Autistic expressions

The teenage boy sat in a chair wearing a most unusual baseball cap. Mounted on the hat was a small video camera, which angled downwards over the bill and pointed directly at his left eye. The camera tracked eye movements as the teen watched an old 1960s movie starring Richard Burton and Elizabeth Taylor—Who’s Afraid of Virginia Woolf?

But something was different about this boy as he watched the onscreen drama unfold. The eye-tracking equipment told the story: this boy was watching the actors’ mouths or sometimes zeroing in on objects in the background, but he wasn’t focusing on the actors’ eyes, as most people do.

That’s because this teenage boy was autistic—a developmental disorder that severely impairs social interactions, including eye-to-eye contact. The study, the first of its kind, was conducted by Fred Volkmar (BS, '72, psychology), professor of child psychiatry at Yale University and an internationally recognized expert on autism and related disorders. He is also the winner of a 2009 LAS Alumni Achievement Award.

Volkmar grew up in southern Illinois in the small village of Sorento, and received his BS in psychology from the University of Illinois in 1972. At U of I, he was one of the first undergraduates to work with William Greenough, a professor acclaimed for his work in brain development.

By the time Volkmar finished his undergraduate degree at Illinois, he had published or collected the data for seven papers, all of which appeared in journals—an astonishing record for an undergrad. His first paper, published in the prestigious journal Science, earned Volkmar the Psi Chi national prize for undergraduate research.

At U of I, Volkmar was also exposed for the first time to the issue of autism; and it was an Illinois professor who suggested he pursue child psychology. So Volkmar went to medical school at Stanford University, where he studied psychiatry and spent some time in a school for autistic children, inspiring his life’s work.

Since going to Yale in 1982, he has become an expert in the field of autism. In 1994, he even served as the primary author of the official medical definition of autism, which can still be found in the Diagnostic and Statistical Manual of Mental Disorders. To establish the official diagnosis, Volkmar coordinated more than 100 clinicians as they studied about 1,000 cases from 20 different sites.

“Autism is characterized by severe problems in social interaction and communication, as well as by unusual mannerisms, such as body rocking or finger flicks,” he says. “It can also take the form of obsessive interest in unusual subjects, such as deep-fat fryers, telegraph pole insulators, brick manufacturing, or elevators.”

Clinicians now know that autism is a genetic, brain-based disorder, thanks in part to the work done by Volkmar. What’s more, autism is significantly more common among boys, with symptoms typically showing up before age three.

Volkmar has studied the brain activity of autistic children, and he found that when they look at faces, they do not use the fusiform gyra, the part of the brain typically triggered when a person looks at a face. Instead, autistic children use the part of the brain that most people use to look at objects.

“This tells us that the wiring is fundamentally different,” Volkmar says. “Faces don’t have the same specialness to them,” which explains why autistic children have difficulty picking up visual clues from people’s faces, hampering their social interaction.

Volkmar’s eye-tracking research tells a similar story. Other researchers had tracked the eye movements of autistic children as they looked at static images, and they found no difference between autistic and other children. It wasn’t until Volkmar’s team tracked eye movements while children watched moving images that the truth came out: autistic children focus on objects and people’s mouths instead of eyes.

“About 90 percent of the important information in a social interaction comes from looking at the top half of a person’s face,” he says. “But when these children only look at the mouth, they miss out on a very substantial body of information. We’re trying to disentangle how these processes get so disrupted early in life.”

Volkmar also does research on related disorders, such as Asperger syndrome. Children with this syndrome share similarities with autistic children, but have much greater verbal skills. For instance, he recalls working with an 8-year-old boy who had the verbal ability of a 12-year-old, but his nonverbal, problem-solving skills were a little below an 8-year-old, and his social skills were that of a 2-and-a-half-year-old.

Children with autism and Asperger syndrome have come a long way, he says, with many more going to college and more families seeking specialized help. To assist families along the way, Volkmar has written numerous books, including his most recent—A Practical Guide to Autism: What Every Parent, Family Member, and Teacher Needs to Know.

Since 2006, he has also been director of the Yale Child Study Center, an institution that is just two years shy of its 100th anniversary. This interdisciplinary center in the School of Medicine draws people from psychology, psychiatry, pediatrics, neurobiology, epidemiology, nursing, speech and language, and genetics to study all kinds of issues, including obsessive-compulsive disorders, Tourette syndrome, and autism.

“The exciting thing right now is that we’re on the threshold of being able to identify the genes behind autism,” Volkmar says. “Once we are able to look at how the genes are expressed in the brain, hopefully we’ll be able to develop new treatments. It’s a very exciting time to be in autism research.”