This reviewer had read Kristeva in October, 2016 in this Journal (and the review is freely available online and had garnered some small publicity). Over the last one year this reviewer has taken a very short view of her tautological work. Having read her carefully this reviewer has decided that she should be rejected as a psychoanalyst, notwithstanding her huge popularity as a feminist. But this reviewer through a nuanced critique of theoretical psychoanalysis find her and her ilk lacking caritas.

This study draws upon naturalistic ethnographic data to expand current understandings regarding the socio-communicative capabilities and challenges of children with autism spectrum disorders in mid-childhood. Affording a view of the children’s spontaneous interactions within naturally occurring family and community settings, the study explores a range of discursive resources utilized by the children to accomplish socially reciprocal positive politeness practices in tandem with others. Emphasizing contextualized deployment of politeness forms in interaction, the practice-based conception developed here construes positive politeness as a (...) discursive process encompassing both socio-cultural and interpersonal knowledge/skills; and contributes to a perspective in which social and communicative realms are conceptualized as integrated domains of functioning. (shrink)

The aim of our study was to investigate the effects of a small therapeutic animal on the social behavior of nine autistic children. The social contacts of the autistic children were evaluated by a descriptive method of direct observation that was performed without and with the presence of a TA. In period one, contacts with an unfamiliar person and acquaintances were registered; in period two, contacts with the acquaintances and the TA were registered. The frequency of contacts of (...) autistic children with their acquaintances significantly increased in the presence of the TA . The frequency of contacts with the TA was significantly higher than the frequency of contacts with the UP . The form of the autistic children’s contacts with A, with the UP, and with the TA was individually dependent, and the presence of the TA changed the characteristics of contacts with A. Our results indicate that the presence of a small TA can positively influence the quantity and quality of the social behavior of autistic children and that the characteristics of social contacts were dependent on the individual. (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)

Autism and early-onset schizophrenia share common dimensions of social communication deficits. The possible role of common genetic factors has to be seriously considered, such as the serotonin transporter gene that influences the severity of social communication impairments (negative symptoms) and hallucinations (positive symptoms). Autism and the negative syndrome of schizophrenia might be at one extreme of a continuum, and paranoid schizophrenia (positive symptoms) at the other extreme.

Autism is typically framed as stemming from empathy deficits as well as more general cognitive and sensory issues. In turn it is further associated with other purported harms: ranging from psychological suffering to diminished moral agency. Given such associations, in the philosophical literature, autism is widely taken to hinder the possibility of both thriving and attaining personhood. Indeed, this purported stifling of thriving personhood can be taken as the core harm associated with autism as such. In direct contrast to this (...) dominant view, the key aim of this thesis is to raise reasonable doubt as to the validity of this exclusion, by establishing that there is no decisive reason to accept the notion that autism is inherently harmful. This builds on arguments made by autistic self-advocates who argue in favour of de-medicalising and instead politicising autistic disablement and distress. However, the originality of this thesis lies in three key factors. First: it focuses more specifically on the purported impossibility of thriving autistic personhood, since I take this more fundamental matter to underlie all the other issues relating to these wider debates. Second: I use a negativist methodology. That is, instead of, say, arguing that autistic individuals can be useful to society or have positive attributes, my aim is to raise reasonable doubt regarding the core assumption underlying the dominant framing of autism as a pathology: namely, that autism and thriving personhood are inherently at odds. Third, I draw on methodologies developed by feminist philosophers and critical theorists in order to further our understanding of autism and the ethical issues surrounding it with more nuance than I have found in the existing literature. In sum: after a critical analysis of the concept of autism, and then further analysis of the relationship between autism and the harms it is associated with, I conclude that we have no decisive reason to think that being autistic, in and of itself, is at odds with either thriving or personhood. This chimes with the notion that autism is best framed as a difference, disabled by society rather than medical pathology, raises important problems for both ethical and psychiatric theory, and has significant implications for autism policy and practice. (shrink)

Augmentative and Alternative Communication Technology [AAC Tech] is a relatively young, multidisciplinary field aimed at developing technologies for people who are unable to use their natural speaking voice due to congenital or acquired disability. In this paper, we take a look at the role of AAC Tech in promoting an ‘empathic turn’ in the perception of non-speaking autistic persons. By the empathic turn we mean the turn towards a recognition of non-speaking autistic people as persons whose ways of (...) engaging the world and expressing themselves are indicative of psychologically rich and intrinsically meaningful experiential lives. We first identify two ways in which AAC Tech contributes positively to this development. We then discuss how AAC Tech can simultaneously undermine genuine empathic communication between autistic persons and typically developed communicators (or neurotypicals). To mitigate this concern, we suggest the AAC field should incorporate philosophical insights from Design for Emotions and enactive embodied cognitive science into its R&D practices. To make our proposal concrete, we home in on stimming as an autistic form of bodily expressivity that can play an important role in empathic communicative exchanges between autistic persons and neurotypicals and that could be facilitated in AAC Tech designed for autistic people. (shrink)

Autobiographical memory (AM) is closely linked to the self-concept, and fulfills directive, identity, social, and adaptive functions. Individuals with autism spectrum disorder (ASD) are now known to have atypical AM, which may be closely associated with social communication difficulties. This may result in qualitatively different autobiographical narratives, notably regarding social identity. In the present study, we sought to investigate this concept and develop a cognitive intervention targeting individuals with ASD. First, 13 adolescents with ASD and 13 typically developing adolescents underwent (...) an AM interview featuring an original coding system designed to analyze the social self. We observed that the narratives produced by the ASD group focused more on the family than on extended social spheres, compared with those of the comparison group. Moreover, participants with ASD did not include themselves in the social groups they mentioned, and produced more references to others, compared with typically developing participants. Second, we designed a cognitive intervention program consisting of individual and group sessions that targeted AM. We conducted a pilot study among three adolescents with ASD aged 12, 16, and 17 years. Preliminary results showed that the program increased extra-family narrative references by the two youngest adolescents, who produced more social integration markers. Our study of autobiographical narratives yielded interesting findings about social positioning in ASD and showed how AM can be targeted in rehabilitation programs as a vector of social interaction. (shrink)

It often seems incorrect to say that psychiatric conditions are diseases, and equally incorrect to say that they are not. This results in what would seem to be an unsatisfactory stalemate. The present essay examines the considerations that have brought us to such a stalemate in our discussions of autism. It argues that the stalemate in this particular case is a reflection of the fact that we need to find the logical space for a position that rejects both positive (...) and negative answers. It then suggests one way in which we might find such space, by applying Michael Dummett’s notion of semantic disharmony. (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)

In this dissertation I argue for a wider and more robust notion of the modularity of mind thesis. The developmental disorder of autism is the prime analytic tool for developing this approach. I argue that a variety of other approaches are deeply flawed in that they cannot account for the autistic spectrum disorder. I mean by this the autistic profile of deficits such as the lack of social interaction and the avoidance of social contact. I begin with Fodorian (...) modularity. I argue that autism presents us with a case that threatens the division Fodor has between modules and central systems. The autistic disorder exemplifies an area of higher cognition that has many of the properties commonly associated with modular processing. Since Fodor cannot opt for a modular account of theory of mind it must be that his account of central systems is incorrect. I next argue that Baron-Cohen's amended modular architecture cannot explain autism since the autistic deficit cannot be due to a defective module for processing intentional action. Furthermore, his use of modularity threatens to make his view of cognition incoherent. Finally I take up Gopnik and Meltzoff's approach that eschews any type of modularity and instead posits a general learning mechanism. If autism, as they claim, were a general theory-building problem, then one should expect to see other behavioral deficits in other areas of autistic cognition. We do not. I then offer an alternative version of modularity inspired by Karmiloff-Smith . It gives us advantages. On Karmiloff-Smith's account we would expect the autistic deficit to have more perceptually basic components and recent research is bearing this out. Progressive modularity also provides us with a framework in which to understand the ways autistic persons understand the social world. This approach also seeks to unify the cognitive work being done on development with burgeoning work on development in neuroscience. (shrink)

Bilingualism is a valuable tool that enriches and facilitates cultural, social and lived experiences for autistic and non-autistic people alike. Research consistently finds no negative effects of bilingualism and highlights the potential for positive effects across cognitive and socio-cultural domains for autistic and non-autistic children. Yet parents of autistic children remain concerned that bilingualism will cause delays in both cognitive and language development and are still frequently advised by practitioners to raise their child monolingually. Evidently, (...) findings from research are not reflected in practice or subsequent advice, and it is essential to identify ways to ensure equal access to additional language learning. We briefly summarise the existing literature on bilingualism and autism, considering perspectives from the bilingual autistic community, and experimental research. We identify the most pertinent barriers to participation for autistic bilingual children in terms of familial, clinical and educational perspectives. We propose novel solutions to promote additional language learning and suggest changes to practice that will contribute to an evidence base for families and practitioners. This commentary makes innovative recommendations at both the individual and societal level to ensure that autistic bilingual people have equal rights and opportunities to language learning and are optimally supported in accessing them. (shrink)

Objectives: Autism spectrum disorder (ASD) is a juvenile onset neurodevelopmental disorder with social impairment and stereotyped behavior as the main symptoms. Unaffected relatives may also exhibit similar ASD features due to genetic factors. Although previous studies have demonstrated atypical brain morphological features as well as task-state brain function abnormalities in unaffected parents with ASD children, it remains unclear the pattern of brain function in the resting state.Methods: A total of 42 unaffected parents of ASD children (pASD) and 39 age-, sex-, (...) and handedness-matched controls were enrolled. Multiple resting-state fMRI (rsfMRI) analyzing methods were applied, including amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), degree centrality (DC), and functional connectivity (FC), to reveal the functional abnormalities of unaffected parents in ASD-related brain regions. Spearman Rho correlation analysis between imaging metric values and the severity of ASD traits were evaluated as well.Results: ALFF, ReHo, and DC methods all revealed abnormal brain regions in the pASD group, such as the left medial orbitofrontal cortex (mOFC) and rectal gyrus (ROI-1), bilateral supplementary motor area (ROI-2), right caudate nucleus head and right amygdala/para-hippocampal gyrus (ROI-3). FC decreasing was observed between ROI-1 and right anterior cingulate cortex (ACC), ROI-2, and bilateral precuneus. FC enhancing was observed between ROI-3 and right anterior cerebellar lobe, left medial temporal gyrus, left superior temporal gyrus, left medial frontal gyrus, left precentral gyrus, right postcentral gyrus in pASD. In addition, ALFF values in ROI-1, DC values in ROI-3 were positively correlated with AQ scores in pASD (ρ1 = 0.298, P1 = 0.007; ρ2 = 0.220, P2 = 0.040), while FC values between ROI-1 and right ACC were negatively correlated with AQ scores (ρ3 = −0.334, P3 = 0.002).Conclusion: rsfMRI metrics could be used as biomarkers to reveal the underlying neurobiological feature of ASD for unaffected parents. (shrink)

Video games are popular and ubiquitous aspects of human culture, but their relationships to psychological and neurophysiological traits have yet to be analyzed in social-evolutionary frameworks. We examined the relationships of video game usage, motivations, and preferences with autistic and schizotypal traits and two aspects of neurophysiology, reaction time and targeting time. Participants completed the Autism Quotient, Schizotypal Personality Questionnaire, a Video Game Usage Questionnaire, and two neurophysiological tasks. We tested in particular the hypotheses, motivated by theory and previous (...) work, that: participants with higher autism scores would play video games more, and participants with higher schizotypy scores would play video games less; and autism and positive schizotypy would be associated with opposite patterns of video game use, preferences and motivations. Females, but not males, with higher autism scores played more video games, and exhibited evidence of relatively male-typical video game genre preferences and motivations. By contrast, positive schizotypy was associated with reduced video game use in both genders, for several measures of game use frequency. In line with previous findings, males played video game more than females did overall, preferred action video games, and exhibited faster reaction and targeting times. Females preferred Puzzle and Social Simulation games. Faster reaction and targeting times were associated with gaming motives related to skill development and building behavior. These findings show that gaming use and patterns reflect aspects of psychology, and gender, related to social cognition and imagination, as well as aspects of neurophysiology. More generally, the results suggest that video game use is notably affected by levels of autistic and schizotypal traits, and that video games may provide an evolutionarily novel medium for imaginative play in which immersive play experiences can be decoupled from social interaction. (shrink)

In a study concerning visual body part recognition, a “self-advantage” effect, whereby self-related body stimuli are processed faster and more accurately than other-related body stimuli, was revealed, and the emergence of this effect is assumed to be tightly linked to implicit motor simulation, which is activated when performing a hand laterality judgment task in which hand ownership is not explicitly required. Here, we ran two visual hand recognition tasks, namely, a hand laterality judgment task and a self-other discrimination task, to (...) investigate whether the self-advantage emerged even if implicit motor imagery was assumed to be working less efficiently and how individual traits [such as autistic traits and the extent of positive self-body image, as assessed via the Autism Spectrum Quotient and the Body Appreciation Scale-2, respectively] modulate performance in these hand recognition tasks. Participants were presented with hand images in two orientations [i.e., upright and upside-down ] and asked to judge whether it was a left or right hand. They were also asked to determine whether it was their own, or another person’s hand. Data collected from men and women were analyzed separately. The self-advantage effect in the hand laterality judgment task was not revealed, suggesting that only two orientation conditions are not enough to trigger this motor simulation. Furthermore, the men’s group showed a significant positive correlation between AQ scores and reaction times in the laterality judgment task, while the women’s group showed a significant negative correlation between AQ scores and differences in RTs and a significant positive correlation between BAS-2 scores and dprime in the self-other discrimination task. These results suggest that men and women differentially adopt specific strategies and/or execution processes for implicit and explicit hand recognition tasks. (shrink)

The theory of mind (ToM) deficit associated with autism spectrum disorder has been a central topic in the debate about the modularity of the mind. In a series of papers, Philip Gerrans and Valerie Stone argue that positing a ToM module does not best explain the deficits exhibited by individuals with autism (Gerrans 2002; Stone & Gerrans 2006a, 2006b; Gerrans & Stone 2008). In this paper, I first criticize Gerrans and Stone’s (2008) account. Second, I discuss various studies of individuals (...) with autism and argue that they are best explained by positing a higher-level, domain-specific ToM module. (shrink)

Autonomy of people on the autism-spectrum has only been very rarely conceptually explored. Autism spectrum is commonly considered a hetereogenous disorder, and typically described as a behaviorally-defined neurodevelopmental disorder associated with the presence of social-communication deficits and restricted and repetitive behaviors. Autism research mainly focuses on the behavior of autistic people and ways to teach them skills that are in line with social norms. Interventions such as therapies are being justified with the assumption that autists lack the capacity to (...) be self-reflective and to be “author of their lives”. We question this assumption, as some empirical research shows that autists are aware of their strengths and are critical about social norms, we take this as a starting point to reconsider the beliefs about autistic people’s capacities. As a theoretical framework, we draw on Berlin’s idea of positive and negative liberty as he clearly distinguishes between one’s own developed preferences and the simple absence of interference. By drawing on the concept of positive liberty, we illustrate that a lot of autists are aware of their own needs, and usually do not deny their own needs, values and interests. This makes them less prone than non-autistic people to adapt their preferences to external influences, which might be seen as sticking to an authentic way of living. Our analysis shows that many autists are hindered to be autonomous due to unjustified interference, unreflected assumptions about their self-determination, or by paternalistic actions. These observations contribute to a better understanding when help and interference are justified and a more differentiated understanding of autonomy of autistic people. (shrink)

Autistic people continue to face considerable stigmatization. Much work remains to be done to identify and tackle the causes of this stigmatization. We identify two related assumptions that generate and perpetuate this stigmatization: one ontological; one epistemic. We argue that breaking the stigma around autism requires addressing these twin assumptions. The ontological assumption presupposes the pathologization of autism as a disorder. Addressing this first assumption requires taking neurodiversity seriously and moving away from neuronormativity. The epistemic assumption posits that “allistics-know-best” (...) and prevents allistics from acknowledging the epistemic limits of their own perspective. Addressing this second assumption requires centering Autistics’ perspectives and experiences in the production, dissemination, and use of knowledge about Autistics. To make our case against these two problematic assumptions, we draw on the key epistemological notions of standpoint, ignorance, and epistemic injustice—which have implications for all fields that concern minoritized groups and the contents produced about or with them. Fruitfully connecting our original pluralist conception of epistemic agency (which centers crucial experiential knowledge beyond mere propositional knowledge) to 4E cognition (embodied, embedded, extended, enacted), we identify a new category of epistemic injustice: ecological epistemic injustice. We then illustrate the importance of addressing the widespread yet problematic ontological and epistemic assumptions underlying the stigmatization of autism by turning to the case of applied behavioral analysis (ABA), which instantiates both neuronormativity and epistemic injustice. (shrink)

Background Visual atypicalities in autism spectrum disorder (ASD) are a well documented phenomenon, beginning as early as 2–6 months of age and manifesting in a significantly decreased attention to the eyes, direct gaze and socially salient information. Early emerging neurobiological deficits in perceiving social stimuli as rewarding or its active avoidance due to the anxiety it entails have been widely purported as potential reasons for this atypicality. Parallel research evidence also points to the significant benefits of animal presence for reducing (...) social anxiety and enhancing social interaction in children with autism. While atypicality in social attention in ASD has been widely substantiated, whether this atypicality persists equally across species types or is confined to humans has not been a key focus of research insofar. Methods We attempted a comprehensive examination of the differences in visual attention to static images of human and animal faces (40 images; 20 human faces and 20 animal faces) among children with ASD using an eye tracking paradigm. 44 children (ASD n = 21; TD n = 23) participated in the study (10,362 valid observations) across five regions of interest (left eye, right eye, eye region, face and screen). Results Results obtained revealed significantly greater social attention across human and animal stimuli in typical controls when compared to children with ASD. However in children with ASD, a significantly greater attention allocation was seen to animal faces and eye region and lesser attention to the animal mouth when compared to human faces, indicative of a clear attentional preference to socially salient regions of animal stimuli. The positive attentional bias toward animals was also seen in terms of a significantly greater visual attention to direct gaze in animal images. Conclusion Our results suggest the possibility that atypicalities in social attention in ASD may not be uniform across species. It adds to the current neural and biomarker evidence base of the potentially greater social reward processing and lesser social anxiety underlying animal stimuli as compared to human stimuli in children with ASD. (shrink)

Neurodiversity, the advocacy position that autism and related conditions are natural variants of human neurological outcomes that should be neither cured nor normalized, is based on the assertion that autistic people have unique neurological differences. Membership in this community as an autistic person largely results from clinical identification, or biocertification. However, there are many autistic individuals who diagnose themselves. This practice is contentious among autistic communities. Using data gathered from Wrong Planet, an online autism community (...) forum, this article describes the debate about self-diagnosis amongst autistic self-advocates and argues for the acceptance of the practice in light of the difficulties in verifying autism as a ‘natural kind.’ This practice can counteract discriminatory practices towards and within the autistic community and also work to verfiy autistic self-knowledge and self-expertise. This discussion also has important implications for other neurocommunities, neuroethical issues such as identity and privacy, and the emerging field of critical autism studies. (shrink)

Linguistic repetitions in children are conceptualized as negative in children with autism – echolalia, without communicative purpose – and positive in typically developing (TD) children – linguistic alignment involved in shared engagement, common ground and language acquisition. To investigate this apparent contradiction we analyzed spontaneous speech in 67 parent–child dyads from a longitudinal corpus (30 minutes of play activities at 6 visits over 2 years). We included 32 children with autism and 35 linguistically matched TD children (mean age at recruitment (...) 32.76 and 20.27 months). We found a small number of exact repetitions in both groups (roughly 1% of utterances across visits), which increased over time in children with autism and decreased in the TD group. Partial repetitions were much more frequent: children reused caregivers' words at high rates regardless of diagnostic group (24% of utterances at first visit), and this increased in frequency (but not level) over time, faster for TD children (at final visit: 33% for autism, 40% for TD). The same happened for partial repetition of syntax and semantic alignment. However, chance alignment (as measured by surrogate pairs) also increased and findings for developmental changes were reliable only for syntactic and semantic alignment. Children with richer linguistic abilities also displayed a higher tendency to partially re–use their caregivers' language (alignment rates and semantic alignment). This highlights that all children commonly re–used the words, syntax, and topics of their caregivers, albeit with some quantitative differences, and that most repetition was at least potentially productive, with repeated language being re–contextualized and integrated with non–repeated language. The salience of echolalia in ASD might be partially explained by slight differences in frequency, amplified by lower semantic alignment, persistence over time, and expectations of echolalia. More in–depth qualitative and quantitative analyses of how repetitions are used and received in context are needed. (shrink)

In this paper, I provide further support for my earlier claim that the existence of high-functioning autistic speakers does not undermine Davidson's theory of radical interpretation. Andrews and Radenovic, in criticizing my arguments for this position, have presented fresh evidence from the clinical literature on autism for the existence of an individual who speaks but does not interpret, and maintain that the existence of such an individual seriously challenges Davidson's theory. I counter this claim by showing that the (...) evidence they point to in fact better supports the conclusion that this autistic speaker, and others like him, are Davidsonian interpreters. (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)

Background: Studies on autistic strengths are often focused on what they reveal about autistic intelligence and, in some cases, exceptional and atypical reasoning abilities. An emerging research trend has demonstrated how interests and strengths often evident in autism can be harnessed in interventions to promote the well-being, adaptive, academic and professional success of autistic people. However, abilities in certain domains may be accompanied by major limitations in others, as well as psychiatric and behavioral issues, which may challenge (...) their inclusion in support programs. Objectives: To provide an in-depth, pragmatic, real-life example of the psychological and psychiatric management of interests and strengths in an autistic adolescent. Method: An autistic teenager, C.A., with above-average calendar calculation and musical abilities, received psychiatric, neuropsychological, and language standardized and clinical assessments, combined with a measurement of his musical and calendar calculation abilities. C.A. and his parents then received psychiatric and psychological support over a 14-month period, targeting their perceptions of C.A.’s interests, strengths, and co-occurring difficulties. Results: C.A. had a verbal IQ within the intellectual disability range and a non-verbal IQ in the low mean range. Modest calendar calculation, absolute pitch, and matrix abilities coexisted with severe receptive and expressive language disorder. The discrepancy between his abilities in areas of strengths and his limitations in other domains led to anxiety, frustration, and sometimes behavioral issues. Displacing the focus from academic performance to interests, as well as promoting the use of his strengths to develop new skills independently of their short-term adaptive benefits yielded positive effects on C.A.’s self-assessment, quality of life, and behavior at follow up. Discussion: The appealing idea that abilities mostly found in autistic people, such as calendar calculation, can be directly harnessed into academic achievement and lead to paid employment may have detrimental effects, especially when such abilities are modest and associated with other limitations. These abilities should be primarily used to maximize well-being and quality of life, independently of their short-term adaptive function, which may or may not be positive. (shrink)

A central diagnostic and anecdotal feature ofautismis difficulty with socialcommunication. We take the position that communication is a two-way,intersubjectivephenomenon—as described by thedouble empathy problem—and offer uprelevance theory(a cognitive account of utterance interpretation) as a means of explaining such communication difficulties. Based on a set of proposed heuristics for successful and rapid interpretation of intended meaning, relevance theory positions communication as contingent on shared—and, importantly,mutuallyrecognized—“relevance.” Given that autistic and non-autistic people may have sometimes markedly different embodied experiences of (...) the world, we argue that what is most salient to each interlocutor may be mismatched. Relevance theory would predict that where this salient information is not (mutually) recognized or adjusted for, mutual understanding may be more effortful to achieve. This paper presents the findings from a small-scale, linguistic ethnographic study of autistic communication featuring eight core autistic participants. Each core autistic participant engaged in three naturalistic conversations around the topic of loneliness with: (1) a familiar, chosen conversation partner; (2) a non-autistic stranger and (3) an autistic stranger. Relevance theory is utilized as a frame for the linguistic analysis of the interactions. Mutual understanding was unexpectedly high across all types of conversation pairings. In conversations involving two autistic participants, flow, rapport and intersubjective attunement were significantly increased and in three instances, autistic interlocutors appeared to experience improvements in their individual communicative competence contrasted with their other conversations. The findings have the potential to guide future thinking about how, in practical terms, communication between autistic and non-autistic people in both personal and public settings might be improved. (shrink)

Lying is a common phenomenon amongst human beings. It seems to play a role in making social interactions run more smoothly. Too much honesty can be regarded as impolite or downright rude. Remarkably, lying is not a common phenomenon amongst normally intelligent human beings who are on the autism spectrum. They appear to be ‘attractively morally innocent’ and seem to have an above average moral conscientious objection against deception. In this paper, the behavior of persons with autism with regard to (...) deception and truthfulness will be discussed in the light of two different ethical theories, illustrated by fragments from autobiographies of persons with autism. A systemizing ‘Kantian’ and an empathizing ‘ethics of care’ perspective reveal insights on high-functioning autism, truthfulness and moral behavior. Both perspectives are problematic from the point of view of a moral agent with autism. High-functioning persons with autism are, generally speaking, strong systemizes and weak empathizers. Particularly, they lack ‘cognitive empathy’ which would allow them to understand the position of the other person. Instead, some tend to invent a set of rules that makes their behavior compatible with the expectations of others. From a Kantian point of view, the autistic tendency to always tell the truth appears praiseworthy and should not be changed, though it creates problems in the social life of persons with autism. From a care ethics perspective, on the other hand, a way should be found to allow the high-functioning persons with autism to respect the feelings and needs of other persons as sometimes overruling the duty of truthfulness. We suggest this may even entail ‘morally educating’ children and adolescents with autism to become socially skilled empathic ‘liars’. (shrink)

The Theory Theory (TT) versus Simulation Theory (ST) debate is primarily concerned with how we understand others’ mental states. Theory theorists claim we do this using rules that are akin to theoretical laws, whereas simulation theorists claim we use our own minds to imagine ourselves in another’s position. Theorists from both camps suggest a consideration of individuals with autism spectrum disorders (ASD) can help resolve the TT/ST debate (e.g., Baron-Cohen 1995; Carruthers 1996a; Goldman 2006). We present a three-part argument (...) that such research has so far been inconclusive and that the prospects for studies of ASD to resolve the debate in the near future remain uncertain. First, we discuss evidence indicating that some individuals with ASD can perform effectively on tests of mental state understanding, which questions what ASD can tell us regarding theorising or simulation. Second, we claim that there is compelling evidence that domain-general mechanisms are implicated in mental state reasoning, which undermines how ASD might inform the TT/ST debate given that both theories appeal to domain-specific mindreading mechanisms. Third, we suggest that neuroscientific evidence for an assumed role of the mirror neuron system in autism also fails to arbitrate between TT and ST. We suggest that while the study of ASD may eventually provide a resolution to the TT/ST debate, it is also vital for researchers to examine the issues through other avenues, for example, by examining people’s everyday counterfactual reasoning with mental state scenarios. (shrink)

This paper reflects on the three main ethical challenges we faced when conducting digital ethnography in three autism Brazilian communities on Facebook: how to position oneself as a researcher, how...

This article outlines the emergence of ABA (Applied Behaviour Analysis) in the mid-20th century, and the current popularity of ABA in the anglophone world. I draw on the work of earlier historians to highlight the role of Ole Ivar Lovaas, the most influential practitioner of ABA. I argue that reception of his initial work was mainly positive, despite concerns regarding its efficacy and use of physical aversives. Lovaas’ work, however, was only cautiously accepted by medical practitioners until he published results (...) in 1987. Many accepted the results as validation of Lovaas’ research, though both his methods and broader understanding of autism had shifted considerably since his early work in the 1960s. The article analyses the controversies surrounding ABA since the early 1990s, considering in particular criticisms made by autistic people in the ‘neurodiversity movement’. As with earlier critics, some condemn the use of painful aversives, exemplified in the campaign against the use of shock therapy at the Judge Rotenberg Center. Unlike earlier, non-autistic critics, however, many in this movement reject the ideological goals of ABA, considering autism a harmless neurological difference rather than a pathology. They argue that eliminating benign autistic behaviour through ABA is impermissible, owing to the individual psychological harm and the wider societal impact. Finally, I compare the claims made by the neurodiversity movement with those made by similar 20th- and 21st-century social movements. (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)

Substantial research efforts have been devoted to developing a cure for autism, but some advocates of people with autism claim that these efforts are misguided and even harmful. They claim that there is nothing wrong with people with autism, so there is nothing to cure. Others argue that autism is a serious and debilitating disorder and that a cure for autism would be a wonderful medical breakthrough. Our goal in this essay is to evaluate what assumptions underlie each of these (...) positions. We evaluate the arguments made on each side, reject those that are implausible and then highlight the key assumptions of those that remain. (shrink)

Historically, entities with a vested interest in a product that critics have suggested is harmful have consistently used research to back their claims that the product is safe. Prominent examples are: tobacco, lead, bisphenol A, and atrazine. Research literature indicates that about 80–90 % of studies with industry affiliation found no harm from the product, while only about 10–20 % of studies without industry affiliation found no harm. In parallel to other historical debates, recent studies examining a possible relationship between (...) mercury exposure and autism spectrum disorder show a similar dichotomy. Studies sponsored and supported by industry or entities with an apparent conflict of interest have most often shown no evidence of harm or no “consistent” evidence of harm, while studies without such affiliations report positive evidence of a Hg/autism association. The potentially causal relationship between Hg exposure and ASD differs from other toxic products since there is a broad coalition of entities for whom a conflict of interest arises. These include influential governmental public health entities, the pharmaceutical industry, and even the coal burning industry. This review includes a systematic literature search of original studies on the potential relationship between Hg and ASD from 1999 to date, finding that of the studies with public health and/or industry affiliation, 86 % reported no relationship between Hg and ASD. However, among studies without public health and/or industry affiliation, only 19 % find no relationship between Hg and ASD. The discrepancy in these results suggests a bias indicative of a conflict of interest. (shrink)

Background: Few robust autism-specific outcome assessments have been developed specifically for use by teachers in special schools. The Assessment of Barriers to Learning in Education – Autism is a newly developed teacher assessment to identify and show progress in barriers to learning for pupils on the autism spectrum with coexisting intellectual disabilities. Aims: This study aimed to conduct a preliminary validity and reliability evaluation of the ABLE-Autism. Methods and procedures: Forty-eight autistic pupils attending special schools were assessed using the (...) ABLE-Autism. Multi-level modelling was used to evaluate test-retest reliability, internal consistency and convergent validity with the Teacher Autism Progress Scale. Outcomes and results: Results showed excellent test-retest reliability and internal consistency. A large effect size suggested that the ABLE-Autism is strongly correlated with the Teacher Autism Progress Scale. Teacher feedback was positive and suggested that the ABLE-Autism is easily understood by teachers, relevant to autistic pupils in special schools, and adequately covers the skills and behaviours that teachers believe are important to assess for these pupils. Conclusions and implications: Although further validation is recommended, the preliminary evaluation of the ABLE-Autism suggests that it is a useful and has the potential to be an effective outcome assessment for autistic pupils in special schools. (shrink)

Face perception and emotion categorization are widely investigated under laboratory conditions that are devoid of real social interaction. Using mobile eye-tracking glasses in a standardized diagnostic setting while applying the Autism Diagnostic Observation Schedule (ADOS-2), we had the opportunity to record gaze behavior of children and adolescents with and without Autism Spectrum Conditions (ASCs) during social interaction. The objective was to investigate differences in eye-gaze behavior between three groups of children and adolescents either (1) with ASC or (2) with unconfirmed (...) diagnosis of ASC or (3) with neurotypical development (NTD) during social interaction with an adult interviewer in a diagnostic standard situation using the ADOS-2. In a case control study, we used mobile eye-tracking glasses in an ecologically valid and highly standardized diagnostic interview to investigate suspected cases of ASC. After completion of the ASC diagnostic gold standard including the ADOS-2, the participants were assigned to two groups based on their diagnosis (ASC vs. non-ASC) and compared with a matched group of neurotypically developed controls. The primary outcome measure is the percentage of total dwell times assessed for different areas of interest (AOI) with regard to the face and body of a diagnostic interviewer and the surrounding space. Overall, 65 children and adolescents within an age range of 8.3–17.9 years were included in the study. The data revealed significant group differences, especially in the central-face area. Previous investigations under laboratory conditions gave preferential attention to the eye region during face perception to describe differences between ASC and NTD. In this study – using an ecologically valid setting within a standard diagnostic procedure – the results indicate that neurotypically developed controls seem to process faces and facial expressions in a holistic manner originating from the central-face region. Conversely, participants on the Autism Spectrum (tAS) seem to avoid the central-face region and show unsystematic gaze behavior, not using the preferred landing position in the central-face region as the Archimedean point of face perception. This study uses a new approach, and it will be important to replicate these preliminary findings in future research. (shrink)

Many autistic people are becoming increasingly involved in, and increasingly critical of, autism intervention research. They have expressed concerns regarding applied behavior analysis interventions on a number of grounds, one of which is the prevalence of conflicts of interests among autism intervention researchers. These concerns are now also being addressed by non-autistic researchers. COIs can introduce bias into the research process, and allow researchers to demonstrate positive effects for interventions that are not actually effective. Despite these concerns, there (...) are no studies to date that examine the prevalence of COIs in behavioral journals. Because ABA services are routinely provided to autistic people in the United States as a means to address difficulties experienced by autistic people, this is an important area of investigation. We tallied author COIs in articles published over a 1-year period that tested, commented on, or reviewed ABA autism intervention strategies, extracted from eight journals devoted to publishing behavioral research. We coded included studies for COIs related to researcher employment as an ABA clinical provider or a training consultant to ABA clinical providers. We found that 84% of studies had at least one author with this type of COI, but they were only disclosed as COIs in 2% of studies. Additionally, 87% of studies with statements claiming the authors did not have COIs, were authored by researchers found to have clinical/training consultancy COIs. Pervasive, undisclosed COIs likely lead to researcher bias, and could at least partially account for persistent poor quality research in this area. The high prevalence of COIs among this research corroborates the concerns expressed by many autistic people. The autism community – including autistic people, autism researchers, and other stakeholders – should be aware of the prevalence of undisclosed COIs in this literature and take this into account when using, providing, or recommending ABA services. (shrink)

There are some necessary conditions on causal relations that seem to be so trivial that they do not merit further inquiry. Many philosophers assume that the requirement that there could be no temporal gaps between causes and their effects is such a condition. Bertrand Russell disagrees. In this paper, an in-depth discussion of Russell’s argument against this necessary condition is the centerpiece of an analysis of what is at stake when one accepts or denies that there can be temporal gaps (...) between causes and effects. It is argued that whether one accepts or denies this condition, one is implicated in taking on substantial and wide-ranging philosophical positions. Therefore, it is not a trivial necessary condition of causal relations and it merits further inquiry. (shrink)

Autism is a widely researched area and much emphasis has been placed in research on the differences between the autistic and non-autistic populations. Such research commonly draws on proposed deficits within people with autism in order to explain differences. This paper seeks to present an alternative understanding of differences and draws on writings of people with autism in such a discussion. The construction of ‘Neurologically Typical syndrome’ (NT) will be presented as an inverted construction of diagnosis, which serves (...) to challenge the dominant position of ‘NTs’ and ‘NT traits’ over autistic traits. It will be argued that such an alternative representation of people with and without autism has important implications for our construction of and understanding of autism. (shrink)

Sensory symptoms are common in autism spectrum disorder. Previous studies have shown a positive correlation between sensory symptoms and internalizing problems; however, the role of the suffering due to sensory symptoms is not well understood. In the present study, we hypothesized that the relationship between sensory symptoms and internalizing problems in children is mediated by children’s and surrounding people’s suffering due to sensory symptoms. Parents of 113 students aged 6–15 years with and without ASD completed questionnaires about their children’s (...) class='Hi'>autistic traits, sensory symptoms, suffering due to sensory symptoms, and internalizing problems. The results showed that autistic traits and sensory symptoms were distributed as a continuum throughout children with and without ASD. Therefore, we investigated the relationship among variables in children with and without ASD attending regular classes. Structural equation modeling indicated that those who scored higher on sensory symptoms demonstrated greater suffering due to sensory symptoms as predictors of internalizing problems. Our findings provide evidence for developing a support system that specifically reduces suffering due to sensory symptoms, especially for students in regular classes. (shrink)

Keeping a conversation going is the social glue of friendships. The DSM criteria for autism list difficulties with back-and-forth conversation but does not necessitate that all autistic children will be equally impacted. We carried out three studies (two pre-registered) with verbally-fluent school children (age 5-9 years) to investigate how autistic and neurotypical children maintain a conversation topic. We also investigated within-group relationships between conversational ability and cognitive and socio-cognitive predictors. Study 1 found autistic children were more likely (...) than neurotypical controls to give off-topic and generic minimal responses (e.g. ‘mm’, ‘oh’) and were less likely to give non-verbal responses (e.g. nodding or use of facial affect to respond). Nonetheless, the autistic group provided topic-supporting responses 62% of the time, indicating some aspects of conversation topic maintenance are a relative strength. Studies 2 and 3 found large individual differences in topic-supporting conversational responding amongst both neurotypical and autistic children. These were positively related to theory of mind ability and age in both groups. Conversational skills lie on a continuum for the general population and differences by diagnostic group are a matter of degree. Given the importance for peer relationships, we suggest a whole-classroom approach to supporting conversation skills in all children. (shrink)

The origin of moral agency is a much-debated issue. While rationalists or Kantians have argued that moral agency is rooted in reason, sentimentalists or Humeans have ascribed its origin to empathic feelings. This debate between rationalists and sentimentalists still stands with respect to persons with mental disorders, such as individuals diagnosed with mild forms of Autism Spectrum Disorder, without intellectual impairment. Individuals with ASD are typically regarded as moral agents, however their ability for empathy remains debated. The goal of this (...) paper is to investigate the mechanisms of moral actions in people with ASD, by finding arguments for the origin of their moral actions, supporting either the sentimentalist or the rationalist view of the dispute. We propose to revisit the debate using Interpretative Phenomenological Analysis to study the autobiographies of individuals with High-Functioning Autism and Asperger Syndrome. While conducting the systematic analysis of 10 autobiographies, we re-examined both the rationalist and the sentimentalist positions, considering the links between empathic feelings and moral agency. The investigation of the temporal dimensions of emotional experiences, an aspect overlooked by previous research, indicated that individuals with ASD empathize with others, but in different ways as compared to neurotypicals. A relationship between emotional experience and the type of moral agency exhibited by individuals with forms of ASD was established. As a consequence, our analyses support the sentimentalist stance on moral action. (shrink)

The book takes as its point of departure the notion that similarity and contiguity are fundamental to meaning. It shows how they manifest in oral, literate, print and internet cultures, in language acquisition, pragmatics, dialogism, classification, the semantics of grammar, literature and, most centrally, metaphor and metonymy. The book situates these reflections on similarity and contiguity in the interplay of language, cognition, culture, and ideology, and within broader debates around such issues as capitalism, biodiversity, and human control over nature. Positing (...) that while similarity-focused systems can be reductive, and have therefore been contested in social science, philosophy and poetry, and contiguity-based ones might disregard useful statistical and scientific evidence, Andrew Goatly argues for the need for humans to entertain diverse metaphors, models, and languages as ways of understanding and acting on our world. The volume also considers the cognitive connections between the similarity-contiguity duality and the noun-verb distinction. This innovative volume will appeal to scholars involved in wider debates on meaning, within the fields of cognitive semantics, pragmatics, metaphor and metonymy theory, critical discourse analysis, and the philosophy of language. Equally, the motivated and intelligent general reader, interested in language, philosophy, culture and ecology, should find the later chapters of the book fascinating, and the earlier technical chapters accessible. (shrink)

Sensory deficits are a feature of autism and schizophrenia, as well as the upper end of their non-clinical spectra. The mismatch negativity (MMN), an index of pre-attentive auditory processing, is particularly sensitive in detecting such deficits; however, little is known about the relationship between the visual MMN (vMMN) to facial emotions and autism and schizophrenia spectrum symptom domains. We probed the vMMN to happy, sad, and neutral faces in 61 healthy adults (18–40 years, 32 female), and evaluated their degree of (...) autism and schizophrenia spectrum traits using the Autism Spectrum Quotient (AQ) and Schizotypal Personality Questionnaire (SPQ). The vMMN to happy faces was significantly larger than the vMMNs to sad and neutral faces. The vMMN to happy faces was associated with interpersonal difficulties as indexed by AQ Communication and Attention to Detail subscales, and SPQ associated with more interpersonal difficulties. These data suggest that pre-attentive processing of positive affect might be more specific to the interpersonal features associated with autism and schizophrenia. These findings add valuable insights into the growing body of literature investigating symptom-specific neurobiological markers of autism and schizophrenia spectrum conditions. (shrink)

Positive Psychology Interventions as an Opportunity in Arab Countries to Promoting Well-being AbstractIn this perspective paper, we emphasize the importance of further research on culturally-sensitive positive psychology interventions in the Arab region. We argue that these interventions are needed in the region because they not only reduce mental health problems but also promote well-being and flourishing. To achieve this, we shed light on the cultural elements of the Arab region and how the concept of well-being differs from that of Western (...) culture. We review the research conducted in Arabia, briefly evaluate the quality of this research and list some adapted measurements. We furthermore propose guidelines and recommendations for future evidence-based positive psychology interventions research to align with the national culture in various sectors and community samples that contribute to the development of well-being in the Arab world.Introduction Extensive research on Positive Psychology Interventions (PPIs) - defined as activities focus on promoting positive feelings, thoughts, or behaviour (Sin & Lyubomirsky, 2009) - has shown their effectiveness in well-being and mental illness (e.g., Chakhssi et al., 2018; Hendriks et al., 2020). A recent review of 347 studies showed that PPIs have a significant effect on promoting quality of life and well-being and reducing anxiety and depression (Carr et al., 2020). However, the issue is that most of these studies (82%) remain narrow in focus only on Western Educated Industrialised Rich Democratic (WEIRD) countries (Hendriks et al., 2019). Therefore, they may not be effective for other countries such as the Arab countries where there are various cultural differences. This highlights the key role that culture can play in enhancing PPIs engagement, acceptability, and eventually, effectiveness (Hendriks & Graafsma, 2019). Recently, the field of PP in the Arab region has begun to grow (Basurrah et al., 2021; Rao et al., 2015). However, studies conducted in these countries are scant and of poor methodological quality. We have found humble quantity and quality of empirical studies. Yet, Arab countries, home to 5% of the world’s population, have a burden of mental health problems above global levels (GBD 2015 Eastern Mediterranean Region Mental Health Collaborators, 2018). Prevalent stigma, war and conflict were some of the contributors (Maalouf et al., 2019). Thus, to properly address this cultural stigma against mental health problems, PPIs could provide an additional role alongside traditional psychology approaches (e.g., Cognitive Behavioural therapy - CBT). Further, in light of the political conditions that some Arab countries are going through and the negative effects that they cause, it has become necessary to use the method of prevention that is the focus of PP and not only of treatment as a strategy for applications and practice. It has been noted that the mental health care system in the Arab region focuses highly on illnesses treatment and neglects the significant role that PP plays in enhancing human potential and well-being. We - here in Arabia –are becoming more influenced by many global issues particularly the COVID-19 pandemic and their impact on mental health and well-being (e. g. prevalence of stress, anxiety, depression among the general population during the pandemic (Salari et al., 2020). In response, Waters et al. (2021) have recently presented how positive psychological factors can play a significant role in buffering mental illness, enhancing mental health throughout the pandemic, and building positive processes and capacities that can help to promote future mental health.Here in this perspective paper, we highlight the cultural aspects of Arab countries. Specifically, we present previous PPIs research conducted in Arabia and briefly evaluate the quality of this research. Importantly, we discuss the need of developing an indigenous and culturally sensitive PP among the Arab region (Lambert et al., 2015).Arab Culture “Arab World,” which comprises 5% of the world’s population, refers to the Arab countries in the Middle East and North Africa. Despite the increasing pace and progress of different businesses in many Arab countries, individual communities are still limited in certain prominent economic places. Arab people rather gather in collective communities. They generally share the same Arabic Islamic culture, speak the same language, and descend from the same Arab families when going back in history no matter what nationality they have nowadays. Yet, very many changes came to communities before borders were drawn between countries and after. For instance, geography, topography, demography, and socio-economic status affect peoples’ nature of jobs and lifestyles. For example, Arabs in the east, west, or the middle have similar tongues; however, almost every Arab country has its accent. Therefore, people need to go back to the formal Arabic language ‘Fus-ha’ or learn more about different Arabic dialects when communicating cross-countries. According to Hofstede’s model (2011) based on the individualism-collectivism dimension, the Arab countries (Eastern society) have been classified as a collectivist culture, where their identity and decisions are influenced by social systems. In contrast, the United States (Western society) has been classified as an individualist culture focusing on individual decisions. Although there are degrees of individualism among Arabs in certain countries, they still share collective common characteristics. Here, we explore the meaning of collectivistic conceptions of the self, emotions, values, and religion in Arab countries and how they differ from those in individual Western cultures. The Self Since the field of PP focuses on the development of self, it is vital to recognize that self-concept varies across cultures. Individualism generally emphasises the self-directed and autonomous individual (Realo et al., 2002). People in individualist countries focus primarily on their personal characteristics (e.g., motives, abilities) to build their self-concept. On the other hand, collectivism refers to several social structures that highly value the groups to which people belong, such as family and tribe (Realo, 2003). People in collectivist countries such as the Arab countries focus primarily on their relationships with others to build their self-concept (Markus & Kitayama, 1991). Hence, research from Arab countries should focus on the core elements of collectivism when implementing PPIs to make a significant, meaningful impact. For example, people from a collective culture may experience a greater enhancement in well-being when practising interventions that are more prosocial and group-oriented such as compassion, performing acts of kindness, writing a gratitude letter, and using character strengths in everyday context including social context, compared with self-oriented interventions such as identifying character strengths. Emotions, value, and Religion Research shows that Western culture emphasises the goal of maximizing positive emotions, while Eastern culture emphasises embracing and balancing positive and negative emotions (Leu et al., 2011). To illustrate, culture plays an important role in influencing perceptions of happiness. People in individualist countries value happiness highly. In contrast, people from the collective countries value low arousal positive emotions (Leu et al., 2011) and exhibit a fear of happiness (Joshanloo & Weijers, 2014; Joshanloo, 2013). Hence, the influence of positive emotions plays a limited role in the mental health of Eastern society. Speaking of Value, for an Arab, the family is the centre of honour and the most important social unit. This loyalty has an impact on every part of an Arab’s life. Arabs honour their families and highly value their friendships. Therefore, future research could shed more light on group-oriented interventions (e.g., kindness) that focus more on the relationship with family, friends, and community. When it comes to religion, Arab society has a rich culture in values and believes that place a high emphasis on spirituality. Religion is the most important and distinctive aspect of Arab culture. Arab countries vary in terms of religion, with Islam being the predominant religion in most of them. Well-being (Hedonic and Eudaimonic) It is necessary here to clarify what is meant by hedonic and eudaimonic definitions of well-being. While the term ‘Hedonic’ is based on the pursuit of maximum levels of pleasure (feeling good), the term ‘Eudaimonic’, on the other hand, is based on meaning and the development of virtues (functioning well; Keyes & Annas, 2009). Research indicates that cultures are not equally supportive of hedonic and eudaimonic aspects (Joshanloo & Jarden, 2016). In comparison to collectivism, hedonism appears to be more congruent with individualism (Joshanloo, 2014). Pleasure and positive emotions are considered a way to pursue happiness in Western culture, while this method is not highly favoured in Eastern cultures (Lee et al., 2013); Because they consider suffering and negative emotions as contributing factors to spiritual development. Therefore, the eastern perspective is more in line with a eudaimonistic view which emphasises virtues, meaning, and feeling of belongingness. However, although we believe that both approaches can be found to a certain level in both cultures, the differences suggest that there are different routes to happiness. Positive Psychology in the Arab region Positive psychology - "the scientific study of what makes life most worth living" (Seligman & Csikszentmihalyi, 2000) - is one of the newest branches of psychology. It focuses on three main pillars: (1) positive subjective experiences (such as happiness and love); (2) positive individual characters (such as gratitude and compassion); and (3) positive institutions (for the application of positive principles within institutions and organizations; Seligman & Csikszentmiha lyi, 2000). Some of the main topics of interest in positive psychology include character strengths, gratitude, hope, happiness, mindfulness, optimism, positive thinking, and resilience. Within the applications of this science, various domains of well-being (such as happiness, engagement, positive emotions, and meaning) can be enhanced by practising positive psychology interventions (Sin & Lyubomirsky, 2009). Interestingly, these interventions have also produced benefits beyond well-being, such as reduced mental health issues (Chakhssi et al., 2018; Hendriks et al., 2020).Nowadays, PP is increasingly noticed in the Arab world (Lambert & Pasha-Zaidi, 2019; Rao et al., 2015). In recent years, there has been a great effort to explore the PP field across Arab countries. Several initiatives have emerged aimed at promoting well-being and flourishing. For example, the Middle East Journal of Positive Psychology published its first volume in 2015. On the International Day of Happiness in 2017, United Arab Emirates University launched its Emirates Center for Happiness Research. Meanwhile, Effat University in Saudi Arabia started the first Positive Psychology and Well-being Research Lab, the first symposium, and the first PP course. In 2019, Louise Lambert and Nausheen Pasha-Zaidi published the first regional text entitled “Positive Psychology in the Middle East/North Africa.” There are other efforts spent in the region as well; such as the work conducted in Egypt. Ibrahim Younus established the Arab Association for Positive Psychology https://www.psycholearn.com/en/associative.php which provides several courses on PP and also published a book entitled “The Power of Positive Psychology” (Younus, 2017). Despite this development, nothing can compare to the quantity and even quality of research in other countries. In light of our observations, the few PP studies may be attributed to the lack of awareness of the constructive approach and prevention compared to problem-solving. An Arab dentist once said: “people do not come to me until they are badly in pain.” In any case, many studies have taken place in Arab countries in the last decade, more of which are descriptive and less of which experimental. For example, Abdel-Khalek (2010) found positive correlations between quality of life, subjective well-being, and religiosity among students in Kuwait. Abdel-Khalek (2016) developed “the Arabic Scale of Religiosity,” which significantly correlated with PP variables among students in Algeria, Kuwait, and Egypt. Recently, empirical studies on PPIs have arisen in Arab-Islamic countries. More attention has been focused on promoting well-being and alleviating the high burden of mental health problems in the region (GBD 2015 Eastern Mediterranean Region Mental Health Collaborators, 2018). For instance, several studies examined the effectiveness of mindfulness among university students (e.g., Al-Ghalib & Slim, 2018; Awad, 2019; Thomas et al., 2016), parents of children with autism (Rayan & Ahmed, 2016) and addicted adults (Al-Rashidi, 2018). Such an intervention has positive effects. Participants who practised mindfulness reported reduction in stress and depression as well as improvement in well-being and resilience. Moreover, the results of a recent pilot study found positive impacts on enhancing emotional regulations and reducing stress among Arab teachers (Berkovich-Ohana et al., 2020). Some studies have also begun to examine various interventions targeting character strengths (Basurrah et al., 2020; Chérif et al., 2020), self-compassion (Elaiwah, 2017), positive thinking (Mohammed et al., 2014; Hadad, 2014), and hope (Zaki, 2016). Interestingly, a new finding considering the fear of happiness among people from collective countries has been examined. Lambert et al. (2019) provided evidence that a 14-week PPIs programme has an impact on reducing the fear and fragility of happiness beliefs among university students in the United Arab Emirates.Since Arab countries place great emphasis on spirituality, several authors have considered the aspect of religion when implementing PPIs. For instance, an empirical study by Al-Seheel and Noor (2016) found that expressing gratitude towards God “Allah” increases the happiness of the Muslim more than the usual gratitude intervention. Additionally, Al-Ghalib and Salim (2018) examined a religiously sensitive mindfulness-training programme with university students and found a positive effect on life satisfaction and a slight reduction in stress, depression, and anxiety. Hence, the role of religion is vital to make the interventions more relevant to Arab culture where people can connect Islamic philosophy with PP theories and practices. These studies reviewed here provide further support for the need for culturally sensitive interventions among the Arab population. More recently, the first systematic review of PPIs in Arab countries was conducted by Basurrah et al. (2021; the protocol has been published in BMJ Open and the final manuscript has been submitted for publication). Reviewing a total of 39 studies, the most commonly studied interventions were mindfulness, positive thinking, and resilience. Only a handful of studies examined gratitude, character strengths, forgiveness, self-compassion, savouring, or finding flow. Further analysis revealed that most studies from Arab countries have several methodological limitations. This included a lack of protocol guidelines, few well-designed randomized controlled trials (RCTs), blinding issues, small sample sizes, lack of active control groups, and lack of research into certain populations (e.g., teachers, employees, and people in distress in refugee camps). Discussion PP was founded on an individualistic framework (Christopher & Hickinbottom, 2008). To ensure that PPIs are culturally meaningful, this paper includes some cultural elements of the Arab region that should be considered to serve the needs of the Arab population. In the Arab world, some people may believe that PP is solely about happiness and being positive. If so, it is important to educate the public about the findings of rigorous studies evaluating PPIs such as gratitude, hope or flow on health, well-being and performance. To explain the value and effectiveness of these evidence-based approaches, examples might include studies linking gratitude with benefits for people with heart disease (Cousin et al., 2021), or how PPIs can promote quality of life in cancer patients (Casellas-Grau et al., 2014). There is some evidence about PPIs being effective in improving well-being in the Arab region, but research in this region is still in its infancy and little information is available regarding PPIs and the experience of Arabs participating in such interventions. Hence, there is still much more to investigate in this regard. Future research should empirically examine the effectiveness of various unstudied interventions such as savouring, gratitude, self-compassion, character strengths or finding flow. A combination of quantitative and qualitative approaches is required to provide an in-depth understanding of Arabs’ experience and impressions of PPIs and how and why they work. This may provide useful information to inform the appropriate design of PPIs to suit Arab culture and needs. Furthermore, while some research on PPIs has been carried out in the region, most of these studies have been of poor quality that suffered from small sample sizes, confounding factors, and a high degree of bias. To overcome these issues, future research should improve research quality, including protocol guidelines and well-designed RCTs. In particular, research should include randomization, allocation, blinding, power analysis to determine adequate sample size, active control groups to reduce bias, and follow-up periods of at least 12 months.Among the most popular resources that future PP practitioners may refer to are the International Positive Psychology Association (IPPA) and the International Positive Education Network (IPEN). Also, we recommend the Middle East Journal of Positive Psychology and the first regional book (Lambert & Pasha-Zaidi, 2019). To develop and/or adapt a multi-component PPIs, we would recommend referring to Character Strengths (Peterson & Seligman, 2004), the theory of well-being (PERMA Model: Positive Emotion, Engagement, Relationships, Meaning, and Accomplishment; Seligman, 2011), and the Five Ways to Well-being: Connect, Be Active, Take Notice, Keep Learning, and Give (Aked et al., 2008). Finally, single-component PPIs are based on theories like Broaden-And-Build (Fredrickson, 2004), Hope (Snyder et al., 2002), and Self-Determination (Deci & Ryan, 2012) can be also considered. Two other concepts that would be usefully applied are ‘Savouring’ (Bryant & Veroff, 2007) and Phillip Zimbardo’s Time Perspective (Stolarski et al., 2015). For instance, savouring has a positive temporal orientation to reminiscing the good memories from the past, enjoying the hedonic present moments, and willing proactively to make a better future. Now, what is even maybe more interesting for Muslims is “Transcendent Future” where all intentions, words and actions are devoted to that life after death. In addition, there is a model already prepared for the clinical purpose called Positive Psychotherapy (PPT). Tayyab Rashid and Martin Seligman published a PPT manual for clinicians in 2018. And for cross-cultural applications, including Muslim Arab culture, Rashid and Al-Haj Baddar (2019) have written a paper presenting PPT and its efficacy. PPT overview in detail shows sessions, themes, skills, practice, and cultural considerations where a mixture of PPIs based on PERMA, Strengths, and other PP concepts can be found. Regarding PP measurements, it is highly recommended to generate indigenous tools based on cultural backgrounds reviewed here in the article. An example of this is a tool for measuring Muslim well-being by including domains beyond what is found in Western literature. So far, in the Arab region, several attempts have been made to adapt PP tools. For example, Marei Salama-Younes (2018) validated the Arabic versions of different measures of well-being (e.g., satisfaction with life scale, the subjective vitality scale). Other validated scales as well include the self-compassion scale (Alabdulaziz et al., 2020), and the passion scale (Salama-Younes & Hashim, 2018). Conclusion This paper has discussed the cultural aspects of Arab countries and the need of developing culturally sensitive PPIs. The past decade has seen an increase in mental health problems in the Arab region. Stigma and lack of awareness have been always there. Among the issues are also wars, conflicts, and displacement in many Arab countries such as Iraq, Lebanon, and Palestine (Hassan et al., 2016). These indicate an urgent need to prevent mental illness and promote well-being. Indeed, we highlighted the importance of integrating culture with PPIs, following the guidelines for the cultural adaptation of PPIs (Hendriks & Graafsma, 2019) and the ethical guidelines for PP practice (Jarden et al., 2020). Another significant contribution of this paper is to highlight the importance of improving the quality of research conducted in Arab countries. In brief, this paper has several practical implications. It is an open invitation for researchers, policymakers, and practitioners alike to be more exposed to PP; as well as to better conceptualising and adapting interventions and measurement tools to the local culture in different sectors to maximize their effectiveness. And as we consider it as an invitation for us too, here we are starting a PPIs practice guide in Arabic language and for Arab practitioners. The insights gained from this paper may be useful for placing well-being on top of priorities for achieving individual, organizational, and optimal national functioning in different sectors. There is also a need to change the stigma or negative beliefs about seeking health for psychological support, which is an issue for countries in the Middle East (Baess, 2018). (shrink)

Recent research showed the potential benefits of robot-assisted therapy in treating children with Autism Spectrum Disorder. These children often have some form of Intellectual Disability too, but this has mainly been neglected by previous robotics research. This article presents an empirical evaluation of robot-assisted imitation training, where the child imitated the robot, integrated into the Treatment and Education of Autistic and related Communication handicapped Children program. The sample included six hospitalized children with different levels of ID, from mild to (...) profound. We applied mixed methods to assess their progress, during treatment and three months later. Results show increased Gross Motor Imitation skills in the children, except for those with profound ID and the therapists’ positive attitude towards the humanoid robot. Furthermore, the therapists suggest how a robot could be used to autonomously collect and analyze the information obtained in the rehabilitation training for a continuous evaluation of the participants. (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)

We argue that autism and psychosis spectrum disorders cannot be conceptualized as polar extremes of mentalizing ability. We raise two main objections: (1) the autistic-psychotic continuum, as conceptualized by the authors, excludes defining features of schizophrenia spectrum: negative symptoms, which correlate more strongly with mentalizing impairments; and (2) little evidence exists for a relationship between mentalizing ability and positive symptoms.