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A cybernetic approach to childhood psychosis

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... 262 ROY M. KAHN AND MICHAEL A. ARRIB ... Piagetian schemata may be reflected here; and at more explicit biological levels, Levy (1970) and Sperry (1971) have experimentally studied brain function as it actually occurs, and information-processing
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  Journal of Autism and Childhood Schizophrenia, 1973, 3, 3,261-273 A Cybernetic Approach to Childhood Psychosis 1 RoY M. KAHN 2 MICHAEL A. ARBIB California State University at University of Massachusetts at San Francisco and University Amherst, Department of Computer of California Ext.) at Berkeley and Information Science A theoretical approach to childhood psychoses is presented with a focus on insights gained from the development of computer techniques. Such insights can be applied to the study and treatment of autism and related psychoses in early life, leading to an understanding of psychotic behavior in terms of a defect of the process rather than defect of result. It is assumed that the aim of adaptation in children and adults is to correlate present perception with past experience so as to build up internal models of the world which aid in formulating and choosing beneficial courses of action. This process is described cybernetically in terms of programming and hardware, with the understanding that as the thinking mechanism matures physiologically, the program is continually modified by experience. Childhood psychoses can be classified in terms of defects in the program and hardware, and it is postulated that the resulting theory has clear and testable consequences for therapy and future research. Many different attempts have been made to understand human behavior by studying hypothetical machines which might behave in similar ways. The aim is to set higher standards of explanation in psychology by requiring that a claim to understanding of a system be supported by plausible mechanisms for the processes described. The present paper sets forth some necessary elements which cybernetics can contribute to such an effort toward the control of behavior in childhood psychoses. 1 This paper is based on research supported in part by the Public Health Service under Grant No. 5-R01 NS 09755-03 COM from the National Institute of Neurological Diseases and Stroke. 2Requests for reprints should be sent to Dr. Roy M. Kahn, 21 Avenida Drive, Berkeley, California 94708. 261 Copyright 9 1973 by V. H. Winston & Sons, Inc.  262 ROY M KAHN AND MICHAEL A ARRIB HARDWARE AND SOFTWARE PROGRAMS AND PSYCHOSIS The basic approach of cybernetics to psychological functioning is to view the brain as an immensely sophisticated information-processing and storing device. In computer science, a computer's information processing capacity and style are determined largely by its hardware and software. Hardware comprises the unchangeable aspects of the wiring, structure, and built-in programs. Software is the program and the overall operating system, which together constitute the array of routines or sub-routines to be followed in the active search for new or old information, and in the absorption, storage, retrieval and use of input information. In computers, it is possible to create models that simulate human internal activity, such as the precursors to overt behavior to see whether the mechanisms underlying the model-functioning can indeed replicate observed human behavior. Adopting the metaphor of hardware and software, we suggest that programs in the brain of a human child evolve in part and over time by the development of body systems as the child matures, in part by the nature of the inputs themselves as the systems develop, and most importantly by the interactions between these factors. Piagetian schemata may be reflected here; and at more explicit biological levels, Levy (1970) and Sperry (1971) have experimentally studied brain function as it actually occurs, and information- processing models and systems. There is one significant difference between current computers and persons in our scheme which may be less true as computer technology evolves. It is not now true that unless you program a computer at a specific point in time it may later fail to be programmable in a specific fashion, but such may occur in critical period failures in human development. The overall program of a child's brain may emerge as either: (1) "constructive," through enhancement of normal developmental steps and sequences, and "adaptive," in helping the child to build internal models of the world around him so he can cope with his internal and external environments, or (2) "inappropriate" due to: (a) defects in the objective program contents themselves-wrong information or inputs contradicted by information already stored at hardware levels, or inputs unacceptable across sense modalities, (b) defects in the manner or sequence in which such inputs are fed into the input-receiver perhaps accompanied by inappropriate reward or inconsistent affection, (c) defects in the inputs themselves, which may be selfo contradictory.  CYBERNETIC APPROACH TO PSYCHOSIS 263 "Inappropriate" inputs will ultimately yield peculiar behavioral outputs or inappropriate internal processing of information. These may be analogous to anxiety-driven behaviors or anxiety-based emotional/physiological responses; reactions unsuited to the input. These are the reactions termed neurotic, anxiety-driven, somatic equivalents, or psychotic; but cybernetically they are viewed solely as systems dysfunctions. MEN AND MACHINES The somewhat wrenching conceptual redefinition needed may be suggested by noting that in cybernetic theory a machine may be defined as "any system such that its state and input at one instant determines its subsequent behavior" (Ashby, 1968). By such a definition, the human and his brain may be considered analogous to machines. Humans and computers may each misfunction also because of "hardware" defect. In humans such defects would be termed organic. We have suggested that hardware defects yielding "incompatible systems" may be implicated in infantile autism (Kahn & Arbib, 1971). SYSTEMS The cybernetic approach stresses the need to examine and focus on the failure that exists in the information processing systems themselves. It redefines psychosis as inadequacy or inappropriateness in the process of information processing rather than focusing on internal structures or psychological end-goals. The system itself is the focus. Cybernetics moves away from the argument between the organic and the functional views of psychosis, although this issue may not be obviated altogether (Kahn, 1970). System theorists have begun to analyze the structures of hierarchical biological, social and psychological systems whose units range from gross ones such as social order to small ones such as cells or molecular systems (Apter, 1970; Arbib & Kahn, 1969; Brazier, 1965; Calloway, 1970; Colby, 1968; Dmitriyev, 1966; Kahn & Arbib, 1971; Peterfreund & Schwartz, 1971). A cybernetician's characterization of a system meets some, but not all, of the needs of this problem: a system is characterized by three sets and two functions: (a) a set of inputs, a set of outputs, and a set of internal states, (b) a state-transition function ~i which describes how the current input and internal state determines the next state of the system, and (c) an output function which describes how the current internal state determines the output of the system.  264 ROY M. KAHN AND MICHAEL A. ARBIB We say that a system is adaptive if the state-transition function 5 can change over time. The schema for such change will clearly involve evaluation of how well the current/5 has enabled the system to achieve its various goals. There exist mathematical theories for the design of adaptation schemes for machines with such various tasks as controlling assembly lines, playing checkers or classifying patterns, but these are of little help in conceptualizing the adaptations which constitute the mental development of the child. We hypothesize that the aim of adaptation in the child (and the adult) is to correlate his perceptions of the world and of the results of his interaction with it in such a way as to build up internal models of it which may aid him in perceiving "appropriate" courses of action and in choosing "beneficial" ones. There is no satisfactory definition of such terms as "appropriate" and "beneficial." In practice one must try to render them more precise in each particular application, but in any case, the criteria will often be societal rather than absolute. It is the state of the system as updated by successive inputs via successive/5's that reflects the child's interaction with its current environment. The interaction should be such that the child need not look at the world anew every millisecond in order to classify what is sensed, but can produce a continually updated short-term model of his possible interactions with his surroundings. Long-term memory (LTM) is expressed in a changing/5 and thus a changing treatment of input. It is of value if, as LTM's accumulate, they cohere into some sort of model of the enduring properties of the world, enabling the child to carry out internal experiments through which he may interact more satisfyingly with the world. Thus as he accumulates experience of the world, he must build criteria of what constitutes satisfying interactions with it-present actions being conditioned not merely by past experience, but also by intentions for the future. With regard to the "need for sameness" often described in the infantile autistic child, it appears from his intolerance of environmental change that his memory is not sufficiently adaptive or modifiable through normal intercourse with the environment. Rather than creating current up-dated models and modifying old ones, he may have an inflexible 6 that blocks the model-building process. In contrast, in the "childhood schizophrenias," the 6 appears to flex so as to distort input. Certainly these are different processes. Cybernetics views "psychotic" behavior in both children and adults as process-defects rather than as end-products (overt actions, verbal ex- pressions, or even the internal experience of anxiety). The failure of a process may be at any level from microcellular to societal-international, but systems theory, using computers, may be used to analyze the effects of various possible interactions among these levels objectively, positing  CYBERNETIC APPROACH TO PSYCHOSIS 265 different possibilities and examining resultant effects on output, sub- sequent feedback and process. APPLICATIONS BASED ON CLINICAL OBSERVATIONS In 1968, Colby stated his views as follows: A majestic absurdity characterizes the classification system in psychiatry. Since there is such poor agreement among diagnosticians, the categories of classification are unreliable. And since there is little correlation between diagnosis, signs and symptoms, the categories are of doubtful validity .... Yet a more satisfactory taxonomy is crucial for clinical practice, and in particular for future research designed to yield dependable knowledge. Later he added, Finally, little experimental work has been done in investigating childhood mental disorders from an information-processing standpoint .... A variety of tests and experiments could be introduced while a child is playing with a computer-based system able to control symbols and objects... In fact, Colby's experiments in which he taught "autistic" children to speak employed exactly such a computer and a series of 10 games involving a typewriter, a device which sounded the letters in various ways, and a variety of programs. The experiment capitalized on the clinical observations that children with a diagnosis of infantile autism enjoy machinery, but avoid people, and that people grow bored, angry and inconsistent while computers remain patient. After using such apparatus and programs, 8 "mentally disturbed" children improved in their use of language, and 2 did not. Small computers can be shared by many children with differing programs. Colby's later work (constructing paradigms to determine if programs could be devised to produce the psychological behavior predicted and then extrapolating to possible underlying neural systems-function) emphasizes the need for early model-building if such computer-usage is to become more than an eminently useful but haphazardly understood tool (as is EST today in adult psychiatry). In a similar vein, a cybernetic analysis of the behaviors of children with a diagnosis of infantile autism prompted us to conclude that certain processes are missing or absent in such children, while appearing present but inappropriate
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