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autism ADHD six blindnesses

The Six Blindnesses in Autism and ADHD: What You Need to Know


Navigating daily life can be challenging for neurodivergents due to the “six blindnesses.” In this blog post, you’ll learn about these unique challenges and how they affect those with autism and ADHD.

Introduction

The “six blindnesses” are a memorable way to illustrate some common challenges experienced by autistics and ADHDs. It is important to recognize that these “blindnesses” are not necessarily deficits but rather distinct ways in which neurodivergent people experience the world.

1. Time Blindness

Time blindness refers to the struggle with estimating and managing time, a challenge often tied to executive dysfunction. Those with time blindness may find it difficult to be punctual, adhere to schedules, and meet deadlines. While this issue is predominantly linked to ADHD, it is also observed in autistics.

2. Face Blindness (Prosopagnosia)

Prosopagnosia, or face blindness, affects about 36% of autistics, making it hard for them to recognize faces, even those of close acquaintances or themselves. This condition can also be present in ADHDers, possibly because of traits like hyperactivity, inattention, and impulsiveness, or differences in social cognition.

3. Inside Blindness (Interoception)

Interoception is the awareness of internal bodily signals. Many ADHDers struggle with recognizing and responding to internal states such as hunger, thirst, fatigue, and pain, a condition referred to as inside blindness. This challenge is likened to having a broken internal thermometer. Autistics may also experience similar difficulties with interoception.

4. Feeling Blindness (Alexithymia)

Alexithymia is characterized by difficulty in identifying and describing emotions. This condition can hinder the ability to display nonverbal emotional expressions like smiling or crying. Internally, individuals with alexithymia might feel empty, overwhelmed, or confused, often leading to a disconnect from their emotional responses. Physical reactions typical of emotional states, such as blushing or a tense stomach, might occur, but linking these sensations to specific emotions can be challenging.

Approximately 50% of autistics and 42% of adult ADHDers experience alexithymia. While some symptoms resemble depression, both can co-occur, which can lead to misdiagnosis. Alexithymia can manifest as emotional blanking, where individuals adopt a flat expression and limit outward emotional displays, often as a defense mechanism in response to stress or perceived threats. This phenomenon may also be a component of PTSD, where emotional blanking represents the internal emotional numbing associated with the condition.

Some neurodivergents may alternate between alexithymia and “emotional storms,” experiencing sudden, intense emotions that surpass their ability to regulate, leading to swift mood swings and heightened reactions.

5. Perspective Blindness (Egocentricity)

Egocentrism involves focusing on one’s own perspective, sometimes neglecting others’ needs. While traditionally attributed to autistics, this trait does not signify selfishness. Autistics may struggle with understanding and accommodating others’ perspectives due to difficulties in navigating social contexts. Similarly, ADHDers may exhibit egocentric tendencies, finding it challenging to comprehend others’ viewpoints during communication.

6. Mindblindness

Mindblindness refers to difficulties in recognizing and understanding mental states in oneself and others, a trait observed in autistics that may contribute to perspective blindness. For ADHDers, core characteristics such as impulsiveness, inattentiveness, and hyperactivity can influence perspective blindness. They may struggle to focus on others, leading to challenges in interpreting tone of voice, facial expressions, and body language, which can hinder understanding others’ intentions, emotions, expectations, or needs.

Concluding Thoughts

The “six blindnesses” illustrate some of the unique challenges faced by neurodivergents. Understanding these blindnesses helps in fostering empathy and creating supportive environments for autistics and ADHDers. Recognizing these challenges as differences rather than deficits allows for better accommodation and appreciation of neurodivergent experiences.

 

References

Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale – I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23–32. https://doi.org/10.1016/0022-3999(94)90005-1

Casassus, M., Poliakoff, E., Gowen, E., Poole, D., & Jones, L. A. (2019). Time perception and autistic spectrum condition: A systematic review. Autism Research, 12(10), 1440–1462. https://doi.org/10.1002/aur.2170

DuBois, D., Ameis, S. H., Lai, M. C., Casanova, M. F., & Desarkar, P. (2016). Interoception in autism spectrum disorder: A review. International Journal of Developmental Neuroscience, 52, 104–111. https://doi.org/10.1016/j.ijdevneu.2016.05.001

Eichhorn, S., Brähler, E., Franz, M., Friedrich, M., & Glaesmer, H. (2014). Traumatic experiences, alexithymia, and posttraumatic symptomatology: A cross-sectional population-based study in Germany. European Journal of Psychotraumatology, 5. https://doi.org/10.3402/ejpt.v5.23870

Hemming, L., Haddock, G., Shaw, J., & Pratt, D. (2019). Alexithymia and its associations with depression, suicidality, and aggression: An overview of the literature. Frontiers in Psychiatry, 10, 203. https://doi.org/10.3389/fpsyt.2019.00203

Kinnaird, E., Stewart, C., & Tchanturia, K. (2019). Investigating alexithymia in autism: A systematic review and meta-analysis. European Psychiatry, 55, 80–89. https://doi.org/10.1016/j.eurpsy.2018.09.004

Kiraz, S., Sertçelik, S., & Erdoğan Taycan, S. (2021). The relationship between alexithymia and impulsiveness in adult attention deficit and hyperactivity disorder. Turkish Journal of Psychiatry, 32(2), 109–117. https://doi.org/10.5080/u23775

Levant, R. F., & Parent, M. C. (2019). The development and evaluation of a brief form of the Normative Male Alexithymia Scale (NMAS-BF). Journal of Counseling Psychology, 66(2), 224–233. https://doi.org/10.1037/cou0000312

Lombardo, M. V., & Baron-Cohen, S. (2011). The role of the self in mindblindness in autism. Consciousness and Cognition, 20(1), 130–140. https://doi.org/10.1016/j.concog.2010.09.006

Lumley, M. A., Neely, L. C., & Burger, A. J. (2007). The assessment of alexithymia in medical settings: Implications for understanding and treating health problems. Journal of Personality Assessment, 89(3), 230–246. https://doi.org/10.1080/00223890701629698

Minio-Paluello, I., Porciello, G., Pascual-Leone, A., & Baron-Cohen, S. (2020). Face individual identity recognition: A potential endophenotype in autism. Molecular Autism, 11, Article 81. https://doi.org/10.1186/s13229-020-00371-0

Nemiah, J. C., Freyberger, H., & Sifneos, P. E. (1976). Alexithymia: A view of the psychosomatic process. In O. W. Hill (Ed.), Modern Trends in Psychosomatic Medicine, 3, 430–439. Butterworths.

Nilsen, E. S., Mangal, L., & Macdonald, K. (2013). Referential communication in children with ADHD: Challenges in the role of a listener. Journal of Speech, Language, and Hearing Research, 56(2), 590–603. https://doi.org/10.1044/1092-4388(2012/12-0013)

Nilsen, E. S., Mewhort Buist, T. A., Gillis, R., & Fugelsang, J. (2013). Communicative perspective-taking performance of adults with ADHD symptoms. Journal of Attention Disorders, 17(7), 589–597. https://doi.org/10.1177/1087054711428947

Parks, K. M. A., Cardy, J. E. O., Woynaroski, T. G., Sehl, C. G., & Stevenson, R. A. (2021). Investigating the role of inattention and/or hyperactivity/impulsivity in language and social functioning using a dimensional approach. Journal of Communication Disorders, 89, 106036. https://doi.org/10.1016/j.jcomdis.2020.106036

Ptacek, R., Weissenberger, S., Braaten, E., Klicperova-Baker, M., Goetz, M., Raboch, J., Vnukova, M., & Stefano, G. B. (2019). Clinical implications of the perception of time in attention deficit hyperactivity disorder (ADHD): A review. Medical Science Monitor, 25, 3918–3924. https://doi.org/10.12659/MSM.914225

Romani, M., Vigliante, M., Faedda, N., Rossetti, S., Pezzuti, L., Guidetti, V., & Cardona, F. (2018). Face memory and face recognition in children and adolescents with attention deficit hyperactivity disorder: A systematic review. Neuroscience and Biobehavioral Reviews, 89, 1–12. https://doi.org/10.1016/j.neubiorev.2018.03.026

Shimamura, K., Inoue, T., Ichikawa, H., Nakato, E., Sakuta, Y., Kanazawa, S., Yamaguchi, M. K., Kakigi, R., & Sakuta, R. (2019). Hemodynamic response to familiar faces in children with ADHD. BioPsychoSocial Medicine, 13, Article 30. https://doi.org/10.1186/s13030-019-0172-1

Tei, S., Fujino, J., Itahashi, T., Aoki, Y., Ohta, H., Kubota, M., Hashimoto, R. I., Nakamura, M., Kato, N., & Takahashi, H. (2019). Egocentric biases and atypical generosity in autistic individuals. Autism Research, 12(11), 1598–1608. https://doi.org/10.1002/aur.2130

Wiersema, J. R., & Godefroid, E. (2018). Interoceptive awareness in attention deficit hyperactivity disorder. PloS One, 13(10), e0205221. https://doi.org/10.1371/journal.pone.0205221