by Dinah Murray and Mike Lesser (circa 2004)
In the normal range of attentional distribution great variety is to be found both between people and within individuals at different times. People who attract a diagnosis of autism tend to be at the extreme of the human spectrum in which people have few to very few deep and unshakeable interests: they are monotropic. The opposite of monotropic is less deep, but more broadly distributed, more flexible, polytropic, attention patterns. In different situations deeper attention in contrast with more thinly spread attention will function differently. We believe that in various ways the monotropic disposition underlies the involuntary disclosures and social disasters which attract autism spectrum diagnoses. The monotropic disposition can vary in several respects which affect both the nature of the diagnosis and whether or not the level of atypicality attracts a diagnosis.
Among the dimensions along which monotropism can vary are:
Steepness, depth of focal interest, which is correlated with slowness and discomfort in switching topic or attentional focus when a competing alternative stimulus is presented. Slow attentional switching is one of the most robust research findings in autism studies; it is sometimes identified as an “executive function disorder”. However, strong anecdotal evidence points to the potential for easy self-directional attention switching. Everyone probably sometimes experiences attention tunnelling so deep that anything else feels invasive. After a while we move on from this intense engagement. But what for most people are special experiences occur many times a day for steeply monotropic individuals. They are likely to be painfully and frequently interrrupted unless they are in complete control of their worlds. For these very monotropic people life tends to veer between intensely rewarding high quality moments, and catastrophes. These are also the people who will take longest to develop connections between their fragmented experiences and who may consequently need the most help to develop their general understanding of life. Lastly, they will also tend to find speech addressed to them both invasive and hard to process unless it is most sensitively tuned in to their current focus.
Diverting the attention of such firmly focussed folk is likely to be counter-productive because it leaves them stranded and confused. Although perhaps softened in adults by age and experience, the old autism saw, “start where the child is” is a reliable strategy. Starting where the individual is maximises the probability of a mutually agreeable experience. Steeply monotropic individuals will not come half way to meet you, at first you must go all the way to meet them. In the long run the effect will be friendly feelings towards you – the key motivator for communicative socialising.
Breadth of focus evinces marked behavioural differences, ranging from the narrowly focussed person happily lost in the experience of, say, the changing light a small head movement can offer, or the contemplation of compassion and universal concern for right action. Of course these may be the same person at different times.
The most narrowly focussed will be children who may have particular difficulty with sensory integration and be unable to take in information simultaneously through more than one sensory channel. They will initially need coaxing into noticing a wider world, and need motivating to engage with it. Their conspicuous lack of engagement is their most likely route to diagnosis. They may often also be steeply monotropic. This combined with extremely narrow focus may undermine all but the most finely judged attempts to generate social connection.
Confidence and available attention
The quantity of available attention varies both between individuals and within individuals over time – confidence has an impact on this both at any given moment and across time. Confidence maximises available attention in two ways: it is replete with positive affect and thus intrinsically motivating. It thus excites aroused interests above the action threshold. Events which damage confidence have the effect of draining all attention into a painful focus which exacerbates the tendency not to reach out and connect. Being unable to proceed with confidence shrinks one’s horizons of possibility. This has a major impact on the next point.
Confidence depends on perceived understanding. Saying “well done!” a lot may be good for self-esteem but it is not necessarily helpful in building up competence. Succesful experiences, in particular, succesful ventures build confidence. A subjectively succesful event is one that has fulfilled one’s hopes, however small. Motivating hope and building confidence without setting up failure depends also on developing understanding (cf Lawson, Attwood, Clements and Zarkowska). Without sound understanding, the expectations will crash, and the confidence will go so painfully it may even be permanently demotivating. Ensuring opportunities for lifelong learning is essential for everyone on the autism spectrum.
Capacity to keep a functional level of arousal outside the current interest
Amongst monotropic individuals, capacity to maintain arousal outside the focal interest varies. This reduces discomfort in topic change and allows better preparedness for unexpected eventualities. We propose that limited attention makes it harder to maintain both deep current interests and general preparedness. One of those will tend to be lost.
Dispersed arousal provides the elasticity needed for coping with a rapidly changing world. Without elasticity, change can be unintelligible, and catastrophically unexpected. Change may easily precipitate epsiodes of involuntary disclosure. If enough extra-focal interest is available on the contrary multiple connections between interests will be more rapidly made. Ultimately more broadly interconnected interests may emerge which minimise the effort needed to adapt to life’s constant change. People who develop this elasticity will normally do so at the expense of depth of attention, and they will normally cope skilfully enough with life’s exigencies to avoid involuntary disclosure. They may never invite a diagnosis at-all. They may even be ‘normal’?
Degree to which interests are socially approved
Monotropic interests such as spit bubbles and excrement smearing are likely to attract a Kanner’s autism diagnosis. If an individual’s interests tend towards language, mathematics or music, etc., these tendencies may be perceived as career options, and even today attract no diagnosis, or perhaps a diagnosis of Asperger’s.
People who acquire less socially acceptable interests tend to experience rapid and repeated social rejection. This will demotivate the effort required to work out what’s going on socially. Society is not any particular size. Starting where the person is, we can become an approving society for that individual. If we ignore the individual’s interests in their early years and fail to make our own friendly interest known, then awareness or understanding of social possibilities may not occur until problematically late in life. Building a community of friendly people around autistic individuals is a generally reliable longterm strategy.
Whether or not an interest in language has been a monotropic focus in the developing years makes a difference to the likely diagnosis. If language has been an early interest, then the individual in question is unlikely to get a strict autism diagnosis but may get a diagnosis of Asperger’s. Such a person may have a very large vocabulary and may read well before showing understanding. Such a person will have interests structured overall by linguistic meaning, and will thus also have lost a good deal of freedom to structure their own meanings and their own experiences. We suggest that the early acquisition of language and all that follows from it is a genuine and profound difference within the autism spectrum. It points to distinctive capacities.
Those who have not tuned in to the usual processes of discourse need help to access acceptable modes of communication. Non-linguistic modes of thinking have always had something special to offer, and still do.
Rapidity of arousal: the more rapid the rate of someone’s emotional arousal, the less chance they have to get it under control. Being monotropic means it is likely to take some time before the resources for gaining control can be marshalled. This can cause conspicuously unacceptable behaviour which comes across as explosive and frightens those who witness it. It often also frightens those who are feeling it, and involves loss of capacity to interact effectively with those around. A situation of that sort may have a range of catastrophic consequences, and may lead to severe and even permanent loss of social facility. Such involuntary disclosure reveals an incapacity without explaining it: explanation is demanded. The pressure for explanation tends only to worsen the crisis. When the need for recovery time is not recognised this may lead to grave consequences such as incarceration and drugging. It temporarily disables communication, and may lead to permanent loss of independence.
Dennis [Debbaudt]’s Asperger’s ID card offers a way of making constructive disclosure possible in this sort of situation. Finding a way of getting control of those feelings in order to preempt the i.d. would be even better (see Clements & Zarkowska for some ideas). We need to recognise that people in this type of confusion are swamped and do not have control. We need to acknowledge their requirement for recovery time and reduction of social pressure at these times.
Level of action threshold – having a relatively low action threshold may mean that one monotropically aroused interest is rapidly succeeded by another. Action releases arousal and decreases activation in one area of interest, and another interest may take over, leading to activity with the same pattern repeating. Insufficient action to complete or satisfy an interest or task demand before moving on may be an unwanted result. Noting and responding to a wide variety of stimuli may be a benefit. People with this disposition may attract an Attention Deficit type diagnosis.
Emotional character – this is probably one of the key factors in learning: people do not explore or learn when they are angry or afraid or depressed. Feelings will be as extreme as the individuals’ monotropic dispositions dictate. These feelings are unlikely to be tuned to those of other people and will not be presented in socially graceful packaging. But that neither means individuals are not experiencing feeling, nor that they are necessarily unaware of other people’s feelings. They may not understand that other people have distinct emotions, or they may be highly if imprecisely aware of other people’s feelings. They may be so sensitive that complete avoidance even of positive feelings from other people is the appealing option.
They are likely to be driven by their very forceful emotions into behaviours which make other people feel uncomfortable because the behaviours are not socially tuned and thus do not fulfill current social expectations. As Dennis emphasises in his chapter, it is wise not to repond to unusual presentations with upset or agitation. These feelings are an indication, even when they come across as anger, that there is meaning in that person’s life. It is this meaning that depression sucks out of life. Ensuring people have access to the pursuit of interests which they find satisfying may be the best way of preventing this (Attwood, Oasis…).
This article by Dinah Murray and Mike Lesser is some version of an excerpt from a chapter in “Coming Out Asperger: diagnosis, disclosure and self-confidence“, edited by Dinah Murray. The book was published in 2006 by Jessica Kingsley. Sebastian Dern proposed to make this version.
The chapter appears to have been cut from the book itself at a late stage.