Simon Baron-Cohen

Sir Simon Philip Baron-Cohen (born 15 August 1958) is a British clinical psychologist and professor of developmental psychopathology at the University of Cambridge. He is the director of the university's Autism Research Centre and a Fellow of Trinity College.

In 1985, Baron-Cohen formulated the mindblindness theory of autism, the evidence for which he collated and published in 1995. In 1997, he formulated the prenatal sex steroid theory of autism, the key test of which was published in 2015. In 2003, Baron-Cohen formulated the empathising-systemising (E-S) theory of autism and typical sex differences, the key test of which was published in 2018.

Baron-Cohen has also made major contributions to research on autism prevalence and screening, autism genetics, autism neuroimaging, autism and vulnerability, autism intervention and synaesthesia. He was knighted in the 2021 New Year Honours for services to people with autism.

Early life and education
Baron-Cohen was born into a middle-class Jewish family in London, the second son of Judith and Hyman Vivian Baron-Cohen.

Baron-Cohen completed a BA in human sciences at New College, Oxford, and an MPhil in clinical psychology at the Institute of Psychiatry, King's College London. He received a PhD in psychology at University College London; his doctoral research was in collaboration with his supervisor Uta Frith.

Career
Baron-Cohen is professor of developmental psychopathology at the University of Cambridge in the United Kingdom. He is the director of the university's Autism Research Centre and a Fellow of Trinity College.

Baron-Cohen is a Fellow of the British Psychological Society (BPS), the British Academy, the Academy of Medical Sciences, and the Association for Psychological Science. He is a BPS Chartered Psychologist and a Senior Investigator at the National Institute for Health and Care Research (NIHR).

Baron-Cohen serves as vice-president of the National Autistic Society (UK), and was the 2012 chairman of the National Institute for Health and Care Excellence (NICE) Guideline Development Group for adults with autism. He has also served as vice-president and president of the International Society for Autism Research (INSAR). Baron-Cohen is the co-editor in chief of the journal Molecular Autism.

Baron-Cohen was the chair of the Psychology Section of the British Academy. He is also a clinical psychologist who has created a diagnosis clinic in the UK for late autism diagnosis in adults.

Baron-Cohen gave the keynote lecture on the topic of Autism and Human Rights at the United Nations on World Autism Awareness Day in 2017.

The mind blindness theory of autism
Baron-Cohen has worked in autism research for over 40 years, starting in 1982. In 1985, while he was member of the Cognitive Development Unit (CDU) in London, Baron-Cohen and his colleagues Uta Frith and Alan Leslie formulated the "theory of mind" (ToM) hypothesis, to explain the social-communication deficits in autism. ToM (also known as "cognitive empathy") is the brain's partially innate mechanism for rapidly making sense of social behavior by effortlessly attributing mental states to others, enabling behavioral prediction and social communication skills. They confirmed this using the false belief test, showing that a typical four-year-old child can infer another person's belief that is different to their own, while autistic children on average are impaired in this ability.

Baron-Cohen's 1995 book, Mindblindness summarized his subsequent experiments in ToM and the disability in ToM in autism. He went on to show that autistic children are blind to the mentalistic significance of the eyes and show deficits in advanced ToM, measured by the "reading the mind in the eyes test" (or "eyes test") that he designed. Baron-Cohen conducted the first neuroimaging study of ToM in typical and autistic adults, and studied patients demonstrating lesions in the orbito- and medial-prefrontal cortex and amygdala can impair ToM. He also reported the first evidence of atypical amygdala function in autism during ToM. In 2017, Baron-Cohen's team studied 80K genotyped individuals who took the eyes test. He found single nucleotide polymorphisms (SNPs) partly contribute to individual differences on this dimensional trait measure on which autistic people are impaired. This was the evidence that cognitive empathy/ToM is partly heritable. The National Institutes of Health recommended Baron-Cohen's eyes test as a core measure that should be used as part of the Research Domain Criteria (RDOC) for assessing social cognition.

Empathizing-systemizing (E-S) theory
In 1997, Baron-Cohen developed the empathizing-systemizing (E-S) theory which proposes that humans can be classified on the basis of their scores along two dimensions (empathizing and systemizing). Empathizing includes both cognitive empathy (imagining what someone else is thinking or feeling) and affective empathy (responding with an appropriate emotion to what someone is thinking or feeling). Systemizing is the drive to analyse or construct rule-based systems to understand how things work. A system is defined as anything that follows if-and-then patterns or rules.

The E-S theory argues that typical females on average score higher on empathizing relative to systemizing (they are more likely to have a brain of type E), and typical males on average score higher on systemizing relative to empathizing (they are more likely to have a brain of type S). Autistic people are predicted to score as an extreme of the typical male (they are more likely to have a brain of type S or extreme type S). These predictions were confirmed in a 2018 online study of 600,000 non-autistic people and 36,000 autistic people. This also confirmed that autistic people on average are “hyper-systemizers”.

Working with the personal genomics company 23andMe, Baron-Cohen's team studied 56K genotyped individuals who had taken the Systemizing Quotient. He concluded that the genetics of autism not only includes genes associated with disability but also include genes associated with talent in pattern recognition and understanding how things work.

Prenatal neuroendocrinology
Baron-Cohen's work in E-S theory led him to investigate whether higher levels of prenatal testosterone explain the increased rate of autism among males. Baron-Cohen's prenatal sex steroid theory of autism gained additional support in 2015 and 2019 in finding elevated prenatal androgens and estrogens are associated with autism.

In his 2004 book Prenatal Testosterone in Mind (MIT Press), Baron-Cohen put forward the prenatal sex steroid theory of autism. He proposed this theory to understand why autism is more common in males. Using the Cambridge Child Development Project that Baron-Cohen established in 1997, a longitudinal study studying children of 600 women who had undergone amniocentesis in pregnancy, he followed these children postnatally. This study demonstrated, for the first time in humans, how normative variation in amniotic prenatal testosterone levels correlates with individual differences in typical postnatal brain and behavioral development. His team discovered that in typical children, amount of eye contact, rate of vocabulary development, quality of social relationships, theory of mind performance, and scores on the empathy quotient are all inversely correlated with prenatal testosterone levels. In contrast, Baron-Cohen found that scores on the embedded figures test (of attention to detail), on the systemizing quotient (SQ), measures of narrow interests, and number of autistic traits are positively correlated with prenatal testosterone levels. Within this study, his team conducted the first human neuroimaging studies of brain grey matter regional volumes and brain activity associated with prenatal testosterone. Other clues for the theory came from Baron-Cohen's postnatal hormonal studies which found that autistic adults have elevated circulating androgens in serum and that the autistic brain in women is ‘masculinized’ in both grey and white matter brain volume. An independent animal model by Xu et al. (2015, Physiology and Behavior, 138, 13–20) showed that elevated prenatal testosterone during pregnancy leads to reduced social interest in the offspring.

Baron-Cohen's group also studied the rate of autism in offspring of mothers with polycystic ovary syndrome (PCOS), a medical condition caused by elevated prenatal testosterone. He found that in women with PCOS, the odds of having a child with autism are significantly increased. This has been replicated in three other countries (Sweden, Finland, and Israel) and is in line with the finding that mothers of autistic children themselves have elevated sex steroid hormones. However, to really test the theory, Baron-Cohen needed a much larger sample than his Cambridge Child Development Project, since autism only occurs in 1% of the population. So, he set up a collaboration with the Danish Biobank which has stored over 20 thousand amniotic fluid samples in 2015, which Baron-Cohen linked to later diagnosis of autism via the Danish Psychiatric Register. He tested the prenatal androgens and found that children later diagnosed as autistic were exposed to elevated levels of prenatal testosterone, and the Δ4 sex steroid precursors to prenatal testosterone. In 2019, Baron-Cohen tested the same cohort's levels of exposure to prenatal estrogens and again found these were elevated in pregnancies that resulted in autism. These novel studies provide evidence of the role of prenatal hormones, interacting with genetic predisposition, in the cause of autism.

Other contributions
In 2006, Baron-Cohen proposed the assortative mating theory which states that if individuals with a systemizing or "type S" brain type have a child, the child is more likely to be autistic. One piece of evidence for this theory came from his population study in Eindhoven, where autism rates are twice as high in that city which is an IT hub, compared to other Dutch cities. He also found both mothers and fathers of autistic children score above average on tests of attention to detail, a prerequisite for strong systemizing.

In 2001, Baron-Cohen developed the autism-spectrum quotient (AQ), a set of fifty questions that measures how many autistic traits a person has. This was one of the first measures to show that autistic traits run right through the general population and that autistic people on average simply score higher than neurotypicals. The AQ has subsequently been used in hundreds of studies including one study of half a million people, showing robust sex differences and higher scores in those who work in STEM.

Baron-Cohen also developed Mindreading, for use in special education. His team also developed The Transporters, an animation series aimed at teaching emotion recognition to preschool age autistic children, and conducted the first clinical trial of lego therapy in the UK, finding that autistic children improve in social skills following this.

Baron-Cohen has also contributed to applied autism research. He found that autistic people are being failed by the criminal justice system, and have higher rates of suicidality, higher rates of postnatal depression, and higher rates of medical and physical health conditions.

Reception
Spectrum News had described the work of Baron-Cohen on theory of mind as “a landmark study”. The Lancet described him as “a man with extraordinary knowledge, but his passionate advocacy for a more tolerant, diverse society, where difference is respected and cultivated, reveals a very human side to his science”.

Baron-Cohen’s book, The Essential Difference was described by The Guardian as “compelling and inspiring” while his book, The Pattern Seekers was selected as the Editor’s Choice by the New York Times. A book review published in Phenomenology and the Cognitive Sciences characterized The Essential Difference as "very disappointing". According to Time magazine, his views on systemizing traits had "earned him the ire of some parents of autistic children, who complain that he underestimates their families' suffering". Baron-Cohen has replied in an op-ed in Scientific American acknowledging the challenges families face. He has also commented that the huge body of scientific evidence supporting predictions from the mindblindness and E-S theories cannot be ignored.

Baron-Cohen and his book The Science of Evil were described by The New York Times “an award-winning psychologist” who had “unveiled a simple but persuasive hypothesis for a new way to think about evil.”

Baron-Cohen has faced criticism by some for his "empathizing-systemizing theory", which states that humans may be classified on the basis of their scores along two dimensions (empathizing and systemizing); and that females tend to score higher on the empathizing dimension and males tend to score higher on the systemizing dimension. Feminist scientists, including Cordelia Fine, neuroscientist Gina Rippon, and Lise Eliot have opposed his extreme male brain theory of autism, calling it "neurotrash" and neurosexism. Rippon also argues against using "male" and "female" for describing different types of brains, and that brain types do not correspond to genders. Baron-Cohen has defended the neuroscience of sex differences against charges of neurosexism, arguing that "Fine's neurosexism allegation is the mistaken blurring of science with politics", adding that "You can be a scientist interested in the nature of sex differences while being a clear supporter of equal opportunities and a firm opponent of all forms of discrimination in society."

Time magazine has also criticized the assortative mating theory proposed by Baron-Cohen, claiming that it is largely speculative and based on anecdotal evidence. The theory claims that autism rates are increasing because "systemizers", individuals with more autistic traits, are more likely to marry each other and are more likely to have autistic offspring due to relatively recent societal changes. James McGrath has criticized the autism-spectrum quotient, writing that the score increases if one indicates interest in mathematics, and decreases if one indicates interest in literature or art. He claims that this leads to the false notion that most autistic people are strong in math. Baron-Cohen has replied to this by saying there are no questions in the AQ that ask about mathematical interest, and that the finding that AQ is associated with scientific and mathematical talent has been found in multiple studies, suggesting these may have shared mechanism such as strong systemizing. The AQ has been used in hundreds of independent studies showing that both psychological and biological variables correlate with the number of autistic traits a person has.

Critics also say that because Baron-Cohen's work has focused on higher-functioning individuals with autism spectrum disorders, it requires independent replication with broader samples and that his theories are based on subjective perceptions. In response to this Baron-Cohen said that his findings have been found both using self-report, parent-report questionnaires and performance measures and agrees that the presence of learning disabilities in a third of autistic individuals may change the way empathy or systemizing are manifested.

The mindblindness hypothesis has faced criticism from the scientific community. Baron-Cohen has also commented that the vast majority of studies have replicated the findings, despite the heterogeneity of autism and that huge body of scientific evidence supporting predictions from the mindblindness and E-S theories cannot be ignored.

Baron-Cohen's theories about mindblindness are also questioned by academic philosophers, particularly Autistic academic philosophers, in part on the basis that non-autistic people are as blind to the internal states of autistic people as autistic people are to those of non-autistic people. Baron-Cohen agrees that the “double-empathy” problem is an important contribution to this field. There is also criticism of his concept of theory of mind in relation to autism on the grounds that it implies he is classifying autistic people as not fully human. Baron-Cohen has replied that autistic people are fully human and that theory of mind or cognitive empathy exists on a bell curve. He views autism as an example of neurodiversity and disability.

Recognition
Baron-Cohen was awarded the 1990 Spearman Medal from the BPS, the McAndless Award from the American Psychological Association, the 1993 May Davidson Award for Clinical Psychology from the BPS, and the 2006 presidents' Award from the BPS.

Baron-Cohen received an honorary degree from Abertay University in 2012, and was awarded the Kanner-Asperger Medal in 2013 by the Wissenschaftliche Gesellschaft Autismus-Spektrum as a Lifetime Achievement Award for his contributions to autism research. Baron-Cohen was also knighted in the 2021 New Year Honours for services to people with autism.

Baron-Cohen's Mindreading and The Transporters special educational software were nominated for the British Academy of Film and Television Arts (BAFTA) awards in 2002 and 2007.

Personal life
In 1987, Baron-Cohen married Bridget Lindley. They had three children.

Baron-Cohen has an elder brother, Dan Baron-Cohen, and three younger siblings, brother Ash Baron-Cohen, and sisters Suzie and Liz. His cousins include actor and comedian Sacha Baron Cohen and composer Erran Baron Cohen.

Single-authored books

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 * (published in the US as The Science of Evil: On Empathy and the Origins of Human Cruelty, ISBN 978-0-465-02353-0)
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