TUCSON—Autism has been described as a different way of making sense of the world. Marked by impaired communication and social interaction skills, autism presents a constant challenge to everyday functioning for both children and adults with the disorder. To compensate, many rely on the art of visual thinking, as their imagination translates spoken and written words into full-color movies with sound.

Thinking in pictures has helped Temple Grandin, PhD, excel in areas where others may not. Diagnosed with autism as a child, she has written and spoken extensively on her experience and insights. As an Associate Professor of Animal Science at Colorado State University in Fort Collins, she has applied many of those same insights toward learning and teaching animal behavior, as well as designing livestock facilities for leading corporations in the meatpacking industry.

"My mind works like Google images," said Dr. Grandin at the 18th Annual Meeting of the American Neuropsychiatric Association. "the more information that I get and I put into my mind, the more Web pages I have in my mind to search."

An early example of visual thinking that Dr. Grandin described was walking out onto a rooftop through an open door to look at the stars, which symbolized thinking about the future. “Now why did I have to have this door?” she asked. “Because without a visual image, I couldn’t think. Now today, I have enough information loaded into my mind of all the experiences that I’ve had that allow me to search the inside of my head and bring up these different Web pages.”

Visual thinking is not akin to hallucination, she pointed out. "I'm not imagining that there is something out there, like a lion is going to come and get me. When I design equipment, I can actually test run the equipment in my head."

ANIMALS AND AUTISM

Dr. Grandin has been working with animals for more than three decades. She has designed livestock-handling facilities and worked as a consultant for Swift and Company, McDonald’s Corporation, Burger King, and Wendy’s, in addition to other companies throughout the world. Being autistic, she says, has helped her in those endeavors. The reason: “My thinking processes are like an animal’s,” she said. “We both think by making visual associations.”

Understanding animals requires thinking in ways other than with the use of language, according to Dr. Grandin, who believes that people with autism and animals share a number of similarities along those lines. While she uses pictures, animals also think with sensory-based memories, through visualization, smell, and hearing. Dr. Grandin has also theorized that animals share some of the same savant skills as people with autism—for example, people who can memorize long lists of names and statistics, birds with exceptional migratory skills, and squirrels that recall where they have buried hundreds of acorns.

Another common bond is fear, the primary underlying emotion in people with autism and in animals, according to Dr. Grandin. People with autism fear social situations, and for prey animals in particular, fear provides the motivation to flee from a predator. Both animals and autistic persons are fearful of, or are at least hypersensitive to, details such as bright light, loud and high-pitched sounds, sudden movement, and objects that seem out of place.

Fear memories in animals are difficult and often impossible to erase. One example that Dr. Grandin has encountered and identified was a horse afraid of black hats after being abused by someone who wore a black hat. The horse was not afraid of a white cowboy hat, but a black cowboy hat had to be placed on the ground before the horse would move near it. He was afraid of the hat only when it was on someone’s head. “[The association] is very specific,” said Dr. Grandin. “A dog will become afraid of the road where he was hit by a car sometimes, rather than by the car, because that is what he was looking at when he got hit by the car.” Also, while training animals to tolerate human interaction at a zoo, she found that chimpanzees were afraid of burlap cloth, because they had been captured in burlap bags when they were young. “If you put burlap in [their cage], they would bury it under the straw,” she said. In addition, “all dogs know the voice of a good person and a bad person.”

Before designing her first cattle-handling system, Dr. Grandin visited a number of different facilities so as to add many pictures and examples in her mind. “I put all the good stuff that worked in one category and the bad stuff in another category,” she said. “I had to learn a whole lot of specific examples of what was out there before I could build something new.”

The ability to think in smaller visual details has helped Dr. Grandin in that effort. After visiting a number of feed yards, she observed that cattle frequently did not want to enter into chutes or other areas if shadows and people were present at the other end. She reasoned that cattle would respond better in a facility with curved lanes because of the animals’ innate circling behavior. “Cattle have a natural behavior to want to go back to where they came from,” she said. She has since developed and incorporated the curved-lane design at many plants.

One company that she was working for was going to tear down its entire facility because cattle would not enter a particular building. The reason, she pinpointed, was that the cattle were spooked by a flag waving from a nearby flagpole. “Little visual details that [people] don’t tend to notice, they notice,” she said. “Everybody assumes that cattle are going to be afraid of getting slaughtered. They are more scared of things like high contrast of light and dark and rapid movement.”

Dr. Grandin has also helped to create and implement animal welfare guidelines throughout the industry. The issue has been one of her leading causes, as many high-functioning people with autism have a strong sense of social justice, she noted. “I’m going to get concerned about things that I can picture,” she said. “I am very concerned about physical suffering.

“In the mid-1980s, the meat plants were a mess. They did a lot of things to animals that were really bad. I’ve worked on implementing McDonald’s animal welfare program, and it has resulted in huge changes, big improvements.” Focusing on details has helped in that regard as well. “I find that the normal mind tends to get too vague,” she said. “I’m constantly going through guidelines, and [other people] are writing, ‘Handle them properly, or give them sufficient space.’ What is sufficient space? What is proper handling?”

In response, Dr. Grandin devised a numerical scoring system to assess proper handling of cattle and pigs at meat plants. “Animals fall down, for example,” she said. “It could be due to rough handling. It could be slippery floors. Instead of telling [company officials] how to fix the floor, I’m going to measure the outcome, which is falling down. The scoring system has worked beyond my wildest dreams. It is used at every plant in the country.”

CONSCIOUSNESS WITHOUT LANGUAGE?

Whether, or how, animals think has been a source of debate. Dr. Grandin favors the view of Professor Marian Stamp Dawkins from the University of Oxford in the United Kingdom, who defined thinking in animals as solving a problem under new conditions. “She defined it by what it is not,” noted Dr. Grandin. “It is not operant or classical conditioning, and it is not hard-wired instinctual behavior…. The killing bite in cats and dogs is hard wired. What they direct it at is learned, but that little program is instinctual.

“On a sensory basis, I think the orienting response is the beginning of thinking, because it is not a reflex. You’ve all seen a deer hear something and [freeze]. When he is [freezing], he can make a decision: Do I chase, flee, or keep on grazing or doing whatever I’m doing?… A decision is being made. It’s not just a reflex. That’s the beginning of consciousness. There is a lot of discussion about what consciousness is. Some philosophers think that if you don’t have language, you are not truly conscious. I have language, but language narrates the videos in my mind.”

THE AUTISTIC BRAIN

Recent studies have shed light on why many people with autism are adept at visual thought. Using fMRI, Kana et al analyzed functional connectivity among cortical regions of the brain and found that the language and spatial centers in people with autism were not as well synchronized as those in controls. In addition, in people with autism, the brain regions typically associated with visual tasks were also active during language-related tasks. Furthermore, Hardan et al found that greater cortical thickness may contribute to the increased gray matter volume and total brain size that have been observed in patients with autism and that it may also be related to anomalies in cortical connectivity.

Children with autism frequently demonstrate drawing ability at an early age, and similar talent has been shown in others who lack verbal skills as well. In patients with frontotemporal dementia, Miller et al found that loss of function in the anterior temporal lobes led to the facilitation of artistic skills. The patients’ drawings “looked like autistic savant art,” said Dr. Grandin. “But they are from patients with frontotemporal dementia who had no previous interest in art. As their language parts got wrecked, their [artistic] talents came out. Language is covering up the more sensory-based kind of thinking.”

Autism is the most common of five disorders within the pervasive developmental disorders category, which also includes Asperger’s syndrome, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. Although people with autism share common general characteristics, each person is affected differently and in varying degrees, and not all are visual thinkers.

Dr. Grandin has observed and distinguished two other types of specialized brains in high-functioning people with autism and Asperger’s syndrome. The pattern thinker, she said, excels in music, math, and computer programming. An example of a pattern thinker may be Vincent van Gogh, as physicists recently determined that the swirling patterns in some of his paintings, including “Starry Night,” fit the mathematical structure of turbulence observed in water or in air from a jet engine. “I don’t think that van Gogh could go and do anything about water turbulence, but somehow it just got drawn in there,” commented Dr. Grandin. Another type of specialist mind, she said, is the verbal logic thinker, who thinks in word details and is good at language and history. Those who are believed to have had autism or Asperger’s syndrome traits include Einstein, Socrates, Mozart, Jane Austen, Charles Darwin, Isaac Newton, Marie Curie, W. B. Yeats, and Andy Warhol.

BOTTOM-UP THINKING

People with autism form concepts in a different manner than others. For the autistic individual, details are assigned to categories, which then are used to form a larger concept. “I take lots of little details, and I put them together to form a whole,” said Dr. Grandin. “It’s bottom-up thinking. It’s like putting together the pieces of a puzzle. For most people, it is top-down thinking.”

Forming concepts is also a sensory-based, as opposed to word-based, process for people with autism. “There’s been some interesting research with animals, showing that the sensory parts of the brain are set up to put information into file folders, just like you do on a computer,” noted Dr. Grandin. “It goes in this file or that file, and there are times when you have to open a new file. People with autism sometimes have a hard time opening a new file.”

Children with autism learn by example, and they should be taught early about concepts such as learning right from wrong, sharing, and taking turns, emphasized Dr. Grandin. “You have to teach a concept, especially to a nonverbal person with autism, in the same way you teach a guide dog about intersections,” she said. “[The dog] learns the intersection concept by being shown many different intersections—ones with lines, lights, stop signs, curbs, and dirt ones that don’t have any curbs. If you only showed him ones with white lines, then he wouldn’t know what to do if he went to an intersection that had no white lines. Well, we teach right and wrong the same way. I learned things like traffic danger after my nanny took me out and showed a dead, squashed squirrel to me. Then I understood what would happen if a car hit me.”

Although autistic children learn primarily through scripting and memorization in the beginning, their thinking process changes in time, noted Dr. Grandin. “Kids would tease me and call me ‘tape recorder,’ because I would tend to always say the same thing all the time,” she said. “But after you learn more and more experiences, the Google of your mind has more things to search.... I’ve got some Web pages that I’m not very proud of, but I don’t do those things. My frontal cortex goes, ‘No, no, you’re not going to do this.’ But basically, I’m thinking with the part of the brain that most people would consider subconscious.”

SENSORY OVERLOAD AND ANXIETY

Sensory issues can be debilitating for people with autism and can make staying in school and holding a job impossible. “We’ve got to address these,” said Dr. Grandin. “There needs to be a lot more research.” Distractions like flickering lights “make it so that people can’t do regular jobs—fluorescent lights flashing on and off like a discotheque. For me, my big problem was sound sensitivity. When the school bell went off, it hurt my ears. I still have problems with scratchy clothing.”

A key issue is differentiating between bad behavior and sensory overload in children with autism, according to Dr. Grandin. “One of the ways you can screen a child for sensory problems is ask what happens at Wal-Mart,” she said. “If every time you go into Wal-Mart there is a screaming fit, that’s a tip-off that a child has very severe sensory problems.

“Sometimes I found that taking an antidepressant helped calm down my sensory problems. A lot of exercise also helped; it’s really important. Some people are helped by the gluten-free casein-free diet. The problem with autism is that it is just so variable. Sensory problems are real. These are not hallucinations.”

Dr. Grandin experienced anxiety and increasingly severe panic attacks until she began regularly taking an antidepressant in her early 30s. “I’ve been on the same low dose of an antidepressant for 30 years,” she said. “I don’t dare stop taking it…. I just want to give you a little hint about antidepressants—[use] low doses for people on the autism spectrum. I’ve had parent after parent say, ‘He did fine on one, and then they raised the dose, and he couldn’t sleep and he got all agitated.’”

Dr. Grandin advises parents to apply their autistic child’s obsessions to the child’s schoolwork. “If a child likes trains, then teach reading with trains,” she said. “Teach history with trains. You take that obsession and turn it into something constructive.” Most children with autism are “good at one thing, bad at something else,” she added. “The problem is that autism is a continuum, going all the way from science—like Einstein—down to somebody who remains nonverbal.”

Greater educational emphasis must be devoted to autistic children’s strengths instead of only to their deficits, Dr. Grandin pointed out. “I can’t emphasize enough that we’ve got to build on the talent area,” she said. “There are a lot of Asperger’s people out there. You wouldn’t have any electric lights if it were not for Nikola Tesla, who invented the power plant. Tesla today would definitely be diagnosed as autistic. Einstein didn’t have any language until age 3. You have to build on the strength area. And we wouldn’t have any Silicon Valley either without Asperger’s syndrome. When it comes to life, I am what I do. This is why I put such emphasis on careers.”

Dr. Grandin noted that she and others with autism tend to be more interested in things than in people. “But if we didn’t have people who were interested in things, you wouldn’t have any technology,” she said. “With all the medications that you use, a lot are not made by the really social people. Think about it. Did the really social people invent the first stone spear? I don’t think so.”

High-functioning people with autism and Asperger’s syndrome need mentors, stressed Dr. Grandin. However, many schools are not equipped to deal with these children. “There’s a whole world of people out there interested in techie things that a lot of educators don’t know about,” she said. “The lucky ones live in Silicon Valley and get good jobs. Unlucky ones get frustrated and bored and get in trouble with the law and have awful jobs. Mentoring saved me. I had a fantastic science teacher [as a mentor]. He gave me a reason to study.”            

—Colby Stong

Suggested Reading
Grandin T. Animals in Translation: Using the Mysteries of Autism to Decode Animal Behavior. New York: Scribner; 2006.
Grandin T. Thinking in Pictures, Expanded Edition: My Life With Autism. London: Vintage; 2006.
Hardan AY, Muddasani S, Vemulapalli M, et al. An MRI study of increased cortical thickness in autism. Am J Psychiatry. 2006;­163:  1290-1292.
Kana RK, Keller TA, Cherkassky VL, et al. Sentence comprehension in autism: thinking in pictures with decreased functional connectivity. Brain. 2006;129:2484-2493.
Miller BL, Cummings J, Mishkin F, et al. Emergence of artistic talent in frontotemporal dementia. Neurology. 1998;51:978-982.

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