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New Directions: Autism, Mirror Neurons, and Applied Behavior Analysis 421 NEW DIRECTIONS: Autism, Mirror Neurons, and Applied Behavior Analysis Autism is a multiply determined and multiply expressed disorder that has become alarmingly prevalent. The source of the disordered behaviors labeled as autism is not clear, but the treatment of choice is EIBI by skilled behavior analysts (Charlop-Christy & Kelso, 1997; Ghezzi, Williams, & Carr, 1999; Foxx, 2008). Because of its unknown etiology and often extraordinary behavioral manifestations, people are desperate to try different treatments and to promote a variety of possible causes. The definition of autism is almost exclusively based on behavior, primarily in terms of deficits such as poor eye contact, little communication skill, noncompliance, and lack of social play (Klin, Chawarska, Rubin, & Volkmar, 2004; Volkmar, Carter, Grossman, & Klin, 1997). The autistic child looks normal but does not show ageappropriate behavior, especially social behavior. There is a set of molecular pathways that are abnormally expressed in the brain of autistic people (Voineagu, Wang, Johnston, Lowe, Tian, Horvath et al., 2011), and genetic mutations associated with autism (Sanders, Murtha, Gupta, Murdoch, Raubeson, Willsey et al., 2012), but at present the causal evidence is not definitive. The discovery of the “mirror neuron” system (see Chapter 11) and its lack of development in autistic children suggest that these youngsters may benefit from intensive behavioral training in generalized imitation (Baer et al., 1967) and other forms of visual discrimination training. The mirror system allows the observer to process information about self-performed actions and, using the same system, to understand the actions, emotions, and intentions of others (Oberman & Ramachandran, 2007). The integration of behavioral neuroscience with applied behavioral interventions could greatly enhance the understanding and treatment of childhood autism (see Thompson, 2007, pp. 429–430). One possibility is that intensive early training is effective for up to 50% of autistic children with intact neural systems because it organizes and activates the mirror neural system in the developing child, as Iriki (2006) suggests is the case for lower primates. Obviously neural mechanisms are altered during early experience, and the immature nervous system is especially sensitive to environmental influences during maturation and development. Thompson (2007) recently suggested that “early differential reinforcement of discriminative responding [by autistic children] to visual images of hand and arm movements may promote gene expression in the mirror neuron system” (p. 437). EIBI has produced lasting modifications of autistic behavior in some children, and it is possible that interventions aimed at priming the mirror neuron system (e.g., training to discriminate the actions and emotions modeled by others) could be even more effective. Unfortunately, there is a subgroup of autistic children who do not benefit from 30 or more hours of weekly behavioral treatment (Thompson, 2007, p. 429). Modern neural imaging could help to demarcate autistic children who are unable to form synapses in the brain (especially the mirror neuron areas) and profit from EIBI. However, these individuals could be treated by alternative behavioral procedures designed for their specific deficits and excesses.