HYPER-SYSTEMIZING THEORY IN PARENTS OF CHILDREN WITH AUTISTIC SPECTRUM DISORDER
Introducere:Sistematizarea este abilitatea de a înțelege regulile unui sistem și necesită competențe deductive și analitice. Empatia se referă la înțelegerea emoțiilor și a comportamentului uman și necesită abilități sociale și de comunicare. Conform teoriei hipersistematizării (propusă de Baron-Cohen) cu toții avem un mecanism de sistematizare (SM) care este setat la diferite persoane la diferite nivele. Părinții copiilor cu tulburări de spectru autist au un nivel al SM setat între cel al persoanelor cu Tulburare Asperger și cel al bărbaților cu dezvoltare tipică. Conform teoriei lui Baron-Cohen autismul poate fi rezultatul genetic a doi părinți cu un nivel ridicat de sistematizare și un nivel scăzut de empatizare (mariaj asortativ). Obiective: confirmarea diferențelor între sexe pe baza scorurilor SQ (coeficient de sistematizare) și EQ (coeficient de empatizare); confirmarea diferențelor dintre părinții copiilor cu autism și cei ai copiilor cu dezvoltare tipică folosind SQ si QE; investigarea relației între SQ, EQ și ASQ (Adult Autism Spectrum Quotient) atât în lotul cu TSA (Tulburare de spectru autist) cât și în lotul de control. Metoda: am evaluat cu ajutorul ASQ, SQ și EQ un lot de 50 de cupluri (mame și tați ai copiilor diagnosticați cu TSA în Clinica de Psihiatrie a Copilului și Adolescentului, Spitalul Clinic de Psihiatrie Prof. Dr. Al. Obregia) și un lot de control: 50 de cupluri, părinți ai copiilor cu dezvoltare tipică din populația generală. SPSS 16.0 a fost utilizat pentru analiza statistică a datelor. Rezultate: există o diferență statistică semnificativă între scorurile EQ și SQ obținute de mame și tați în ambele loturi. Nu există o diferență semnificativă statistic între scorurile SQ și EQ între cele două loturi. Există o corelație moderată negativă între EQ și ASQ atât la mame cât și la tați în grupul TSA. Concluzii: autismul poate fi rezultatul genetic a doi părinți hipersistematizați (mariaj asortativ). Conform teoriei hipersistematizării, femeile au scoruri EQ mai mari, în timp ce bărbații au scoruri SQ mai mari. Faptul că scorurile EQ și SQ pot fi corelate cu trăsăturile de spectru autist sugerează că sistematizarea și empatia pot fi corelate.
Autism spectrum disorders (ASD) are a group of pervasive neurodevelopmental disorders characterized by: impaired communication, impaired social interaction, restricted and repetitive interests and behaviours. ASDs include the three diagnoses: autistic disorder, Asperger’s disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS). The degree of impairment among individuals with ASD is variable (1; 2).
Autistic traits are found not only at a high level in people with such diagnoses but are also found on a continuum at lower levels throughout the population (Wheelwright et al, 2006). This continuum is revealed using a second instrument, the Autism Spectrum Quotient (AQ), which measures such individual differences (3).
Systemizing (SM) is the ability to understand and derive the rules of a system, and requires deductive and analytical skills. Systemizing allows a search for structure (patterns, rules, regularities, periodicity) in informations. The goal of systemizing is to test if the changing data is part of a system (4). When we systemize we are trying to identify the rules that govern the system, in order to predict how that system will behave (5).
A system is working with precise rules. Some examples of systems are:
-mechanical systems (e.g., a video-recorder),
-umerical systems (e.g., a bus timetable),
-abstract systems (e.g., mathematics),
-natural(e.g., a leaf),
-collectible (e.g., a collection),
-social systems (e.g., a management hierarchy, the rules of etiquette).
In all these cases, we systemize by noting regularities (or structure) and rules. When we systemizing the observations are recorded in a standardized manner (5).
Systemizing allows the brain to predict that event “E” will occur with probability “P”. In this case the brain will identify the laws driving the system. Some systems are
100% lawful (e.g. a mathematical formula). These systems that are 100% lawful have zero (or minimal) variance, and can therefore be predicted and controlled
100%. A computer might be an example of a 90% lawful system: there is a variance because the operating system may work differently depending on the software. Social relationships are the least governed by laws (4).
According to Baron-Cohen there are 8 levels of systemizing (SM).
Levels 1 to 4 are found usually in the general population. Level 1 corresponds to individuals who have little or no interest or drive to systemize. These people have the talent to socialize easily, a lack of precision over details, and can easily cope with change (6).
Level 2 might show typical female interests (e.g. emotions) and those with an SM at Level 3 typical male interests (e.g. maps, mechanisms) (6;7).
Level 4 corresponds to individuals who systemize at a higher level than average. We would expect from a person who systemize at level 4 to be talented at understanding systems with moderate variance (e.g. engineering).
According to Baron-Cohen theory above average systemizers have more autistic traits (4). Scientists have scored higher than nonscientists on the Autism Spectrum Quotient (AQ) and mathematicians (who by definition focus on abstract systems) of all the sciences score the highest on the AQ (3). Another example of people who are above average systemizers is parents of children with autism spectrum conditions (8; 9). The genetic implications of this is very important. Boltin (1996 ) quoted by Baron-Cohen (2006) considered that these parents as having the ”broader phenotype” of autism (4). People on the autistic spectrum have their SM set at levels above those in the general population: from Level 5 to Level 8.
Level 5 corresponds to Asperger Syndrome; the people diagnosed with Asperger Syndrome can easily systemize totally lawful systems (those that are 100% lawful, such as bus timetables, historical chronologies) or highly lawful systems (e.g., computers) and could be interested in moderately lawful system like weather. People with AS score higher than average on the Systemizing Quotient (SQ) and can achieve extremely high levels in systemizing domains such as mathematics, physics, or computer science. They have an “exact mind” when it comes to art and show superior attention to detail (4).
In people with high-functioning autism the SM is set at Level 6, in those with medium functioning autism, it is at Level 7, and in low-functioning autism the SM reaches the maximum degree (Level 8).
A person who systemize at Level 6 would be able to deal with systems that were less lawful (e.g., at least 80%). Clinically they present mild language delay, mild repetitive behaviour, mild delay in theory of mind, and stilted social behavior (they attempt to systemize social behavior). In social relation they use systemizing to mentalize and perform above average on sequences that contain temporal or physical–causal information (4).
If the SM is set at Level 7, the person would be able to deal with systems that were less than 100% lawful, but still highly lawful (at least 90%). The child with medium functioning present moderate language delay, his mindblindness is less than total and have a little more ability to generalize than someone with classic autism (4).
At level 8, the higher level of the SM and the low- functioning group, the person can not generalize, he tries to identify laws that may apply to the system (4).
According to Davis (1994), quoted by Baron- Cohen (2008) “empathizing refers to the ability to identify another person’s emotions and thoughts and to respond to these with an appropriate emotion “. Empathizing is defined as the drive to identify another person’s emotions and thoughts, and to respond to these with an appropriate emotion (6).
There are two “fractions” to empathy: a cognitive component (overlapping with what is also called “Theory of Mind” or mind reading), and an affective component (responding emotionally to another’s mental state).
Empathizing is a set of skills, relates to understanding human emotion and behaviour and requires social and communication skills. There are individual differences in empathy. Thereby women are better at decoding nonverbal communication, picking up subtle nuances from tone of voice or facial expression, or judging a person’s emotional state than men. Questionnaires measuring empathy typically find that women score higher than men (10).
THE HYPER-SYSTEMIZING THEORY
The hyper-systemizing theory (proposed by Baron-Cohen) assume that we all have a systemizing mechanism (SM), and this is set at different levels in different individuals. A high systemizer searches all data for patterns and regularities. When SM is set at a medium level the peoples can systemize some, but not all of the time and for some peoples SM is set so low and they would hardly notice if regularity or structure was in the input or not (4). Genes and other biological factors (possibly fetal testosterone) turn this mechanism up or down (11).
“According to the empathizing–systemizing (E- S) theory, autism and Asperger syndrome are best explained not just with reference to empathy (below average) but also with reference to a second psychological factor (systemizing), which is either average or even above average. So it is the discrepancy between E and S that determines if you are likely to develop an autism spectrum condition.” (4).
This theory explains why people with autism prefer either no change, or systems which change in highly lawful or predictable ways (e.g. mathematics, repetition, objects that spin, routine, music, machines, collections) and why they become disabled when faced with systems characterized by ‘complex’ change (such as social behaviour, conversation, people’s emotions, or fiction). According with Baron-Cohen this theory can explain the core of autism: both a social deficit and the what Kanner named “need for sameness” (4).
There are four strengths of E-S theory according to Baron-Cohen:
1.The E-S theory can explain both social and nonsocial features in autism spectrum conditions. Below average empathy explain the social and communication difficulties, and average or even above average systemizing explain the narrow interests, repetitive behaviour, and resistance to change/need for sameness (5
2.The E-S theory explains the profile of autism spectrum conditions: the dissociation between empathy (set to low) and systemizing (set to high);
3.The E-S theory can explain the inability to “generalize” in autism spectrum condition; the autistic person is trying to understand each system as unique (5);
4.From E-S theory new methods of intervention can be developed: for example, using the systemizing to teach empathy (12).
The main objectives of this research are
-To confirm gender differences reported using the SQ and EQ
-To confirm the differences between parents of autistic children and parents of children with typical development using SQ and EQ
-To investigate the relationship between the EQ, SQ and AQ in both a typical and an ASC sample.
We evaluated using AQ (Adult Autism Spectrum
Quotient), SQ (Systemizing Quotient) and EQ (Empathy
Quotient) a sample of 50 couples (mothers and fathers of children diagnosed with ASD). Their children were diagnosed with ASD in Child and Adolescent Psychiatry Department, „Prof. Dr. Al. Obregia” Hospital of Psychiatry, Bucharest Romania. Children were diagnosed after DSM IV-TR criteria for autism and using ADOS (Autism Diagnosed Observational Scheduled). All children had an ADOS score over 8 (suggestive for ASD).
The parents sample was compared with a control sample: 50 couples, parents of children with typical development from general population.
The Adult AQ (Autism Spectrum Quotient) is a questionnaire developed by ARC (Autism Research Centre, Cambridge) published in 2001 by Simon Baron- Cohen. Consisting of fifty questions; it aims to investigate whether adults of average intelligence have symptoms of Autistic Spectrum Disorder. ARC’s studies have shown that people with a clinical diagnosis tend to score above 32 out of 50 on the AQ, first-degree relatives tend to score higher than average on the AQ, males in the general population tend to score higher than females, and scientists tend to score higher than non-scientists on the AQ (13). AQ is a useful tool for assessing autism phenotypes in non-clinical samples (14).
The Systemizing Quotient (SQ) consisting of 60 questions gives a score based on how interested you assess yourself to be in each of the following forms of systemizing. According to SQ scores we obtain 4 categories: L (Low), A (Average), AA (Above average), H (High) (13).
The Empathy Quotient (EQ) consisting of 40 questions is intended to measure how easily you pick up on other people’s feelings and how strongly you are affected by other people’s feelings. According to EQ scores we obtained 4 categories: L (Low), A (Average), AA (Above average), VH (Very High) (13).
The statistical software package SPSS 16.0 has been used to conduct data analysis. We performed descriptive statistics (measures of central tendency, measures of variability), Pearson’s chi-squared test, Pearson product-moment correlation and inferential parametric test for significance (i.e. Student’s t-test).
RESULTS EQ scores
Both in mothers and fathers, there is no statistically significant difference between ASD and control groups regarding the frequency of occurrence of different EQ categories. (χ2mothers= 5.96, p= 0.11; χ2fathers= 5.44, p= 0.14)
(Figure 1; Figure 2).
Figure 1. EQ categories in fathers – comparison between
Control and ASD groups
Figure 2. EQ categories in mothers – comparison between
Control an ASD groups
There is a statistically significant difference between EQ total scores of mothers and fathers, in both groups with mothers scoring considerably higher than fathers (Table 1).
-Control group: mean EQmothers = 41.21; mean EQfathers= 36.04 (t= 2.148, p= 0.034) -ASD group: mean EQmothers = 45.07; mean EQfathers= 40.00 (t= 2.34. p= 0.021)
Figure 3 displays the comparison between EQ scores of mothers in both groups (Control and ASD) as well as in fathers. There is no evidence of statistically significant differences regarding EQ scores neither in mothers (t= 1.723, p= 0.088) nor in fathers (t= 1.732, p= 0.086).
Table 1. Differences in EQ total scores between mothers and fathers in Control (1) and ASD (2) groups
Figure 3. EQ scores –comparative distribution
In fathers, there is a statistically significant difference (χ2fathers= 9.411, p= 0.024) between ASD and
Control groups regarding the frequency of occurrence of different SQ categories, with higher A (average) and AA (above average) rates in the Control group and higher H (High) rates in the ASD group (Figure 4).
The same analysis in mothers shows no statistically significant difference between ASD and Control groups (χ2mothers= 1.995, p= 0.573;) (Figure 5).
There is a statistically significant difference between SQ total scores of mothers and fathers, in both groups with fathers scoring considerably higher than mothers (Table 2).
-Control group: mean SQmothers = 28.73; mean SQfathers= 36.88 (t= 4.180, p= 0.000)
-ASD group: mean SQmothers = 26.69; mean SQfathers= 35.27 (t= 3.58. p= 0.001)
Figure 4. SQ categories in fathers – comparison between
Control and ASD groups
Figure 6 shows the comparison between SQ scores of mothers in both groups (Control and ASD) as well as in fathers. There is no evidence of statistically significant differences regarding SQ scores neither in mothers (t=0.937, p= 0.351) nor in fathers (t=0.733, p=0.465).
Table 2. Differences in SQ total scores between mothers and fathers in Control (1) and ASD (2) groups
The same pattern of correlation (moderate, negative correlation) was found between EQ and ASQ scores in mothers from the ASD group (r= -0.573, p=
According to Baron-Cohen theory, females score higher on average on EQ and males score higher on average on SQ (6). In our study, we found a statistically significant difference between EQ total scores of mothers and fathers, in both groups with mothers scoring considerably higher than fathers. Also, we found a statistically significant difference between SQ total scores of mothers and fathers, in both groups with fathers scoring considerably higher than mothers. These results are consistent with literature data according to which males are more systemize than females.
Because there are some clear sex differences in empathizing (females performing better on many such tests) and in systemizing (males performing better on tests of this) the E-S theory has been extended into the extreme male brain theory of autism (EMB). EMB theory was proposed also by Baron-Cohen (2002) (15). According to this theory the Autism and Asperger Syndrome can be seen as an extreme of the typical male profile (5).
Baron-Cohen described using E-S theory and EMB theory five different “brain types”:
-Type E (E > S): empathy is stronger than systemizing;
-Type S (S > E): systemizing is stronger than empathy;
-Type B (balanced) (S = E):empathy is as good (or as bad) as systemizing;
-Extreme Type E (E >>S): empathy is above average, systemizing is below average;
-Extreme Type S (S >> E): systemizing is above average, empathy is below average (5).
According with E-S model more females have a brain of Type E, and more males have a brain of Type S. People with autism spectrum conditions, if they are an extreme of the male brain, are predicted to be more likely to have a brain of Extreme Type S (5).
There is evidence for systemizing being part of the genetic mechanism for autism:
-fathers and grandfathers (both maternal and paternal) of children with autism are twice as likely to work in the occupation of engineering compared to men in the general population (8);
-students in the natural sciences (engineering, mathematics, physics) have a higher number of relatives with autism than do students in the humanities (16).
From Baron-Cohen point of view, if systemizing talent is genetic, such genes appear to co-segregate with genes for autism. Parents of children with autism spectrum conditions have their SM set mid-way between people with Asperger Syndrome and typical males. Both mothers and fathers of children with ASD have been found to be strong in systemizing on the Embedded Figures Test. Also both mothers and fathers of children with ASD have elevated rates of systemizing occupations among their fathers. Mothers of children with autism show hyper- masculinized patterns of brain activity during a systemizing task. All this evidence can suggest that both parents may be contributing to ASD with their systemizing genotypes (4;8).
According with Baron-Cohen’s theory autism could be the genetic result of two parents with a high systemizing quotient and a low empathy quotient (assortative mating) (4).
In our study, we didn’t find any evidence of statistically significant differences regarding SQ scores and EQ scores neither in mothers nor in fathers between groups (Control and ASD).These results are not consistent with literature data according to which parents of autistic children systemize at a higher level than average. A possible cause for this discrepancy with the literature may be the relatively small number of subjects included in our research.
In their study Wheelwright et al (2006) founded a strong negative correlation between the ASQ and EQ, and a moderate positive correlation between the ASQ and SQ both in ASD group and control. In authors’ opinion the fact that the number of autistic traits an individual possesses can be predicted in terms of their empathizing and systemizing scores suggests that empathizing and systemizing may be linked in important ways (17).
In our research, we found a moderate-strong, negative correlation between EQ and ASQ scores in fathers of ASD group. Moreover, there is a moderate-strong, negative correlation between EQ and ASQ scores in mothers from the ASD group. These results are in concordance with data from literature and confirm that autistic traits correlate with low empathizing scores.
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