Thinking in Pictures

0:01Juno: The woman who wrote today's book says she doesn't do her thinking in words. She does it in pictures, and the words come afterward, as a translation.

0:12Beck: Temple Grandin. An animal scientist who designs equipment for handling cattle, and by 1995, on her second book about her own autism.

0:22Juno: She can build a machine in her head, run it, find the flaw and fix it before anyone pours concrete.

0:31Beck: That's her account of her own mind, and I don't get to score it. It's hers.

0:37Juno: So what do you get to score?

0:40Beck: The step after. A reader finishes this book and turns her sentence about herself into a sentence about autistic people. That second sentence has studies behind it, and they don't all agree.

0:53Juno: She noticed that too, didn't she?

0:56Beck: About ten years later, in writing. It's one reason this is a good one.

1:02Juno: Today: Thinking in Pictures, Temple Grandin, 1995, expanded in 2006.

1:22Juno: The Observatory, presented by Lone Star Telehealth. We read the book so you can decide whether to.

1:29Juno: Last time NeuroTribes told a century of autism through the doctors who named it and the families who lived with the names.

1:37Beck: Today someone who was handed one of those names writes the description herself.

1:43Juno: What's she saying, in terms she'd put her name to?

1:47Beck: Her mind runs on images. A word she hears becomes a picture, and her memory works like a video library she can search and replay. Abstract ideas are the hard part, so she builds pictures for them. For years other people's relationships made no sense to her, until she found images to stand in for them: doors, gates, a window.

2:09Juno: Doors for a change in her life.

2:12Beck: Yeah. Doors for a change in her life. And the argument built on top of that is practical. A mind like hers is specialized, very good at some things and very bad at others. Algebra defeated her, because there was nothing to see. A cattle facility she could design and test-run in her head. So the work, for a parent, a teacher, or the person themselves, is to find what that mind does well and build a working life on it.

2:42Juno: And on the page?

2:44Beck: Like a set of reports. Chapters on the senses, emotion, medication, animals and faith, each one mixing her own life with the research of the day. The expanded edition keeps the original text and adds updates after the chapters, so you can watch her revise herself.

3:06Juno: That's rarer than it should be.

3:08Beck: Mm-hm.

3:16Juno: Which story do we tell? There's a lot to choose from.

3:21Beck: I'd take the dip vat. Nineteen seventy-eight, a feed yard in Arizona that belonged to John Wayne. Cattle get walked through a deep pool of treated water that kills parasites. The old entrances were a steep, slick slide. Cattle panicked going in, and some drowned.

3:40Juno: That's grim.

3:42Beck: It is. She pictured it from the animal's side: a slippery drop into water with no visible bottom. So she designed a concrete ramp with grooves cut in for footing, and the cattle walked in calmly.

3:57Juno: And it worked.

3:59Beck: It did, until the yard's cowboys laid a sheet of metal over the ramp without telling her and turned it back into a slide. Two cattle drowned the first day. The sheet came off, and the ramp worked again.

4:12Juno: So the design was right and nobody trusted it.

4:16Beck: And that's the whole book in one afternoon. She saw what the animal would see, and the people around her couldn't, until it cost them.

4:26Juno: The squeeze machine is the other one.

4:29Beck: It is. As a teenager, at her aunt's ranch, she watched cattle go still in the squeeze chute that holds them for vaccinations. Later she built a version for herself: two padded boards, with the pressure under her own control. The professionals around her wanted it taken away. A science teacher, Mr. Carlock, told her to find out why it worked instead.

4:52Juno: Good teacher.

4:53Beck: And she tells it as the start of something larger. Learning to accept comfort, as she describes it, came before she could give it.

5:02Juno: That's the chapter I'd read first.

5:12Juno: What's your read on it? Start with the senses, since she gives them a whole chapter.

5:18Beck: Her first claim is that sensory problems are central to autism, not a footnote. Held, and the field moved toward her. When this book came out, the diagnostic manual didn't list sensory differences among the criteria for autism. In 2013 the fifth edition added them: being over-reactive or under-reactive to sound, touch, light and the rest. And a 2019 meta-analysis pooled fifty-five questionnaire studies, about forty-six hundred autistic people in all. Against nonautistic comparison groups, the differences were large for over-reactivity, under-reactivity and sensory seeking, with a lot of variation from study to study.

6:01Juno: So she was early.

6:03Beck: Early, and writing from inside it.

6:06Juno: What about deep pressure? She says it calms.

6:10Beck: Held as a pattern, and smaller than the chapter suggests. In 1999 a pilot study, with her among the authors, tested her machine. Twelve autistic children were randomly assigned to her machine with the pressure on, or to the same machine with the pressure off, twice a week for six weeks. Parents rated less tension in the pressure group; the change in anxiety was only marginal. Twelve children.

6:38Juno: And since?

6:40Beck: The claim underneath got a bigger test in 2014, with weighted blankets and sleep. Seventy-three autistic children with severe sleep problems, randomized, each trying a weighted blanket and an ordinary one for two weeks apiece. On a wrist monitor, the weighted blanket didn't help them sleep longer, fall asleep faster or wake less. The children and their parents preferred it anyway.

7:02Juno: They liked it and it didn't do anything.

7:06Beck: Nothing a monitor could catch. Liking it is worth something. It's a different finding from calming.

7:13Juno: Fair.

7:15Juno: Then the one I didn't expect from a 1995 book.

7:19Beck: Facilitated communication, where a helper supports someone's hand or arm while they type. It had a wave of excitement behind it then, and she was cautious. She wrote that most controlled studies found the helper was doing the typing, left a little room for people who could already read, and said the support had to come off before anyone could be sure. Held, and then some. A 2014 systematic review, done for an international society for assisted communication, looked at the experimental tests of who writes the messages. The facilitators did. The authors concluded the method has no validity.

7:58Juno: So she was more careful than a lot of people with more credentials.

8:03Beck: On that one, yes. She had the excitement on one side and the studies on the other, and she went with the studies.

8:20Juno: Now the title.

8:21Beck: Here's the claim as the book first made it. She's a visual thinker, and in 1995 she wrote as if most autistic people were too. In the expanded edition she says outright that she'd believed that, and she sorts autistic minds into three kinds: visual thinkers like her, pattern thinkers who are strong in math and music, and verbal thinkers who live in word details and facts.

8:47Juno: So she corrected herself before you could.

8:50Beck: Yeah. Before I could. So I'll score what's left. As a group finding, is there anything to picture thinking? Some. In 1994 three autistic adults were beeped at random moments through the day and asked what was in their minds right then. All three described their thoughts mostly or entirely as images. Nonautistic adults sampled the same way report a mix. Three people.

9:17Juno: Three's not many.

9:19Beck: No. A 2006 brain-imaging study gave twelve autistic adults and thirteen matched controls sentences to understand. Some needed a mental image, like a number turned on its side to look like something else. Some didn't. The autistic group used imagery regions for both kinds, the controls mostly for the first. And a 2007 study gave thirty-eight autistic children two intelligence tests. On the visual puzzle test they scored, on average, thirty percentile points higher than on the more common one. Children without autism showed no gap.

9:58Juno: That's a point for her.

10:00Beck: For some autistic people. A 2011 review of the whole hypothesis landed there: worth taking seriously, true of a subset, and nobody can yet say which subset. Then there's evidence running the other way. In 2021 researchers compared a hundred and eighteen people with little or no visual imagery against a hundred and eighteen matched controls. The low-imagery group scored higher on a questionnaire of autistic traits, mostly the items on imagination and social skills. Nobody in it was assessed for autism, so these are traits, not diagnoses. Still, some autistic traits travel with fewer pictures, not more.

10:43Juno: So picture thinking held for some.

10:46Beck: Yeah. Held for some, as a pattern. Not as a description of autism.

10:52Juno: And the three kinds?

10:54Beck: Open. Something like it turns up in research on people in general. A 2005 study found that people who favor visual thinking split into two groups. One was good at vivid, detailed images, and a lot of visual artists landed there. The other was good at spatial relations, and a lot of scientists and engineers landed there. Verbal thinkers scored in between. That's close to her map. Nobody's tested whether autistic people sort into her three.

11:25Juno: I like the three kinds. It gives a reader words for how their own head works.

11:31Beck: It's a good description. A description isn't a finding. And there's a caution from education research: a 2008 review went looking for experiments showing that teaching matched to someone's preferred style beats teaching that isn't. It found almost none done properly, and some that went the other way.

11:50Juno: So you won't sign it.

11:52Beck: I won't sign it, and you won't let it go.

11:56Juno: Then it stays open.

11:58Juno: There's a chapter for parents of young children, too.

12:01Beck: There is, and it covers the Lovaas program, an early form of what's now called applied behavior analysis, or ABA. The book reports the program's claim that nearly half its young children went on to regular classrooms, warns it could overwhelm a child with severe sensory problems, and cites studies favoring twenty to twenty-five hours a week of one-to-one teaching. It also notes that her own mother taught her to read in thirty minutes a day.

12:40Juno: And the evidence?

12:42Beck: For the record, this show doesn't provide or endorse ABA. Plainly, then. The nearly-half figure traces to a 1987 study: nineteen children in the intensive program, about forty hours a week, and nine reached ordinary classrooms. Children weren't randomly assigned; they were placed by therapist availability. A 2018 Cochrane review found five studies of early intensive behavioral programs, two hundred and nineteen children, and only one of the five was randomized. It found gains in everyday adaptive skills and IQ against usual services, and rated the evidence low quality.

13:21Juno: And our listeners are adults.

13:24Beck: So that's where we leave it. Read that chapter as what parents were being offered in 1995.

13:31Juno: She has a medication chapter, and she's in it.

13:35Beck: She is. She describes anxiety attacks that began around adolescence, and a low dose of an antidepressant, started in her thirties, that she credits with calming them.

13:47Juno: Your part.

13:48Beck: Here's where the show stands, and it isn't a formality. We don't prescribe, recommend, rank or compare medications, today or any day. The expert is the prescriber, and the relationship that counts is that one. What a therapist can offer is the step before it: helping someone arrive at that appointment with a clear account of how their days go. It's harder than it looks, and a big part of why people leave those visits with less than they could.

14:19Juno: That one comes from Logan.

14:21Beck: It does. He put it in the show, and not to satisfy a lawyer. He treats the medication conversation this way himself, with everyone he sees, and he thinks every therapist should.

14:34Juno: And someone who'd rather not take anything?

14:38Beck: Gets equal respect. Medication is a frontline treatment; we won't talk around that. It's still a choice, and it stays yours.

14:57Juno: The question I keep coming back to. This is an autistic adult explaining her own mind to a general reader, in 1995. What does that do, from the reader's chair?

15:11Beck: You start.

15:12Juno: It gives a person words for a mind that works differently and works. She doesn't apologize for the visual thinking. She says she wouldn't give it up. She treats it as a tool she learned to use, and the book is the manual. For a reader who's been told for years that their way of thinking is the problem, that lands.

15:35Beck: I'll give you that. Here's the cost. When one autistic person gets famous, her mind becomes the template. People meet an autistic adult and expect pictures, or a special talent, or cattle. Most autistic adults don't fit that, and she says as much in the updates. The template traveled faster than her correction.

15:59Juno: I'll grant that one.

16:00Juno: There's a cost of doing business all through this book, too. The effort of meeting a world built for someone else. She itemizes it: rehearsing what she'll do if a trip goes wrong, keeping backup plans ready, working out social rules by logic, one case at a time.

16:18Beck: Right.

16:19Juno: One more thing readers raise. She designs facilities where cattle are slaughtered, and she writes about animals with real tenderness.

16:28Beck: Animal advocates have asked how those fit together. Her answer is that animals raised for food are owed a decent life and a calm death, and she built audit systems to check whether plants deliver it. Critics say voluntary industry audits don't go far enough. She says the audits changed the plants. Both sides are reading the same record, and the book gives hers, in her terms.

17:00Juno: Last thing before we wrap. Her whole working life is translation. Pictures into words when she talks, words into pictures when she listens.

17:12Beck: And these days a chat window will turn a paragraph into a diagram, or a diagram into a list.

17:19Juno: That sounds made for her.

17:21Beck: It sounds handy for plenty of people, going either direction. A picture thinker can ask to see the steps laid out. A word thinker can ask for the drawing spelled out in sentences. Nobody's studied whether it helps. So treat it like a ruler: try it, keep what works, and don't call it a treatment.

17:41Juno: And what stays out of it?

17:44Beck: Anything you'd want guarded. What you type there sits outside any medical record, and nobody's bound by the rules that protect one.

17:52Juno: She'd check the drawing the way she checks a chute.

17:55Beck: From eye level, looking for the sheet of metal on the ramp.

17:59Juno: Thinking in Pictures, Temple Grandin, 1995, expanded in 2006. Read it for the dip vat, the squeeze machine, and the updates where she argues with her younger self. Read the first chapter as one mind described from inside, not as a map of everyone's.

18:21Beck: The ledger. Sensory differences as central held, and the manual moved toward her. Deep pressure held as something people prefer, more than something trials measure. Her caution on facilitated communication held. Picture thinking held for some autistic people, as a pattern. The three kinds stay open. Nothing goes on the didn't-hold side this time, and part of the reason is that her own updates got there first. Barkley's second edition did the same on therapy.

18:54Juno: It goes up front, with the updates bookmarked.

18:57Beck: Bookmarked where?

18:59Juno: The end of chapter one, where she changes her mind.

19:03Beck: Next time: Uniquely Human. Barry Prizant, 2015, updated in 2022 with Tom Fields-Meyer. Grandin described autism from inside one mind; Prizant spent his career beside autistic people and their families, and argues that what gets called a behavior problem is usually someone coping.

19:26Juno: Inside, then beside. I want to see where the two meet.

19:32Juno: I'll have read the next one by then.

19:34Beck: You'll have read the next one by now.

19:36Juno: By now.

19:39Juno: The Observatory comes to you from Lone Star Telehealth. Logan Williamson is a Licensed Professional Counselor in Texas and Louisiana. What you heard is education about a book. It's not counseling. It's not a verdict on you, and it can't replace care. A diagnosis needs a person across from you, in a real conversation, and this wasn't one.

20:04Beck: Every source, plus the full transcript, is on the episode page. The next episode is two days out.

20:18Juno: Last, and in plain terms. Both hosts, Juno and Beck, are synthetic voices. Neither of us is a person, neither has a license, and nothing we said here was about you. Each script is drafted with AI assistance, and every one is edited and approved by Logan Williamson, who runs Lone Star Telehealth and is a Licensed Professional Counselor in Texas and Louisiana.