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Clinical Neuropsychiatry (2007) 4, 5-6, 208-222 AUTISM MORE THAN THE MIRROR SYSTEM 1 Michael A. Arbib Abstract A number of studies have suggested an important role for defects in mirror neurons in developmental problems that lead to autism. My aim is to place this in perspective by stressing the importance of mirror neuron systems (note plural), while denying that mirror neurons do it (imitation, language, prevent autism) all by themselves We must go both within the mirror to study the working of mirror systems in more detail and beyond the mirror to study mirror neuron systems within the context of larger neural systems for imitation, empathy and language. The present paper approaches this as follows: First, I summarize some basic characteristics of autism spectrum disorder (ASD) and mirror neuron systems (MNSs) and then present an influential view linking MNS and ASD (Williams et al. 2001). MNS activity characterizing goals and actions must be bound to other neural systems recognizing agents and objects a point that is emphasized in a brief detour into the problem of alien voices and hands in schizophrenia (Arbib & Mundhenk 2005) and I will argue that defects in binding of mirror neuron activity may be an important contributor to some deficits in ASD. I then use an fMRI study of imitation of facial expressions of emotion (Dapretto et al. 2006) to show that children with ASD can develop compensatory strategies by exploiting different neural mechanisms to capture some aspects of a socially relevant behavior. I complement discussion of the relevance of mirror neurons to the analysis of ASD by also considering approaches based on Theory of Mind and briefly discuss the roles of the amygdala and other brain regions. Finally, I suggest the promise of incremental computer modeling of the Mirror System and Beyond. Key Words: Mirror Neurons Autism Autism Spectrum Disorder (ASD) Mirror Neuron Systems (MNS) Socially Relevant Behavior Theory Of Mind Amygdala Declaration of interest: None Corresponding Author Michael A. Arbib University of Southern California Brain Project [email protected] As background we provide a brief characterization of the spectrum of neurodevelopmental disorders known as Autistic Spectrum Disorders (ASD), introduce the notion of mirror neuron system (MNS), and then briefly summarize a theory relating ASD to deficits in mirror neurons to set the stage for the rest of the paper. Some Characteristics of ASD Children with ASD are not impaired in: Object permanence understanding Tool use Object categorization Attachment Self recognition but (with differing severity depending on where children lie on the autism disorder spectrum which should not be thought of as one-dimensional) are impaired in: Other recognition Social interaction & Communication/Language Play behavior Imitation & Pantomime Emotion perception Shared attention Pretense 1 This paper is based on a presentation at the Workshop on Neurocognitive Development and Autism: The Mirror Neuron Hypothesis sponsored by Autism Speaks and the National Science Foundation (NSF), and held July 23-24, 2007 at NSF in Arlington, VA, USA. A preliminary version was circulated on-line for the Awares international online autism conference, November 26-30, 2007, http://www.awares.org/conferences/. The author claims no special expertise in autism (though he did co-author essays offering [now outdated] analyses linking autism to cybernetic mechanisms many years ago (Arbib & Kahn 1969, Kahn & Arbib 1973)), but speaks rather from his long-standing involvement in computational cognitive neuroscience, with much attention to mirror neurons in the last decade or so. My thanks to Justin Williams for his perceptive comments on an earlier draft. SUBMITTED NOVEMBER 2007, ACCEPTED MARCH 2008 208 © 2007 Giovanni Fioriti Editore s.r.l. Autism More than the Mirror System I cannot address all these topics in the space of a single article, but hope to provide a useful perspective on a number of them. Some Characteristics of MNS As background for the hypothesis that ASD is related to impairment of the mirror system in the developing child, I review relevant data on mirror neurons. Many neurons in the hand region of ventral premotor area F5 in macaque monkeys show activity in correlation with the grasp type being executed (Rizzolatti et al. 1988). A subpopulation of these neurons, the mirror neurons (MNs), also respond to the observation of goal-directed movements performed by another monkey or an experimenter (e.g. precision pinch or power grip) for grasps more or less congruent with those associated with the motor activity of the neuron (di Pellegrino et al. 1992). By contrast, canonical neurons in F5 fire when a monkey executes certain grasps but not when he observes anothers actions. The same area includes audio-visual mirror neurons (Kohler et al. 2002) that respond not only to the view but also to the sound of actions which have typical sounds (e.g. breaking a peanut, tearing paper). The actions associated with mirror neurons in the monkey seem to be transitive, i.e. to involve action upon an object rather than gesturing in thin air and apply even to an object just recently hidden from view (Umiltà et al. 2001). Further data address the role of mirror neurons in the oro-facial area of macaque F5. Ferrari et al. (2003) showed that about one-third of F5 mouth motor neurons also discharge when the monkey observes another individual performing mouth actions. The majority of these mouth mirror neurons become active during the execution and observation of mouth actions related to ingestive functions such as grasping, sucking or breaking food. Another population of mouth mirror neurons also discharges during the execution of ingestive actions, but have communicative mouth gestures (e.g. lip smacking) as their most effective visual stimuli. Ferrari et al. (2005) find that the observation and/or hearing of the eating actions of others facilitate eating behaviors in pig-tailed macaques and propose that this facilitation of eating rests on the mirror neuron system of ventral premotor cortex. Coudé et al. (2007) trained monkeys to vocalize (with a coo call) for a reward when a piece of food was placed on a table facing them, and did find some F5 cells that fired in relation to such vocalization, but no evidence is yet available for reliable F5 control of normal vocalization nor of mirror neurons in F5 for such vocalization. Returning to mirror neurons for grasping, we may note the following: Perrett et al. (Carey et al. 1997, Perrett et al. 1990) found that STSa, in the rostral part of the superior temporal sulcus (STS, itself part of the temporal lobe), has neurons which discharge when the monkey observes such biological actions as walking, turning the head, bending the torso and moving the arms. Of most relevance to us is that a few of these neurons discharged when the monkey observed goaldirected hand movements, such as grasping objects (Perrett et al. 1990) - though STSa neurons do not seem to discharge during movement execution as distinct Clinical Neuropsychiatry (2007) 4, 5-6 from observation. STSa and F5 may be indirectly connected via inferior parietal area PF (Brodmann area [BA] 7b) (Cavada & Goldman-Rakic 1989, Matelli et al. 1986, Seltzer & Pandya 1994). About 40% of the visually responsive neurons in PF are active for observation of actions such as holding, placing, reaching, grasping and bimanual interaction. Moreover, most of these action observation neurons were also active during the execution of actions similar to those for which they were observers, and were thus called PF mirror neurons (Fogassi et al. 1998). In summary, area F5 and area PF include an observation/execution matching system: When the monkey observes an action that resembles one in its movement repertoire, a subset of the F5 and PF mirror neurons is activated which also discharge when a similar action is executed by the monkey itself. We have only one dataset related to possible mirror neurons in humans (Mukamel et al. 2007) since single neuron recording is only possible in very rare cases in humans, during neurosurgery. Therefore, one usually talks about a mirror region or a mirror neuron system (MNS) in humans, identified by brain imaging (PET, fMRI, MEG, etc.) which is activated relative to a control task both for observation of a class of actions and for execution of that class of actions. An increasing number of human brain mapping studies now refer to the mirror system. However, different brain regions may be implicated as mirror regions or MNSs for different classes of actions. Thus it is important to speak of multiple MNSs. Collectively these data indicate that action observation activates certain regions involved in the execution of actions (or emotions) of the same class. Because of the overlapping neural substrate for action execution and observation in humans as well as other primates, many researchers have attributed high level cognitive functions to MNs such as imitation (Carr et al. 2003), intention attribution (Iacoboni et al. 2005) and on the finding of a mirror system for grasping in or near human Brocas area language (Rizzolatti & Arbib 1998). However, monkeys do not imitate (save in some simple fashion see, for example, Visalberghi & Fragaszy 1990) or learn language and so any account of the role of mirror neurons in imitation and language must include an account of the evolution of the human mirror system (Arbib 2005, Rizzolatti & Arbib 1998) and related brain regions, as well as the biological triggers that can unleash in monkeys a rudimentary imitation capability that goes beyond those they normally exhibit, though still being quite limited compared to those of humans (Kumashiro et al. 2002). Thus imitation and language and other functions impaired in ASD are not inherent in a macaque-like mirror system but instead may depend on the embedding of circuitry homologous to that of the macaque in more extended systems within the human brain. Consider, for example, the claim that the mirror system for grasping first evolved to mediate social understanding. My counter-hypothesis is that: a: The mirror system for grasping evolved originally to provide visual feedback for those hand movements requiring attention to object detail; b: Exaptation exploited this self-ability to map other individuals actions into internal motor 209 Michael A. Arbib representations; and that Understanding and Planning involve far more than the mirror systems, as in Figure 1. We stress the important role of social interaction in the forming of emotions. Human emotions are greatly influenced by our ability to empathize with the behavior of other people. Mirror neurons have been implicated in empathy but with the emphasis not only on recognizing facial expressions but also on empathizing with the emotional stance of other actions. Gazzola et al. (2006) offer fMRI evidence for an auditory-visual mirror system in humans comprising a left hemispheric temporo-parieto-premotor circuit with a dorsal cluster more involved for hand actions, and a ventral cluster more involved for mouth actions. Moreover, individuals who scored higher on the perspective taking component of an empathy scale activated this system more strongly, which the authors adduce as evidence for a possible link between the motor mirror system and empathy. But note that, since we cannot see our own faces, a mirror system for facial expression must involve a different evolutionary scenario than that I have posited for the mirror system for grasping. This reinforces the warning that we must not talk of the mirror system but rather seek to understand the roles of, and interactions between, multiple mirror systems. Echopraxia and echolalia are imitation-like phenomena that are accentuated in autism (Libby et al. 1997, Roberts 1989): Repetitive and stereotyped behaviors and speech may be copied from others words and phrases (echolalia) and sometimes actions (echopraxia) may be mimicked without regard to their normal goals and meanings. What does this tell us about MNSs? First, recall that monkeys hardly imitate (Visalberghi & Fragaszy 1990) yet have mirror neurons, so that these neurons in some sense only provide half the mechanism for imitation having neurons that represent the action of another does not imply that this representation is wired up to drive the circuitry for execution of that action. (Caution: Presumably young monkeys are fully social despite their lack of complex imitation. Empirical c: Issue: What aspects of human sociality does a fully social monkey or ape share, what does he lack?) Figure 2 extends Figure 1 to emphasize the connection (a) which may provide feedback for selfactions, but in monkeys seems not to provide a path from recognizing the action of another to repeating that action. However, even where such a path exists to support imitation (as in humans but not, presumably, in monkeys), it is normally under inhibitory control, since the appropriate response to anothers action is rarely to repeat it. It is, I suggest, this inhibition that is impaired in echopraxia and echolalia. Turning from praxic actions to emotions, consider emotional contagion (Hatfield et al. 1994, Provine 1997): 1) Since emotional states are closely linked to certain facial expressions, observation of a facial expression might result in mirrored (but mainly inhibited) pre-motor activation in the observer and a corresponding retrodicted emotional state. 2) Such a process might help to explain the phenomenon of emotional contagion, in which people automatically mirror the postures and moods of others. Indeed, the former may be like neonatal imitation (Meltzoff & Moore 1977) in facilitating the use of certain effectors or muscle groups rather than capturing the specific goals and actions of a behavior. It has been suggested that mirror neurons can contribute not only to simulating other peoples actions as the basis for imitation, but also simulating other peoples feelings as the basis for empathy (Gallese & Goldman 1998, Goldman 2006, Jacob & Jeannerod 2005). However, this cannot be the whole story. If we see a photo of a persons home destroyed by fire or flood, we empathize with them without seeing their actions or emotions, so that if our mirror neurons are activated it cannot be by recognition of the others actions, but rather by, e.g., more general associative mechanisms linking loss with sadness. Again, if we recognize anger directed at us by another person, our response may be to react with anger or fear but in neither 2EVHUYH 2EVHUYH 0RUHWKDQWKH0LUURU )PLUURU )FDQRQLFDO 5HFRJQL]H$FWLRQV &RPPDQG$FWLRQV ,QWHUSUHWDWLRQ 8QGHUVWDQGLQJ 3ODQQLQJ %H\RQGWKH0LUURU6\VWHP Figure 1. Understanding and planning involve far more than the mirror systems 210 ([HFXWH ([HFXWH D )PLUURU )FDQRQLFDO 5HFRJQL]H$FWLRQV &RPPDQG$FWLRQV ,QWHUSUHWDWLRQ 8QGHUVWDQGLQJ 3ODQQLQJ Figure 2. Inhibiting a direct path from action observation to action execution to block echopraxia Clinical Neuropsychiatry (2007) 4, 5-6 Autism More than the Mirror System case to empathize with their anger; whereas if their anger is directed at a third party, then empathy with their anger is a possible reaction. Note that in any case we must recognize a binding problem for mirror neurons. Whether for MNs representing an action or an emotion, the brain must appropriately bind the activity of a set of mirror neurons to the appropriate agent, whether the first person, second person, or one of multiple third persons. Given all this, it will be useful to set forth a number of key points about mirror systems before considering in more detail their relation to ASD: i. The classic mirror system for grasping is the set of mirror neurons discovered in macaque F5, augmented by the related neurons with mirror properties in PF. STSa provides visual input to PF but seems not to contain mirror neurons. ii. Subsequent studies have shown that some of these neurons also can respond to the sound of actions, while neurons in the oro-facial zone of F5 have mirror properties linking ingestive and certain communicative gestures but not (with a possible minor exception) vocalizations. iii. Human brain imaging identifies a mirror system for grasping in human Brocas area and IPL. iv. Further brain imaging studies also implicate these regions in imitation, imagination and language. v. Caveat 1: Since macaque F5 contains many neurons that are not mirror neurons, it is a mistake to conclude that activity in such a region is mirror neuron activity. Moreover, we must note that a mirror system need not contain mirror neurons! All that is required is that it contain both neurons active for action execution and neurons active for action observation. vi. Caveat 2: The activity of mirror neurons rests on the activity of many other brain regions. Thus it is mistaken to think that mirror neurons per se can account for imitation, imagination and language especially since monkeys have little skill in imitation and no use of language (as distinct from a system of innate calls). vii. We nonetheless consider that the human homologues of the F5 and related parietal mirror system have mirror neurons not only for limb movements but also facial expressions and communicative gestures. When we speak of the mirror system hypothesis of autism, we refer to the impact of deficiencies in these core mirror systems. viii. However, there is no reason to think that these core systems are the only places in the human brain where imaging will yield activation both for doing something and for observing someone else doing it. Thus, Cattaneo et al. (2007) assert that, in humans, the mirror neuron system has two major components. One is formed by the inferior parietal lobule and the ventral premotor cortex plus the caudal part of Brocas area (i.e., the system we have just described) and the other by the insula and anterior cingulate gyrus. Besides its originally proposed role in action understanding, the parieto frontal system appears to mediate the understanding of intentions of others and imitation, whereas the insularcingulate system appears to Clinical Neuropsychiatry (2007) 4, 5-6 play a fundamental role in emotion recognition (Gallese et al. 2004, Singer et al. 2004). However, (a) the parietofrontal system may be involved in understanding of intentions of others and imitation, but only as part of a larger neural system, and (b) the insular-cingulate system is not a mirror system in the sense defined above. ix. Thus, to the extent that we seek to find genetic correlates for autism, we can expect different symptom-complexes to be associated with (a) genetic changes that affect the parietofrontal system and (b) genetic changes that affect the insularcingulate system, whether or not the latter should be considered as a mirror system. Thus, in this paper, when I talk of multiple mirror systems I will be focusing on the various components of the core parietofrontal system, and will continue to stress that these components function effectively only through their connections with other brain regions connections which differ greatly between macaque and human. x. In particular, then, when discussion of ASD symptoms turns to agency attribution, theory of mind and empathy, I am not postulating additional mirror systems but rather asking to what extent these functions depend on core mirror systems within the action-processing framework, and to what extent they depend on other brain mechanisms. Linking MNSs and ASD Williams et al. (2001) suggested that a failure in the development of the mirror neuron system is behind autism and that, moreover, in autism the mirror neuron system is malfunctioning as a whole. They hypothesize that early developmental failures of mirror neuron systems lead to a cascade of developmental impairments that accumulate to yield the clinical syndrome of autism. They focus on a disturbance involving difficulties both in imitating actions and in inhibiting more stereotyped mimicking. To the latter point, consider the repetitive, inflexible and stereotyped behavior and language the echopraxia and echolalia mentioned previously that appears to incorporate some copying from others, in some patients with autism. I suggested (Figure 2) that a controlled inhibitory system is essential for allowing MNs to operate off-line. If damage extends to such inhibitory components, Williams et al. (2001) suggest that certain forms of mimicry might occur, yet be oddly performed. This may be too simple. Loss of inhibition still leaves the MNS functioning. It does not account for the dissociation of imitation and echopraxic mimicry. Moreover, the understanding of others intentions by children with ASD is largely intact (Carpenter et al. 2001). Williams et al. (2001) further argue that mirror neurons may be key elements facilitating the early imitation of actions, the development of language, executive function and the many components of ToM (Theory of Mind, about which more below). They concede that the heterogeneity of ASD may argue against a single cause, yet suggest that the commonalities of the clinical syndrome nevertheless permit the possibility 211 Michael A. Arbib ,QGLUHFW 5RXWH 'LUHFW 5RXWH Figure 3. The dual route model of praxis (the middle and right columns, echoing the language system on the left) in which an action may be imitated via the indirect route in which mirror neurons (in the input praxicon) activate known motor schemas (the output praxicon) or via the direct route in which the action is imitated as an assemblage of meaningless gestures (Adapted from Rothi et al. 1991) of a core dysfunctional mechanism. My counter-point will be that we must go Beyond the Mirror to understand the wide plexus of systems linked to but going beyond, the basic F5/Brocas area mirror neurons.2 We must also address the question of whether an MNS translate between selves, or simply ignores the self. I later discuss the work of Arbib and Mundhenk (2005) concerning the extra machinery that may be required to link an action to a self whether oneself or another. To proceed further, it will be useful to consider a conceptual model that addresses data on apraxia. Addressing the observation that some apraxic patients are unable to pantomime common actions or imitate meaningful gestures but are nonetheless able to imitate meaningless gestures, Rothi, Ochipa, and Heilman (1991) offered the dual route imitation learning model balancing language and praxis which is adapted in Figure 3, where I indicate that the right-hand (praxis) side should be augmented by an action buffer. The input praxicon corresponds to recognition of a familiar action (and is thus part of a mirror system), which can then be imitated by using an existing motor schema in the output praxicon to re-create the action. (The terminology is defined by analogy: the praxicon is for praxis [practical action] what the lexicon is for language). By contrast, the direct route, it is claimed, does not involve re-creation of the action as a whole (which includes activation of the semantics of the action) but rather involves piecemeal analysis of the observed action which allows it to be re-created as a semantics-free assemblage of motor features. However, where Rothi et al. (1991) distinguish a direct and indirect route based on a dissociation between the ability to pantomime a meaningful action and the ability to imitate a meaningless gesture, I would argue that this mistakes the primary role of the direct route we did not evolve to make meaningless gestures. Instead, I hypothesize that our evolving skill in imitation rested in part on the ability not only to acquire novel actions through blind trial-and-error and through the assemblage of known actions, but in addition that the direct route evolved so that familiar tweaks (small intransitive movements that are frequent components of many actions) could be used to adjust a known action to better match an observed novel action. Only later was the direct route exapted for novel gesture imitation. An action combines a motion and a goal and, recognizing the goal, we may fail to pay attention to the details of the motion that achieves it. Whatever the fate of this hypothesis, the key point is that the direct route is, in evolutionary terms, more sophisticated than the indirect route and that the passage from the common ancestor of monkeys and humans to humans involves the ability to dissociate (some) motions from explicit goals. When engaged in stereotypic behavior, the child with ASD seems to focus on the motion without 2 Williams (2008, to appear) offers a more nuanced view, based on recent data, which continues to emphasize the role of mirror neurons, but also notes the importance of the amygdala and orbitofrontal cortex, among other brain regions. However, my emphasis in the present section is on the ideas of the 2001 paper. For an alternative approach to linking mirror neurons and autism, inspired in part by EEG data on µ-waves (Oberman et al. 2005), see Ramachandran & Oberman (2006) and Oberman & Ramachandran (2007). 212 Clinical Neuropsychiatry (2007) 4, 5-6 Autism More than the Mirror System reference to achieving some associated goal. Thus s/he may not so much be reverting to the ancestral system as holding on to one new capability (dissociating the motion from the goal) while losing the complementary ability to infer the goal from the motion. However, we need to look in more detail at the following data: Imitation of meaningless gestures is affected more than imitation of actions with objects (Rogers et al. 1996). Children with autism were more likely to make errors when asked to imitate an unconventional action with a common object (such as drinking from a teapot). Perhaps the use of appropriate objects helps to shape a matching response; by contrast, difficulties in copying raw gestures underlines the more basic nature of the imitative deficit referred to earlier (Merians et al. 1997). This may suggest that the deficit is not at the ancestral level (i.e., at the level of mirror system mechanisms we share with nonhuman primates), but in the higher extensions. There are greater group differences with respect to sequences of actions than when single actions alone are being imitated, suggesting that we need to look beyond mirror systems in isolation to their linkage in sequential action with the basal ganglia and prefrontal cortex (Ring & Serra-Mestres 2002). Patients with ASD have evident imitation deficits (Pennington & Bennetto 1998). Mechanisms underlying imitation could be precursors to full ToM (Rogers & Pennington 1991). Imitation does not require ToM, since it can proceed on the basis of overt behavior without ascription of intentions to the imitatee. Imitation may also be fundamental to the other, broader kinds of social deficits seen in autism, but this does not address repetitive and stereotyped behavior. Rogers and Pennington (1991) talk of the impaired formation/co-ordination of specific self-other representations as being at the root of the cascade of problems of children with ASD. This in turn could explain the failure to develop reciprocal social abilities including shared/joint attention, gestural recognition and language (particularly the social/pragmatic aspects that Rogers and Pennington (1991) note are the most affected), as well as breakdowns in the development of empathy and a full ToM. However, to fully appreciate the implications of such observations we must distinguish what a mirror systems does from the roles of other regions to which it is linked. Returning to the MNS for grasping, I stress that the activity of an F5 mirror neuron for a particular type of grasp (say, Grasp-A) is only part of the code for Grasp-A(Agent, Object), specifying which Agent grasps which object. The full neural representation of the Cognitive Form (CF): Grasp-A(Agent, Object) further requires inferotemporal cortex which holds the identity of the object and regions of the brain, such as those involved in face recognition, which hold the identity of the agent. How these representations are bound together remains a research challenge. But the implications for autism may be better understood by a brief detour into the study of schizophrenia. Schizophrenia: Alien Voices and Hands I briefly summarize an essay (Arbib & Mundhenk 2005) inspired by data on schizophrenic subjects (see Clinical Neuropsychiatry (2007) 4, 5-6 Arbib 2007 for related observations) concerning: · auditory verbal hallucinations (AVH): the subject may believe he is hearing another person or entity talking to him, when in fact the schizophrenic patient is creating subvocal vocalizations, which are the embodiment of the voices he reports hearing. · Delusions of influence: The arm of the patient may move, but the patient attributes it to an external influence. The essay responded particularly to a study by Daprati et al. (1997, and see Franck et al. 2001 for related data) of so-called agency, i.e., in knowing who was the agent of a particular action. 30 normal control subjects and 30 schizophrenic patients performed a requested movement with the right hand, and monitored its execution by looking at an image of a hand movement on a video screen. The subject was asked: You have just seen the image of a moving hand. Was it your own hand? Answer YES if you saw your own hand performing the movement you have been executing. Answer NO in any other case, that is if you doubt that it was your own hand or your own movement. In each trial the subject was presented with an image of: their own hand (Subject); the experimenters hand performing a similar movement (Experimenter Same); or the experimenters hand performing a different movement (Experimenter Different). Both normals and schizophrenics made virtually no errors when seeing their own hand, or a hand performing a different movement. The only errors occurred in the Experimenter Same condition where the median error rate was 5 in the control group, 17 in the non-delusional group and 23 in the delusional group. Daprati et al. (1997) suggest these show a problem for schizophrenics in their sense of agency, but Arbib and Mundhenk (2005) counter that the experiment has nothing to do with attribution of agency: In each case, it seems that the subject knows that he has himself made a movement and which type of movement it is it is a case of monitoring that movement accurately enough to tell whether a slight variant is indeed different. They thus argue that two different factors may affect the symptoms of schizophrenia of concern here, selfmonitoring and attribution of agency: Self-Monitoring: Did I knock over that glass when I swept my arm backward? Agency Attribution: I see/hear hammering? Who is doing it? We rarely recognize the agent from a hand movement alone. We must connect the hand to a recognizable person e.g., by linking the hand to a recognizable face, walk, voice, style of clothing, etc. We can then distinguish two levels of attributing an action: a) Self versus other: If I do not know that I acted then I believe that someone else acted. b) Which other?: If I believe that someone else acted then I may try to determine who the agent of the action is. Lack of knowledge introduces the risk of confabulation. Arbib and Mundhenk (2005) argue that in general the brain simply processes self-actions without need to 213 Michael A. Arbib attribute agency to the action the brain simply does its job of integrating perception, plan and action. However, if ones hand moves in an unexpected way, one may ask What made my arm hand that way? and the answer might be I was moving it intentionally but or I did not intend to move it, but . In other words, the unexpected outcome invokes two processes: Agency Attribution: In general, the world may present many alternative actions for our (conscious or unconscious) consideration. Thus there may be priming of multiple actions, with tonic inhibition preventing the execution of any of them. However, cortical processes interacting with the basal ganglia can disinhibit one of these actions leading to execution of the action. (Normally, the basal ganglia inhibit a set of candidate next-actions until instructed to release one of them; see Dominey & Arbib (1992, Dominey et al. 1995) for a computational model of such disinhibition for the case of saccadic eye movements.) Such cortically instructed disinhibition is, on this account, a reliable neural correlate of an intended action. However, if the tonic inhibition from the basal ganglia were weakened, then some actions could slip through without in this sense being intended. Self-Monitoring: Arbib and Mundhenk (2005) further hypothesize that each intended action is accompanied by a more or less accurate motor working memory of the trajectory of the action. Thus if the need arises to question the agency of the action, the brain may consult its working memories to see whether the observed movement matches the working memory of an intended movement and if so whether the working memory of the expected outcome of the action sufficiently matches the observed trajectory of the outcome. On this basis, the normal brain can decide I am the agent, I was the agent but for some reason the action did not come out as intended, or I am not the agent. The same hypothesis accounts for auditory verbal hallucinations. Schizophrenic patients hallucinate voices that they attribute to external agents; they also have delusions that other people are creating their actions for them and also of influencing others to act (DSM-IV 1994). In addition, patients with schizophrenia have difficulty determining whether they spoke or thought an utterance (Brébion et al. 2002, Franck et al. 2000). Given this, Mundhenk & I suggest that the primary deficit here is in the lack of adequate control of disinhibition so that an action may be committed without there being a disinhibitory signal that represents the decision to execute the action. Lacking any memory of having intended the action, the patient concludes I am not the agent and then proceeds to confabulate, to provide an account for the agency of the observed action. This account is consistent with but offers a fresh perspective on the hypothesis that the problems of schizophrenia involve working memory (Perlstein et al. 2003, Posada et al. 2001). An intriguing research challenge, then, is to understand what distinguishes the lack of inhibition that yields auditory verbal hallucinations and delusions of influence in the schizophrenic from the lack of inhibition that yields echopraxia and echolalia in those children with ASD who exhibit it. My preliminary suggestion is to posit in schizophrenics a deficit in the 214 inhibition which controls which one among alternative courses of action will be executed, while in echopraxia and echolalia the deficit is in the inhibition of the path from action observation to action execution shown in Figure 2. A Challenge for Understanding and Intervention We now recall an fMRI study (Dapretto et al. 2006) linking increased severity of ASD to reduced activity in the mirror system. Stimuli consisted of 80 faces expressing five different emotions: anger, fear, happiness, neutrality or sadness. Subjects either imitated or simply observed the faces. Brain activity (the BOLD signal of fMRI) was studied during imitation of emotional expressions by (a) a typically developing group; and (b) an ASD group. Activity in bilateral pars opercularis of the inferior frontal gyrus often identified as the site of the frontal range of the human mirror system is seen (stronger in the right hemisphere) in the typically developing group (a) but, it is asserted, not in the ASD group (b). However, they found a large left hemisphere overlap for activation of this region in the 2 groups (Figure 1 of Dapretto et al. 2006). Moreover, lesion and imaging studies have implicated pars opercularis in a variety of functions in addition to serving as a mirror system. This raises the research question: What can be added about precise localization of relatively greater activation in normals compared to ASD and, given this, are these difference areas establishable as parts of a mirror system on other grounds? Dapretto et al. (2006) indexed symptom severity in ASD. Controlling for IQ, they found reliable negative correlations between activity in the pars opercularis and the childrens scores on the social subscales of the Autism Diagnostic Observation ScheduleGeneric and Autism Diagnostic Observation InterviewRevised (Lord et al. 2000, Lord et al. 1994) (see Figure 3 of Dapretto et al. 2006). They conclude that the greater the activity in this critical component of the MNS during imitation, the higher a childs level of functioning in the social domain. However, we still have the question whether this correlation applies specifically to the MNS. Dapretto et al. (2006) not only conducted brain imaging studies inside the scanner, but also had half the children in each group perform both tasks during a videotaped session with an eye tracker. Intriguingly, there were no group differences in the amount of time spent fixating on the face and eye region, nor in how well the children imitated facial expressions. This raises a Disturbing Thought: Perhaps an MNS is not important for recognition of facial expressions! However, returning to fMRI data, children with ASD showed greater activity than did the typically developing children in right visual and left anterior parietal areas which are regions known to be modulated by visual and motor attention, respectively. Dapretto et al. suggest that although both groups performed the imitation task as requested, the neural strategies adopted by typically developing children and those with ASD are quite different. Such findings suggest the relevance of the Clinical Neuropsychiatry (2007) 4, 5-6 Autism More than the Mirror System following comments by (Rutter 2005): children [with ASD] could and did acquire a variety of useful social, behavioral, and communication skills but they were much better in demonstrating these in situations comparable to those in which they were taught, rather than through their spontaneous usage of the skills in other situations. [Research] has concentrated on the deficits rather than on the equally important question of the compensatory cognitive strategies that individuals with autism use. The study by Dapretto et al. (2006) combines with these comments to suggest that no matter what future research reveals about the neural correlates of autism the search for alternative strategies for reaching functional goals will continue to be of great importance. Indeed, the two route solution for facial imitation has echoes of the discussion of direct versus indirect routes for imitation in the study of apraxia (recall Figure 3 above). In the present example, I distinguish (i) the gut semantics of emotion which links activation in, e.g., amygdala, orbitofrontal cortex and insula to the embodiment (somatic/visceral) of emotions and the attendant feelings from (ii) the disposition semantics of recognizing that a certain facial expression may betoken a behavioral disposition but without feeling the attendant emotion. This suggests that the subject with ASD might lack that part of the mirror system that links an indirect route to gut semantics, and yet be able to exploit a direct route that can build representations of facial expressions which lack this direct linkage to emotional feeling. The latter representations may still become paired with behavioral disposition through a process of associative learning. It is worth noting that this still requires a mirror system, but it is a mirror system divorced from those neural regions which yield emotional feelings. Theory of Mind Leslie (1987) distinguished two types of representation when analyzing the cognitive mechanism underlying shared attention and pretense: First-order representations describe visible bodies and events. Second-order representations describe invisible minds and mental events and serve to make sense of otherwise contradictory or incongruous information. These constitute a persons Theory of Mind (ToM). The crucial point about ToM is not only that the child comes to appreciate I am like the other/The other is like me even for states that are not necessarily visible externally, but also to understand that the self and the other may differ in the states they are experiencing.3 A standard test of whether a child understands that different people may have different mental states is the Sally-Anne task. The subject is shown a series of pictures in which: (i) Anne sees Sally place a ball in a basket and cover it. (ii) Sally leaves the room. (iii) Anne moves the ball to a box and closes it, replacing the cover on the basket. (iv) Sally returns. The subject is asked: Where will Sally look for the ball after she returns to the room? The 2 or 3 year old, and the older child with ASD, says In the box (Baron-Cohen et al. 1985, see C. D. Frith & Frith 1999 for possible neural correlates). The older normal child who has Theory of Mind says In the basket. Note that the crucial change here is not in having a generic theory of mind but rather in understanding that different people can know different things and understand that Sallys mind is still in the old state even though the subject has seen the ball moved and knows that it is in the box. Consider, for contrast, the photograph task. Here the child sees a series of pictures showing (i) a bed, a chair and a bear on the chair; (ii) a camera taking a photograph of the scene with the photograph being removed from the camera; and (iii) the bear being moved to the bed. Intriguingly, even the child with ASD has ToP (Theory of Photography!) they know that the photograph will still show the bear in the chair even though the bear is now on the bed. This reinforces the point that there is no one grand ToM but rather a growing set of special skills (and some generalizations) about other people which can be present or absent in diverse combinations. Another way to address the issue of adopting anothers perspective is to use an imitation task in which the subject sees someone having their hands linked by their thumbs and showing the palms of his hands to the imitator. Children with autism, unlike normally developing children, will try to imitate the scene by facing the palms of their hands to themselves, instead of to the person who was making the test, i.e., they reproduce the effect the action had on them, rather than the original action as performed by its agent. This makes the point that both imitation and attribution of mental states involve translating from the perspective of another individual to oneself. Such considerations have led to the hypothesis (Carruthers & Smith 1996, Whiten 1996) that the beliefs of children with ASD are based solely on their first-order perceptions of the world. But a niggling doubt remains: Its not just perspective. The Polaroid photograph task shows that the child with ASD can change perspective. Of course, it can be objected that a photograph is first-order even if it is still inside the camera. But recall the definitions: First-order representations describe visible bodies and events. Second-order representations describe invisible minds and mental events. This omits what I will call indirect representations which describe invisible events, and in particular refer to internal states of objects and actors which affect ones predictions about them. Mental events (second-order representations in the above sense) are then a special case of indirect representations. The crucial point of the Polaroid photograph task is that the child with ASD 3 The present section builds in part on the discussion of Theory of Mind in Williams et al. (2001). I would prefer (a lost battle) to use the term Models of Other Minds (MoOM) to stress that what is vital is not a theory of mental behavior but rather an understanding of the mental states and dispositions of others as they vary from occasion to occasion. Clinical Neuropsychiatry (2007) 4, 5-6 215 Michael A. Arbib may form indirect representations, yet not connect them with scenarios of the kind this person is like me; if I had had the experiences they have had, then my mental state would be different, and so what they are now thinking will be different from what I am thinking, namely Again, I suggest that we view ToM as a collection of diverse skills. This discussion links back to my presentation of the Dapretto et al. (2006) finding that ASD children could successfully imitate facial expressions, but using different neural strategies from those adopted by typically developing children; and the observation (Rutter 2005) that research has concentrated on the deficits rather than on the equally important question of the compensatory cognitive strategies that individuals with autism use. What I am suggesting is that training of ASD children in the use of indirect representations in relating facial expressions to behavioral dispositions may yield most of the benefits that typically developing children may gain from a more integrated appreciation of how the mental states of others relate to, yet differ from, their own Baron-Cohen, Leslie, and Frith (1985) argued that difficulties of children with ASD in understanding the beliefs of others suggest that they lack ToM. But such ToM does not typically become robust in normal children before age four, while autistic disorders are manifested earlier. This has led some to search for precursors to ToM, such as pretend play and a capacity to engage in shared attention with another individual. Others have argued that early social deficits are often broader in scope than implied by a focus on ToM, e.g., that the primary deficit is socio-affective, a lack of empathic and emotional engagement with others. However, given the great range of symptoms across the autistic spectrum, talk of the primary deficit seems misleading at best. Indeed, some problems in ASD appear ill accommodated by a primary ToM or socio-affective deficit. These include repetitive and stereotyped behavior (including copied behaviors), obsessive desire for sameness, delayed and deviant language development (including echolalia), and difficulties in perceiving or planning at high-levels of organization (executive function). Meltzoff and Gopnik (1993) proposed that neonatal imitation could provide a key starting-state for the development of ToM. Their claim is that the new-borns capacity to translate between the seen behavior of others and what it is like to perform that same behavior offers a crucial basis for recognizing the linkage between mental states and actions. However, we need to distinguish neonatal imitation from real imitation. The neonate is mastering the correspondence problem of matching parts of its own body (whether seen or unseen) to moving parts of other bodies, not learning about the feel of specific behaviors. The former is more like effector matching and contagion in yawning or smiling. However, neonatal imitation may build the substrate for real imitation. Visual preshaping for goal-directed manual actions seems inoperative until about 9 months of age, and it seems plausible to infer that mirror neurons, and their role in imitation of novel actions, cannot be in place any earlier than this (Oztop et al. 2004). Individuals with ASD experience difficulties in executive functions (Hughes et al. 1994, Ozonoff & 216 Jensen 1999, Ozonoff et al. 1991) such as planning ability and attentional shifting. Normal executive functions may be the product of the individuals trial and error, but it is also possible that the child learns something of these functions from others, perhaps initially in relatively concrete contexts, such as playing with building blocks in infancy, and then at higher levels of abstraction and over longer time frames (ZukowGoldring & Arbib 2007). The initial stages in such a process might correspond to some kind of programlevel imitation of the type involved in apes acquiring new skills over months of observation of others (Byrne 2003, Byrne & Russon 1998). Griffith et al. (1999) found that apart from tests requiring rule reversal, there was no deficit of executive function in children under 4 years of age with autism. (Indeed, whether children with autism make more reversal errors than properly matched controls remains unclear; see Williams et al. 2004.) This suggests that the types of executive function exhibited by normal children younger than four do not require the proper functioning of processes impaired by those developmental processes (whose nature still eludes us) that are impaired in autism. Consider the similar time-scale for success on the Sally-Anne task. Some executive functions, including inhibition and possibly visual working memory appear to be spared in autism (Hughes 1996, Ozonoff & Strayer 1997, Russell 1997) though it is unclear how claims for sparing of inhibition are to be reconciled with the disinhibition characteristic of echopraxia and echolalia seen in some children with ASD. Implicit in the above is a call for a much less accepting view of the notion of mental state as a unitary concept. The appropriate critique would also build on my earlier brief analysis of the simulation theory of empathy (Gallese & Goldman 1998, Goldman 2006, Jacob & Jeannerod 2005). Some authors have proposed the Simulation Theory of ToM which proposes that children come to read minds by putting themselves in the others shoes, and using their own minds to simulate the mental processes that are likely to be operating in the other. As noted earlier, a key point here is to appreciate that the other is other i.e., that the simulation must use different variables from those that describe ones self. I stated this as the binding problem for mirror neurons: For mirror neurons for emotions to function properly in social interaction, not only must the brain have mirror neurons simultaneously active for multiple emotions, but it must also bind the encoding of each emotion (whether self or other) to the agent who is, or appears to be, experiencing it. I hypothesize that a mirror neuron system that cannot solve this binding problem, distinguishing the mental states of different people, would both yield a number of autistic symptoms and also show much less activity in a variety of tasks. Further Neural Correlates Children with ASD show not only characteristic ToM, but also impairment in reconstructing non-routine events from the personal past and in planning for the future. Suddendorf and Corballis (1997) proposed that the executive capacity to disengage or dissociate from Clinical Neuropsychiatry (2007) 4, 5-6 Autism More than the Mirror System ones actual current state (putting it offline) in order to simulate alternative states underlies both theory of mind and mental time-travel the ability to mentally construct possible (e.g. planned) events in the future and reconstruct personal events from the past. Thus, in this account mirror neurons may be involved through simulation and executive functions. However, this also looks beyond the mirror, e.g., access to the personal past might involve linking MNSs with hippocampus , whereas future planning could involve linking MNS with prefrontal cortex. In either case, we see another version of the binding problem for mirror neurons though here the binding must distinguish self-now from self-then or self-hypothetical rather than self versus other. Frith & Frith (2000) reviewed brain imaging studies of both typical individuals and those with autism, seeking to identify sites active in ToM functions. They found that a well demarcated area of the paracingulate gyrus has been consistently implicated, as have areas of the anterior cingulate cortex but not the mirror neuron regions. The paracingulate gyrus and the anterior cingulate cortex are closely linked and receive dense serotonergic innervation. One possible reason for the failure of these tasks to activate MN regions may be related to the control tasks that have been used or we may have the type of distinction between basic emotions and declarative emotions that came up in my linkage of the Dapretto et al. (2006) results to the dual route notions of Rothi et al. (1991). Other MRI studies have revealed abnormalities in subcortical regions, particularly in the cerebellum where a reduced vermis and Purkinje cells were found in its posterior and inferior areas. Riva and Giorgi (2000) found that cerebellar vermal lesions led to two profiles: (i) post-surgical mutism, which evolved into speech disorders or language disturbances similar to agrammatism; and (ii) behavioral disturbances ranging from irritability to behaviors reminiscent of autism. In addition, cerebellar and hippocampal changes have been related to symptoms of autism (Bauman & Kemper 2005). Cerebellar damage could produce lack of gaze control (needed for joint attention) and lack of response reassignment (needed for multiple goal directed activities such as social interactions). Hippocampal lesions impair precise representation of temporal information across a range of tasks and would impair construction of a time-space map of events. Such mapping is vital for extracting abstract structure from sequences of events to produce second-order representations. Baron-Cohen et al. (2000) found altered functioning in different brain regions including the medial prefrontal cortex and the amygdala. They advocated the amygdala theory of autism: In an fMRI study involving judging from the expressions of another persons eyes what that other person might be thinking or feeling, patients with autism did not activate the 7HPSRUDO&RUWH[ 2EMHFWUHFRJQLWLRQ 2EMHFWIHDWXUHV &DXVDO2SHUDWRU µ:KDW¶ SDWKZD\ 3DULHWDO&RUWH[ 2EMHFWDIIRUGDQFH H[WUDFWLRQ µ+RZ¶ SDWKZD\ 3UHIURQWDO&RUWH[ :RUNLQJPHPRU\ 3ODQQLQJ 6SDFHWLPHPDS +LSSRFDPSXV 1DYLJDWLRQ 'HFODUDWLYH PHPRU\ 3UHPRWRU 0LUURUQHXURQV 0RWRUSODQV 0RWRU&RUWH[ 0RWRUFRPPDQG )LUVWRUGHUUHSUHVHQWDWLRQV RZQSHUFHSWLRQ 7KDODPXV 3RQV &XUUHQWVWDWHQH[WVWDWH ([FHSWLRQPDQDJHPHQW RZQYVRWKHUV¶ VHOHFWLRQ 6WULDWXP *3L 671 %* 0HPRU\DQGVHTXHQFH PDQDJHPHQW ,QKLELWLRQ &HUHEHOOXP ,QYHUVHDQG IRUZDUGPRGHOV 5HVSRQVHUHDVVLJQPHQW WLPLQJ 6DYHGFRQWH[WHYHQWV 2QHVKRWOHDUQLQJ 6HFRQGRUGHU UHSUHVHQWDWLRQVRWKHUV¶ SHUFHSWLRQ Figure 4. Salvador Mármols schematic of the Beyond the Mirror System highlighting functions and interactions whose impairment may be implicated in various aspects of Autistic Spectrum Disorders (Mármol Yahya 2002, unpublished) Clinical Neuropsychiatry (2007) 4, 5-6 217 Michael A. Arbib amygdala, whilst people without autism did show amygdala activity. The amygdala was therefore proposed to be one of several neural regions that are abnormal in autism. However, Amaral et al. (2003) answered negatively the question Is the amygdala an essential component of the neural network for social cognition? Adult rhesus monkeys with bilateral lesions of the amygdala demonstrate near normal social interactions with conspecifics. Neonatal animals with amygdala lesions at 2 weeks of age also demonstrate species-typical social behaviors such as the generation of facial expressions as well as grooming and play behavior. They conclude that the amygdala is not essential for the interpretation of social communication or for the expression of social behavior. Amygdala does appear to participate in the evaluation of the safety of social interactions and so, they suggest, may have a role in modulating the amount of social behavior in which an organism will participate. Such considerations led Salvador Mármol to develop the scheme shown in Figure 4 (Mármol Yahya 2002, unpublished). The point here is not to debate the adequacy of this scheme (though thought-provoking, it is surely too simple) but rather to indicate the challenges of charting the manifold interactions of the brain wherein a variety of different malfunctions can conspire to place a child on the road to ASD. Modeling the Mirror System and Beyond It is well understood that ASD is linked to changes in many genes, and increasingly well understood that across the spectrum of ASD we see differential changes in many brain regions. Much data from molecular biology and brain imaging, etc., will be required to characterize these changes. But how do changes within any one region affect its development and function, and how does change in one region affect the competition and cooperation of the larger network of brain regions of which it is part? My claim is that mere verbal analysis is inadequate for the long-term challenge, and that only increasingly complex simulations will be able to chart this unfolding complexity. I am not unbiased in this judgment my primary research is in computational neuroscience, trying to understand how behavior is mediated by interaction between various brain regions, each analyzed in terms of the activity of large neural circuits (see Arbib 2003a for a non-technical introduction, and Arbib 2003b for all the gory details), but I have avoided this type of formal analysis in the body of the paper. In this Section, I say just enough about a few models to indicate what is involved. Figure 5 shows the MNS Model of the Mirror System for grasping (Oztop & Arbib 2002). It relies on two visual analyses: one extracts the affordances (opportunities for grasping) of the attended object; the other analyzes the motion of the hand and changes of hand shape. Together, these represent how the hand approaches the objects affordances, coding within the brain hand-object relations in an object-centered coordinate framework. The model shows how synaptic plasticity can enable a set of trajectories (movement and preshaping of the hand in relation to an objects Figure 5. The MNS Model of the Mirror System Model for grasping (Oztop & Arbib 2002). Note that it involves not only the mirror system itself, but visual systems along with non-mirror regions of premotor cortex as well as temporal and parietal cortex. The point is that, to understand even the most basic aspects of the mirror system, one must understand how it is embedded in, and gains its functionality from, a much larger network of brain regions 218 Clinical Neuropsychiatry (2007) 4, 5-6 Autism More than the Mirror System affordances for grasping) to become associated with the activity of specific sets of mirror neurons. MNS simulation results show that (a) the model can indeed appropriately associate sets of trajectories with classifications of actions (mirror neuron coding); and (b) the confidence level of these judgments is reduced by changes in parametric properties of the trajectories. The moral of this effort is that modeling using adaptive neural networks supports the view that the repertoire of the mirror system is acquired rather than innate. Recent work has developed a more extensive model of the mirror system for grasping, the MNS2 model (Bonaiuto et al. 2007). It adds two important capabilities: 1) Audible Grasps: Kohler et al. (2002) found F5 mirror neurons that responded to the sight and sound of actions with characteristic sounds such as paper tearing and nut cracking. MNS2 addresses this by adding audio input connected to the output layer of the learning network, with the connections modified with Hebbian learning. This explains how the mirror system can learn to pair each grasp type with a different pattern in the audio input layer if indeed the action has a distinctive sound pattern. 2) Hidden Grasps: Umiltà et al. (2001) found that grasp-related mirror neurons will respond to grasps obscured by a screen as long as an appropriate object was previously seen before being obscured by a screen. MNS2 addresses this by adding working memory for parietal cortex for object and hand information, with dynamic remapping to update working memory representation of hand location based on visible arm movement, mechanisms already explored in early modeling of the saccadic system (Dominey & Arbib 1992). My point is not to provide a comprehensive exposition of the models here, but rather to show that once one works through in computational detail the representations and interactions involved in even the basic workings of the mirror system, one is forced to consider subtleties that become obscured in a purely verbal analysis based on the lumping of all the detailed workings of neural circuitry into a few blobs on an fMRI scan. Looking to future work in computational neuroscience that extends the scheme shown in Figure 5, I note the need for a range of extensions in modeling the mirror system and beyond: Selective attention (attending to the instrument and object related within the action) Recognizing the object Recognizing the agent The binding problem when actions and emotions must be bound to different agents Understanding the role of mirror systems and inhibition in imitation Beyond the hand what are the commonalities and differences of mirror systems for hand, face, articulators, and other effectors? Broadening the linkage to motivational systems Going beyond recognition of single actions to recognition of sequences and hierarchical actions Integrating the study of transitive and intransitive actions Language the Mirror System Hypotheses: (Arbib Clinical Neuropsychiatry (2007) 4, 5-6 2005, Rizzolatti & Arbib 1998) And even this menu does not go far enough since it omits the role of many other brain regions discussed in the Section on Further Neural Correlates. Manifesto Lets stop talking about the mirror neuron system. Lets accept that mirror neurons do not understand and try to define their role within larger systems supporting actual behavior in real life situations. In particular, more attention is needed to the fact that a mirror neuron system that cannot solve the binding problem, distinguishing the mental states of different people, would yield a number of autistic symptoms and show much less activity in a variety of tasks. Other relevant mechanisms whose deficits may correlate with ASD symptoms include inhibitory mechanisms, and distinct paths for imitation suggested by the direct and indirect routes of the praxis model of Rothi et al. (1991). Detailed analysis of how mirror systems function within a broader context will help assess what possibly different MNS defects contribute to: social deficits communication abnormalities repetitive/stereotyped behavior while doing justice to important correlates, such as those on amygdala and orbitofrontal cortex, of other brain regions with varied symptoms of ASD. Deeper understanding of mirror systems will rest not only in brain imaging of humans undergoing a range of cognitive and other tasks, but also on further research on monkeys: neurophysiological: more details on, e.g., mirror neuron outflow; behavioral: Comparing monkey sociality with normal and autistic human sociality; and comparative/evolutionary: Assessing what monkeys & humans do/do not share in terms of imitation, empathy, communication and sociality. This will ground what we can learn about human brain mechanisms from such comparisons. The data and the models reviewed in this article caution us (i) to avoid viewing the mirror system as just a bunch of mirror neurons lighting up for specific observed actions and instead look in more detail at what it takes for mirror neurons to do their jobs, and (ii) to understand that they cannot do these jobs save as part of larger neural systems beyond the mirror system. 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