Autism as a disorder of prediction

Proc Natl Acad Sci U S A. 2014 Oct 21;111(42):15220-5. doi: 10.1073/pnas.1416797111. Epub 2014 Oct 6.


A rich collection of empirical findings accumulated over the past three decades attests to the diversity of traits that constitute the autism phenotypes. It is unclear whether subsets of these traits share any underlying causality. This lack of a cohesive conceptualization of the disorder has complicated the search for broadly effective therapies, diagnostic markers, and neural/genetic correlates. In this paper, we describe how theoretical considerations and a review of empirical data lead to the hypothesis that some salient aspects of the autism phenotype may be manifestations of an underlying impairment in predictive abilities. With compromised prediction skills, an individual with autism inhabits a seemingly "magical" world wherein events occur unexpectedly and without cause. Immersion in such a capricious environment can prove overwhelming and compromise one's ability to effectively interact with it. If validated, this hypothesis has the potential of providing unifying insights into multiple aspects of autism, with attendant benefits for improving diagnosis and therapy.

Keywords: Markov models; endophenotype; heterogeneity; probabilistic processing; theory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autistic Disorder / diagnosis*
  • Autistic Disorder / genetics*
  • Basal Ganglia / metabolism
  • Cerebellum / metabolism
  • Cognition
  • Corpus Striatum / metabolism
  • Humans
  • Infant
  • Language
  • Markov Chains
  • Models, Theoretical
  • Neuronal Plasticity
  • Phenotype
  • Probability
  • Social Behavior
  • Time Factors