In this paper, I present a challenge for Michael McKenna’s conversational theory of moral responsibility. On his view, to be a responsible agent is to be able to engage in a type of moral conversation. I argue that individuals with autism spectrum disorder present a considerable problem for the conversational theory because empirical evidence on the disorder seems to suggest that there are individuals in the world who meet all of the conditions for responsible agency that (...) the theory lays out but who are nevertheless not responsible agents. Attending to the moral psychology of such individuals will, I think, help shed light on an important gap in the conversational theory. (shrink)

Autism spectrum disorder (ASD) is a psychopathological condition characterized by persistent deficits in social interaction and communication, and restricted, repetitive patterns of behavior and interests. To build an ecological-enactive account of autism, I propose we should endorse the affordance-based approach of the skilled intentionality framework (SIF). In SIF, embodied cognition is understood as skilled engagement with affordances in the sociomaterial environment of the ecological niche by which an individual tends toward the optimal grip. The human econiche (...) offers a whole landscape of affordances, and situated individuals respond to a field of relevant affordances. An important part of SIF is an ecological-enactive interpretation of the free energy principle and predictive processing. Predictive processing accounts indicate that in ASD too much precision is assigned to prediction errors. Autistic persons depend heavily on current sensory information and less on prior beliefs and cannot attune to stable regularities. To reduce uncertainty, they over-rely on routines, strict habits, and a familiar environment—a predictable ecological niche they construct. I argue that skilled intentionality gives us the framework from which to analyze the autistic field of affordances. Autistic patterns of affordance-related bodily states of action readiness are only sensitive to very specific solicitations in the environment and achieve optimal grip in well-known situations. Autism is to be understood as a disorder of bodily normativity. Taking this approach helps us figure out what neurotypical people can do to attune their environment in order to scaffold the needs of autistic individuals by redesigning the landscape of affordances. (shrink)

Autism spectrum disorder is characterised by differences in unimodal and multimodal sensory and proprioceptive processing, with complex biases towards local over global processing. Many of these elements are implicated in versions of the rubber hand illusion, which were therefore studied in high-functioning individuals with ASD and a typically developing control group. Both groups experienced the illusion. A number of differences were found, related to proprioception and sensorimotor processes. The ASD group showed reduced sensitivity to visuotactile-proprioceptive discrepancy but (...) more accurate proprioception. This group also differed on acceleration in subsequent reach trials. Results are discussed in terms of weak top-down integration and precision-accuracy trade-offs. The RHI appears to be a useful tool for investigating multisensory processing in ASD. (shrink)

We present results from a single case study based on semi-structured interviews with a student (a boy in school year 3) diagnosed with autism spectrum disorder and his school staff after participating in a short and small-scale intervention carried out in a socio-economically disadvantaged Swedish elementary school in 2019. The student participated in a seven week long intervention with a total of 12 philosophical dialogues (ranging from 45 to 60 minutes). Two facilitators, both with years of facilitation (...) experience and teacher degree and at least BA in philosophy, facilitated the majority of the dialogues and mainly followed a ”routine” procedure. The student was interviewed in direct connection to the end of the intervention about his experiences from the dialogues and his perceptions about whether and how the dialogues had influenced him. The student’s two teachers, who had participated in the dialogues as participants, were interviewed as a pair, also in direct connection to the end of the intervention, while the school principal was interviewed two years after the study. These staff interviews concerned the staff’s experiences of the influence of the dialogues on the students within the intervention as well as transfer effects to other contexts in school. The data from the study include detailed elaborations from a student perspective of different effects on the student’s communicative and cognitive development, which are in several respects supported also by staff reports. The results show that the student was able, interested, and willing to participate in philosophical dialogues, and our data point to several positive outcomes for the student in the communicative and cognitive domains. (shrink)

This paper discusses different frameworks for understanding imagination and metaphor in the context of research on the imaginative skills of children with autism spectrum disorder (ASD). In contrast to a standard linguistic framework, it advances an embodied and enactive account of imagination and metaphor. The paper describes a case study from a systemic therapeutic session with a child with ASD that makes use of metaphors. It concludes by outlining some theoretical insights into the imaginative skills of children (...) with ASD that follow from taking the embodied-enactive perspective and proposes suggestions for interactive interventions to further enhance imaginative skills and metaphor understanding in children with ASD. (shrink)

Externalist theories hold that a comprehensive understanding of mental disorder cannot be achieved unless we attend to factors that lie outside of the head: neural explanations alone will not fully capture the complex dependencies that exist between an individual’s psychiatric condition and her social, cultural, and material environment. Here, we firstly offer a taxonomy of ways in which the externalist viewpoint can be understood, and unpack its commitments concerning the nature and physical realization of mental disorder. Secondly, we (...) apply a strongly externalist approach to the case of Autistic Spectrum Disorder, and argue that this condition can be illuminated by appeal to the hypothesis of extended cognition. We conclude by briefly considering the significance this strongly externalist approach may have for psychiatric practice and pedagogy. (shrink)

The ability of a group of adults with high functioning autism (HFA) or Asperger Syndrome (AS) to distinguish moral, conventional and disgust transgressions was investigated using a set of six transgression scenarios, each of which was followed by questions about permissibility, seriousness, authority contingency and justification. The results showed that although individuals with HFA or AS (HFA/AS) were able to distinguish affect-backed norms from conventional affect-neutral norms along the dimensions of permissibility, seriousness and authority-dependence, they failed to distinguish moral (...) and disgust transgressions along the seriousness dimension and were unable to provide appropriate welfare-based moral justifications. Moreover, they judged conventional and disgust transgressions to be more serious than did the comparison group, and the correlation analysis revealed that the seriousness rating was related to their ToM impairment. We concluded that difficulties providing appropriate moral justifications and evaluating the seriousness of transgressions in individuals with HFA/AS may be explained by an impaired cognitive appraisal system that, while responsive to rule violations, fails to use relevant information about the agent’s intentions and the affective impact of the action outcome in conscious moral reasoning. (shrink)

Recent research has begun to investigate sensory processing in relation to nonclinical variation in traits associated with the autism spectrum disorders (ASD). We propose that existing accounts of autistic perception can be augmented by considering a role for individual differences in top-down expectations for the precision of sensory input, related to the processing of state-dependent levels of uncertainty. We therefore examined ASD-like traits in relation to the rubber-hand illusion: an experimental paradigm that typically elicits crossmodal integration of visual, (...) tactile, and proprioceptive information in an unusual illusory context. Individuals with higher ASD-like traits showed reduced effects of the rubber-hand illusion on perceived arm position and reach-to-grasp movements, compared to individuals with lower ASD-like traits. These differences occurred despite both groups reporting the typical subjective experience of the illusion concerning visuotactile integration and ownership for the rubber hand. Together these results suggest that the integration of proprioceptive information with cues for arm position derived from the illusory context differs between individuals partly in relation to traits associated with ASD. We suggest that the observed differences in sensory integration can be best explained in terms of differing expectations regarding the precision of sensory estimates in contexts that suggest uncertainty. (shrink)

Rutherford and Ray think that human beings have mental mechanisms that help them to detect individuals that, deliberately, do not follow a rule. In the same way, they hold that autism is not a disorder in which these mechanisms are damaged. This idea seems contrary to the thesis, supported by some researchers, that autistic people have a theory of mind deficit. This is because of, if Rutherford and Ray are right, autistic people can detect other people's intentions. In (...) this paper, Rutherford and Ray's experiment is analyzed and it is concluded that they do not prove that people with autism can understand intentions. Such an experiment only shows that autistic people and general population share common logical-linguistic abilities. (shrink)

Rutherford and Ray think that human beings have mental mechanisms that help them to detect individuals that, deliberately, do not follow a rule. In the same way, they hold that autism is not a disorder in which these mechanisms are damaged. This idea seems contrary to the thesis, supported by some researchers, that autistic people have a theory of mind deficit. This is because of, if Rutherford and Ray are right, autistic people can detect other people’s intentions. In (...) this paper, Rutherford and Ray’s experiment is analyzed and it is concluded that they do not prove that people with autism can understand intentions. Such an experiment only shows that autistic people and general population share common logical-linguistic abilities. (shrink)

Several theories propose that one of the core functions of inner speech (IS) is to support subjects in the completion of cognitively effortful tasks, especially those involving executive functions (EF). In this paper we focus on two populations who notoriously encounter difficulties in performing EF tasks, namely, people diagnosed with schizophrenia who experience auditory verbal hallucinations (Sz-AVH) and people within the Autism Spectrum Conditions (ASC). We focus on these two populations because they represent two different ways in which (...) IS can fail to help in EF tasks, which can be illustrative for other mental conditions. First, we review the main components of EF (Section 1). Then we explain the functions that IS is taken to perform in the domain of EF (Section 2) and review the evidence concerning problems about EF in the two populations of our study: Sz-AVH (Section 3) and ASC (Section 4). After this we further detail our account about what a properly functioning IS can do for both populations and how different IS profiles may impact EF performance: in the case of Sz-AVH, the uncontrolled and intrusive character of IS negatively affects EF performance, whereas in ASC, EF is not sufficiently supported by IS, given the tendency in this population to present a diminished use of IS (Section 5). We finally briefly discuss Attention Deficit/Hyperactivity Disorder (ADHD) and Developmental Language Disorders (DLD). (shrink)

This paper presents a challenge for exemplar theories of moral concepts. Some have proposed that we acquire moral concepts by way of exemplars of actions that are prohibited as well as of actions that are required, and we classify newly encountered actions based on their similarity to these exemplars. Judgments of permissibility then follow from these exemplar-based classifications. However, if this were true, then we would expect that individuals who lacked, or were deficient in, the capacity to form or access (...) exemplars of this kind would be similarly deficient in the ability to classify new actions according to them, and this relative inability would be manifested in the moral judgments made by such individuals. However, there is reason to suspect, I think, that a number of individuals who have been diagnosed with Autism Spectrum Disorder actually have the deficiencies I have described here but are nevertheless fully able to make sound moral judgments. If this is so, then it must be th... (shrink)

Autism spectrum disorder is usually understood through deficits in social interaction and communication, repetitive patterns of behavior, and hyper- or hyporeactivity to sensory input. Affordance-based Skilled Intentionality that combines ecological-enactive views of cognition with Free Energy and Predictive Processing was proposed as the framework from which to view autism integrally. Skilled Intentionality distinguishes between a landscape of affordances and a field of affordances. Under the integrative Skilled Intentionality Framework, it can be shown that autistic differences in (...) the field of affordances stem from aberrant precision estimation. Autistics over-rely on the precision afforded by the environment—a stable econiche they build. According to this approach, autism is understood as characterized by an atypical field of affordances. I will build on the ecological-enactive account of autism to suggest that one way to shape the neurotypical landscape of affordances in accordance with autistic needs is through the use of Ambient Smart Environments (ASEs). Taking the cue from autistic lived experience, ASEs could help minimize environmental uncertainty and afford affective scaffolding by supporting dynamic and flexible niche construction in accordance with individual autistic styles. (shrink)

In this paper, I consider a novel challenge to John Martin Fischer and Mark Ravizza’s reasons-responsiveness theory of moral responsibility. According to their view, agents possess the control necessary for moral responsibility if their actions proceed from a mechanism that is moderately reasons-responsive. I argue that their account of moderate reasons-responsiveness fails to provide necessary and sufficient conditions for moral responsibility since it cannot give an adequate account of the responsibility of individuals with autism spectrum disorder. Empirical (...) evidence suggests that autistic individuals demonstrate impairments in counterfactual thinking, and these impairments, I argue, are such that they cast doubt on Fischer and Ravizza’s construal of moderate reasons-responsiveness. I then argue that modifying the view in order to accommodate individuals with ASD forces them to defend a strong reasons-responsive account despite the fact that they explicitly deny that such an account can adequately characterize what it is to be morally responsible for one’s actions. (shrink)

Background: Although inclusive education is widely discussed, its implementation has not, arguably, been far-reaching. There remains a lack of specific, targeted approaches towards fully including learners with physical and mental impairments in the educational space. Objectives: This study investigated the extent of the inclusion of learners with autism spectrum disorder (ASD) in three schools in Johannesburg. Method: A qualitative interpretivist design was adopted. Teachers who work with learners with ASD were interviewed using open-ended questions. The sampled data (...) were analysed using thematic analysis, making use of both a priori codes and emergent codes that arose from the open-ended questions. Results: The findings reveal numerous pedagogic strategies such as differentiation, scaffolding, use of visual cues, group work and collaboration that can include learners with ASD in the classroom space. Conclusion: Teacher collaboration and teacher training are vital in ensuring that learners with ASD are fully included in the classroom space. (shrink)

Autism is a psychopathological condition around which there is still much prejudice and stigma. The discrepancy between third-person and first-person accounts of autistic behavior creates a chasm between autistic and neurotypical (non-autistic) people. Epistemic injustice suffered by these individuals is great, and a fruitful strategy out of this predicament is much needed. I will propose that through the appropriation and implementation of methods and concepts from phenomenology and ecological-enactive cognitive science, we can acquire powerful tools to work towards greater (...) epistemic justice for autistic individuals. I will use the resources found in the skilled intentionality framework, integrated with various phenomenological theories. From these approaches, we can view autistic impairments and disability relationally and how epistemic enablement and disablement form. Phenomenology and its methods help us learn more about the perceptual and social experiences of autistic individuals. The voices of the autistics themselves will be of the greatest importance here. I will show that, through restructuring our landscape of affordances and with a greater phenomenological understanding of the autistic inner world, we can devise new strategies that afford greater epistemic enablement and epistemic justice. (shrink)

Autism Spectrum Condition presents a challenge to social and relational accounts of the self, precisely because it is broadly seen as a disorder impacting social relationships. Many influential theories argue that social deficits and impairments of the self are the core problems in ASC. Predictive processing approaches address these based on general purpose neurocognitive mechanisms that are expressed atypically. Here we use the High, Inflexible Precision of Prediction Errors in Autism approach in the context of cultural (...) niche construction to explain atypicalities of the relational self, specifically its minimal, extended, and intersubjective aspects. We contend that the social self in ASC should not be seen as impaired, but rather as an outcome of atypical niche construction. We unpack the scientific, ethical, and practical consequences of this view, and discuss implications for how the challenges that autistic persons face should be approached. (shrink)

The current assessment of behaviors in the inventories to diagnose autism spectrum disorders (ASD) focus on observation and discrete categorizations. Behaviors require movements, yet measurements of physical movements are seldom included. Their inclusion however, could provide an objective characterization of behavior to help unveil interactions between the peripheral and the central nervous systems. Such interactions are critical for the development and maintenance of spontaneous autonomy, self-regulation and voluntary control. At present, current approaches cannot deal with the heterogeneous, dynamic (...) and stochastic nature of development. Accordingly, they leave no avenues for real-time or longitudinal assessments of change in a coping system continuously adapting and developing compensatory mechanisms. We offer a new unifying statistical framework to reveal re-afferent kinesthetic features of the individual with ASD. The new methodology is based on the non-stationary stochastic patterns of minute fluctuations (micro-movements) inherent to our natural actions. Such patterns of behavioral variability provide re-entrant sensory feedback contributing to the autonomous regulation and coordination of the motor output. From an early age, this feedback supports centrally driven volitional control and fluid, flexible transitions between intentional and spontaneous behaviors. We show that in ASD there is a disruption in the maturation of this form of proprioception. Despite this disturbance, each individual has unique adaptive compensatory capabilities that we can unveil and exploit to evoke faster and more accurate decisions. Measuring the kinesthetic re-afference in tandem with stimuli variations we can detect changes in their micro-movements indicative of a more predictive and reliable kinesthetic percept. Our methods address the heterogeneity of ASD with a personalized approach grounded in the inherent sensory-motor abilities that the individual has already developed. (shrink)

How we ought to diagnose, categorise and respond to spectrum disabilities such as autism and Attention Deficit/Hyperactivity Disorder (ADHD) is a topic of lively debate. The heterogeneity associated with ADHD and autism is described as falling on various continua of behavioural, neural, and genetic difference. These continua are varyingly described either as extending into the general population, or as being continua within a given disorder demarcation. Moreover, the interrelationships of these continua are likewise often vague (...) and subject to diverse interpretations. -/- In this paper, I explore geneticists' and self-advocates’ perspectives concerning autism and ADHD as continua. These diagnoses are overwhelmingly analysed as falling on a continuum or continua of underlying traits, which supports the notion of “the neurodiversity spectrum”, i.e., a broader swath of human neural and behavioural diversity on which some concentrations of different functioning are diagnosed. I offer a taxonomy of conceptions of the genetic, phenotypic, and endophenotypic dimensionality within and beyond these diagnostic categories, and suggest that the spectrum of neurodiversity is characteristically endophenotypic. (shrink)

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published in 2013 containing the following changes from the previous edition: gone are the subcategories ‘Autistic Disorder,’ ‘Asperger Syndrome’ and ‘PDD-NOS,’ replaced by the single diagnosis ‘Autism Spectrum Disorder,’ and there is a new category ‘Social Communication Disorder.’ In this paper I consider what kind of reasons would justify these changes if one were (a) a realist about autism, or (b) (...) one were a constructivist. I explore various analyses of autism in the research literature that portray it as essentially either a psychological, neurological or genetic phenomenon, and discuss these by reference to the diagnostic criteria and by analogy with the way we understand race and sex categories. I conclude that no realist reasons are available to justify the changes in the diagnostic criteria, and further, that the only way the changes could be justified is if one takes the position that the DSM categories are social constructs. I conclude by exploring what implications follow from this. (shrink)

ABSTRACT: Simon Baron-Cohen has argued that autism and related developmental disorders (sometimes called “autism spectrum conditions” or “autism spectrum disorders”) can be usefully thought of as the condition of possessing an “extreme male brain.” The impetus for regarding autism spectrum disorders (ASD) this way has been the accepted science regarding the etiology of autism, as developed over that past several decades. Three important features of this etiology ground the Extreme Male Brain theory. (...) First, ASD is disproportionately male (approximately 10:1 in the case of Asperger’s Syndrome or high-functioning autism (HFA) and approximately 4:1 in the case of autistic disorder). Second, ASD is not psychogenic but biological in origin, and hence is not the product of sexist conditioning or childrearing practices, although these may affect the development of the disorder. Third, ASD is regarded as a spectrum developmental disorder, unlike other disorders such as Down Syndrome that are diagnosed by a (nearly) binary criterion. Down Syndrome, for example, is diagnosed by the presence in all or most cells within a given individual of an extra copy of Chromosome 21. Autism, on the other hand, is diagnosed by the presence of a set of symptoms that vary in their intensity and in their milder forms seem to conform to purported sex differences in cognitive, emotional, and social functioning. -/- In this paper, I do not challenge accepted science regarding the etiology of autism, and I do not challenge the idea of ASD as a disorder. Nor do I wish to offer an alternative account of what autism is. Instead, I focus on the usefulness of thinking of a disorder as an extreme version of ordinary sex differences. Does it follow from the fact that a disorder is more often found in men that we should think of it as an extreme form of maleness? If not, what other conditions must be met in order to warrant this way of thinking about ASD? What does it mean to say that ASD is a form of “extreme male brain”? Feminists are rightly skeptical of theories that make claims about male and female brains, so how should we respond to the clear evidence that the differences between typical and ASD individuals are not caused by childrearing practices? I explain what I take to be Baron-Cohen’s central argument that autism should be seen as the extreme male brain, and critique that argument. I conclude that there is no good argument that autistic symptoms should be regarded as an extreme form of male mental traits, and that Baron-Cohen’s claim does not help us to understand autism, women, or men. His claim is a speculative thesis that is readily mobilized for sexist practices. As such it requires a higher threshold for evidentiary support and rigorous argumentation—support and argumentation that does not exist. -/- KEYWORDS: autism, brain, gender, neuroscience, feminism, male . (shrink)

This article attempts to show why an experimental hypothesis is plausible and merits testing; in brief, the hypothesis is that autism begins with a failure in early learning and that changing the environment of early learning would dramatically change its incidence. Strong statistical evidence supporting this hypothesis has been published by Waldman et al., but to date this evidence has largely been ignored, perhaps because it challenges prevalent beliefs about autism. This article also suggests that the current epidemic (...) of autism is serious enough, and intellectually mysterious enough, to merit attention from a wider community of brain scientists: New ideas are needed. A confirmation of this article’s hypothesis would have interesting implications for brain science. (shrink)

The aim of this paper is to discuss monastic paideia in the context of providing shelter for ASD individuals in the High Middle Ages. Firstly, we will canvas the historical and conceptual shift from Ancient Greek paideitic ideas to their Christian counterparts. Then, by drawing on the recent literature in the history of medicine that traces the signs and symptoms of autism spectrum disorder (ASD) in Hildegard of Bingen, a German abbess in the 12th century, we will (...) turn to her invented language Lingua Ignota as a source of both her diagnosis and a manner of dealing with her disability. This, in turn, could be further advanced by identifying monasteries as therapeutic loci for neuroatypical individuals who had trouble finding their place within the arid and somewhat monochromatic medieval society. (shrink)

I use critical phenomenological resources in Tetsurō Watsuji and Sarah Ahmed to explore the spatial origin of some social impairments in Autistic Spectrum Disorder (ASD). I argue that a critical phenomenological perspective puts pressure on the idea that social impairments in ASD are exclusively (or even primarily) neurocognitive deficits that can be addressed by focusing on cognitive factors internal to the autistic person — for example, training them to adopt a more neurotypical approach to social cognition. Instead, I (...) argue that the structure and character of some neurotypical spaces may play a regulative role in shaping aspects of at least some of the social impairments autistic people exhibit when they inhabit these spaces. I also briefly consider some possible therapeutic applications of this critical phenomenological approach. (shrink)

(This version was submitted to Behavioral and Brain Science. A revised version was published by Biological Theory) Estimates of autism’s incidence increased 5-10 fold in ten years, an increase which cannot be genetic. Though many mutations are associated with autism, no mutation seems directly to cause autism. We need to find the direct cause. Complexity science provides a new paradigm - confirmed in biology by extensive hard data. Both the body and the personality are complex dynamic systems (...) which spontaneously self-organize from simple dynamic systems. Autism may therefore be caused by the failure of a simple dynamic system. We know that infants who cannot track their mother’s face often become autistic, that eye-contact initiates intersubjectivity which is blocked in autism, and that the infant-mother pair seems designed to promote eye-contact, as does the eye’s appearance. This author earlier proposed that failure of eye-contact might directly cause autism and that early non-maternal childcare, including television/video, would therefore be statistically linked to autism. Waldman et al. (2008; 2006) recently proved that autism is strongly linked to precipitation (indoor activity) and to the introduction of cable. The most plausible explanation? Early exposure to television/video is linked to autism. Furthermore a normal developmental cascade (blocked in autism) has been deciphered: (a) Infant-mother eye-contact triggers increased maternal attention. (b) Early maternal attention permanently increases not only baseline vasopressin but also that oxytocin release which is triggered by subsequent maternal attention. (c) Vasopressin and oxytocin promote face recognition, gazing-at-the-eyes, emotion recognition, and social bonding. The eye-contact hypothesis suggests a clinical study addressing prevention: recruit prospective parents who agree to curtail television/video/computer/wi-fi in their families; measure autism’s incidence in their children. (shrink)

This book examines autism from the tradition of analytic philosophy, working from the premise that Autism Spectrum Disorders raise interesting philosophical questions that need to be and can be addressed in a manner that is clear, jargon-free, and accessible. The goal of the original essays in this book is to provide a philosophically rich analysis of issues raised by autism and to afford dignity and respect to those impacted by autism by placing it at the (...) center of the discussion. (shrink)

Some researchers and autistic activists have recently suggested that because some ‘autism-related’ behavioural atypicalities have a function or purpose they may be desirable rather than undesirable. Examples of such behavioural atypicalities include hand-flapping, repeatedly ordering objects (e.g., toys) in rows, and profoundly restricted routines. A common view, as represented in the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-TR (APA, 2000), is that many of these behaviours lack adaptive function or purpose, interfere with learning, and constitute the non-social (...) behavioural dysfunctions of those disorders making up the Autism Spectrum. As the DSM IV-TR continues to be the reference source of choice for professionals working with individuals with psychiatric difficulties, its characterization of the Autism Spectrum holds significant sway. We will suggest Extended Mind and Enactive Cognition Theories, which theorize that mind (or cognition) is embodied and environmentally embedded, as coherent conceptual and theoretical spaces within which to investigate the possibility that certain repetitive behaviours exhibited by autistics possess functions or purposes that make them desirable. As lenses through which to re-examine ‘autism-related’ behavioral atypicalities, these theories not only open up explanatory possibilities underdeveloped in the research literature, but also cohere with how some autistics describe their own experience. Our position navigates a middle way between the view of autism as understood in terms of impairment, deficit and dysfunction and one that seeks to de-pathologize the Spectrum. In so doing we seek to contribute to a continuing dialogue between researchers, clinicians and self- or parent advocates. (shrink)

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders included the Social Communication Disorder as a new mental disorder characterized by deficits in pragmatic abilities. Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons—including bridging a nosological gap in the macro-category of Communication Disorders—in the last few years researchers have identified major issues in such revision. For instance, the symptomatology of SPCD is notably close to that of Autism (...) Spectrum Disorder. This opens up the possibility that individuals with very similar symptoms can be diagnosed differently and receive different clinical treatments and social support. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. In the second part, we focus on the validity and reliability of SPCD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography. (shrink)

This chapter explores the idea that the need to establish common knowledge is one feature that makes social cognition stand apart in important ways from cognition in general. We develop this idea on the background of the claim that social cognition is nothing but a type of causal inference. We focus on autism as our test-case, and propose that a specific type of problem with common knowledge processing is implicated in challenges to social cognition in autism spectrum (...) disorder (ASD). This problem has to do with the individual’s assessment of the reliability of messages that are passed between people as common knowledge emerges. The proposal is developed on the background of our own empirical studies and outlines different ways common knowledge might be comprised. We discuss what these issues may tell us about ASD, about the relation between social and non-social cognition, about social objects, and about the dynamics of social networks. (shrink)

This review aimed at exploring the psychosocial disorders of Nigeria as a nation, its effect on the citizens and the remedy. Psychosocial disorder is a mental illness induced by life experiences, stress, as well as maladaptive cognitive and behavioural processes. The prevalence of these disorders include depression, schizophrenia, anxiety disorders, substance use disorder, personality disorder and autism spectrum disorders have rapidly increase over the past years in Nigeria with its negative impact on the socioeconomic status, (...) psychological well-being; peaceful coexistence and mental health of the entire society. These have precipitated some social anomalies such as bribery and corruption, antisocial behaviour, religious fanaticism, terrorism and so on. The study therefore recommends the need for government to implement effective mental health interventions program that would facilitate easy access to mental healthcare services in Nigeria. There is also an urgent need to improve the mental health awareness of Nigerians through education and public mental health campaign. (shrink)

Autism has been defined as a disorder of social cognition, interaction and communication where ritualistic, repetitive behaviors are commonly observed. But how should we understand the behavioral and cognitive differences that have been the main focus of so much autism research? Can high-level cognitive processes and behaviors be identified as the core issues people with autism face, or do these characteristics perhaps often rather reflect individual attempts to cope with underlying physiological issues? Much research presented in (...) this volume will point to the latter possibility, i.e. that people on the autism spectrum cope with issues at much lower physiological levels pertaining not only to Central Nervous Systems (CNS) function, but also to peripheral and autonomic systems (PNS, ANS) (Torres, Brincker, et al. 2013). The question that we pursue in this chapter is what might be fruitful ways of gaining objective measures of the large-scale systemic and heterogeneous effects of early atypical neurodevelopment; how to track their evolution over time and how to identify critical changes along the continuum of human development and aging. We suggest that the study of movement variability—very broadly conceived as including all minute fluctuations in bodily rhythms and their rates of change over time (coined micro-movements (Figure 1A-B) (Torres, Brincker, et al. 2013))—offers a uniquely valuable and entirely objectively quantifiable lens to better assess, understand and track not only autism but cognitive development and degeneration in general. This chapter presents the rationale firstly behind this focus on micro-movements and secondly behind the choice of specific kinds of data collection and statistical metrics as tools of analysis (Figure 1C). In brief the proposal is that the micro-movements (defined in Part I – Chapter 1), obtained using various time scales applied to different physiological data-types (Figure 1), contain information about layered influences and temporal adaptations, transformations and integrations across anatomically semi-independent subsystems that crosstalk and interact. Further, the notion of sensorimotor re-afference is used to highlight the fact that these layered micro-motions are sensed and that this sensory feedback plays a crucial role in the generation and control of movements in the first place. In other words, the measurements of various motoric and rhythmic variations provide an access point not only to the “motor systems”, but also access to much broader central and peripheral sensorimotor and regulatory systems. Lastly, we posit that this new lens can also be used to capture influences from systems of multiple entry points or collaborative control and regulation, such as those that emerge during dyadic social interactions. (shrink)

Affordances are action-possibilities, ways of relating to and acting on our world. A theory of affordances helps us understand how we have bodily access to our world and what it means to enjoy such access. But what happens to bodies when this access is somehow ruptured or impeded? This question is relevant to psychopathology. People with psychiatric disorders often describe feeling as though they’ve lost access to affordances that others take for granted. Focusing on schizophrenia, depression, and autistic spectrum (...) disorder, I argue that thinking about the bodily consequences of losing access to everyday affordances can help us better understand these reports. An affordance-based approach to psychopathology can illuminate some of the causes, as well as the experiential character and content, of affective disorders in psychopathology. It can also draw our attention to some under-explored ethical and political dimensions of these issues needing further consideration. (shrink)

In the late summer of 1998, the authors, a cognitive scientist and a logician, started talking about the relevance of modern mathematical logic to the study of human reasoning, and we have been talking ever since. This book is an interim report of that conversation. It argues that results such as those on the Wason selection task, purportedly showing the irrelevance of formal logic to actual human reasoning, have been widely misinterpreted, mainly because the picture of logic current in psychology (...) and cognitive science is completely mistaken. We aim to give the reader a more accurate picture of mathematical logic and, in doing so, hope to show that logic, properly conceived, is still a very helpful tool in cognitive science. The main thrust of the book is therefore constructive. We give a number of examples in which logical theorizing helps in understanding and modeling observed behavior in reasoning tasks, deviations of that behavior in a psychiatric disorder (autism), and even the roots of that behavior in the evolution of the brain. (shrink)

Abstract: In this article, we explore what are ethical forms of holding service users responsible in mental health care contexts. Hanna Pickard has provided an account of how service users should be held responsible for morally wrong or seriously harmful conduct within contexts of mental health care, called the clinical stance. From a clinical stance one holds a person responsible for harm, but refrains from emotionally blaming the person and only considers the person responsible for this conduct in a detached (...) sense. Her account is based on what are considered best practices in the treatment of people with borderline personality disorder and addiction. We ask if this account generalizes across different diagnostic criteria and different clinical contexts. To begin to answer this question, we compare the clinical stance to an account of what are considered best practices in the treatment of service users at a specialized clinic for people with autism spectrum disorder in the Netherlands. We refer to this alternative account as the nurturing stance and highlight relevant similarities and differences between the clinical stance and the nurturing stance. We conclude with suggestions for further research and theorizing. (shrink)

Purpose: Despite the prevalent use of the golden ratio in the environment design for autistic users, there is no experimental research that explains their desired space ratio. This study aims to find the desired ratio in the learning environment, like an occupational therapy room for autistic users, while considering effective variables on their choices. Methodology: Based on McAllister's (2012) study, a scale model inspired by a dollhouse has been chosen to work and play with autistic children directly and find their (...) desired space ratio. Meanwhile, the furniture configuration and the access type in the environment could also define the ratio for interviewees. Accordingly, the scale model was designed with six different scale rooms containing three ratios and two spatial access types represented by the furniture arrangement. 50 autistic children of different ages, genders, and disorders in the moderate and medium spectrum have been randomly sampled. Then, they were asked to choose their desired ratio by playing with the scale model and putting the doll in their preferred room. This study also included 50 non-autistic children as a control group with different genders and defined ages. Result: After interviewing both groups, the chi-square test with Cramer's V calculation analyzed the result to find the statistically significant correlation between control variables, among which two independent variables had a statistically significant correlation with the chosen ratio for all the interviewees. First, being autistic significantly impacted their desired ratio choice as autistic children went for a ratio of 2:5, and no autistic ones had a high tendency toward the golden ratio (1:1.6). The chi-square test also showed that the access type in the scale model was the effective variable for both groups when choosing their desired ratio. Conclusion: The access type of the room with its furniture configuration impacted how users perceived the room's ratio, as well as being autistic or non-autistic users. (shrink)

To date, diagnosing Attention Defi cit Hyperactivity Disorder remains indeed one of the most controversial issues in contemporary psychiatry and behavioural sciences. Most of the conceptual problems regarding the validity of this diagnostic category arise from the heterogeneity of syndromal pictures and the high rate of comorbidity observed in subjects diagnosed with ADHD at all stages of the longitudinal course of the disorder. In this regard, DSM 5 increased complexity by allowing a diagnosis of comorbidity between ADHD and (...) autism spectrum disorders while these two diagnoses were mutually exclusive in DSM-IV-TR. (shrink)

False belief tasks have enjoyed a monopoly in the research on children’s development of a theory of mind. They have been granted this status because they promise to deliver an unambiguous assessment of children’s understanding of the representational nature of mental states. Their poor cousins, true belief tasks, have been relegated to occasional service as control tasks. That this is their only role has been due to the universal assumption that correct answers on true belief tasks are inherently ambiguous regarding (...) the level of the child’s understanding of mental states. It has also been due to the universal assumption that nothing in the child’s developing theory of mind would lead to systematically incorrect answers on true belief tasks. We review new findings that 4- and 5-year-olds do err, systematically and profoundly, on the true belief versions of all the extant belief tasks. This reveals an intermediate level of understanding in the development of children’s theory of mind. Researchers have been unaware of this intermediate level because it produces correct answers in false belief tasks. A simple two-task battery—one true belief task and one false belief task—is sufficient to remove the ambiguity from each task. The new findings show that children do not acquire an understanding of beliefs, and hence a representational theory of mind, until after 6 years of age, or 2 years later than most developmental psychologists have concluded. This raises the question of how to interpret other new findings that infants are able to pass false belief tasks. We review these new infant studies, as well as recent studies on chimpanzees, in light of older children’s failure on true belief tasks, and end with some speculation about how all of these new findings might be reconciled. (shrink)

Volume 20, Issue 4, May 2020, Page 46-48.

Dubourg and Baumard mention a potential role for the human drive to systemise as a factor motivating interest in imaginary worlds. Given that hyperexpression of this trait has been linked with autism (Baron-Cohen, 2002, 2006), we think this raises interesting implications for how those on the autism spectrum may differ from the neurotypical population in their engagement with imaginary worlds.

If each of the subtypes of autism is defined simply as constituted by a set of symptoms, then the criteria for its observation are straightforward, although, of course, some of those symptoms themselves might be hard to observe definitively. Compare with telling whether or not someone is bleeding: while it might be hard to tell if someone is bleeding internally, we know what it takes to find out, and when we have the right access and instruments we can settle (...) the issue. But matters are not so simple for the autism subtypes. For one thing, how do we settle which symptoms to group together under one heading? One key difference between “autism disorder” and “Asperger’s disorder” is that the former exhibit language delays (sometimes extreme), whereas the latter do not. But is that a sign of genuinely distinct conditions or is that an artifact of the distinct groups of subjects that Leo Kanner and Hans Asperger worked with? And in general, although there are certainly types of behavior that are taken to be indicative of autism, none by itself is taken by diagnosticians to be either necessary or sufficient for a definitive diagnosis for any of the autism subtypes. What is the diagnostician to do? This is not merely an academic issue, as many parents can attest. Are we in a situation, then, that each practitioner has his or her own “pet” signs that are the “real keys” to the diagnosis? That would suggest that the term “autistic” might meet the fate of the outdated term “neurotic,” which turned out to be a pseudo-scientific term for an inexact clumping together of unrelated phenomena. The assumption amongst specialists seems to be that we will reach the point with "autism" that we have with "water": there will be a root essence to autism whose presence or absence settles a diagnosis. If that is to be the case, however, we have to settle the level of application of the concept. Does the term apply to people who exhibit particular behaviors? Or is it possible to exhibit “autistic” behaviors without actually being autistic, because autism is instead a particular feature of the mind (as, for example, in Baron-Cohen’s “impaired theory of mind module” theory, discussed below) which usually but not necessarily has behavioral effects? Or is autism located instead in the brain, perhaps in damage to key areas, which in turn would typically have an effect on modules of the mind? Or perhaps autism is located in genetics or biology, so that some people with damage to the brain caused by accidents so that they exhibit autistic symptoms would not actually be autistic. Conversely, supposing one had an “autistic brain” but showed none of (or not a sufficient number of) the symptoms, would one not be autistic? The assumption is that the genotypes and phenotypes will line up neatly, but if they do not, what happens to the concept “autistic?” (There is an analogy in the philosophy of sex and gender: androgen insensitive individuals tend to self-identify as female and have outward female traits, but have XY chromosomes—should we go with chromosomes or self-identity in assigning sex category?) Finally, the implications for these complications for diagnosis and categorization, with the attendant social and medical implications is discussed. The typical assumption of the medical profession is that autism cannot be “cured.” That assumes that autism is not simply the symptoms. However, at the same time, the tests used to diagnose ASDs work simply from the symptoms (for example, Baron-Cohen’s Sally/Anne test, which ASD children of a certain age almost all fail, but which practically no ASD adult fails). This implies an inherent confusion over the status of the concept. I conclude that attempts to make sense of some true or accurate summary of what it is to be autistic (such as one would find in the DSM) are almost certainly misguided and will vanish into history along with “neurotic.” But as with racial terms, which are similarly shifting and perverse, the term has already passed into the public sphere and will have a lasting and dangerous influence beyond its short scientific shelf-life. (shrink)

Siblings compete for parental care and feeding, while parents must allocate scarce resources to those offspring most likely to survive and reproduce. This could cause offspring to evolve traits that advertise health, and thereby attract parental resources. For example, experimental evidence suggests that bright orange filaments covering the heads of North American coot chicks may have evolved for this fitness-advertising purpose. Could any human mental disorders be the equivalent of dull filaments in coot chicks—low-fitness extremes of mental abilities that evolved (...) as fitness indicators? One possibility is autism. Suppose that the ability of very young children to charm their parents evolved as a parentally selected fitness indicator. Young children would vary greatly in their ability to charm parents, that variation would correlate with underlying fitness, and autism could be the low-fitness extreme of this variation. This view explains many seemingly disparate facts about autism and leads to some surprising and testable predictions. (shrink)

As it emerged from philosophical analyses and cognitive research, most concepts exhibit typicality effects, and resist to the efforts of defining them in terms of necessary and sufficient conditions. This holds also in the case of many medical concepts. This is a problem for the design of computer science ontologies, since knowledge representation formalisms commonly adopted in this field (such as, in the first place, the Web Ontology Language - OWL) do not allow for the representation of concepts in terms (...) of typical traits. The need of representing concepts in terms of typical traits concerns almost every domain of real world knowledge, including medical domains. In particular, in this article we take into account the domain of mental disorders, starting from the DSM-5 descriptions of some specific disorders. We favour a hybrid approach to concept representation, in which ontology oriented formalisms are combined to a geometric representation of knowledge based on conceptual space. As a preliminary step to apply our proposal to mental disorder concepts, we started to develop an OWL ontology of the schizophrenia spectrum, which is as close as possible to the DSM-5 descriptions. (shrink)

According to a popular line of thought, being excluded from interpersonal life is to be exempted from accountability, and vice versa. In ordinary life, this is most often illustrated by the treatment of people with serious psychological disorders. When people are excluded from valuable domains on the basis of their arbitrary characteristics (such as race and sex), they are discriminated against, prevented from receiving the benefits of participation in those domains for morally irrelevant reasons. Exemption from accountability—via exclusion from the (...) interpersonal domain—seems to prevent exempted parties from receiving crucial human goods for morally irrelevant reasons. This chapter discusses two widely deployed ways of trying to ameliorate morally costly disabilities. Both fail to apply viably to various psychopathologies. The solution involves disentangling accountability and interpersonality in a way that also provides insights into our shared human nature. (shrink)

No two individuals with the autism diagnosis are ever the same—yet many practitioners and parents can recognize signs of ASD very rapidly with the naked eye. What, then, is this phenotype of autism that shows itself across such distinct clinical presentations and heterogeneous developments? The “signs” seem notoriously slippery and resistant to the behavioral threshold categories that make up current assessment tools. Part of the problem is that cognitive and behavioral “abilities” typically are theorized as high-level disembodied and (...) modular functions—that are assessed discretely (impaired, normal, enhanced) to define a spectral syndrome. Even as biology reminds us that organic developing bodies are not made up of independent switches, we remain often seduced by the simplicity of mechanistic and cognitive models. Developmental disorders such as autism have accordingly been theorized as due to different modular dysfunctions—typically of cortical origin, i.e., failures of “theory of mind” (Baron-Cohen et al., 1985), of the “mirror neuron system” (Ramachandran and Oberman, 2006), of “weak central coherence” (Happe and Frith, 2006) or of the balance of “empathizing” and “systemizing” (Baron-Cohen, 2009), just to list a few. -/- The broad array of autonomic (Ming et al., 2005; Cheshire, 2012) and sensorimotor (Damasio and Maurer, 1978; Maurer and Damasio, 1982; Donnellan and Leary, 1995; Leary and Hill, 1996; Donnellan and Leary, 2012; Donnellan et al., 2012) differences experienced and reported by people with autism have by such theories typically been sidelined as “co-morbidities,” possibly sharing genetic causes, but rendered as incidental and decisively behaviorally irrelevant symptoms—surely disconnected from cognition. But what if the development of cortically based mental processes and autonomous control relies on the complexities and proper function of the peripheral nervous systems? Through such an “embodied” lens the heterogeneous symptoms of autism invites new interpretations. We propose here that many behavioral-level findings can be re-defined as downstream effects of how developing nervous systems attempt to cope and adapt to the challenges of having various noisy, unpredictable, and unreliable peripheral inputs. (shrink)

Although enactive approaches to cognition vary in terms of their character and scope, all endorse several core claims. The first is that cognition is tied to action. The second is that cognition is composed of more than just in-the-head processes; cognitive activities are externalized via features of our embodiment and in our ecological dealings with the people and things around us. I appeal to these two enactive claims to consider a view called “direct social perception” : the idea that we (...) can sometimes perceive features of other minds directly in the character of their embodiment and environmental interactions. I argue that if DSP is true, we can probably also perceive certain features of mental disorders as well. I draw upon the developmental psychologist Daniel Stern’s notion of “forms of vitality”—largely overlooked in these debates—to develop this idea, and I use autism as a case study. I argue further that an enactive approach to DSP can clarify some ways we play a regulative role in shaping the temporal and phenomenal character of the disorder in question, and it may therefore have practical significance for both the clinical and therapeutic encounter. (shrink)

As a result of vocal autism activists pushing against traditional views of autism, there is a bilateral debate that reflects a deeper philosophical divide between medical and social definitions of disability. Both sides seek to determine the manner in which autistics and their communities view autism, and thus influence the manner in which cures or treatments are sought, dispensed and taken up. Through an investigation of this debate, this project will explore the practical benefits and ethical obligations (...) of accommodating autistic differences. One side of this debate, which we will call the cure theory approach, seeks treatments that will eradicate or at least minimize autistic symptoms. The philosophical assertion that lies behind this objective is that autistic differences, particularly disruptive autistic differences, ought to be removed. The other side of the debate, which we will call the neurodiverse perspective, seeks to define autism as neurological difference, that is relationally determined, rather than a disorder or a syndrome. The neurodiversity movement recommends educating autistics and their communities regarding how to fully accommodate autistic differences. The underlying philosophical commitment of the neurodiverse perspective is that it is in the best interests of autistics and their communities to accommodate differences, rather than seek treatments that encourage conformity. I will argue that these two sides are not mutually exclusive. Through a synthesis of the neurodiverse and cure theory points of view I will enable the development of a method, which facilitates justice for autistics and their communities. This synthesis garners the maximum capabilities that the expression of autistic differences can offer, and maintains the freedom for all community members to actualize their capabilities. (shrink)

Impairments in pragmatic abilities, that is, difficulties with appropriate use and interpretation of language – in particular, non-literal uses of language – are considered a hallmark of Autism Spectrum Conditions (ASC). Despite considerable research attention, these pragmatic difficulties are poorly understood. In this paper, we discuss and evaluate existing hypotheses regarding the literalism of ASC individuals, that is, their tendency for literal interpretations of non-literal communicative intentions, and link them to accounts of pragmatic development in neurotypical children. We (...) present evidence that reveals a developmental stage at which neurotypical children also have a tendency for literal interpretations and provide a possible explanation for such behaviour, one that links it to other behavioural, rule-following, patterns typical of that age. We then discuss extant evidence that shows that strict adherence to rules is also a widespread feature in ASC, and suggest that literalism might be linked to such rule-following behaviour. (shrink)