12 Oct


Is there a relationship?

By Lirio S. Covey, Ph.D.

Do you feel sounds and taste shapes? Do you smell songs or hear flavors?

No, you may not be hallucinating; you could be truly experiencing this phenomenon of simultaneously felt multiple experiences. You could be a synesthete, someone with synesthesia!

Synesthesia is a neurological condition wherein perception of one sensory modality produces simultaneous awareness of one or more other sensory modalities. For example, hearing music can stimulate a sense of sweetness or the feel of a tickle on a body part. Or when reading letters of the alphabet, each letter is viewed in color, varying from one letter to another. Or hearing a certain word triggers the taste of a favored drink.

Why is this of interest to autism?

The estimated prevalence of synesthesia in the general population is 2-4%; among autistic persons, the estimated prevalence of synesthesia is much higher – about 20%. Considered distinct conditions, yet commonalities between autism and synesthesia have been noted. They share similar traits such as heightened sensory sensitivity and attention to detail and, like autism, synesthesia is viewed as biological in origin and unlearned.

Why is this of special interest to autism?

Synesthesia has been speculated to be among features of the savant syndrome, which in turn has been seen among some, but not exclusively, persons with autism. The savant syndrome can be described as possessing an exceptional ability in a particular field, for example, extraordinary talents or skills in music, painting, sculpture, and mathematical calculations, memory, in the context of overall handicap, usually intellectual disability.

Does the savant visual artist see not only shapes and colors but also feel tingling in his/her skin? Does the savant pianist hear the music, feel the keys, and enjoy scents as she plays? Does the superbly skilled woodworker who feels the shape and grains of the wood, also hear music and smell aroma in the music? Could this richness wrought by experiencing multiple sensations underlie the savant’s exceptional and unique abilities? And do such synesthetic qualities mark savants?

What might the commonality of synesthesia and its possible link to savant status as well as autism imply for understanding and managing autism? As noted earlier, while a higher than expected prevalence of synesthesia has been seen with autism, those synesthetic traits are present only in a subset (about 20%) of persons with autism. Thus, could the co-presence of synesthesia, with or without savant status, and autism identify a subset of persons on the autism spectrum.


If there is such a subset, what other observable or underlying neurobiology traits characterize that subset? How could recognition and comprehension of such a subset impact the management of autistic persons, especially those with extraordinary (aka savant) qualities. Such knowledge and subsequent practice could optimize the positive abilities of this unusual subset of autistic persons who have synesthetic qualities. This would be a welcome departure from one-size-fits-all, under-nourishing formative methods that fail to optimize exceptional talent.

In addition, greater understanding of the behavioral and neurobiological linkages between autism and synesthesia could be productive towards optimizing the positive abilities and traits, not only of a select subtype, but also of others in the larger population of persons with autism.


Van Leeuwen T, Van Lier R. Spectrum/ Autism Research News, June 16, 2020.

Harrison JE & Baron-Cohen S (Eds) 1996. Synesthesia: Classic and contemporary readings. Cambridge, MA: Blackwell.


25 Aug


What’s the relationship? What’s the effect on autism traits?

By Lirio S. Covey, Ph.D.

Recent studies have shown an association between dyslipidemia (abnormally high levels of lipids such as cholesterol and triglycerides in the blood) and autism. Dyslipidemia can be determined by blood tests; it is medically treatable.

1. In a study conducted at Boston’s Children’s Hospital in Massachusetts ( 2.75 million people, 25,514 of whom were children with autism), blood lipid profiles, such as triglyceride levels, were higher in children with autism, regardless (controlled for) of age, medication, sex, or metabolic conditions such as obesity or diabetes.

2. In health care claims of 34 million people across the United States, 6.6 percent of 80,714 autistic persons had dyslipidemia.

3. In the general population, the estimated proportion of children with autism is 1-2%. In a study of parents with a history of dyslipidemia, 16% of them had a greater risk of having autistic children.

What questions concerning autism do these findings raise?

1. Are high lipid levels (cholesterol or triglycerides) risk factors for autism? If so, this association would mark the presence of a potential biological indicator of autism risk.

2. Thus far, there has been no specific biological autism risk factor (with the exception of genes whose relation to autism risk has been widely observed but knowledge of which specific genes or combination of genes are involved remains to be determined). High lipid levels would constitute an additional diagnostic marker of the presence of autism, beyond the established clinically observable signs.

3. Because only a subgroup of persons with autism will demonstrate high lipid levels, would elevated lipid levels identify a particular subtype of autism? This could lead to specific and possibly more targeted, personalized, and efficacious intervention approaches.

4. What neuronal mechanisms related to autism are affected by high lipid levels?

5. Will normalizing elevated lipid levels be therapeutic towards improving behavioral autism traits that impair the day-to-day functioning of autistic individuals?

6. Will normalizing elevated lipid levels reduce premature mortality in persons with autism?

7. Will administering lipid-lowering medications, such as statins, reduce premature mortality in persons with autism?

Reference: Ekaterina Pesheva. Autism-Cholesterol Link. New research reveals a subtype of autism associated with lipid abnormalities. August 17, 2020. Research.

An unwelcome habit

24 Feb

Self-injurious behavior in autism

Self-injurious behaviors (SIB), such as skin picking, head banging, hair pulling, scratching, are frequently seen among individuals with autism. Up to half of autistic people harm themselves, and SIB can be persistent. In a research study, self-injurious behavior persisted in over 44% of such cases during a 10-year period.

The common predictors of SIB are impulsivity and over-activity. Other predictors are stereotyped behavior, problems in social communication and reduced self-control. SIBs may provide a physical outlet for emotional pain. They are observed more often in women with autism as in men with the condition.

Uncontrolled SIB can lead to adverse consequences on educational, work, health and social outcomes. Caregivers and clinicians should be sensitive and observant to their occurrence. SIBs call for help as early as possible, even during the childhood years once they are detected. Interestingly, SIB can be subject to self-restraint indicating that the underlying difficulty in impulse control can be addressed by behavioral modification approaches.


Laverty C et al, Molecular Autism, 2020 Jan 20: 11:8. Persistence and predictors of self-injurious behavior in autism: a ten-year prospective cohort study.-

Maddox BB et al, Autism, May 21 (4) 412-422. 2017. Untended wounds: Non-suicidal self-injury in adults with autism spectrum disorder.

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