Autism: An evolutionary perspective, Professor Simon Baron-Cohen, 1st Symposium of EPSIG, 2016 - Free Educational videos for Students in K-12 | Lumos Learning

Autism: An evolutionary perspective, Professor Simon Baron-Cohen, 1st Symposium of EPSIG, 2016 - Free Educational videos for Students in k-12

Autism: An evolutionary perspective, Professor Simon Baron-Cohen, 1st Symposium of EPSIG, 2016 - By Lumos Learning

00:01 uh , our next speaker is Professor Simon Baron Cohen
00:03 , who you bust here . Also , you've probably
00:06 heard this every time . Sasha , his cousin .
00:09 I'm just I feel so privileged . Hyphenated cousin .
00:14 I understood . So , yeah . Congratulations on your
00:17 cousin's Professor Baron Cohen is a professor of developmental psychopathology
00:23 at the University of Cambridge and director of the University
00:28 of Cambridge Autism Research Center . And that information hasn't
00:31 gone out of date as it is . Still the
00:32 case . Um , now , when I was just
00:36 having a look at your kind of background from what
00:39 I could lean on the Internet , what I've got
00:41 from that is I think you've published over 300 papers
00:43 are and numerous books and extraordinarily prolific creative career over
00:49 the last 30 years , dating back to a lot
00:51 of only work about theory of mind and dealing with
00:54 the dilemmas faced by patients with autistic spectrum disorders and
00:58 their families . Which , I think it's fair to
01:01 say , have shaped all of our thinking over the
01:04 years as clinicians interested in helping this particular group of
01:10 patients . Um , so marvelous contribution to psychiatry .
01:16 Um , Professor Simon , Professor Baron Cohen has worked
01:22 on issues of sexual dime or fees and in the
01:24 human brain . And , ah , differences of adaptation
01:30 between males and females and familiar work about systematize ng
01:37 and empathizing brains , which I suspect may be part
01:39 of your presentation . Um , uh , I think
01:45 probably . Well , author of a number of books
01:48 which I think it's worth mentioning . Not not by
01:52 name and in great detail , But just to make
01:55 the point that I think you've written extraordinarily accessible books
01:59 which are very important because of their ability to share
02:03 scientific knowledge , not only within the medical community and
02:07 they work very well as medical textbooks , but also
02:09 within the much broader community of interested people out there
02:13 . The general public , which is , of course
02:15 , what we want to influence and shape . So
02:17 I'm very grateful to you for joining us this afternoon
02:20 . Thank you very much . Thank you very much
02:23 . So , first of all , thank you for
02:25 inviting me to take part in this , uh ,
02:27 very interesting day . I'm sorry I missed the morning
02:31 . I was here to catch most of your lecture
02:34 , Randy , and that was a real privilege for
02:35 me . So I've been teaching psychology , atypical psychology
02:41 to the medical students in Cambridge for about 20 years
02:45 and giving them a lecture on evolutionary psychiatry , describing
02:50 your work , making it accessible to doctors who are
02:54 really at the beginning of their career . So they're
02:56 starting to think in this Darwinian way , so some
02:59 of you may maybe former students of mine . But
03:03 hopefully these ideas are beginning to permeate into the field
03:06 of psychiatry so that we start thinking about the function
03:11 of behaviors and emotions , not just thinking about how
03:14 to eliminate them . So I'm talking about a neurodevelopmental
03:19 condition , autism again from an evolutionary perspective . And
03:26 I thought I'd start just with a picture of a
03:27 child with autism doing the classic thing that kids with
03:32 autism do . So he's playing alone . It's one
03:36 of the features of autism is not really interacting socially
03:40 , but he's doing something intelligent . He's lining things
03:43 up to make very clear patterns that he is imposing
03:49 on the world . And as many of you know
03:51 , kids with autism get very distressed . If anyone
03:55 disturbs their perfect universe , their order of patterns that
03:59 they're creating one other child before we get into what
04:05 we understand about autism again , a child playing on
04:09 his own , so it's encompassing the word autism ,
04:13 which just means self not interacting with others but again
04:18 doing something very intelligent . So he's playing with water
04:23 , and he's fascinated by the patterns that can be
04:26 created as you block the flow of water with your
04:29 hands . So fascination with patterns but solitary . What
04:37 you probably know is that the prevalence of autism has
04:40 been rising year by year . So this shows you
04:43 data from the mid nineties through to the early two
04:46 thousands . So autism has been getting more and more
04:49 common . If we continue that graph just looking at
04:54 data from the U . S . From the Center
04:56 for Disease Control , you can see that the increase
05:00 has continued . And if we go right up to
05:04 the latest data , which is 2014 , Center for
05:08 Disease Control in the US uh , the estimate now
05:11 is autism is diagnosed in one in 48 boys and
05:17 one in 100 and 89 girls . This is child
05:21 data , and if you average across the two gender
05:25 is it's about one . In 68 kids end up
05:27 with a diagnosis of autism . So this is way
05:30 more common than when I first started out in this
05:33 field back in the mid eighties , when Michael Rutter
05:37 and others whose names you'll recognize was saying that autism
05:40 was four in 10,000 . So very rare . We
05:44 now think of autism is very common . Um ,
05:48 and my talk isn't about why the increase . But
05:51 I think we can probably attribute most of that to
05:55 greater recognition . Better awareness , a lot more services
05:59 on the ground looking for autism . So more eyes
06:01 looking for potential cases . And , of course ,
06:04 we've broadened the definition of autism to include Asperger's syndrome
06:09 . So we've moved from a categorical diagnosis to a
06:12 spectrum diagnosis and added a whole subgroup and the graph
06:16 on the right there really shows you at a glance
06:19 the whole picture of autism , because you can see
06:22 that within both males and females , there are some
06:25 people who have below average i Q . So they
06:28 not only have autism , but they have learning difficulties
06:31 as well . And , of course , some who
06:33 have average or even above average IQ what we would
06:37 call Asperger's syndrome . So we tried to measure this
06:43 idea of a spectrum by creating something called the autism
06:47 spectrum , questioned to questionnaire that adults can fill in
06:51 for themselves the queue . So that's self report ,
06:55 or parents can fill it in about their child ,
06:57 and each item on the questionnaire is one autistic trait
07:02 , and the scale , As you can see it
07:03 , goes from 0 to 50 . The dotted line
07:06 on the left is the normal distribution that emerges when
07:10 you ask adults in the population to fill in this
07:13 instrument . So what that's telling us is that we
07:16 all have some autistic traits . Nobody really score zero
07:21 . The solid line on the right are the scores
07:24 from adults who already have a diagnosis of autism or
07:28 Asperger's syndrome . And again we get this kind of
07:31 bell curve , so there's a kind of range of
07:34 scores . But the point I wanted to make here
07:38 is that there's a spectrum not only within those who
07:42 come to the clinic , but it's a spectrum that
07:45 runs right through the population and evolution . Natural selection
07:50 could well have been operating on those individual differences in
07:53 autistic traits that we see in the population . So
08:00 the first part of my talk is just to tell
08:02 you what we know about autism , and I'm going
08:04 to go through this quite a fast pace so we
08:07 can get onto the kind of evolutionary relevance . But
08:10 what we do know is that autism is in part
08:13 genetic , because if you've got one child with autism
08:17 in the family , the likelihood of another child also
08:20 having autism is one in three . So if we
08:23 take the general population prevalence of about 1% you can
08:27 see that the presence of uh , one family member
08:31 with autism rapidly increases the likelihood of somebody else also
08:34 having it . So this looks like it's partly genetic
08:39 . The reason I would say that not just familial
08:42 but genetic is that the hunt for autism genes is
08:46 revealing hundreds of so called risk genes . This comes
08:50 from a website called safari dot org , where they
08:55 report every new genetic association that's found for autism .
09:00 So here are the human chromosomes , and the colored
09:03 dots represent a published finding of a genetic association with
09:09 autism or Asperger's syndrome . Where you can see at
09:12 a glance is that almost every human chromosome harbors some
09:16 genes for autism , so we know autism is not
09:20 mono genic . It's massively palla genic . What we
09:24 don't know is what these genes are doing , what
09:26 their function is which genes are necessary and sufficient to
09:30 cause certain types of autism or certain symptoms of autism
09:36 . But there's no doubt that autism is in part
09:38 genetic . But we know autism isn't completely genetic because
09:44 of identical twins like these girls , where one has
09:47 autism and one doesn't . If autism was 100% genetic
09:51 , if one has it , they should both have
09:53 it , um , so discordant pairs of this kind
09:57 suggest epigenetic factors . Environmental factors that can act on
10:03 the gene in someone who is genetically predisposed to autism
10:08 might also be part of the story , and you
10:10 can see that this study from King's College , London
10:13 , um , Robert Clemens Group shows differences in gene
10:18 expression in discordant twin pairs in terms of what's going
10:25 on in the brain . In autism , we certainly
10:28 see differences . So just zooming in on different structures
10:33 , you can see a difference in the size of
10:35 the amygdala in autism . Compared to controls that the
10:40 amygdala is larger in Children with autism than in typically
10:43 developing Children , we also know that the brain in
10:49 autism seems to be growing faster than in typical development
10:54 . So on the left is a graph showing growth
10:59 trajectories um in blue are typically developing Children who each
11:04 had to m r I scans so that you can
11:07 join the dots to create growth curves . And in
11:11 red are kids with autism again who had a repeat
11:15 MRI so you can look at how quickly the brain
11:18 is growing . And you can see that the autism
11:20 group at each time point is showing a larger brain
11:24 , suggesting that the brain is growing quicker . The
11:28 cartoon on the right comes from Eric Cautions Group in
11:32 San Diego postmortem study where you get the opportunity to
11:36 look at the brain from people with autism and dissect
11:39 it . Observe it , uh , in , uh
11:43 , in fine detail , finding 60% more neurons or
11:48 nerve cells in the frontal cortex in people with autism
11:52 than in comparison , uh , brains . So the
11:55 larger brain seems to correspond with heavier brain if you
12:01 wear it at postmortem and also more nerve cells ,
12:03 more neurons in different parts of the brain . Here's
12:09 another structure , which differs between autism and controls .
12:12 The corpus callosum , the connective tissue between the two
12:15 hemispheres , which in autism is smaller in the posterior
12:19 part of the corpus callosum . Compared to typical individuals
12:23 So I'm just showing you some examples of differences in
12:27 brain development brain structure , and we'll come onto brain
12:31 function to show that these kids right from the earliest
12:35 point , the brain is developing differently . This is
12:40 a paper that was just published this year . Uh
12:43 , Christine occur again at King's College London . But
12:46 using data from a national , uh , dataset um
12:51 , showing that you can identify in DT diffusion imaging
13:00 , short connections and more long range connections . And
13:05 then in autism , you find more of the short
13:07 range connections and fewer of the long range connections than
13:11 you do in a typical sample . So again ,
13:14 just differences in the wiring of the brain again ,
13:19 back to the postmortem evidence . If you just look
13:23 at the individual neuron , the nerve cell , this
13:28 is a very , I think , a very interesting
13:30 study . So on the right , we've got a
13:32 neuron from a brain from someone who had autism and
13:37 on the left of typical individual and again with the
13:40 naked eye , you should be able to see more
13:42 of the white dots all along the neuron . And
13:46 each dot is a location of a dendritic spine or
13:50 the location of synapses where the neuron is making connections
13:53 with its neighbor . So this is suggesting more connectivity
13:58 between neurons in the autistic brain . Not just more
14:02 neurons , but more connections between neurons , uh ,
14:05 in autism compared to a typical brain giving you flavor
14:08 of the differences between someone with autism and someone without
14:12 autism . So that's a bit about genetics and a
14:15 bit about the brain . And , of course ,
14:17 there are major differences in behavior and cognition . This
14:21 is again a study from UC San Diego By Karen
14:26 PIERCE . What they did was they looked at two
14:29 year old Children coming into the clinic , and they
14:33 presented them either with a face to look at a
14:36 social stimulus or a geometric design . And they filmed
14:41 how long each child looked at either the social or
14:44 the non social stimulus . What they found was that
14:47 if a child looked for more than 70% of the
14:50 time at the non social stimulus , the probability that
14:54 that child had autism was 100% . So when I
14:57 read this paper , I was sort of blown away
15:00 . That may be a behavioral test , could be
15:03 diagnostic , and it could save us hours of interviewing
15:06 families and observing the child and so forth . Obviously
15:10 a caveat . With a study like this , it
15:12 was a clinic study . We don't know whether the
15:14 accuracy would be as good if you rolled it out
15:17 into the community into the general population . But either
15:21 way , just the take home message from the study
15:23 is that a typical child tends to naturally look at
15:27 faces . They're drawn to look at people , and
15:30 presumably the emotional information in faces and a child with
15:35 autism doesn't show that that typical preference . Rather ,
15:39 they're more interested in patterns in this case , geometric
15:42 patterns . So what we're seeing is evidence of difference
15:46 , not necessarily pathology , just a brain that's wired
15:49 differently and finds different aspects of the environment of interest
15:56 . So other differences psychologically between autism and a typical
16:00 person is in terms of attention to detail . Some
16:04 of you recognize this task on on the left .
16:08 It's called the Embedded Figures test , where you have
16:10 to find the shape hidden in the overall design as
16:13 quickly as you can . People with autism are super
16:17 quick and super accurate . On tests like this ,
16:21 where the cube is hidden in there , I'll let
16:23 you see if you can find it and when we've
16:26 asked people not just to do this test at the
16:29 behavioral level , but also to do it whilst they're
16:31 lying in an MRI scanner . Functional imaging People with
16:35 autism show less activity in the posterior parietal cortex whilst
16:41 they're solving the task at a higher level , so
16:44 the brain is in some sense , more efficient .
16:47 They're ending up with better performance but showing less brain
16:51 activity to achieve that performance . So these differences in
16:55 function between the autistic brain and the typical brain another
17:02 suggestion that people with autism focus on detail whilst the
17:07 rest of us focus on the big picture comes from
17:10 the results of the block design test , which many
17:14 of you will have seen or used as part of
17:17 the test in Children or adults . People with autism
17:21 show their best performance on block design . Where you
17:25 have to take , you have to select which little
17:27 cubes you need , which have different colored faces to
17:31 create the design up above . And kids with autism
17:35 are very quick at this , and they don't seem
17:37 to improve in their speed . Whether you segment the
17:42 designers , it's been done on the right to help
17:44 a child to find the solution or whether you just
17:47 present them with the overall design . So evidence of
17:51 superiority in understanding the components that make up a larger
17:57 design more more evidence for people with autism . Being
18:04 detail oriented is in this test where you simply ask
18:08 the person , What letter do you see ? People
18:12 with autism are more likely to report they've seen the
18:14 letter H . Um , obviously , both answers H
18:20 or A are correct , and the test is really
18:23 just designed to see whether you're more focused on local
18:26 detail or more global information suggesting that people with autism
18:30 are more detail or local oriented . And finally ,
18:35 a study that came out a couple of years ago
18:37 showing again superior performance in kids on the autism spectrum
18:42 in spotting patterns where you give them repeat information where
18:47 you get it . Whether the individual is getting a
18:48 chance to learn that certain shapes always co occur ,
18:53 always occur together , and kids with autism seem to
18:55 be quicker picking up these regularities . So when we
19:01 think of autism , we think of it as a
19:03 child is quite isolated , trouble making friends trouble communicating
19:08 . We tend to focus on the social deficits .
19:11 But we should keep in mind that autism is more
19:14 complex than that . This 10 year old child ,
19:17 Max Park in California , loves the Rubik's Cube ,
19:21 so he's fascinated by patterns . He's ranked in the
19:25 top 101 100 Rubik Cube players in the world .
19:29 So whilst he has trouble socializing , he's also showing
19:33 areas of not just intact ability but superior ability .
19:38 So we need to think of both sides of autism
19:41 when we try to think about and how a partly
19:45 genetic condition may have been selected for in evolutionary terms
19:52 . And this is Derek Parra Vicini , who lives
19:55 in this country . So he has a mental age
19:58 of a four year old , very limited language ,
20:01 so learning difficulties . He's also been blind from birth
20:04 . So congenital blindness . And he has autism .
20:09 Quite a package . Um , whenever he hears any
20:13 jazz song that's played , he can immediately reproduce it
20:17 after just hearing it once . If you play a
20:21 10 note chord on the keyboard , he can instantly
20:25 identify all of the 10 notes in the chord ,
20:28 suggesting that in his case , the talent is obviously
20:33 an auditory information . He's blind , but he can
20:36 dissect the information into its component parts very fast ,
20:39 just as we saw on the embedded figures test or
20:42 the block design test . The same ability that you
20:45 see in autism of taking information and reducing it down
20:49 to its component parts very rapidly and spotting patterns .
20:55 So the other side of autism , which has only
20:57 just made it into the latest DSM DSM five ,
21:01 is sensory issues . Parents and people with autism were
21:06 telling us for about 40 years that they had sensory
21:09 issues , but it wasn't part of DSM three or
21:12 four . It's now part of DSM five . Bless
21:15 You , and this is really showing you that if
21:19 you put someone with autism into functional magnetic resonance imaging
21:24 , you give them headphones whilst they're blindfolded , and
21:27 you simply look at which part of the brain responds
21:30 when they hear a tone and unexpected auditory stimulus .
21:35 You see a greater response in the auditory cortex in
21:38 people with autism , compared to the typical individual suggesting
21:42 hypersensitivity . This is obviously a study just in the
21:45 auditory domain , but you could do the same in
21:48 the tactile or the visual or the taste , uh
21:53 , channels and still find this hypersensitivity so in terms
22:00 of the social difficulties which we know are present .
22:04 Uh , the earliest demonstration of these comes from these
22:09 studies . They're called baby Siblings studies where , you
22:13 know there's already one child with autism in the family
22:16 . So you're watching the new baby in the family
22:18 . Who is that genetic increased risk of autism and
22:22 finding that , for example , if you present them
22:26 with a stimulus of the eyes looking direct at the
22:29 infant or away from the infant . The P 400
22:34 electro physiological wave that can be recorded just using e
22:37 R P or E G type equipment is reduced in
22:41 those Children who go on to develop autism . So
22:45 perception of faces and social information seems to be different
22:50 . This is even in the first year of life
22:55 . This work comes from Ami Klin , who was
22:57 at Yale University , has now moved to Emory ,
23:00 where he used gaze tracking to see where somebody looks
23:05 whilst they're watching a movie . So this clip ,
23:08 um , is from Who's Afraid of Virginia Woolf ?
23:12 And in Yellow , The Gaze Tracker is showing us
23:17 that that's where the typical individual is looking whilst they're
23:19 watching the movie . Looking at Elizabeth Taylor's face ,
23:22 but particularly her eyes and in red is where people
23:26 with autism tend to look , so they are looking
23:28 at the face but focusing more on the mouth than
23:30 the eyes . So the gaze tracking technology is giving
23:33 us a window into what is of interest and what
23:37 is , uh , the attentional focus of people with
23:40 autism . And as you kindly mentioned in the introduction
23:46 , there's been a lot of work , uh ,
23:48 starting from our group . But many other groups looking
23:52 at so called theory of mind , the ability to
23:54 put yourself into someone else's shoes and to imagine other
23:57 people's perspectives , which Children and adults with autism and
24:01 find challenging so that they don't tend to participate in
24:05 games like hide and seek when they're very young .
24:07 Or deception , which typical four year olds enjoy ,
24:11 because they're keeping track of what other people know what
24:14 other people might want and intend . And instead ,
24:16 Children with autism tend to avoid those kinds of interactions
24:20 , finding them very confusing . We developed this test
24:26 called the Eyes Test , which some of you may
24:28 know to measure social cognition in adults with Asperger's syndrome
24:34 and in the general population . Uh , so you're
24:37 showing photographs of the eye region of the face ,
24:40 and you have to pick which of the four words
24:42 that surrounds the photo . Best describes what the person
24:45 in the photo is thinking or feeling so very degraded
24:50 , black and white still photographs , Uh , but
24:53 people are pretty accurate at picking out that she's dispirited
24:57 or a bit sad , just from minimal information of
25:00 emotions around the eyes . You can see that the
25:03 data down on the in the graph on the left
25:06 comes from thousands of individuals who have taken this test
25:09 online , showing that both males and females with autism
25:12 score lower on this test of reading emotions from the
25:16 eye region of the face . And when we asked
25:19 them to take that same test whilst they're lying in
25:21 the scanner , we find that people with autism show
25:24 less activity in the left inferior frontal gyrus whilst they're
25:29 trying to decode someone's facial expression from information around the
25:34 eyes compared to a typical control group . So evidence
25:38 , I hope I've presented for both talents but also
25:42 disabilities in the same individuals . So some of you
25:47 know that just last year , an important new book
25:51 was published about autism called neuro Triumphs . It's by
25:55 a journalist called Steve Silberman . Um , it won
25:59 the Samuel Johnson Prize for nonfiction , very deservedly ,
26:03 because it tells a whole new history of autism .
26:07 But also , if you look at the subtitle of
26:10 his book , he talks about the future of neuro
26:12 diversity , and his book , in many ways is
26:15 a sort of manifesto for this new concept of neuro
26:19 diversity , which has psychiatrists and clinical psychologists We should
26:24 be paying a lot of attention to because it's really
26:27 the idea that there are many ways for the brain
26:29 to develop . There isn't a single way to be
26:32 normal . There are individual differences in the population which
26:36 may be there for reasons of natural selection . We're
26:39 not all made the same that we all have our
26:41 strengths and our weaknesses and autism . Maybe just one
26:46 example of neuro diversity in the environment . Silverman chose
26:52 as the front cover design for his book An Image
26:55 of Biodiversity and we're all very familiar with that related
26:59 concept of how important it is for us to preserve
27:02 diversity in the Amazon rainforest or elsewhere . And he
27:07 really argues the same should be true for neuro diversity
27:12 that in any classroom of Children , you're going to
27:15 find some . Some kids are more verbal , some
27:18 kids are more spatial , some kids are more sociable
27:21 and some kids are more musical . And all of
27:23 these different brain types , if you like , are
27:25 part of the diversity that you find in any garden
27:29 , so that in any primary school you should expect
27:33 two or three kids with autism to be part of
27:35 that diversity on the right here , we've got a
27:40 picture of Henry Cavendish . Silberman devotes a whole chapter
27:43 of his book to the biography of this physicist who
27:47 was not only famous for the discovery of hydrogen but
27:52 , as Silberman makes a very strong case , probably
27:55 had autism . He did his absolute utmost to avoid
27:58 people , um , so he would leave messages for
28:01 his servants and for other people he had to interact
28:04 with rather than meeting them face to face . And
28:07 it was really just content to do his physics to
28:10 do his scientific experiments away from the social world .
28:17 So here's the concept of neuro diversity attributed to Judy
28:22 Singer , who has autism herself but which first appeared
28:26 in print in 1998 . The reason for dwelling on
28:30 this is I think it's a revolutionary concept for our
28:33 field . Um , and this poster is produced by
28:39 the neurodivergent the movement , which comes from the autism
28:43 community asking for autism acceptance , the idea that they're
28:48 not necessarily inferior or impaired or , um , pathological
28:54 . In some way they're just different , just like
28:56 we might find amongst , for example , fruit .
29:00 They're not all the same for genetic reasons . We
29:03 might expect them to be of different flavors . I
29:08 think the notion of neuro diversity goes back quite a
29:10 lot further than I was suggesting . So here's Albert
29:14 Einstein , and there's a quote from him on the
29:16 left . If you judge a fish by its ability
29:19 to climb a tree , it will live believing it
29:22 is stupid . So we just think about animals in
29:26 different ways . And Einstein again , The case has
29:30 been made that he might have had autism . Here's
29:34 a quote from his biography . I do not socialize
29:38 because it would distract me from my work . So
29:40 he was really just focused on his physics . He
29:44 did quite well . He he also enjoyed sailing ,
29:48 but he did that alone when he was at Princeton
29:51 , and he used to enjoy playing the violin .
29:54 But , um , you know , people weren't his
29:57 main focus the world of objects in the world of
30:00 systems and understanding the laws behind , uh , the
30:05 physical world , which led him to his discovery of
30:08 relativity . So here's Hans Asperger on the left ,
30:13 the pediatrician whose name is now given to one of
30:15 those subgroups and he said , for success in science
30:20 , a dash of autism is essential . So there's
30:23 that idea that autism might come and come by degrees
30:26 . We might all have some of it . And
30:28 maybe a certain modicum of autism might be quite good
30:32 for focusing your attention just on one so called obsessional
30:36 topic . Part of the autism diagnosis , as you
30:39 know , is that they develop obsessional interests . But
30:42 that's a rather kind of pejorative way of describing that
30:45 they just have passions or interests . Um , and
30:49 on the right , here we have Newton again .
30:51 The case has been made that he , too had
30:54 autism , so not only discovered gravity , but famously
30:58 fell out with almost all of his colleagues and had
31:01 difficulties with communication . So we see this potential link
31:07 between autism and scientific talent , at least speculated in
31:12 biographies and anecdotes . Well , we've tried to measure
31:16 this to see if it's actually the case . Um
31:20 , so we developed a questionnaire called the System Izing
31:22 Questions , which asks how interested you are in different
31:26 kinds of systems , whether they're mechanical systems like computers
31:31 , mathematical systems like mathematics , natural systems like the
31:35 weather . And you can see that people with autism
31:37 score higher in terms of their strength of interest in
31:41 systems than people in the general population . We've also
31:46 gone out to test whether kids with autism or Asperger's
31:50 might be better at solving mechanical reasoning tasks like this
31:55 one , where you have to look at the wheel
31:57 going anti clockwise and predict what will happen to that
32:00 point . P . The correct answer here is See
32:04 , it will move back and forth , and kids
32:06 with Asperger's syndrome age 12 , outperform typical 12 year
32:12 olds in solving these kinds of mechanical reasoning problems ,
32:16 suggesting that despite their social difficulties in certain aspects of
32:20 the environment , their understanding is actually precocious . So
32:28 I'm located at Cambridge , so opportunistically we decided to
32:33 look at the rate of autism amongst the math students
32:36 at Cambridge University . So we just asked them that
32:39 very straight question do you have autism ? And you
32:42 see , You see , the results show a much
32:46 higher rate of diagnosed autism in students at I would
32:51 say , this is a very good university in the
32:54 field of mathematics compared to the humanities . So again
32:58 reinforcing this idea that there might be a link between
33:02 a lot of autistic traits or even a clinical diagnosis
33:05 of autism and talent at understanding systems , including mathematics
33:13 , and , again just taking advantage if you like
33:16 , of students being on the doorstep . We gave
33:19 the AQ that measure of autistic traits to students working
33:23 in sciences or in the humanities , finding that the
33:27 scientists didn't have a higher rate of autism . They
33:30 just had more autistic traits compared to those working in
33:33 the humanities . So again , those individuals who were
33:37 attracted by the more predictable world that can be systemized
33:43 , which is what we do in science , where
33:44 we try to understand lawful relationships between variables might end
33:48 up in science , Uh , may have higher number
33:51 of autistic traits than those who can deal with the
33:54 less lawful world of people , the unpredictability of people
33:59 and the way we write about people . For example
34:01 , in literature where this link comes from between autism
34:07 and scientific talent is likely to be genetic , because
34:11 years ago we looked at the occupations of fathers of
34:15 Children with autism , just asking them about where they
34:19 work and finding a disproportionate number of fathers of Children
34:23 with autism work in the field of engineering compared to
34:27 fathers of typically developing Children , obviously , engineering is
34:31 a very good case of where you need to be
34:34 good at understanding systems . But to get the job
34:37 , you may not have been selected on the basis
34:40 of your social skills , more your understanding of how
34:43 things work . So looking back where there's a child
34:47 with autism in the family , at the genetics ,
34:49 if you like . What's been positively selected , perhaps
34:53 in evolutionary terms is not autism itself , but perhaps
34:57 an aptitude for understanding systems , which would be an
35:00 advantage in fields where you're either building a system like
35:04 engineering or trying to understand the system . We found
35:07 the same pattern amongst the grandfathers of Children with autism
35:10 on both sides of the family , so this led
35:15 to the prediction . Is autism more common in places
35:18 like Silicon Valley ? So Silicon Valley has obviously been
35:22 attracting people who have an aptitude for systems for quite
35:27 a few years , and they moved there and they
35:29 work there and they potentially start a family there and
35:32 have Children . So if there's a genetic link between
35:35 scientific attitude or technical intelligence and risk of autism in
35:40 the offspring , we should see it in places like
35:43 Silicon Valley . So Silicon Valley is quite a long
35:47 way away from London . So we went to a
35:50 Silicon Valley a bit closer to home in the Netherlands
35:54 and looked particularly the city of Eindhoven Eindhoven has got
35:58 the Eindhoven Institute of Technology a bit like mitt .
36:02 It also had the Philips factory there for over 100
36:05 years , attracting people to go and work there in
36:08 the fields of electronics and more recently , it so
36:12 that now a third of jobs in Eindhoven are in
36:15 the IT sector . We compared the rate of autism
36:18 in Eindhoven to two other Dutch cities , Utrecht and
36:23 Harlem , selected because there are similar size and similar
36:26 demographic and found that the rate of autism in Eindhoven
36:30 was more than twice as high as in those two
36:33 other Dutch cities . So this was based on school
36:36 records contacting every school in each of these three cities
36:40 to ask them for the number of kids who already
36:43 have a diagnosis of autism , we don't know much
36:46 about the parents . This was a school based study
36:49 , but the inferences that this may be something to
36:52 do with the parents' occupations . So to try to
36:59 make sense of all of the data that I've shown
37:02 you this afternoon and to try and make it more
37:06 relevant to an evolutionary perspective , I just want to
37:09 mention the model that was mentioned in the introduction this
37:14 empathy system izing model . The idea is that in
37:18 the population in the general population , these are two
37:22 dimensions along which we see individual differences . So along
37:28 the y axis , we've got empathy . And if
37:30 you're at zero , it means you're absolutely average for
37:34 the population as you go up the Y axis ,
37:38 your above average and empathy or the ability to read
37:41 other people's thoughts and feelings , but also responded with
37:45 an appropriate emotion . If you're below zero , it
37:48 means you've got difficulties in that domain . And on
37:51 the X axis , we've got system izing the ability
37:55 to , um to understand the system , but also
38:00 build a system by identifying the rules that govern the
38:03 system So you can predict how the system works again
38:07 towards the right . So the positive values your above
38:11 average on system izing and over to the left your
38:15 below average . And the idea is that we all
38:17 fall somewhere in this space , these two dimensions .
38:22 What we found in our research is that in the
38:24 dark blue quadrant , up at the top left more
38:27 women in the population fall in that area where they've
38:30 got above average empathy . But their system izing could
38:35 be anywhere from average through to below average . Uh
38:39 huh . Sorry . That's in the light blue part
38:43 of the graph . Um in the white part of
38:46 the graph are individuals who are equally good at system
38:49 izing or empathy . So they may be equally talented
38:55 or equally challenged . But they don't show much of
38:58 a discrepancy in their aptitudes or abilities In both areas
39:03 . The pink area is where most men on average
39:06 , fall in the population where their system izing is
39:10 at a slightly higher level than their empathy . And
39:13 what we were predicting is that people with autism would
39:16 fall in the bottom right hand quadrant that dark red
39:19 zone where their system izing maybe anywhere from average to
39:24 above average . But their empathy would be less than
39:27 minus one . So in the below average range ,
39:30 which is often the trigger for needing a diagnosis ,
39:33 that they're struggling with relationships . So that was the
39:36 model , and what we did was we went out
39:39 into the population . We gave people these two questionnaires
39:44 the empathy question which measures your empathy , the system
39:47 izing question which measures your system izing and just sort
39:55 of helping you read the data . Here in yellow
39:59 are females in the population , and you might be
40:02 able to see them clustering in the top left hand
40:05 quadrant of the graph in green are males in the
40:09 population where you might see them clustering more in the
40:13 center and in purple and red are males and females
40:19 with autism who you might be able to see clustering
40:22 in the lower right hand quadrant . So each data
40:27 point here is an individual . Um , and of
40:30 course , all we can do is look at groups
40:33 , males , females , people with autism , on
40:35 average , because individuals may be typical or atypical for
40:39 their group . So , you know , we can
40:44 see . We can see a little green dot up
40:46 here of a man whose well up in the female
40:49 range on his empathy . Um , and we can
40:52 see you know , a woman all the way down
40:55 here who's in the so called autistic range . So
40:58 individuals may not fit the trends for their groups or
41:03 we can talk about is statistical averages . But if
41:06 we do account for these different brain types , and
41:10 this is my last slide so we can leave time
41:12 for discussion , this is what we find that if
41:16 we look at individuals whose empathy is at a higher
41:20 level than their system izing , we find more women
41:24 than men in that have that profile . If we
41:29 look at the opposite profile individuals whose system izing is
41:33 at a higher level than their empathy , this is
41:36 percentages . We find more men than women , show
41:39 that cognitive profile and if we look at it as
41:43 an extreme of this one , so system izing is
41:47 either intact or above average . But empathy is below
41:51 average . Well , this is where we find the
41:53 majority of people with autism or Asperger's syndrome , so
41:58 the data and are in line with the directions predicted
42:03 by the model . But really , the reason for
42:05 leaving this up is my final slide is to show
42:08 that diversity that exists in the population we all fall
42:12 in one or other of these five brain types ,
42:15 if you like to find in cognitive terms , although
42:18 increasingly we're starting to map their neural substrate and the
42:23 both environmental and biological determinants of these different brain types
42:30 . But we might well imagine that natural selection has
42:35 favored one type of brain over another for different kinds
42:39 of evolutionary niches over thousands hundreds of thousands of years
42:44 or millions of years in primate evolution , some of
42:48 which fallout along , um , sex differences . But
42:53 actually nothing to do with your sex because it turns
42:56 out that prenatal hormones and genes play a much bigger
43:00 role than your actual sex , and that people with
43:03 autism may just be showing an extreme of the variation
43:07 that we see in the population selected potentially for their
43:12 their talents , being very good at spotting patterns ,
43:15 being very good at innovation and understanding new machines or
43:20 new tools that will help us even if they find
43:24 the social world more challenging . So I'm going to
43:27 stop there . Thank our funders . And particularly the
43:31 autism research Trust that supports our work . And we
43:34 can open it up for discussion . Thank you .
43:44 Thank you , Simon . I'm sure there'll be quite
43:46 a number of questions , but could I just ask
43:47 you briefly ? I had reason to work with large
43:52 numbers of transgender patients over the years . Um ,
43:55 one of the observations I have is that there are
43:58 certainly some trans women who will say , you know
44:01 , I always socialized with women , and the reason
44:03 I like doing that was that they didn't just kind
44:04 of thump and kick each other . They talk to
44:07 each other at school , for example . And it
44:09 was a safer and better place to be , which
44:11 seems fine and fixed with the model , as it
44:14 were there . Another group of people , though ,
44:15 who appear to describe a kind of subjective change when
44:19 they start to take when they begin estrogen hormone treatment
44:22 . Uh , and I've just got a very vivid
44:26 recollection of one patient in particular who talked about the
44:29 sort of revelatory experience of being amongst the girls and
44:32 finally feeling at home as it were , which was
44:34 very striking at the time . I'm not aware of
44:38 that should be but not aware of literature looking specifically
44:42 at that group of people and particularly at hormone exposure
44:46 for transgender patients . But I just wonder if you've
44:48 got any knowledge of that area to comment on ,
44:51 Uh , just a brief comment , which is that
44:55 the the area of research of autism and gender is
45:00 just beginning to open up and including transgender . So
45:04 we're now becoming a bit more aware that instead of
45:07 asking people for their sex and giving them a binary
45:10 choice , male or female , we need to be
45:13 a bit more sort of fluid because a lot of
45:18 people with autism don't want to identify as either male
45:21 or female . And they prefer to tick the other
45:24 box , and that increasingly , a lot of people
45:27 with autism are identifying as either transgender or discussing how
45:33 their gender doesn't fit neatly into traditional categories . So
45:37 whether there's a hormonal element to this or some other
45:40 factor , But this is a new area of research
45:44 , certainly evidence for higher than expected number of trans
45:48 male patients with autistic traits , and that would certainly
45:52 be our clinical experience . Okay , so you have
45:56 the furry microphone somewhere . Can I ask a question
46:01 , please do . Engineers that marry have as many
46:06 Children as others . Two engineers marry and have as
46:09 many Children . Yes , because the evolutionary theory would
46:13 be about reproduction . Sure , so , presumably people
46:17 with autistic traits . If there's an evolutionary advantage ,
46:21 some would have as many Children , not less ,
46:24 because it's difficult to explain autism in evolutionary terms if
46:28 it decreases fitness . Sure . Um , so I
46:34 don't know the data on fertility fertility rates amongst engineers
46:39 versus other groups in the population . Maybe someone else
46:42 does . Um , But if you think again ,
46:46 about for the fertility in relation to resources , an
46:52 engineer could be someone who ends up with considerable resources
46:56 if they have the skills and the tools that other
47:00 people need in the community . So if engineering skill
47:05 is related to resources , we know that there is
47:09 a connection between wealth , economic status and fertility rates
47:13 that may explain the persistence of the range of autistic
47:18 or engineering type autistic jeans . Yeah , I mean
47:21 , the puzzle always was that , You know ,
47:24 back in the old days , the kind of autism
47:26 we saw in the clinic , we couldn't really imagine
47:28 this person ever growing up to have a relationship ,
47:31 let alone an intimate relationship that might result in Children
47:35 . So why were the genes for autism persisting in
47:38 the gene pool ? Now we've broadened autism into a
47:41 spectrum , and we can look at Asperger's syndrome and
47:44 we see what's called the broader for genotype amongst the
47:49 parents of Children with autism , which might include skills
47:53 in engineering or in technical intelligence . We can see
47:57 that actually , there's plenty of scope for these individuals
47:59 not only having married and had Children so passing on
48:02 their genes , but maybe even being selected positively selected
48:06 by a mate for those positive trades . Well ,
48:12 Bill Gates is a really interesting examples . Everyone speculates
48:16 that he's got autism . He resists the idea .
48:19 So any time a journalist's journalist tries to sort of
48:22 thrust a microphone into his into his face and say
48:25 , You know , Mr Gates , do you have
48:27 autism or kind of the sort of blunt way that
48:30 journalists sometimes do ? He gets sort of irritated ,
48:33 But those people who worked with Gates , uh ,
48:37 sort of report that actually , he's got a lot
48:40 of those behaviors , and he's done quite well .
48:42 Yeah , mhm . What are your thoughts about the
48:47 contention , uh , that autism represents a slow life
48:53 history strategy or is associated with a slow life history
48:57 strategy and that , um , their reproductive success or
49:01 niche is with a state of intense monogamy and long
49:07 term relationships and investment in a single relationship , as
49:11 opposed to , uh , psychosis , which is claimed
49:16 to be a fast life history strategy . And that
49:19 , I mean , there has been this research and
49:21 these claims . I don't know what your thoughts are
49:23 about that I don't know that research , but I
49:26 mean , it makes sense the way you're describing it
49:28 . Slow life and fast life . Certainly there's quite
49:32 a lot of data that's accumulating , showing that fathers
49:36 of Children with autism tend to marry late . So
49:40 maybe that fits in with the slow life . Is
49:43 that right ? And you know , it's been kind
49:45 of open to interpretation as to why that's the case
49:49 . And some people suggest , well , that could
49:51 just be because their social skills are not as great
49:55 . They've got some of the genes for autism because
49:57 we see it coming out in the next generation .
49:59 So maybe they've just taken longer to find a partner
50:03 because of reduced social skills . But I mean ,
50:07 you know , I guess you're talking about slow life
50:10 and fast life trajectories which may not be sort of
50:13 under the within the awareness of the individual . These
50:17 are just sure , but it's very interesting from one
50:21 Simon to another . Simon Foster from Red Car .
50:25 And I'm a child psychiatrist . So I'm fascinated by
50:28 autism . And I heard you talk 20 years ago
50:30 , and you're just as accessible and entertaining as you
50:33 were then . So it's great to hear again .
50:36 Um , what I'm wondering is the extent of genetic
50:43 , um , or the extent that the genes are
50:47 distributed amongst the chromosomes . Doesn't that suggest that autism
50:52 is very old ? It's been with us for a
50:54 long time . Have you got any thoughts on that
50:58 ? Um , that might be one implication . Um
51:04 , so you know , one view about the genetics
51:07 of autism is that it's not about diseased jeans or
51:11 mutations . Rare mutations , although there are rare mutations
51:15 that can give rise to so called syndrome IQ autism
51:19 . But autism may also be the result of common
51:22 variants in the population , and that these common variants
51:26 may be distributed right across the genome . Each of
51:30 these common variants may be contributing very smaller facts ,
51:34 so it may be combinations of particular variants that are
51:39 not disease genes . They just contribute in different ways
51:44 to , um to skills , whether it's language or
51:48 whether it's mechanical skills or or any other . Now
51:51 , you also suggesting that because we see those dots
51:54 right across all 23 pairs of chromosomes , that means
51:58 it's very old . Another view might be that actually
52:03 , the epigenetic factors are more important that actually ,
52:07 maybe the epigenetic factors can can influence a lot of
52:11 gene expression . And then when we pick up genetic
52:15 findings were kind of we're not looking at the effigy
52:18 name , so there's different ways of interpreting it .
52:22 Um , I just think that the first person that
52:25 picked up a burning stick or a bit of half
52:30 half burnt flesh from a thunder and lightning storm and
52:33 thought This is tasty . Maybe we can reproduce this
52:37 effect ourselves . Were they systematize is sure . Well
52:43 , I mean , I think I think you're sort
52:45 of raising the question about , um , about when
52:48 an evolution did some of some of these very human
52:53 attributes first emerge , and I think if you look
52:56 at the evidence from tools , for example , the
53:00 fossil evidence from tools in evolution . You'd probably go
53:04 back at least 70,000 years in terms of when toolmaking
53:09 really took off and where you can see the evidence
53:12 of a very systematic mind varying their tools , which
53:17 you didn't really see much before 70,000 years ago .
53:22 Spirits . California , uh , adult psychiatrist , I've
53:25 been . I have been seeing people with autistic spectrum
53:30 in the clinics over the years , and one of
53:33 the things that impressed me it was in the what
53:37 I had in my mind , the difference between Asperger's
53:40 and autism , and that the autistic people they did
53:45 not want to be with people where there's Vegas wanted
53:49 to be with people , and it seems that that
53:53 has just if it's not so much important . But
53:57 for me , in the clinical practice and especially how
54:00 you can deal with people , it's a huge amount
54:03 of difference . Sure , I mean , it's not
54:07 a binary that you either want to be with people
54:09 or don't want to . It's probably about the kind
54:12 of dose of social interaction that each of us enjoys
54:17 , so some of us enjoy seeing a friend once
54:19 a week . Other people need to see a friend
54:22 once a day . So there are individual differences in
54:26 social motivation and social behavior . Uh , and ,
54:31 uh , you know , whether it's a kind of
54:33 discriminated between autism and Asperger's . I'm not sure ,
54:36 because even within the group called Asperger's , you see
54:40 quite a variation that some people are very content just
54:45 being solitary and they actually sleep during the day .
54:49 They're awake at night because then they're not . They're
54:52 not having to have any social contact . Um ,
54:56 and others , you know , do want the social
54:58 contact but don't have the social skills to know how
55:01 to have those relationships and so feel very lonely and
55:04 isolated . So I think there's kind of this individual
55:07 differences , even within Asperger's syndrome . Do you ever
55:11 feel that events move a predisposition predisposition to autism ?
55:17 Two more florid form , and if so , what
55:20 sort of innovation ? Let's see , um , so
55:25 I think of the word florid as the word that
55:28 sort of adult psychiatrists use in relation to psychosis .
55:33 You know , that kind of you suddenly see all
55:35 the symptoms blossoming . Um , whereas in autism ,
55:39 I don't know that we kind of really think about
55:41 the manifestation of symptoms in this kind of florid way
55:45 . I think it's much more sort of , um
55:48 , that if you look back , you can see
55:49 a particular pattern of behavior that was there right from
55:53 the earliest point . So I work in a clinic
55:57 NHS clinic for adults with suspected Asperger's syndrome . But
56:01 we ask the parents to come along with their 40
56:04 year old son so that we can get a developmental
56:08 history of was the pattern of behavior there , even
56:11 at primary school . And so it's not so much
56:14 this kind of florid explosion of symptoms where there's a
56:17 trigger , it's more that , actually right from the
56:21 earliest point . This was a child who didn't really
56:24 socialize in the same way they were more focused on
56:28 objects than on people . Maybe they didn't need a
56:32 diagnosis in primary school or even secondary school because they
56:35 somehow sort of managed in primary school . Maybe they
56:40 were focused on their academic work didn't really mix with
56:43 kids in the playground . In secondary school , we
56:46 often see a kind of more difficult picture where suddenly
56:52 the adolescent teen age group is much more demanding of
56:57 , you know , if you don't have social skills
56:59 it's much harder to navigate that . So a lot
57:01 of the kids get their diagnosis for the first time
57:04 in secondary school . But some of them have managed
57:06 to get through until they leave home and they go
57:08 to college and then they need their diagnosis or when
57:12 they are not functioning well at work . So in
57:15 midlife , so it's not about particular triggers . It's
57:18 about what nice there in who is protecting them ,
57:24 whether it's the family up until a certain point ,
57:27 who is concerned about the child or the individual .
57:29 And at what point do they do their symptoms their
57:32 autistic traits start to interfere with . At one point
57:37 , I was told as a student that a number
57:40 of Children became autistic when their fathers came back from
57:44 the war right , and the association between mother and
57:49 child was interrupted . Right ? So I would say
57:53 that probably theories of autism have changed a little bit
57:59 . I mean , we used to have all sorts
58:01 of theories about autism to do with how the mothers
58:04 were cold and unemotional , or maybe over involved with
58:07 the child , and , you know , so I
58:08 can imagine this kind of event of the father coming
58:11 back from war might have fitted into certain kinds of
58:14 theories of autism . But I think nowadays we kind
58:17 of understand autism is this biomedical neurodevelopmental condition , which
58:23 I've hoped I've shown is just a different pattern of
58:27 , you know , the relative sort of focus that
58:31 the individual has on the social world versus the non
58:33 social world and that sort of events that might happen
58:38 in the child's life , about whether the father is
58:40 absent or present , their probably less important than the
58:44 genetic predisposition . Uh , and there are there must
58:48 be environmental factors . But we're not very good at
58:50 identifying what those are yet . I guess if Dad
58:53 comes home with PTSD and takes takes to whiskey in
58:56 a big way and starts knocking them around , that
58:58 might have an impact on the social scale . Well
59:00 , but for any child Yeah , that's right .
59:03 Maybe a confusion of sure Vina Titus Yeah , that's
59:07 just it . A question , I think , on
59:09 the David Guinea , retired psychiatrist from Oxford . Could
59:14 I ask you a little bit about the group ?
59:17 The other end of the spectrum that is the individuals
59:20 who are very high empathizes and low , insistent ,
59:25 systematize ng What are they ? What is this group
59:30 like ? Clinically . So I think . Well ,
59:34 the word clinically is probably the most important word here
59:37 because they may not come to clinics . So these
59:39 people have got very good empathy . So we might
59:42 infer that they they've got good social network and good
59:45 relationships . Friends community . So actually , they may
59:50 be protected from needing to go to a clinic .
59:54 It's probably the people who have below average empathy who
59:57 struggle with with relationships , who might then develop secondary
60:01 depression because they're isolated , who end up coming to
60:05 clinical attention . So the people up at the top
60:08 left hand quadrant with super empathy may be doing just
60:12 fine . We don't know too much about them .
60:14 We know that they exist because you can see them
60:16 there . We can see more yellow dots , so
60:18 there's more females . But you can see the odd
60:21 green dot um , and we know also that they
60:26 may struggle with systems . So maybe at school they
60:31 didn't enjoy mathematics or the natural sciences and went for
60:35 other kinds of subjects , and that when the computer
60:39 goes wrong and they just phoned the help desk ,
60:41 so I don't think that these individuals would necessarily ,
60:46 um , have problems . They just are part of
60:50 the variety we see in the population . I suppose
60:53 . I was wondering whether they were the group that
60:56 one does see from time to time people who do
61:00 seem deeply empathic but really very disorganized and the sort
61:04 of term I'm not sure if it's at all PC
61:07 . The term that springs to mind is Scat e
61:10 uh , she's not a clinical diagnosis , which is
61:12 it's a non clinical term , but it's a description
61:17 of what ? Of how a person may be like
61:20 that . And I'm thinking how that fits into the
61:24 evolutionary picture . If you think that is , that
61:29 could characterize what that sort of person might be like
61:32 , Right ? Uh , so , as I say
61:34 , we don't we don't There hasn't been much research
61:37 into the people who are at the opposite end of
61:40 autism , so we know a lot about people with
61:42 autism because they come to clinical attention , and then
61:45 they make it into research studies . The group at
61:48 the other end of that dimension . If we think
61:50 of the diagonal , uh , we know less about
61:53 maybe they've got sort of executive type problems in being
61:58 very systematic in organizing things , but I think that
62:01 maybe a bit too simplistic because people with autism can
62:04 also have those executive types organizing difficulties . Um ,
62:09 but we just don't know . But I think it'll
62:11 be good to have more research into that other group
62:14 . I just wonder whether those of us who might
62:16 ask you that question I tend to be mailed .
62:19 I've got 22 daughters . Both have gone through adolescence
62:25 . I have to say we're both shockingly empathic ,
62:27 and I found it very difficult to comprehend it .
62:31 And we're sort of a coffee time , I think
62:34 , really , Unless they're really , really pressing questions
62:36 . So , um so I think , first of
62:38 all , just to thank you very much for a
62:40 really enlightening and beautifully flowing presentation , which I think
62:45 is just , you know , uh , been excellent
62:47 , uh , for us as clinicians . And to
62:50 think about in terms of the evolutionary background to these
62:53 conditions , choosing my words carefully there , Um So
62:58 thank you very much .


First Symposium of the Evolutionary Psychiatry Special Interest Group of the Royal College of Psychiatrists, Oct 4th 2016 in London. Lecture by Professor Simon Baron-Cohen from Cambridge University Autism Research Centre.


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