach social habits to autistic children. The negative experience acquired in social contacts may be one of the factors contributing to the formation of autistic attitudes.A study by the Tinbergens (1983) is extremely important, although it has not received appropriate support from other authors. Agreeing that autism is of an affective nature (insisted upon especially by authors of psychoanalytic studies), ethologists who have made a comparative analysis of the behavior of normal children and of autistic children conclude that defensive forms of behavior are hypertrophied in the latter.As is evident from this brief review, the literature is replete with observations and disjointed hypotheses on autism; hence, the skepticism of some authors with regard to finding a common foundation for symptoms of infantile autism that are very different in nature becomes understandable (Kagan, 1981). …