Treatment for whom? Towards a phenomenological resolution of controversy within autism treatment

Stud Hist Philos Biol Biomed Sci. 2019 Oct;77:101176. doi: 10.1016/j.shpsc.2019.04.001. Epub 2019 Apr 16.

Abstract

Autism's mainstream, behavioural treatment has recently faced allegations from neurodiversity activists, who claim that behaviourism is methodologically faulted and in serious breach of patient consent and human rights. In the present paper, I delve into this mounting controversy to suggest, contra behaviourism, that people with autism diagnoses do not just display a divergent set of behaviours, but should be seen to operate in 'worlds' different to those in typical neurological conditions. To philosophically accommodate this difference in 'worlds' and to utilise it in thinking about treatment orientation, I use Edmund Husserl's concept of the life-world (lebenswelt). I proffer that the autistic life-worlds should be used as the basis of treatment evaluation. I suggest that phenomenological ways of approaching autism, currently understudied, should be further developed and that behavioural treatment should be accordingly 'filtered' to accommodate the autistic life-worlds, and with them certain criticisms from neurodiversity.

Keywords: Applied behaviour analysis; Autism; Autism treatment; Neurodiversity; Phenomenology; Phenomenology of illness; Philosophy of cognitive neuroscience; Philosophy of medicine; Philosophy of psychology; Philosophy of science.

MeSH terms

  • Autistic Disorder / psychology
  • Autistic Disorder / therapy*
  • Humans
  • Philosophy*