0:00:04 > 0:00:06There are over half a million people
0:00:06 > 0:00:11in Britain who experience the world very differently to the rest of us.
0:00:11 > 0:00:14These are people with autism.
0:00:15 > 0:00:20A puzzling condition which, 70 years after it was first given a name,
0:00:20 > 0:00:22we still know very little about.
0:00:24 > 0:00:26My name is Uta Frith.
0:00:26 > 0:00:29I'm a psychologist and I've spent my career
0:00:29 > 0:00:33trying to unravel the mysteries of the autistic mind.
0:00:33 > 0:00:38By spending time with many different people on the autistic spectrum,
0:00:38 > 0:00:40I want to show you what a complex condition it is.
0:00:40 > 0:00:43I want you to join me as I reveal
0:00:43 > 0:00:46what I've discovered about these amazing people.
0:00:46 > 0:00:4923rd of May. CHILDREN SHOUT OUT
0:00:49 > 0:00:5116th of August 2001.
0:00:51 > 0:00:53It was a Thursday.
0:00:53 > 0:00:55Kenny, how do you do it?
0:00:55 > 0:00:58How is it possible to have this extraordinary ability?
0:00:58 > 0:01:02And how do people with autism cope with relationships?
0:01:02 > 0:01:04I don't know. Why are we together? You tell me.
0:01:04 > 0:01:08You're my...required amount of social contact.
0:01:08 > 0:01:09SHE CHUCKLES
0:01:09 > 0:01:13These fascinating people that I've met over the years
0:01:13 > 0:01:17have shown me that another kind of reality exists,
0:01:17 > 0:01:21that is full of immense challenges, mysteries...
0:01:21 > 0:01:23but also joy.
0:01:23 > 0:01:25Mum always wears blue because of the dolphin thing.
0:01:25 > 0:01:28- He thinks I'm a dolphin! Why? - You've got the dolphin smile.
0:01:28 > 0:01:31- It's the smile!- And you love fish, like dolphins.- I do love fish.
0:01:31 > 0:01:33You like us to throw you sea bass when you're in bed.
0:01:33 > 0:01:38I want to show you that by understanding their world,
0:01:38 > 0:01:41we can learn more about OUR world.
0:01:55 > 0:01:58In my quest to understand the autistic mind,
0:01:58 > 0:02:02I've spent a lifetime conducting rigorous experiments.
0:02:03 > 0:02:04OK, let's have a look.
0:02:04 > 0:02:07By comparing people with autism to the rest of us,
0:02:07 > 0:02:11we can start to see what autism really is.
0:02:13 > 0:02:16My fascination with autism began 50 years ago
0:02:16 > 0:02:18when I met some autistic children,
0:02:18 > 0:02:21while I was training to be a clinical psychologist.
0:02:23 > 0:02:27I was immediately fascinated of the paradox of how these beautiful,
0:02:27 > 0:02:30bright-eyed children could be so detached from the world.
0:02:30 > 0:02:34When I asked a question, an autistic child would repeat it
0:02:34 > 0:02:38and not answer it. And I couldn't engage them in a conversation.
0:02:38 > 0:02:42And I couldn't engage them with toys, either.
0:02:42 > 0:02:46An autistic child might rapidly complete a jigsaw puzzle
0:02:46 > 0:02:51but show absolutely no interest in a game of teddy bears' picnic.
0:02:51 > 0:02:54I passionately wanted to find out what was going on here.
0:02:57 > 0:02:59Back in the 1960s,
0:02:59 > 0:03:03these children were being given the new diagnosis of autism.
0:03:03 > 0:03:06"Autos" in Greek means "self"
0:03:06 > 0:03:09and refers to their apparent self absorption.
0:03:09 > 0:03:12Autism takes on many forms
0:03:12 > 0:03:15and exists on a wide spectrum, from mild to severe.
0:03:16 > 0:03:18It was, and still is,
0:03:18 > 0:03:21characterised by the difficulty these children have
0:03:21 > 0:03:24communicating and interacting with others
0:03:24 > 0:03:27and by and their tendency to have very narrow interests
0:03:27 > 0:03:31and to repeat activities over and over again.
0:03:34 > 0:03:37What's this, Joe? What's...
0:03:37 > 0:03:40One of these children was Joe Allison.
0:03:40 > 0:03:42- 'And this?- Bowl.
0:03:42 > 0:03:44'Bowl. And this?
0:03:44 > 0:03:46- 'Box.- Box. And this?'
0:03:48 > 0:03:50- Who is that?- Yes.
0:03:50 > 0:03:53- It's...- Joe Allison.
0:03:53 > 0:03:55It's Joe Allison learning to talk.
0:03:55 > 0:03:56Yes.
0:03:56 > 0:04:00- 'What's this, Joe?- Money.- Money.
0:04:00 > 0:04:03- 'What's this, Joe?- Money. - Yes, money.'
0:04:03 > 0:04:05Joe is now 57
0:04:05 > 0:04:09and this is the first time I've seen him since he was a young boy.
0:04:12 > 0:04:16- Do you remember her, Joe?- Yes. - She was very kind.
0:04:16 > 0:04:17What is this, Joe?
0:04:18 > 0:04:20HE MUTTERS What is it?
0:04:20 > 0:04:24- Ba-ma.- A barrow.- A bu-bbow.
0:04:28 > 0:04:30Back then, we thought that
0:04:30 > 0:04:34if only we could teach these children to speak,
0:04:34 > 0:04:37then everything would be OK and the autism would go away.
0:04:39 > 0:04:42'Joe understood about the Christmas story,
0:04:42 > 0:04:45'about Father Christmas and Christmas dinner.
0:04:45 > 0:04:48'And it's the first time we've been able to have a tree
0:04:48 > 0:04:50'and none of the ornaments have been broken.'
0:04:50 > 0:04:52- And who's this?- Mum.
0:04:52 > 0:04:55- Is it Mum?- Yes.
0:04:55 > 0:04:58- 'So now you have some hope for Joe? - I certainly do.
0:04:58 > 0:05:01'I don't know how far he will go but one feels if he's gone this far,
0:05:01 > 0:05:03'why shouldn't he go a great deal further?'
0:05:03 > 0:05:05- That's nice, isn't it?- Yes.
0:05:08 > 0:05:10'But 50 years on,
0:05:10 > 0:05:14'we now know that autism is a lifelong brain abnormality.
0:05:17 > 0:05:22'Half of those affected have significant learning disabilities
0:05:22 > 0:05:26'and well over 80% are unable to live independently.'
0:05:37 > 0:05:42When I tell people what I do, the first thing they ask about
0:05:42 > 0:05:45are the autistic individuals known as savants,
0:05:45 > 0:05:47who have remarkable gifts.
0:05:47 > 0:05:50Many people with autism have talents
0:05:50 > 0:05:53that appear to be at odds with the rest of their abilities.
0:05:57 > 0:06:01And occasionally, these skills can be quite extraordinary.
0:06:01 > 0:06:03Start with the easy one...
0:06:03 > 0:06:05and work your way down through these operations
0:06:05 > 0:06:07to get your answer at the bottom.
0:06:09 > 0:06:12This is 15-year-old Kenny Mpanga,
0:06:12 > 0:06:16who was diagnosed with autism when he was eight.
0:06:16 > 0:06:18Unlike many other autistic children,
0:06:18 > 0:06:21Kenny is able to attend a mainstream secondary school,
0:06:21 > 0:06:23with a specialist autism unit.
0:06:23 > 0:06:26Would anybody else be able to have a go using that method now,
0:06:26 > 0:06:29Kenny's method, for doing this? 24 squared.
0:06:29 > 0:06:31Watch what he did again.
0:06:31 > 0:06:34Kenny has a gift for mental arithmetic...
0:06:34 > 0:06:36How many could multiply 9 by 36 in your head, though?
0:06:36 > 0:06:39..and constantly amazes his classmates.
0:06:39 > 0:06:42- Kenny, you're too smart! - HE CHUCKLES
0:06:42 > 0:06:44You are actually too smart! You got all of them correct.
0:06:44 > 0:06:50- Why are you in this set?- Why? He's so smart! Seriously, how, how?
0:06:50 > 0:06:52- What do you do?- It's a secret?
0:06:52 > 0:06:54It's an African thing!
0:06:54 > 0:06:56THEY CHUCKLE
0:07:01 > 0:07:05And Kenny has one very unusual talent.
0:07:05 > 0:07:07- 22nd of February. - Oh, that was a Thursday.
0:07:07 > 0:07:10- 23rd of May.- It was a Wednesday.
0:07:10 > 0:07:1316th of August 2001.
0:07:13 > 0:07:14It was a Thursday.
0:07:14 > 0:07:17He's a calendrical calculator...
0:07:17 > 0:07:19That was a Saturday.
0:07:19 > 0:07:24..which means you can give him a date in the past or future
0:07:24 > 0:07:27and he'll tell you which day of the week it falls on.
0:07:27 > 0:07:29Thursday.
0:07:29 > 0:07:32- ..1936.- Er, that was a Tuesday.
0:07:34 > 0:07:37Kenny's of huge interest to psychologists,
0:07:37 > 0:07:41who want to know how he has acquired this remarkable skill
0:07:41 > 0:07:43despite his language difficulties.
0:07:44 > 0:07:47He and his mum Harriet have come to
0:07:47 > 0:07:51the Institute of Education in London, so that he can be assessed.
0:07:51 > 0:07:54Then in 1878...
0:07:54 > 0:07:59Professor Richard Cowan studies calendrical calculators, like Kenny.
0:07:59 > 0:08:02- 1889, it was a Wednesday.- Yeah.
0:08:02 > 0:08:05March the 14th 1985.
0:08:06 > 0:08:10- I would say that was a Thursday. - Absolutely right.
0:08:10 > 0:08:15And how about April the 22nd 1977?
0:08:15 > 0:08:17That was a...Friday.
0:08:17 > 0:08:18Absolutely right again.
0:08:18 > 0:08:23- And the 6th of July 1987? - That was a Monday.
0:08:23 > 0:08:25Brilliant, yeah.
0:08:25 > 0:08:27I mean, it's remarkable, isn't it?
0:08:27 > 0:08:31So you're very... It's almost like you're taking no time at all!
0:08:33 > 0:08:36I mean, do you see anything in your head?
0:08:36 > 0:08:40- I mean, do you have a mental image of the calendar or...?- No, I don't.
0:08:40 > 0:08:45- So it's just... You hear the date and you know the answer?- Yeah.
0:08:45 > 0:08:48It does blow you away sometimes, you know,
0:08:48 > 0:08:50the way he just knocks those off.
0:08:50 > 0:08:54But it can be quite an amusing party trick when, er,
0:08:54 > 0:08:58he tells people these things and they all go, "What, what, what?!"
0:08:58 > 0:09:01It is quite amusing but, er, yes, it does keep him busy.
0:09:01 > 0:09:02It's good to have a hobby.
0:09:02 > 0:09:07How did you go about working out the dates in the future?
0:09:07 > 0:09:11It all started when I was about seven or eight.
0:09:11 > 0:09:15I didn't look in any diaries or calendars. OK.
0:09:15 > 0:09:17I just, er...
0:09:17 > 0:09:19I think I just remembered that, er...
0:09:21 > 0:09:25Certain dates being a certain day
0:09:25 > 0:09:29and remembering that and, er,
0:09:29 > 0:09:32knowing that, er, every...
0:09:32 > 0:09:36Every year a day goes forward, apart from leap years.
0:09:36 > 0:09:40OK, so that's the "one year, one day" rule.
0:09:40 > 0:09:42That's when I also found out that, er,
0:09:42 > 0:09:47in one century every 28 years are the same.
0:09:47 > 0:09:51OK, so within a century every 28 years repeat.
0:09:51 > 0:09:56What's remarkable is that Kenny has identified complex patterns in the calendar,
0:09:56 > 0:10:00including the irregularities caused by leap years.
0:10:01 > 0:10:04And he works the answers out in a second.
0:10:04 > 0:10:08The 20th of December in 1994.
0:10:08 > 0:10:11- That was a Tuesday.- Yep.
0:10:11 > 0:10:14And the 3rd of August in 1980?
0:10:14 > 0:10:17- Er, that was a Sunday.- Yes, again.
0:10:17 > 0:10:21Kenny's excellent memory and his desire to practise obsessively
0:10:21 > 0:10:24are two features of the autistic mind.
0:10:24 > 0:10:28But his skill goes far beyond just memory and practice.
0:10:28 > 0:10:32He's able to spot patterns and he's devised his own system
0:10:32 > 0:10:37for coming up with the correct answers to date problems.
0:10:37 > 0:10:39This is very creative.
0:10:44 > 0:10:48Only about 10% of people with autism are as gifted as Kenny,
0:10:48 > 0:10:52but as many as a third have unexpected abilities -
0:10:52 > 0:10:55like perfect musical pitch
0:10:55 > 0:10:57and being able to recite from memory.
0:11:01 > 0:11:02Well done.
0:11:02 > 0:11:05So what does Kenny think about his autism?
0:11:05 > 0:11:10I see things in a different way than my other peers do and, er...
0:11:13 > 0:11:18And sometimes they think I'm, sort of, weird, the way I, er...
0:11:18 > 0:11:23I express my thoughts and opinions and, er,
0:11:23 > 0:11:26I guess some of my peers don't understand.
0:11:26 > 0:11:30I just... I think about things a different way.
0:11:32 > 0:11:35Can we ever discover what it is about the autistic mind
0:11:35 > 0:11:39that enables such remarkable talents to develop,
0:11:39 > 0:11:41aside from memory and practice?
0:11:43 > 0:11:45Hello, Peter.
0:11:45 > 0:11:47'I've devised a task,
0:11:47 > 0:11:50'using the popular children's game Where's Wally?,
0:11:50 > 0:11:53'to help explain the way autistic minds work.
0:11:55 > 0:11:58'The challenge is to find a tiny picture of Wally
0:11:58 > 0:12:00'in amongst this chaotic scene.
0:12:06 > 0:12:10'Peter, who doesn't have autism, struggles to find Wally.'
0:12:12 > 0:12:14Yeah, where's Wally?
0:12:14 > 0:12:16Come on, Wally, where are you?
0:12:20 > 0:12:22OK, let's have a look.
0:12:22 > 0:12:27'Paul, who is autistic, finds him really rather quickly...'
0:12:27 > 0:12:32That his archenemy. I obviously know that. And his girlfriend there!
0:12:32 > 0:12:37- Oh, there he is.- Wow! That was amazingly fast! That's amazing.
0:12:38 > 0:12:41'..whereas Peter's still trying to find Wally.
0:12:46 > 0:12:49'Next up is Chloe, who is also autistic.'
0:12:51 > 0:12:55Amazing! That was fabulously quick.
0:12:55 > 0:12:57Well done! Well done!
0:12:58 > 0:13:01'And then Laurie, who's also on the autistic spectrum.'
0:13:01 > 0:13:05That's it! That's amazing. Yeah! Amazing!
0:13:05 > 0:13:07'Peter needs some help.'
0:13:07 > 0:13:13- Do you want, er, a kind of vague clue, or not really?- Er, yes.
0:13:13 > 0:13:15A vague clue. Sort of like...
0:13:15 > 0:13:16Oh, he's up, is he?
0:13:16 > 0:13:19The boats are a good clue.
0:13:19 > 0:13:21Yes, right, OK.
0:13:21 > 0:13:23- That him?- Yeah!
0:13:23 > 0:13:26'The one thing we've noticed time and time again
0:13:26 > 0:13:31'is that autistic people see details that escape the rest of us.
0:13:32 > 0:13:35'This gives us clues to understanding the condition,
0:13:35 > 0:13:38'because it means that they often miss the bigger picture -
0:13:38 > 0:13:43'focusing instead on the details that are the same whatever context they're in.'
0:13:46 > 0:13:49And it doesn't just apply to Where's Wally? -
0:13:49 > 0:13:53it shows us how differently autistic people experience the world.
0:13:53 > 0:13:56And it explains why they get upset
0:13:56 > 0:13:59when an ornament in their house has been moved a fraction,
0:13:59 > 0:14:02and also why their interests seem so narrow.
0:14:05 > 0:14:07This intense focus on detail
0:14:07 > 0:14:10and the abilities that sometimes emerge from
0:14:10 > 0:14:13it is a strange quirk of our mind -
0:14:13 > 0:14:17and it's a quirk that's very frequent in autism.
0:14:17 > 0:14:21But it doesn't begin to tell us what autism is really like.
0:14:22 > 0:14:26Sidney, can you start it for us, sending a clap in one direction? Thank you.
0:14:30 > 0:14:33The serious problems people with autism face
0:14:33 > 0:14:37are when they have to interact and communicate with others.
0:14:39 > 0:14:43I've come to meet acting student Jules Robertson,
0:14:43 > 0:14:46who has a form of autism known as Asperger syndrome.
0:14:48 > 0:14:51People with Asperger syndrome do not have language problems
0:14:51 > 0:14:54and are of average or above-average intelligence.
0:14:57 > 0:14:59Jules has recently enrolled on a drama course
0:14:59 > 0:15:01because he wants to be an actor.
0:15:03 > 0:15:06So, Sidney, can we have you sitting on the bus?
0:15:08 > 0:15:13I join him and his mum, the novelist Kathy Lette,
0:15:13 > 0:15:18for what turns out to be an interesting and unusual conversation.
0:15:18 > 0:15:22- Jules has this idea that everybody has an animal.- Oh!
0:15:22 > 0:15:25- They have a totem animal.- Mum always wears blue because of the dolphin.
0:15:25 > 0:15:28- He thinks I'm a dolphin cos of my big...- What about me?
0:15:28 > 0:15:32- What do you think? What animal am I? - Like a flamingo. A flamingo head.
0:15:32 > 0:15:36- You've got a face like a flamingo. - Like a flamingo!- Why am I a dolphin?
0:15:36 > 0:15:39- Why?- You've got a dolphin smile. - Smile.- It's the smile!
0:15:39 > 0:15:41- And you love fish.- I do love fish! - You love sea bass.
0:15:41 > 0:15:44You like us to throw you sea bass when you're in bed.
0:15:44 > 0:15:46And I jump up and catch it!
0:15:46 > 0:15:51I just wanted to ask you, what is it like for you to have this chat here?
0:15:51 > 0:15:53Well, yeah. Having...
0:15:53 > 0:15:57I can tell you what it's like having Asperger's, as well. That's very...
0:15:57 > 0:16:00- Well, please.- So hard. Er...
0:16:00 > 0:16:05It's really hard. People don't understand how hard it is.
0:16:05 > 0:16:07They just... They just don't.
0:16:07 > 0:16:09They just expect me to be able to...
0:16:09 > 0:16:14get on with life really easily and it's not easy for me to do that.
0:16:14 > 0:16:19But is that also why it's difficult just to chat and...
0:16:19 > 0:16:25- You know, just to chat for no reason?- Yeah, it's hard to...
0:16:25 > 0:16:30- to, er...make effort with people. To be engaging with people.- Yes.
0:16:30 > 0:16:32It's really challenging.
0:16:33 > 0:16:35THEY CHUCKLE
0:16:37 > 0:16:41- Jules, do you want to go in and make...- OK.- ..Becka disappear?
0:16:41 > 0:16:44Do you like Steve Martin?
0:16:44 > 0:16:46THEY LAUGH
0:16:48 > 0:16:50What's remarkable about Jules
0:16:50 > 0:16:53is that he's able to use his acting classes
0:16:53 > 0:16:56to help him cope with the social world.
0:16:56 > 0:16:58Oh!
0:17:00 > 0:17:04You can leave any time you want, Jules. Well done!
0:17:04 > 0:17:07What we're seeing, really, here
0:17:07 > 0:17:10is a little universe of social interactions -
0:17:10 > 0:17:13little miniature scenes are being enacted.
0:17:13 > 0:17:17And we see how much reciprocity there is between these young people.
0:17:17 > 0:17:19Freeze!
0:17:21 > 0:17:23This acting class gives Jules an opportunity
0:17:23 > 0:17:29to learn about social interactions and the natural flow of everyday conversation,
0:17:29 > 0:17:33which is precisely what autistic people struggle with.
0:17:33 > 0:17:36I was one foot from the ball!
0:17:36 > 0:17:40I think that Jules really has taken advantage of this
0:17:40 > 0:17:45and he's able to learn a lot about what's going on
0:17:45 > 0:17:52in a very relaxed and playful way, that situations can be rehearsed.
0:17:52 > 0:17:54- YOU CANNOT BE SERIOUS!- Freeze!
0:17:57 > 0:17:59Dad, you need to seriously stop wearing my clothes!
0:17:59 > 0:18:01LAUGHTER
0:18:01 > 0:18:03Mom's going to freak out again!
0:18:03 > 0:18:05You remember she drove herself to drink last night!
0:18:05 > 0:18:09- Well, I am a transvestite!- No, but Mom doesn't need to know that.
0:18:09 > 0:18:10Freeze!
0:18:11 > 0:18:14Jules copes really well in his acting class
0:18:14 > 0:18:17and his lack of filter helps the other students
0:18:17 > 0:18:19to lose their inhibitions, too.
0:18:19 > 0:18:22But it's real-life social interactions
0:18:22 > 0:18:24that are the challenge for him.
0:18:24 > 0:18:28I observed you being with the other drama students
0:18:28 > 0:18:31and you seemed really happy there. Was that true?
0:18:31 > 0:18:32I was very happy there.
0:18:32 > 0:18:35I'm not so happy now but I was really happy then.
0:18:37 > 0:18:39Jules will always tell the truth.
0:18:39 > 0:18:43I used to try and explain to Jules that you couldn't always be truthful -
0:18:43 > 0:18:45you know, that you had to be more diplomatic...
0:18:45 > 0:18:48That is a problem, isn't it? Can you sometimes tell a lie?
0:18:48 > 0:18:50Is it sometimes all right to tell a lie?
0:18:51 > 0:18:55He used to say to me, "Are you teaching me to lie?"
0:18:55 > 0:18:56And it's a hard concept, isn't it?
0:18:56 > 0:18:58What do you think, Jules? Do you...
0:18:59 > 0:19:01Er...
0:19:03 > 0:19:05Er...
0:19:05 > 0:19:07No, I think it's good to tell the truth.
0:19:07 > 0:19:10So I'm always in favour of that.
0:19:10 > 0:19:12Where does it come from?
0:19:12 > 0:19:15- Why does it happen?- Autism?- Yes. - What do you think?
0:19:17 > 0:19:19- What's your explanation? - I just think...
0:19:19 > 0:19:22I just think people's brains are different.
0:19:22 > 0:19:24Yes, I think you've hit the nail on the head.
0:19:24 > 0:19:27- People's brains are different.- Yeah.
0:19:27 > 0:19:30And that's how the world is.
0:19:36 > 0:19:42Jules is so likeable and charming, and really good company.
0:19:42 > 0:19:45But it is clear that often he just does not get it.
0:19:46 > 0:19:48He dances to a different tune.
0:19:49 > 0:19:55What I've learned over the last 50 years is that not having
0:19:55 > 0:19:58a special kind of social navigation system
0:19:58 > 0:20:02is what sets autistic people apart from the rest of us.
0:20:26 > 0:20:31So why can't people with autism fully share in our social world?
0:20:31 > 0:20:36Is there an extra social sense beyond sound, sight and touch
0:20:36 > 0:20:37that they don't have?
0:20:39 > 0:20:43Here is a deceptively simple task that I helped devise in the 1980s.
0:20:47 > 0:20:50It gives some insight into how most of us who don't have autism
0:20:50 > 0:20:55instinctively understand the complex to and fro of social interactions.
0:20:55 > 0:21:00So, I'm going to tell you a little story about these two dolls.
0:21:00 > 0:21:02This one is Sally...
0:21:04 > 0:21:06..and this one is Ann.
0:21:08 > 0:21:11Sally has a basket
0:21:11 > 0:21:12and Ann has a box.
0:21:14 > 0:21:15And Sally...
0:21:17 > 0:21:22..has a marble and she's putting that marble into her basket.
0:21:22 > 0:21:23Keep it safe.
0:21:23 > 0:21:28Now Sally wants to go out to play
0:21:28 > 0:21:31and she's going right out of the room.
0:21:31 > 0:21:33Now, Ann...
0:21:35 > 0:21:36..naughty Ann...
0:21:38 > 0:21:40..takes that marble
0:21:40 > 0:21:42out of the basket...
0:21:43 > 0:21:48..and puts it into her box.
0:21:48 > 0:21:50There it is.
0:21:52 > 0:21:56Now it's time for Sally to come back...
0:21:57 > 0:22:00..and she wants to play with her marble.
0:22:03 > 0:22:05Where will Sally look for her marble?
0:22:06 > 0:22:08In her basket.
0:22:08 > 0:22:10Of course!
0:22:10 > 0:22:13- Why does she look in her basket? - Cos she put it there.
0:22:13 > 0:22:15She did, and...?
0:22:16 > 0:22:20She didn't know that the other girl took it.
0:22:20 > 0:22:22Yes.
0:22:22 > 0:22:23Why didn't she know?
0:22:23 > 0:22:28- Cos she was out.- She was outside. She didn't see it, did she?- No.
0:22:28 > 0:22:30Ha!
0:22:30 > 0:22:31Well done.
0:22:34 > 0:22:37We'd expect most normally developing four-to-five-year-olds
0:22:37 > 0:22:40to correctly identify where Sally will look for her marble
0:22:40 > 0:22:43when she returns.
0:22:43 > 0:22:47They understand that Sally has no knowledge of the marble being moved
0:22:47 > 0:22:50and so she will look for it where she put it,
0:22:50 > 0:22:52rather than where it really is.
0:22:54 > 0:22:59What this shows is that most of us instinctively know that other people
0:22:59 > 0:23:04have their separate beliefs, wishes and intentions - minds of their own.
0:23:05 > 0:23:08It turns out that this is the key to understanding other people,
0:23:08 > 0:23:13to explain why they're doing what they're doing.
0:23:13 > 0:23:18It's our extra social sense that we haven't had a name for
0:23:18 > 0:23:20but I called it "mentalising",
0:23:20 > 0:23:26because beliefs, wishes and intentions are mental states.
0:23:26 > 0:23:29Could you please hide that coin somewhere?
0:23:29 > 0:23:34All right, I shall hide it in the special pyramid box.
0:23:34 > 0:23:36- There it is.- OK.
0:23:36 > 0:23:40Back in the 1980s we discovered that autistic children
0:23:40 > 0:23:44had a very different response to Sally/Ann-type tests.
0:23:44 > 0:23:47This is ten-year-old Aurelius, who is autistic.
0:23:49 > 0:23:51I take the coin from here...
0:23:51 > 0:23:55My then colleague, Dr Alan Leslie, asks Aurelius where he thinks
0:23:55 > 0:23:58I will look for my coin after it's been moved.
0:23:58 > 0:24:01- And when Uta comes back in...- Yes.
0:24:01 > 0:24:04..where will Uta look for her coin?
0:24:04 > 0:24:06In the triangle box.
0:24:06 > 0:24:09'Aurelius says that I will look for the coin where it really is,
0:24:09 > 0:24:12'rather than where I must believe it is.
0:24:12 > 0:24:16'He doesn't understand that I can't know the coin has been moved
0:24:16 > 0:24:18'and that I now have a false belief,
0:24:18 > 0:24:23'because he doesn't take into account that I have a mind of my own
0:24:23 > 0:24:26'with beliefs and thoughts that are different to his.
0:24:26 > 0:24:31'And this is the key to understanding the social problems of autism.'
0:24:31 > 0:24:33Well, my coin is here, isn't it?
0:24:33 > 0:24:35No!
0:24:40 > 0:24:44I believe that mentalising is that extra social sense
0:24:44 > 0:24:47that most of us are born with and that makes us
0:24:47 > 0:24:51so curious to know what's in each other's minds.
0:24:51 > 0:24:57Also, it enables us to change other people's minds through persuasion
0:24:57 > 0:25:02and sometimes to manipulate other people's minds through deception.
0:25:02 > 0:25:04You won't find autistic people doing that.
0:25:04 > 0:25:09Autistic people don't have that extra social sense
0:25:09 > 0:25:13and that explains why they're often so frustrated
0:25:13 > 0:25:17when we don't know already what's in their minds.
0:25:19 > 0:25:23The challenges caused by the absence of this extra social sense
0:25:23 > 0:25:25never go away for people with autism.
0:25:31 > 0:25:34- Hello, Cathy, I'm Francesca. - Hi, nice to meet you.
0:25:34 > 0:25:38My collaborator of 20 years, Professor Francesca Happe, and I
0:25:38 > 0:25:42hit on the idea of using animated cartoons
0:25:42 > 0:25:45that give the compelling impression of social scenarios.
0:25:46 > 0:25:49Would autistic people interpret the scenarios
0:25:49 > 0:25:52in a different way from the rest of us?
0:25:55 > 0:25:58You'll see two triangles moving around, interacting on the screen,
0:25:58 > 0:26:01and I just want you to tell me what you think is going on.
0:26:01 > 0:26:03As it unfolds, let me know
0:26:03 > 0:26:06what you think's going on between the triangles.
0:26:06 > 0:26:09The actors in these movies are two little triangles
0:26:09 > 0:26:13and the challenge is to work out what the story is.
0:26:13 > 0:26:14Try it for yourself.
0:26:30 > 0:26:32Cathy is not autistic
0:26:32 > 0:26:37and she has just watched this story about persuasion unfold.
0:26:37 > 0:26:39The big triangle is trying to persuade the little triangle
0:26:39 > 0:26:42to come somewhere with him and he's trying to encourage him
0:26:42 > 0:26:43and now he's pushing him along.
0:26:43 > 0:26:46The little triangle is quite reluctant, I think.
0:26:47 > 0:26:51Oh, and he's just been barred from re-entering, hasn't he?
0:26:51 > 0:26:54These animations invite the spontaneous use
0:26:54 > 0:26:57of our extra social sense, mentalising,
0:26:57 > 0:27:01and most of us immediately get the gist of what is going on.
0:27:01 > 0:27:04It's almost like a parent pushing their kid out
0:27:04 > 0:27:08or persuading them to leave the little pen.
0:27:08 > 0:27:12Fantastic. That's lovely. OK, we've got another one now.
0:27:25 > 0:27:28The second movie was about the little triangle
0:27:28 > 0:27:30playing a game of knock and run.
0:27:30 > 0:27:32The little blue one's coming... He's knocking on the door.
0:27:33 > 0:27:36The red one's going to open the door and he's gone, hidden.
0:27:36 > 0:27:39Oh, it's like a knock-knock and then hide round the corner
0:27:39 > 0:27:43like a kid knocking and running on the front door of the house.
0:27:43 > 0:27:45Gone back inside.
0:27:45 > 0:27:47Sat down, relaxing, and the kid's knocking again.
0:27:49 > 0:27:51There we go - open the door and he's gone, yep.
0:27:53 > 0:27:56It's knock and run. Oh, he's going inside now.
0:27:58 > 0:28:01Yeah, like a child playing a trick on their mum or dad
0:28:01 > 0:28:03while they're relaxing, watching telly or something,
0:28:03 > 0:28:04they get a knock on the door
0:28:04 > 0:28:07- and then they're running round the corner.- Fantastic.
0:28:07 > 0:28:09..and I'll move you in on your chair
0:28:09 > 0:28:11so that you're just in the shot.
0:28:11 > 0:28:13Can you edge forward a little bit more..?
0:28:13 > 0:28:15When the same movie is shown to autistic people,
0:28:15 > 0:28:18they miss the point of what is going on.
0:28:18 > 0:28:21They tell a story, but it doesn't fit the action.
0:28:22 > 0:28:26Yeah, so the big, red triangle looks like it's trapped
0:28:26 > 0:28:28in the big, blue square.
0:28:28 > 0:28:31Then the small, blue triangle comes.
0:28:33 > 0:28:36It looks like he's trying to look for a way...
0:28:36 > 0:28:39He unlocked the door for the red triangle and then...
0:28:39 > 0:28:42We showed these animations to people in a brain scanner
0:28:42 > 0:28:47and found that autistic people had less activity in those brain regions
0:28:47 > 0:28:51that are now known to be dedicated to mentalising.
0:28:51 > 0:28:54I think it was a boxing ring and one of the opponents was sizing up
0:28:54 > 0:28:56the other one before he'd let him in.
0:28:56 > 0:28:58And then when they got in,
0:28:58 > 0:28:59they decided they didn't want to fight.
0:29:01 > 0:29:05It's more like an opening and closing of something
0:29:05 > 0:29:06for that one.
0:29:09 > 0:29:11I think that's it for that one.
0:29:12 > 0:29:15Ah, that's interesting - the red one's escaped.
0:29:17 > 0:29:20Oh, what's he going to do now?
0:29:20 > 0:29:24Ah, I thought that would happen. The red one's slipped back in.
0:29:24 > 0:29:27Maybe he's been taken prisoner
0:29:27 > 0:29:29by the blue triangle.
0:29:29 > 0:29:31"You will like your dungeon!"
0:29:33 > 0:29:37Oh, now they're having a bit of a barney and fighting with each other.
0:29:37 > 0:29:43When it comes to interpreting the triangles as agents,
0:29:43 > 0:29:47they really can get hold of the wrong end of the stick and then,
0:29:47 > 0:29:51of course, that leads them into a completely different kind of script.
0:29:51 > 0:29:53But it's really a wonder, isn't it,
0:29:53 > 0:29:57how we can actually agree with each other
0:29:57 > 0:30:03about our interpretations of things that are just geometric shapes?
0:30:03 > 0:30:05Yes, or particularly to think that we made up
0:30:05 > 0:30:08the scripts of those animations on the train
0:30:08 > 0:30:10and we thought, "How should they move?"
0:30:10 > 0:30:12We made them so they looked that way to us
0:30:12 > 0:30:14and when we first showed them to ordinary people,
0:30:14 > 0:30:17we had no idea whether they'd see them in the way that we'd seen them.
0:30:17 > 0:30:21It was amazing that even children as young as four or five
0:30:21 > 0:30:22could get the gist.
0:30:22 > 0:30:24We were very surprised at that.
0:30:27 > 0:30:32We seem to share a way of interpreting each other's actions,
0:30:32 > 0:30:36so imagine being autistic and not having this nifty piece
0:30:36 > 0:30:40of mental machinery that instantly tracks social interactions.
0:30:40 > 0:30:43Just watching a cartoon or listening in to a chat
0:30:43 > 0:30:45can be a baffling experience.
0:30:46 > 0:30:49You don't know why people say what they say
0:30:49 > 0:30:51and you don't get the point of jokes and banter.
0:30:51 > 0:30:54Likewise, if you don't know what's going on,
0:30:54 > 0:30:58you tend to say things that others can't comprehend.
0:30:58 > 0:31:03All this can make you anxious, frustrated and vulnerable.
0:31:06 > 0:31:09Is anyone here anxious now?
0:31:09 > 0:31:13Anybody feeling particularly anxious or worried now?
0:31:13 > 0:31:14Why not?
0:31:14 > 0:31:16Why aren't you anxious?
0:31:16 > 0:31:17You should be.
0:31:17 > 0:31:18Anxiety, really,
0:31:18 > 0:31:22is the feeling that you're probably not going to be able to cope
0:31:22 > 0:31:24with something that is about to happen,
0:31:24 > 0:31:27- something in the future... - This is Sarah Hendrickx.
0:31:27 > 0:31:31She's an accomplished public speaker on the challenges of autism.
0:31:31 > 0:31:33Anxiety is about, "I can't handle it."
0:31:33 > 0:31:37When I saw that, I thought it was a penguin.
0:31:37 > 0:31:40I didn't think it looked like a penguin.
0:31:40 > 0:31:42I thought it was a penguin.
0:31:42 > 0:31:46I thought that a penguin by the side of the road
0:31:46 > 0:31:48was possible in Brighton.
0:31:50 > 0:31:53Your world has got lampposts in it.
0:31:53 > 0:31:54Mine's got penguins.
0:31:56 > 0:32:00And she has been diagnosed with autism spectrum disorder.
0:32:00 > 0:32:03It's not all bad. It's much more interesting.
0:32:03 > 0:32:05Thank you very much for your time.
0:32:08 > 0:32:10So how can someone with autism,
0:32:10 > 0:32:12who finds social situations challenging,
0:32:12 > 0:32:16get up in front of hundreds of people to give a speech?
0:32:18 > 0:32:21This is a functional communication,
0:32:21 > 0:32:23and I'm very good at those situations.
0:32:23 > 0:32:26I'm good at doing my talks, I'm good at doing training
0:32:26 > 0:32:30because it is prescribed. The topic is prescribed, it's my topic,
0:32:30 > 0:32:31it's my script.
0:32:31 > 0:32:34It's not two-way - you have to listen,
0:32:34 > 0:32:36I've got the microphone, I've got the stage.
0:32:36 > 0:32:38It's a completely different dynamic.
0:32:40 > 0:32:42Just like Jules,
0:32:42 > 0:32:45Sarah has no problem performing in front of others.
0:32:45 > 0:32:49But off the stage, chance encounters and interactions with other people
0:32:49 > 0:32:51are unbearable for her.
0:32:52 > 0:32:56- INTERVIEWER:- What are people to you in this sort of situation?
0:32:56 > 0:32:59Frightening.
0:32:59 > 0:33:02Most people are frightening. Most people who...
0:33:03 > 0:33:06..who don't have a purpose are frightening.
0:33:06 > 0:33:07If I know who they are -
0:33:07 > 0:33:10so, the bar staff, or the people who organise the conference -
0:33:10 > 0:33:12I know who they are, they're not frightening,
0:33:12 > 0:33:16because the type of communication that we're going to have
0:33:16 > 0:33:19is pretty set, is pretty limited, is pretty inflexible
0:33:19 > 0:33:23and I can fairly well predict what that will be.
0:33:23 > 0:33:27But a completely unknown person that I either don't know
0:33:27 > 0:33:30or I fail to recognise,
0:33:30 > 0:33:32I have absolutely no idea what's coming next
0:33:32 > 0:33:35or what they're going to want or what they're going to say
0:33:35 > 0:33:39or whether I can respond appropriately quickly enough.
0:33:40 > 0:33:44Sarah is highly intelligent and is one of the rare people
0:33:44 > 0:33:49who are able to describe exactly why social situations are so baffling.
0:33:49 > 0:33:53This gives us a real insight into her condition.
0:33:53 > 0:33:57Every day I try to wake up about an hour before
0:33:57 > 0:33:59I actually need to get up
0:33:59 > 0:34:04and I spend that hour running through what's likely to happen,
0:34:04 > 0:34:08what types of people I might meet, if I'm having a meeting
0:34:08 > 0:34:11or something like that, what kind of conversation.
0:34:11 > 0:34:17I will run, re-enact a potential conversation over and over again
0:34:17 > 0:34:20before I get out of bed to try and have a kind of sense
0:34:20 > 0:34:22of what the whole day is going to be like.
0:34:24 > 0:34:29What's amazing about Sarah is that she very consciously studies
0:34:29 > 0:34:35and imitates the way people respond to each other in social situations.
0:34:35 > 0:34:39That enables her to effectively mask her autism when she's in public.
0:34:39 > 0:34:42What do I do? Do I sit here?
0:34:42 > 0:34:43Sit there.
0:34:43 > 0:34:45Sit there?
0:34:45 > 0:34:48'I've had to watch people, I've had to study people,'
0:34:48 > 0:34:53because it's not there intuitively and if I didn't do that,
0:34:53 > 0:34:55I'd be completely lost.
0:34:55 > 0:35:00But my failure rate is quite high because my learning is rote
0:35:00 > 0:35:03and therefore I'm prone to not pick up the subtleties,
0:35:03 > 0:35:04the nuances of situations,
0:35:04 > 0:35:06so although I'm trying very hard
0:35:06 > 0:35:09to apply all this stuff that I've learned,
0:35:09 > 0:35:12I do get it wrong and I get it wrong with frequency.
0:35:12 > 0:35:15And that's very, very stressful.
0:35:15 > 0:35:20So it could be that imitation is the key to Sarah's success.
0:35:21 > 0:35:23Do you like my nose?
0:35:24 > 0:35:27But there are different kinds of imitation
0:35:27 > 0:35:31and one kind might not be so easy for people with autism,
0:35:31 > 0:35:34but might be crucial to the way most of us bond with each other
0:35:34 > 0:35:37and fit into the social world.
0:35:43 > 0:35:47It can be seen in an experiment by my colleague Dr Antonia Hamilton.
0:35:47 > 0:35:51Here, children are asked to complete some simple tasks.
0:35:51 > 0:35:53- Hi, Joel.- Hi. - Thank you for coming in today.
0:35:55 > 0:35:59Here I've got a big box and hiding inside this box I've got a boat.
0:35:59 > 0:36:03First, I'll show you how I get the boat out, then you'll get a turn.
0:36:08 > 0:36:12There's my boat. It's a nice red boat, isn't it?
0:36:12 > 0:36:14I'll put that back in there.
0:36:14 > 0:36:18Ordinary children mimic exactly what their instructor has done,
0:36:18 > 0:36:20even the pointless finger tapping.
0:36:20 > 0:36:21Well done.
0:36:23 > 0:36:26- Now it's your turn. Can you get the boat out?- Yeah.
0:36:29 > 0:36:30Well done.
0:36:30 > 0:36:32TAPPING
0:36:36 > 0:36:38There's my boat. It's quite a little boat, isn't it?
0:36:38 > 0:36:41Now, autistic kids have a different approach,
0:36:41 > 0:36:44cutting straight to the chase. Can you get the boat out of the box?
0:36:47 > 0:36:48Well done.
0:36:48 > 0:36:51Now it's your turn. Can you get the boat out of the box?
0:36:53 > 0:36:55There, number three.
0:36:55 > 0:36:57Well done.
0:36:57 > 0:37:00So what does your experiment show?
0:37:00 > 0:37:04Well, it shows us that typically developing children will copy
0:37:04 > 0:37:06even actions that are silly actions
0:37:06 > 0:37:09that don't contribute toward the goal.
0:37:09 > 0:37:12We think the reason they're copying that is that they want
0:37:12 > 0:37:16to be like the adult or they want to do everything that the adult does.
0:37:16 > 0:37:19They're not just learning about how this object behaves.
0:37:19 > 0:37:23They're learning to be adult-like and to be social,
0:37:23 > 0:37:25but autistic children are more selective.
0:37:25 > 0:37:28They will do the thing that gets the goal,
0:37:28 > 0:37:32gets the boat out of the box or gets the doll out,
0:37:32 > 0:37:35but they don't bother to copy all of these extra, unnecessary things.
0:37:38 > 0:37:40Sarah is exceptional
0:37:40 > 0:37:42and has made a point of studying social scenarios
0:37:42 > 0:37:45and has learned to copy other people's behaviour.
0:37:45 > 0:37:48This has help her greatly to get on in life.
0:37:50 > 0:37:52Back at home here in Worthing,
0:37:52 > 0:37:55she's just moved in with her partner Keith,
0:37:55 > 0:37:57who is also on the autistic spectrum.
0:37:57 > 0:38:00It's the top of the tree that comes from a well-known,
0:38:00 > 0:38:04- reputable shop where everything costs...- How much?
0:38:04 > 0:38:05Just a pound!
0:38:05 > 0:38:07Is it the top decoration that goes on last?
0:38:07 > 0:38:11They're about to spend their first Christmas together in their new home.
0:38:11 > 0:38:14Or do you put that on first? Oh, you might put lights on first.
0:38:14 > 0:38:16I thought you put lights on first.
0:38:16 > 0:38:19So how can these two people forge a relationship
0:38:19 > 0:38:22when social interactions cause them crippling anxiety?
0:38:23 > 0:38:27- INTERVIEWER:- How did you find each other, meet each other?
0:38:28 > 0:38:29On the internet!
0:38:29 > 0:38:35Where all socially awkward people go to find each other.
0:38:35 > 0:38:38Was there any rush of love at any point in the early days?
0:38:41 > 0:38:43I don't really know what that means.
0:38:45 > 0:38:46Erm...
0:38:46 > 0:38:49I never expected to fall for him
0:38:49 > 0:38:51or be particularly attracted to him or anything.
0:38:51 > 0:38:54It was a really logical experiment,
0:38:54 > 0:38:58to deliberately go out with someone that I didn't fancy that much
0:38:58 > 0:39:00in order to see what it would be like
0:39:00 > 0:39:03to have a nice friendship with somebody,
0:39:03 > 0:39:05cos that wasn't my kind of history.
0:39:05 > 0:39:07What was your thinking?
0:39:07 > 0:39:09You wanted someone to have sex with.
0:39:09 > 0:39:11- Yeah, yeah.- And you were largely...
0:39:11 > 0:39:15- I think that was my initial motivating force, yes. - ..unconcerned about who that was.
0:39:15 > 0:39:18- There wasn't a huge amount of selection process.- No.
0:39:18 > 0:39:20If someone was willing, then so was I.
0:39:22 > 0:39:24So why are we together, then?
0:39:24 > 0:39:27I don't know. Why are we together? You tell me.
0:39:27 > 0:39:28You're my...
0:39:28 > 0:39:30required amount of social contact.
0:39:30 > 0:39:32SARAH LAUGHS
0:39:32 > 0:39:36- I'm your 5ml teaspoon a day? - Yes, that's it.
0:39:37 > 0:39:42Sarah and Keith constantly struggle to make sense of social activities.
0:39:42 > 0:39:46We don't do any socialising whatsoever for Christmas.
0:39:46 > 0:39:48I think you've got a Christmas works lunch
0:39:48 > 0:39:50that everybody goes to in your office.
0:39:50 > 0:39:54Doesn't even occur to me to even think about anything.
0:39:54 > 0:39:56It doesn't feel like...
0:39:56 > 0:39:58It just doesn't occur to me that we would go somewhere.
0:39:58 > 0:40:00Where would we go? What would we do?
0:40:00 > 0:40:03- What would you do?- I don't know. What do you do?- I don't know.- No.
0:40:03 > 0:40:06It wouldn't even occur to me to want to do anything like that,
0:40:06 > 0:40:08not at all. I don't miss people.
0:40:08 > 0:40:12I don't have the emotion of missing somebody when they're not there.
0:40:12 > 0:40:15I might prefer them to be with me...
0:40:16 > 0:40:19..but I don't think it's quite the same emotion
0:40:19 > 0:40:22that I understand that other people have in terms of missing people.
0:40:23 > 0:40:26And yet you two are in a close relationship.
0:40:26 > 0:40:28Yes. We are peas in a pod.
0:40:30 > 0:40:34Do you miss me when I'm not there?
0:40:34 > 0:40:36I don't think you do. I think we've talked about this before,
0:40:36 > 0:40:39- haven't we?- When I have to interact with others, then yes,
0:40:39 > 0:40:42because the interaction that I have with them
0:40:42 > 0:40:45is never as satisfying as the interaction I have with you.
0:40:46 > 0:40:48Is that "missing"?
0:40:48 > 0:40:52You've always said, "I prefer it when you're there,"
0:40:52 > 0:40:55which suggests to me a sort of absence of a...
0:40:57 > 0:41:02I think missing involves abstract imagination. It involves...
0:41:03 > 0:41:07..some kind of ability to picture
0:41:07 > 0:41:09another reality other than the one you're in at the moment
0:41:09 > 0:41:14and I don't think either of us are particularly capable at doing that.
0:41:18 > 0:41:22Sarah and Keith get on really well just the two of them
0:41:22 > 0:41:25and are committed to total honesty
0:41:25 > 0:41:27in their constant reflection and analysis.
0:41:29 > 0:41:32Although Sarah and Keith have restricted
0:41:32 > 0:41:34their contact to other people,
0:41:34 > 0:41:36they do show us that autistic people
0:41:36 > 0:41:40can have meaningful social relationships.
0:41:40 > 0:41:43It's often said that autistic people don't have empathy,
0:41:43 > 0:41:45but that is wrong.
0:41:45 > 0:41:48Sarah and Keith really care for each other.
0:41:48 > 0:41:52What they find difficult is this social navigation
0:41:52 > 0:41:54that the rest of us do automatically.
0:41:58 > 0:42:01Since diagnosis has surged in the last two decades,
0:42:01 > 0:42:05it's tempting to think of autism as a modern phenomenon.
0:42:06 > 0:42:08But is there any evidence in history
0:42:08 > 0:42:12to show that autism has been around for longer?
0:42:12 > 0:42:15Today, people talk about an autism epidemic.
0:42:15 > 0:42:18When I saw the first cases about 50 years ago,
0:42:18 > 0:42:22the estimated number was about five in 10,000.
0:42:22 > 0:42:26Today it is 100 in 10,000.
0:42:26 > 0:42:28This is a huge increase
0:42:28 > 0:42:30and yet it does not necessarily mean
0:42:30 > 0:42:33that more children with autism are born now.
0:42:34 > 0:42:39It does mean that we are much better at diagnosing autism.
0:42:39 > 0:42:41So is autism a new condition,
0:42:41 > 0:42:43or has it always been with us?
0:42:43 > 0:42:46And how would we ever find out?
0:42:51 > 0:42:54I've come to Dumfries & Galloway in the Scottish borders,
0:42:54 > 0:42:57where historian Professor Rab Houston
0:42:57 > 0:43:00has unearthed the story of a family feud
0:43:00 > 0:43:03caused by the very unusual behaviour
0:43:03 > 0:43:08of an 18th century Scottish laird called Hugh Blair.
0:43:09 > 0:43:12This is the place where Hugh Blair was born
0:43:12 > 0:43:14and where he and his family lived
0:43:14 > 0:43:16for the first half of the 18th century.
0:43:23 > 0:43:28Sometime during the 1740s, when Hugh would have been in his mid-30s,
0:43:28 > 0:43:33his brother John and his mother had a tremendous falling out.
0:43:33 > 0:43:38As a result of that, his mother cooked up a marriage -
0:43:38 > 0:43:43she arranged a marriage for Hugh with the daughter of a local surgeon
0:43:43 > 0:43:46who lived in Kirkcudbright, which is the main town quite near to here.
0:43:48 > 0:43:52John was furious, absolutely furious,
0:43:52 > 0:43:57so he took out a writ against Hugh to have his marriage annulled
0:43:57 > 0:44:00on the grounds that he didn't understand what he was doing.
0:44:01 > 0:44:04John, the younger son, would lose his inheritance
0:44:04 > 0:44:07if there were any children from this marriage.
0:44:07 > 0:44:11He needed to prove that Hugh could not be legally married
0:44:11 > 0:44:14since he was mentally incapacitated.
0:44:15 > 0:44:20It's because of this court case that we have an unprecedented insight
0:44:20 > 0:44:22into Hugh Blair's odd behaviour
0:44:22 > 0:44:26and how it relates to the modern diagnosis of autism.
0:44:28 > 0:44:31It was 5th July 1747
0:44:31 > 0:44:35when the case was brought before the Commissary Court of Edinburgh.
0:44:35 > 0:44:39260 years on, Professor Houston discovered the documents,
0:44:39 > 0:44:43which had clearly been unread since they were first written.
0:44:43 > 0:44:46Transcripts of 27 witnesses are very revealing
0:44:46 > 0:44:51about Hugh's mental condition and reminiscent of autism.
0:44:51 > 0:44:54Here, one witness mentions a strange special interest.
0:44:57 > 0:45:00It says that Hugh... "Went to all the burials about,
0:45:00 > 0:45:04"whether rich or poor, and that whether he was invited or not,
0:45:04 > 0:45:08"and this he did both before and after he was a man
0:45:08 > 0:45:10"who arrived at the age of majority."
0:45:10 > 0:45:12Oh, that's just a wonderful observation,
0:45:12 > 0:45:16because that's an example of a kind of special interest, you know?
0:45:16 > 0:45:19A special interest in something that other people
0:45:19 > 0:45:24probably would not be interested in, and for him to be able to find out
0:45:24 > 0:45:28when all these burials were taking place and then to just turn up
0:45:28 > 0:45:30and go there, regardless of who it was -
0:45:30 > 0:45:35I think that's extraordinarily reminiscent of autism.
0:45:35 > 0:45:40Perhaps the most revealing document is Hugh Blair's written testimony.
0:45:44 > 0:45:47Here he was asked questions in writing,
0:45:47 > 0:45:51because the court wondered whether perhaps he was deaf and dumb.
0:45:51 > 0:45:53So, the clerk of the court wrote out,
0:45:53 > 0:45:58"Answer the following question - what brought you to Edinburgh?"
0:45:58 > 0:46:00Hugh Blair's answer reads,
0:46:00 > 0:46:06"Answer the following question - what brought you to Edinburgh?"
0:46:06 > 0:46:09To me, it's really as clear an indication
0:46:09 > 0:46:15of what I call a mentalising failure as you could wish for.
0:46:15 > 0:46:22It's not understanding that you need to tell another person
0:46:22 > 0:46:27something that only you can tell, that they want you to tell.
0:46:27 > 0:46:30He just doesn't get that point.
0:46:32 > 0:46:36The court was convinced that Hugh was mentally incapacitated,
0:46:36 > 0:46:39and his marriage was annulled.
0:46:39 > 0:46:43The Blair estate was ruined by the costs of the court case.
0:46:47 > 0:46:52The case of Hugh Blair is by far the earliest that I would be confident
0:46:52 > 0:46:58in diagnosing as autism, and it's astonishing that you can recognise
0:46:58 > 0:47:03the condition across such vast differences of time and of culture.
0:47:03 > 0:47:07What's so important to me about this is that it enables us to see
0:47:07 > 0:47:12more clearly the common and enduring features of autism.
0:47:15 > 0:47:19It's often said that the enduring features of autism
0:47:19 > 0:47:21are present in many of us.
0:47:21 > 0:47:24Today, we often say someone's "on the spectrum"
0:47:24 > 0:47:28as a catch-all phrase to describe anyone who's a bit eccentric,
0:47:28 > 0:47:31has unusual hobbies or is socially awkward.
0:47:33 > 0:47:35Here at Trinity College Cambridge
0:47:35 > 0:47:39stands a statue to one of our greatest scientists, Isaac Newton.
0:47:41 > 0:47:43He certainly was eccentric,
0:47:43 > 0:47:47and some people have suggested that he may have been autistic.
0:47:50 > 0:47:51I'm not convinced.
0:47:53 > 0:47:57'I'm here to meet Professor Simon Baron-Cohen,
0:47:57 > 0:48:01'who long ago was my PhD student and is now a fellow of Trinity himself.'
0:48:03 > 0:48:05There are personal anecdotes about his life.
0:48:05 > 0:48:07There are. One of the stories is that his lectures were
0:48:07 > 0:48:10very difficult to follow.
0:48:10 > 0:48:13And the students stopped coming but he kept teaching,
0:48:13 > 0:48:15- even though there were no students present.- Oh, really?!
0:48:15 > 0:48:19- Because it was in his job description.- So he was very dutiful.
0:48:20 > 0:48:25Simon is interested in autistic-like traits in the general population,
0:48:25 > 0:48:29so I've come to discuss with him whether autism is in a category
0:48:29 > 0:48:34by itself, or whether it's possible to be a little bit autistic.
0:48:36 > 0:48:39So can you sort of make this a bit...
0:48:39 > 0:48:43You can measure autistic traits, just like any metric,
0:48:43 > 0:48:48like a ruler, where if you were down here at zero
0:48:48 > 0:48:53- or up here at 50, you'd be either low or high or just average.- Yeah.
0:48:53 > 0:48:57So here you would have no autistic traits at all,
0:48:57 > 0:48:59here you would have everything.
0:48:59 > 0:49:03Most people in the population are scoring right in the middle.
0:49:03 > 0:49:05That's the population average, or the mean.
0:49:05 > 0:49:09And people who have a diagnosis on the autistic spectrum
0:49:09 > 0:49:12tend to score right up here.
0:49:12 > 0:49:16Above 30, or 32, out of a scale of 50.
0:49:16 > 0:49:19And actually when you look at the whole population,
0:49:19 > 0:49:23it turns out to be quite a beautiful, normal distribution.
0:49:23 > 0:49:28Very few people down at zero, very few people at the maximum.
0:49:28 > 0:49:32So you could almost say that there might have been a natural selection
0:49:32 > 0:49:34to have an average number.
0:49:34 > 0:49:37At what point, then, would the diagnosis of autism
0:49:37 > 0:49:39become a sort of certainty?
0:49:40 > 0:49:44Well, you get your diagnosis when you go to a clinic.
0:49:44 > 0:49:46It's not about these metrics.
0:49:46 > 0:49:51It's about the clinician looking at how much these traits
0:49:51 > 0:49:54are interfering with your everyday functioning.
0:49:54 > 0:49:58So some people are developing secondary depression,
0:49:58 > 0:50:01because they've got a high number of autistic traits.
0:50:01 > 0:50:03Some children are being bullied,
0:50:03 > 0:50:05because they've got a high number of autistic traits.
0:50:05 > 0:50:07But some people are doing just fine...
0:50:07 > 0:50:11If they're doing fine, irrespective of their score, they don't need...
0:50:11 > 0:50:13- They're not autistic? - They don't need the diagnosis.
0:50:13 > 0:50:16So you withhold the diagnosis,
0:50:16 > 0:50:19unless there's a clear, clinical need.
0:50:19 > 0:50:24So now it's not about science, it's about clinical judgment.
0:50:24 > 0:50:28So there is something of a grey area where some people might
0:50:28 > 0:50:33get the diagnosis if they go to one centre for the diagnostic assessment
0:50:33 > 0:50:36- and not get the diagnosis if they go to another centre...- Absolutely.
0:50:36 > 0:50:39..because it is a judgment call.
0:50:39 > 0:50:44The only thing that differentiates people in the general population
0:50:44 > 0:50:47from people who have a diagnosis is simply
0:50:47 > 0:50:50the number of autistic traits that we have.
0:50:50 > 0:50:54That we're all on the same continuum.
0:50:54 > 0:50:59And...part of what research needs to do is to try and determine -
0:50:59 > 0:51:01is there a qualitative break there?
0:51:01 > 0:51:05Or is it the case that it's simply a matter of degree?
0:51:10 > 0:51:13I've often imagined myself being a bit autistic.
0:51:13 > 0:51:16I'm certainly obsessively focused on my work.
0:51:16 > 0:51:20And in my feelings I am often very analytical and detached.
0:51:21 > 0:51:25And I certainly have said things that hurt people
0:51:25 > 0:51:29without my realising this, and I'm generally baffled
0:51:29 > 0:51:33by the complexities of social relationships. But here it stops.
0:51:36 > 0:51:40It's easy to confuse autistic-like traits with autism,
0:51:40 > 0:51:44so if you think you might be a little bit autistic,
0:51:44 > 0:51:48you very probably are not.
0:51:48 > 0:51:52But whether there is a precise point at which autism begins
0:51:52 > 0:51:57is an open question and for now remains a mystery.
0:51:57 > 0:52:00So in the right position for her, basically.
0:52:01 > 0:52:06Today, most children with autism will be diagnosed before they go to school,
0:52:06 > 0:52:09but some are diagnosed much later.
0:52:09 > 0:52:14Like any condition, doctors and parents want to identify it as early as possible.
0:52:15 > 0:52:19We know that the autistic brain must be wired differently,
0:52:19 > 0:52:22and that there is a genetic reason for this,
0:52:22 > 0:52:25but we don't really know the details yet.
0:52:29 > 0:52:33Here at Birkbeck College in London, they're running a study to see
0:52:33 > 0:52:37if they can detect very early signs of autism.
0:52:37 > 0:52:42They're studying babies who have an increased genetic risk of being autistic,
0:52:42 > 0:52:45because they an autistic sibling.
0:52:45 > 0:52:49And they're comparing them to babies with no increased risk.
0:52:49 > 0:52:55We are looking for early signs of autism, early markers.
0:52:55 > 0:52:58The reason being that, at the moment, the earliest stage
0:52:58 > 0:53:02that a child will possibly get a diagnosis is around two to three years of age.
0:53:03 > 0:53:08So the main aim is to find an early marker to enable us
0:53:08 > 0:53:12to possibly diagnose the disorder earlier.
0:53:17 > 0:53:20They're looking to see how the babies' brains
0:53:20 > 0:53:24react to social and non-social images.
0:53:24 > 0:53:28They use equipment that gently shines light onto the baby's head
0:53:28 > 0:53:32to measure the oxygen level in the blood and, therefore, brain activity.
0:53:52 > 0:53:57This is where we're having the response, in this brain region.
0:53:57 > 0:54:00And this one example is about visual, social cues,
0:54:00 > 0:54:03so this is when the babies are watching the peek-a-boo
0:54:03 > 0:54:05and the Incy Wincy Spider.
0:54:05 > 0:54:09The graph here on the left is what you would typically have
0:54:09 > 0:54:14as a response in infants of this age, so four to six-month-olds.
0:54:14 > 0:54:16We've seen in many, many babies
0:54:16 > 0:54:19that they would have an increase in oxygen in their blood,
0:54:19 > 0:54:22which is this red line here, and this is the response
0:54:22 > 0:54:26that we've had in the infants that have a family risk of autism.
0:54:26 > 0:54:29So they have the brother or sister with autism.
0:54:29 > 0:54:32And what you notice quite strikingly is that the oxygen change
0:54:32 > 0:54:35in this brain region is almost absent in comparison to
0:54:35 > 0:54:37the low-risk infants.
0:54:41 > 0:54:45But the tantalising thing to have emerged from this study so far
0:54:45 > 0:54:49is that not all the babies who have the autistic markers
0:54:49 > 0:54:51go on to get a diagnosis of autism.
0:54:53 > 0:54:56So, the babies we've seen who show
0:54:56 > 0:54:58the possible early markers of autism,
0:54:58 > 0:55:02but who actually don't go on to develop the disorder,
0:55:02 > 0:55:06the ones that fall sort of either side of the line, they...
0:55:07 > 0:55:10It's an interesting thing.
0:55:10 > 0:55:13That's one of the questions that we hope to answer - why don't they?
0:55:13 > 0:55:18Are there protective factors, be that genetic or environmental,
0:55:18 > 0:55:22that kick in, or are these children programmed
0:55:22 > 0:55:24in a slightly different way
0:55:24 > 0:55:27that they're never going to develop the full-blown disorder,
0:55:27 > 0:55:30but they may carry these subtle traits of autism
0:55:30 > 0:55:33throughout their lives without anyone noticing?
0:55:33 > 0:55:36Ready, steady, go!
0:55:38 > 0:55:39What's he doing?
0:55:39 > 0:55:44The idea of a protective factor might explain another mystery -
0:55:44 > 0:55:48why many more boys than girls are diagnosed with autism.
0:55:48 > 0:55:53Could it be that girls have some kind of protective factor,
0:55:53 > 0:55:56perhaps for some genetic or hormonal reason,
0:55:56 > 0:55:59that reduces the impact of autism?
0:55:59 > 0:56:03We could even speculate that these protective factors
0:56:03 > 0:56:07are why many of us grow up to have an autistic-like personality,
0:56:07 > 0:56:10but not actually be autistic.
0:56:15 > 0:56:18LAUGHTER
0:56:19 > 0:56:21Sorry, you've got the wrong idea.
0:56:21 > 0:56:25Despite the insights we've gained over the last few decades
0:56:25 > 0:56:28about how people with autism perceive the world,
0:56:28 > 0:56:33there are still so many questions that remain unanswered.
0:56:33 > 0:56:37How does the brain create these different minds?
0:56:37 > 0:56:41And why are some people autistic in the first place?
0:56:41 > 0:56:45And why does autism come in so many forms?
0:56:45 > 0:56:46Very good.
0:56:47 > 0:56:53Joe needs constant care, and will never be able to live by himself.
0:56:53 > 0:56:54Good to do. >
0:56:54 > 0:56:56- Are you happy here?- Yes.
0:57:00 > 0:57:03And sometimes you go out?
0:57:03 > 0:57:04Yes.
0:57:05 > 0:57:09- And you can relax?- Relax.
0:57:09 > 0:57:11- You also work?- Yes.
0:57:28 > 0:57:29- 'What's this, Joe?- Money.
0:57:29 > 0:57:32'Money. And what's this, Joe?
0:57:32 > 0:57:33- 'Butter.- Bread.
0:57:35 > 0:57:37'And this?
0:57:37 > 0:57:39- 'Milk.- Milk. And this?'
0:57:39 > 0:57:43Almost 50 years ago, I met a bright-eyed young boy
0:57:43 > 0:57:47who had terrible difficulties interacting with the world.
0:57:50 > 0:57:52- 'What is it?- Ba-ma.
0:57:52 > 0:57:55- 'A barrow.- A barrow.
0:57:55 > 0:57:56'What's this?'
0:57:56 > 0:57:59Joe sees things very differently,
0:57:59 > 0:58:03but he inspired me to dedicate a lifetime
0:58:03 > 0:58:05to studying minds like his.
0:58:06 > 0:58:12And in its own way, I'm glad that his life has been fulfilling too.
0:58:15 > 0:58:16What flowers do you like?
0:58:16 > 0:58:18Sunflowers.
0:58:18 > 0:58:19Sunflowers.
0:58:19 > 0:58:20Yes.
0:58:20 > 0:58:22- So you just put the seed in, do you?- Yes.
0:58:22 > 0:58:25- And...a plant comes out?- Yes.