We’re rounding off our little mini-series on “theory of mind” in autism research with episode 5: “New Paradigms, New Values.”

You can find a (not Substack-generated) transcript of the episode, as well as a music-free remix, here.

We will be on hiatus over the holidays, while we cook up some more episodes about the relationship between empathy and autism. But in the meantime, I’ll continue to post here occasionally to let you all know about other fascinating audio projects that tackle issues related to autism and disability.

“New Paradigms, New Values”

In the last several episodes, we’ve explored the bizarre history of autism research focusing on “theory of mind deficits.” So at this point, you’re probably wondering: “where do we go from here?”

We don’t have all the answers, but in this episode, Travis and Joe—from the previous episode—describe some fascinating new avenues for autism research, which promise to help us understand autistic perspectival differences without invoking so-called “theory of mind deficits.” Plus, Travis compares the two most common paradigms in autism research (the “pathology paradigm,” and the “neurodiversity paradigm”), and offers some advice for folks who want to start reading up on the philosophy of autism.

Topics Discussed

* A potential problem with our critique of “theory of mind deficit” research: some autistic people find the theory of mind deficit view of autism helpful for making sense of challenging experiences. (00:29)

* A reminder about the problems associated with the “theory of mind deficit” view of autism; in particular, the view dehumanizes autistic people. (02:41)

* Problems with Barnbaum’s influential book The Ethics of Autism (2008), which assumes the theory of mind deficit view of autism. (04:05)

* But again, some autistic people find the “theory of mind deficit” view of autism helpful. (05:54)

* So, we need good alternatives for understanding and talking about autistic social differences. (07:41)

* The bad news: there’s no single unifying “theory of autism” that can simply replace the “theory of mind deficit” view. (08:25)

* The good news: there are several alternative research programs that promise to help us better understand autistic people’s experiences with perspective-taking. (09:07)

* A sociological alternative: the double empathy problem. (10:16)

* A psychological alternative: monotropism. (12:20)

* Monotropism isn’t just “an autistic thing.” (15:41)

* Why the double empathy problem and monotropism could both be true (they’re not in competition with each other). (17:06)

* A physiological alternative: differences in interoception. (19:04)

* What all of these alternative theories have in common: they don’t have to frame autism in terms of deficits. This focus reflects a shift in value assumptions in autism research. (21:13)

* Science can’t avoid making some value-laden assumptions. Feminist philosophers of science have been talking about this issue for decades. (22:12)

* An example of a value assumption in science and medicine: “classic” heart attack symptoms. (25:02)

* Travis contrasts the “pathology paradigm” in autism research with the “neurodiversity paradigm” in autism research. (25:51)

* Travis gives an example of how the pathology paradigm can distort autism researchers’ interpretation of data. (29:12)

* We shouldn’t merely “study autistic differences”; we need to study autistic differences with the ultimate goal of improving autistic people’s well-being, all while paying close attention to what autistic people say they need. (With a quick call-back to Chloe Farahar.) (33:07)

* Travis explains how philosophy can contribute to autism research. (36:21)

* But philosophers need to be careful! Travis has advice. (37:50)

* Look-ahead to our next topic: empathy and autism. (40:26)

Sources Mentioned

* Barnbaum, The Ethics of Autism (2008).

* Milton, “On the ontological status of autism: the ‘double empathy problem’,” Disability and Society, Volume 27, Issue 6 (2012). https://kar.kent.ac.uk/62639/1/Double%20empathy%20problem.pdf

* More recent research supporting the “double empathy problem” hypothesis includes:

* Morrison, et al., “Outcomes of real-world social interaction for autistic adults paired with autistic compared to typically developing partners,” Autism, Volume 24, Issue 5 (2020). https://pubmed.ncbi.nlm.nih.gov/31823656/

* Sheppard, et al., “Mindreading beliefs in same- and cross-neurotype interactions,” Autism (2023). https://journals.sagepub.com/doi/10.1177/13623613231211457

* Milton, et al., “The ‘double empathy problem’: Ten years on,” Autism, Volume 26, Issue 8 (2022). https://journals.sagepub.com/doi/10.1177/13623613221129123

* Crompton, et al., “Autistic peer-to-peer information transfer is highly effective,” Autism, Volume 24, Issue 7 (2020). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7545656/

* Murray, et al., “Attention, monotropism and the diagnostic criteria for autism,” Autism, Volume 9, Issue 2 (2005). https://journals.sagepub.com/doi/abs/10.1177/1362361305051398

* Dwyer, “Revisiting Monotropism” (blog post from 2021): https://www.autisticscholar.com/monotropism/

* Joe mentions that autistic people might tend to have heightened sympathetic bodily reactions to others’ emotions, but also have more trouble processing those sympathetic bodily reactions (probably because of alexithymia). There is a bunch of research on empathic arousal, alexithymia, and interoception, but as a start:

* Fletcher-Watson and Bird, “Autism and empathy: What are the real links?” Autism, Volume 24, Issue 1 (2020). https://journals.sagepub.com/doi/full/10.1177/1362361319883506

* Kimber, et al., “Autistic People's Experience of Empathy and the Autistic Empathy Deficit Narrative,” Autism in Adulthood (2023). https://www.liebertpub.com/doi/abs/10.1089/aut.2023.0001?download=true&journalCode=aut

* Fan, et al., “Empathic arousal and social understanding in individuals with autism: evidence from fMRI and ERP measurements” Social Cognitive and Affective Neuroscience, Volume 9, Issue 8 (2014). https://academic.oup.com/scan/article/9/8/1203/2375393

* Butera, et al., “Relationships between alexithymia, interoception, and emotional empathy in autism spectrum disorder,” Autism, Volume 27, Issue 3 (2023). https://pubmed.ncbi.nlm.nih.gov/35833505/

* Garfinkel, et al., “Discrepancies between dimensions of interoception in autism: Implications for emotion and anxiety,” Biological Psychology, 114 (2016).

* For more on the feminist critique of the “value-free ideal of science,” see Crasnow, "Feminist Perspectives on Science," The Stanford Encyclopedia of Philosophy (Fall 2023 Edition), Edward N. Zalta & Uri Nodelman (eds.). https://plato.stanford.edu/entries/feminist-science/

* For more on “male norms” in medicine, see: https://www.cbc.ca/radio/thecurrent/the-current-for-march-11-2019-1.5049277/there-s-a-gender-gap-in-medical-data-and-it-s-costing-women-their-lives-says-this-author-1.5049286

* Nick Walker, Neuroqueer Heresies (2021). https://neuroqueer.com/neuroqueer-heresies/

* The paper in which researchers rely on the “pathology paradigm” when interpreting their results: Hu, et al., “Right Temporoparietal Junction Underlies Avoidance of Moral Transgression in Autism Spectrum Disorder,” Journal of Neuroscience, Volume 41, Issue 8 (2021). https://www.jneurosci.org/content/41/8/1699

* Travis’s reading recommendations (to get started with the philosophy of autism):

* Monique Botha (I love their paper, “Academic, Activist, or Advocate?” in Frontiers in Psychology (2021) https://www.frontiersin.org/articles/10.3389/fpsyg.2021.727542/full)

* Damian Milton (see his two “double empathy” problem paper, listed above)

* Ian Hacking

* “Making People Up,” ...