Autism and the Context Sensitivity Function

No, it’s not a typo.  I’m not referring to the better known CSF in vision – Contrast Sensitivity Function.  I’m referring to Vermeulen’s notion of context sensitivity as being dysfunctional in autism. He writes (p. 37) that context is the set of elements within the perceiving person and of elements in the spatial and temporal environment of a stimulus that affect the perception of that stimulus and the meaning given to it.  This influence can be direct, explicit, and conscious but is mainly indirect, implicit, and subconscious.  Contextual sensitivity is the ability to discover contextually relevant information and ignore contextually unimportant information.  Context sensitivity function can be considered as a relationship between the ability to select elements in context that are meaningful, and the appropriate or effective use of this information.  Vermeulen asserts that in contrast to the autistic brain, the neurotypical human brain is inherently context sensitive.

There is an incredible amount of useful information that resonates in Vermeulen’s book, and most of what he writes is intriguing, powerful, and insightful.  I want to highlight a particularly intriguing passage.  Vermeulen writes (p. 369): “Tommy just got new glasses.  His previous glasses were no longer adequate.  But Tommy refuses to wear the new glasses.  Resistance to change, we conclude – typical for autism.  But why does Tommy resist his new glasses?  Is it only because the glasses look different than the previous ones?  Luckily, Tommy gives us some insight.

‘The new glasses are no good’, he says.  ‘I see too much with them’.  From experience, I know that you have to get used to stronger glasses.  But contrary to Tommy, I place the sharpness of the new glasses in a context: The previous glasses were not good enough any more, so what I see now is, in fact, what I should be seeing.  Tommy does not see that context.  For him, seeing more than what he saw with his old glasses is seeing too much.  We clarify this for Tommy with a drawing.”

This is fascinating on so many levels.  The point that Vermeulen makes about children with ASD being resistant to change is well taken.  So often a new Rx change whether in lens power, lens form, or yoked prism may be a difficult transition to make.  Even the feel of the frame may be a huge adjustment for a child with sensory sensitivities.  Where we might part company with Vermeulen however is agreeing who has the reduced context sensitivity function here, Tommy or the author.  After all, seeing more sharply isn’t necessarily the idealized outcome or end result of a change in lenses.  Seeing more needn’t be equated with higher lens power.  Ironically it appears that it’s Tommy who might be able to teach the adults a lesson here.  There’s no need to condition him to wearing a stronger Rx by using communicative pictures that more or stronger is better.  When Tommy says “I see too much”, he’s pointing out that his habitual Rx was comfortable.  Was that merely because it was something he was used to, or because he functioned better in being more peripherally aware than in having his central or detailed vision primed.  Paradoxically Tommy was trying to tell the author that he was better able to put together the whole with his old glasses, and the new ones were shining too strong of a spotlight on the parts.  To this point, Vermeulen may be contextually blind or at least contextually insensitive.  But there is so much else to love about his theories that we can forgive him for overlooking the impact of lenses on visual function.  To decide if I’m taking what he wrote out of context, you’ll just have to read the book and decide for yourself.


8 thoughts on “Autism and the Context Sensitivity Function

  1. Was Tommy referring to information overload? This occurs quite often when people get new hearing aids. The brain was not able to incorporate the amount of new data presented. I would often under dose (prescribe) when there was, in my professional opinion, a problem with what we would call adaptation to a new Rx. Perhaps we should get more meaning out of what Tommy said.

  2. Precisely. My point was that perhaps it wasn’t necessary to “convince” Tommy that change was good just because the doctor decided that he must have a stronger Rx. Why exactly Tommy felt he was seeing “too much” would be left to Tommy being able to articulate that further. Since all the info we have at hand is what the author wrote, we’re left to speculate on the reasons why., We can take an educated guess that it might be a form of sensory overload, much like the best setting for hearing aid amplification isn’t always the one that would allow someone to hear at the most acute level. The bottom line is that Tommy’s context was just fine, and it was (paradoxically) the author who seems to be blind to the context in which Tommy was resisting wearing the new Rx.

  3. Maybe I should clarify some context here about Tommy’s story. When I wrote about Tommy in the book (yes, I am Peter, the author of “autism as context blindness”), I did not tell the whole story. The book has already enough of volume…
    Tommy got new glasses after careful assessment by an opthalmologist, and that assessment was on demand of Tommy’s teacher who got the impression that Tommy’s lenses were not good enough anymore: Tommy often misread what was written on the blackboard and he often “squeezed” his eyes (don’t know if this is the right expression in English) when looking at the blackboard, in order to focus. Moreover, he was complaining now and then about headaches, probably because of all the efforts his eyes and brain had to put in seeing. I will not deny that when you have glasses with stronger lenses, there is in the beginning also a sensory issue, getting adapted to the new input, which might be experienced as sensory overload. But Tommy also had this cognitive problem on top of that: he could not place that awkward feeling into the context of getting used to new glasses and therefore decided that his new lenses were wrong. After clarifying this (as described in the book) and also giving him a visual schedule explaining what “adaptation to new lenses” meant and how long it would take, Tommy decided to give it a try. After only one week, he was pleased with his new glasses…

    Anyway: thank you for the positive feedback on the book!

    Just one more thing: I coined the term “context blindness” already in my first book on autism (“Autistic Thinking”) of 1996, long before “caetextia” was introduced. And Joe Griffin definitively means something else with “caetextia”…

    • Thank you very much for taking the time to comment, Peter. Squeezed his eyes would be a good description of what in the U.S. we call “squinting” to see the board more clearly. I was raising the issue specifically with ASD children, who have sensory sensitivities, that there is a cost:benefit ratio to consider that didn’t come across clearly by the vignette the way it appears in your book, but is clearer now the way you elaborated. Certainly if Tommmy was squinting to see the board, and had headaches that were associated specifically with effort to see the board (one would have to know that these headaches didn’t occur when reading or doing other near tasks for which his vision was fine with his current lenses) — then the effort to adapt to the new lenses through a visual schedule is well worth it. However, this is not always the case. Sometime the children are more in tune with their visual system than the ophthalmologist, and it isn’t in their best interest to be forced to adapt by well meaning adults. For example, if distance blur were a secondary effect of a spasm of the focusing system, a strong lens power might enable sharper distance focus transiently, but be counterproductive to near focus and/or feed into the cycle of spasm. An alternative for example might be either to increase lens power, but not to the full extent that provides 20/20 (or 6/6 in meters). Maximum clarity does not always equate to maximum performance when looking at the ASD child in a more holistic sense.

      I will take another look at “caetextia” and its differentiation. Again,my compliments on an important and very well done book.

      • Leonard,
        I fully agree with you when you say that children sometimes know better than the ophthalmologist what is good for them. So, surely, we should listen carefully to what children tell us about their vision. (However, it is not always easy for children with autism to talk about their experiences and not always easy for us to understand what they tell us). Your reactions are very informative for me, because I am not an expert in vision. So thank you for your comments!

  4. My pleasure, Peter. In addition to the Autism “cloud” on our blog, you can learn more about vision and autism here: There is a theme issue in the journal Optometry and Vision Deveopment devoted entirely to autism that may be of interest:

    You’ll note that developmental optometry is a specialty very much in tune with the functional assessment and needs of children with autism as distinct from the more structural approach to assessment conducted by ophthalmologists (eye physicians specializing in disease and surgery). This is not to diminish the skill set of ophthalmologists in disease and surgery, but to highlight considerations in prescribing lenses or therapy, as in the context of our discussion.

  5. I completely agree with poster. My child “sees too much.” Her vision is acute and I now know her peripheral vision field is close to 300° I have complained to her about walking and even talking with her eyes closed. She informed me that she sees “thermal” images thru her closed eyelids. I’ve known that she has superior vision and colors are stronger and somewhat “uncontained” in the objects but now she is telling me that sometimes its easier to navigate her environment with her eyes closed. She bumps into things and has a hard time not spilling drinks, loves to swing things around which causes problems. Not sure if she can really see thru her eyelids or is just closing out extra stimuli and its just more comfortable for her.

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