Seeing and inviting participation in autistic interactions

Opacity, difference and not knowing: what can psychiatry learn from the work of Édouard Glissant?

Martinican poet, novelist and cultural theorist Édouard Glissant (1928-2011) rejected contemporary simplistic notions of creole hybridity popularised in the 1980s and 1990s in favour of a unique and explicitly antiessentialist construct of Caribbeanness-a form of being that embraces place while shunning any associated ideas of rootednesss. Throughout his work, there is a constant tension between the local and the global, the particular and the universal, the essentialist and the homogenising, a tension that is never resolved but used creatively to stake out an emergent third position against a backdrop of a metaphorical Caribbean seascape. The purpose of this article is to shed light on a central idea developed by Glissant: the importance of acknowledging opacity in the encounter with the Other, in contrast to idealised notions of transparency as inherently desirable. This 'right to opacity' has been embraced in poststructural theory, postcolonial activism and contemporary art. However, I argue that opacity is also a highly relevant notion in clinical contexts, as an essential resource for understanding concepts such as first-person, second-person and third-person perspectives in the phenomenology of mental health and illness. For illustration, I point to a number of clinical tools and approaches-such as the Cultural Formulation Interview, Therapeutic Assessment and the employment of a not-knowing stance in mentalisation-based treatment-that successfully incorporate a respect for opacity as a core value in the clinician-patient encounter. This article is not an attempt to offer a definitive how-to guide on how to make use of the ideas of Édouard Glissant in the clinic; instead, I hope to inspire further discussion about how various notions of opacity and transparency come into play for mental health practitioners and how acknowledging alterity and difference may contribute to more fruitful and respectful ways of engaging with the patient-as-Other.

Applied human neuroscience: Fostering and designing inclusive environments with the 3E-Cognition perspective

The conventional medical paradigm often focuses on deficits and impairments, failing to capture the rich tapestry of experiences and abilities inherent in neurodiversity conditions. In this article, we introduce the 3E-Cognition perspective, offering a paradigm shift by emphasizing the dynamic interplay between the brain, body, and environment in shaping cognitive processes. The perspective fosters a more inclusive and supportive understanding of neurodiversity, with potential applications across various domains such as education, workplace, and healthcare. We begin by introducing the 3E-Cognition principles: embodied, environmentally scaffolded, and enactive. Then, we explore how the 3E-Cognition perspective can be applied to create inclusive environments and experiences for neurodiverse individuals. We provide examples in the realms of education, workplace, and healthcare. In all of these domains, spaces, methodologies, epistemologies, and roles that cater to diverse needs and strengths can be designed using the 3E principles. Finally, we discuss the challenges and benefits of implementing the 3E-Cognition perspective. We focus on the need for technological advancements and research in complex real-world scenarios; we suggest mobile brain/body imaging is a possible solution. We furthermore highlight the importance of recognizing and valuing the diverse manners of experiencing and interacting with the world, the promotion of diverse well-being, and the facilitation of innovation and creativity. Thus, we conclude that the 3E-Cognition perspective offers a groundbreaking approach to understanding and supporting neurodiversity: by embracing the inherent interconnectedness of the brain, body, and environment, we can create a more inclusive and supportive world.

The Interactional Structure of Accounts During Small Group Discussions Among Autistic Children Receiving Special Education Support in Finland

Through a conversation analytic approach, we investigate the emergence of accounts provided by autistic children in small-group discussions. Nine Finnish children (7-10 years old) attending school with special support participated in a five-month-duration pedagogical practice purposefully designed to enhance children's participation in groups. We analyzed videos of sharing circles where children discussed their ideas and interests. Our data show three different account structures, which created different modes of children's participation and gradually changed how they positioned themselves in the group. Results show how accounts can create different focuses of attention; reveal children's reflections on what is relevant to them, and how to promote the exchange of ideas within a small group. Implications for the development of educational practices are discussed.

Material Engagement Shaping Participation of Children on the Autism Spectrum: Embodiment and Subjectivity in Small-Group Learning

This study investigated the material engagement and their affordances for participation of children on the autism spectrum (AS) in small-group learning. Framed by a methodology called Idea Diary that fosters social interactions in classroom environments, our focus was on understanding how and when the construction and manipulation of the diary supported children's participation and knowledge construction in small groups. This investigation was guided by the intersection of the theory of subjectivity developed by Fernando González Rey and enactive accounts of cognition. This framework provided the view of the singularity in the communicative process of children on the AS and the necessary support for examining the mechanisms of engagement that led to children's participation. We present two case studies of 9-10-year-old boys. Data consists of the diaries produced and used by children and video recordings of children's interactions during small-group discussions. Our analytical approach included a qualitative semiotic analysis of the materials and a micro-analysis of the social interactions. The results showed, first, that children on the AS continuously engaged in the construction of the diary, expressing elements of their subjectivity-experiences, ideas and the system through which they interact with the world. Repetition framed children's productions and signalled engagement. Second, material engagement enabled participatory sense-making, which in this study appeared in creating new communicative resources between the child on the AS and their peers and in adapting the narratives, approximating children's perspectives in conversations. Although contextualised within a specific pedagogical practice, the study contributes to advancing our understanding of the role of material engagement in social participation in learning situations involving children on the AS, particularly relevant in educational psychology and education.

Letting Tourette's be: The importance of understanding lived experience in research and the clinic

The most common clinical research question regarding Tourette syndrome focuses on tic reduction, which follows from classical 'lack of inhibition' models. Rooted in views about brain deficits, this model suggests that with higher severity and frequency, tics are necessarily disruptive and should therefore be inhibited. However, emerging calls from people with lived experience of Tourette syndrome suggest that this is too narrow a definition. This narrative literature review analyses issues with brain deficit views and qualitative research on tic context and feelings of compulsion. The results suggest the need for a more positive and encompassing theoretical and ethical position on Tourette's. The article puts forward an enactive analytical approach of 'letting be', that is, approaching a phenomenon without forcing preconceived reference structures onto it. We suggest using the identity-first term 'Tourettic'. Prioritizing the perspective of the 'Tourettic patient', it urges attentiveness to the everyday issues diagnosed people encounter and how these are embedded in further life. This approach highlights the strong relationship between the Tourettic persons' felt impairment, their adoption of an outsider's perspective, and feeling under constant scrutiny. It suggests that this felt impairment of tics can be reduced by creating a physical and social environment in which the person is 'let be' but not 'let go of'. WHAT THIS PAPER ADDS: Its theoretical position allows a more holistic view of Tourette's, integrating tics with oft-overlooked complex compulsions. The 'letting be' position also allows us to view why the presentation of Tourette's is likely to vary with gender and age of onset. 'Letting be' is a promising approach to improve a clinical understanding of Tourettic well-being over and above tic severity and frequency. It integrates quantitative research on Tourette syndrome in the neurosciences with qualitative neurodiversity literature in the medical humanities. It integrates ethical frameworks as developed in enactive philosophy with the conceptualization and treatment of tics and compulsions.

The Foundations of Autistic Flourishing

PURPOSE OF REVIEW

All people-including Autistic people-deserve to live flourishing lives. But what does a flourishing life look like for Autistic people? We suggest that the hidden biases, methodological errors, and key assumptions of autism science have obscured answers to this question. Here, we seek to initiate a broader discussion about what the foundations for a good Autistic life might be and how this discussion might be framed.

RECENT FINDINGS

We identify five ways in which autism science can help us all to secure those foundations, including by (1) giving Autistic well-being prominence in research, (2) amplifying Autistic autonomy, (3) attending better to everyday experiences, (4) acknowledging context, and (5) working in partnership with Autistic people and their families and allies to ensure that they are at the heart of research decision-making. Such an approach would direct the focus of autism research to help shape good Autistic lives.

Beyond Single-Mindedness: A Figure-Ground Reversal for the Cognitive Sciences

A fundamental fact about human minds is that they are never truly alone: all minds are steeped in situated interaction. That social interaction matters is recognized by any experimentalist who seeks to exclude its influence by studying individuals in isolation. On this view, interaction complicates cognition. Here, we explore the more radical stance that interaction co-constitutes cognition: that we benefit from looking beyond single minds toward cognition as a process involving interacting minds. All around the cognitive sciences, there are approaches that put interaction center stage. Their diverse and pluralistic origins may obscure the fact that collectively, they harbor insights and methods that can respecify foundational assumptions and fuel novel interdisciplinary work. What might the cognitive sciences gain from stronger interactional foundations? This represents, we believe, one of the key questions for the future. Writing as a transdisciplinary collective assembled from across the classic cognitive science hexagon and beyond, we highlight the opportunity for a figure-ground reversal that puts interaction at the heart of cognition. The interactive stance is a way of seeing that deserves to be a key part of the conceptual toolkit of cognitive scientists.

Autism and the Sensory Disruption of Social Experience

Autism research has recently witnessed an embodied turn. In response to the cognitivist approaches dominating the field, phenomenological scholars have suggested a reconceptualization of autism as a disorder of embodied intersubjectivity. Part of this interest in autistic embodiment concerns the role of sensory differences, which have recently been added to the diagnostic criteria of autism. While research suggests that sensory differences are implicated in a wide array of autistic social difficulties, it has not yet been explored how sensory and social experience in autism relate on a phenomenological level. Given the importance of the sensory dimension of social encounters in phenomenological analyses of autism, this question must be considered crucial. This article investigates the role played by sensory differences in autistic social experience. Through a phenomenological analysis informed primarily by the philosophy of Maurice Merleau-Ponty with particular emphasis on the relation between intersubjectivity and perception, I argue that sensory differences affect the way other people appear in autistic experience on a pre-reflective level. By drawing on autistic young adults' experiential descriptions of social encounters, this article identifies three aspects of how sensory differences affect social experiences in autism. First, social encounters manifested as sensorially disturbing, chaotic, and unpredictable events. Second, the embodied expressions of others appeared unfamiliar, threatening, and promoted a sense of detachment from the social world. Third, deliberate practices were employed to actively seek perceptual and social meaning in these disorienting social encounters. This analysis stresses the importance of understanding embodied intersubjectivity through its sensory dimensions. In addition, it indicates an important avenue for future research in exploring the potential role of practice in maintaining an intuitive grip on social meaning. By approaching social encounters as sensory and perceptual events, I emphasize how social difficulties in autism are inherently world-involving phenomena rather than a cognitive deficit reducible to the autistic person.

How to Undo (and Redo) Words with Facts: A Semio-enactivist Approach to Law, Space and Experience

In this essay both the facts/values and facticity/normativity divides are considered from the perspective of global semiotics and with specific regard to the relationships between legal meaning and spatial scope of law's experience. Through an examination of the inner and genetic projective significance of categorization, I will analyze the semantic dynamics of the descriptive parts comprising legal sentences in order to show the intermingling of factual and axiological/teleological categorizations in the unfolding of legal experience. Subsequently, I will emphasize the translational and enactive cognitive disposition underlying the construction of the second premise of the so-called judiciary syllogism and thereby the untenability of the idea that 'law makes its facts.' Hence, I will try to bring to the fore the cultural pre-assumptions encapsulated in the positivistic and therefore also formalistic or analytical approaches to legal experience and the loss of their inner consistency when legal experience confronts the phases and major changes of global semiotics. Finally, I will strive to relativize the opposition between the positivist and non-positivistic theories of law in view of an understanding of legal experience focused not only, or at least not primarily, on what 'law is' but also on 'how' it unwinds through, and in spite of, environmental and semantic transformations.