Open Society

The personal accounts of autistic adolescents in our study verify the importance of sensory comfort and lowering anxiety before and during bedtime and are in line with the work of Mazurek and Petroski (2015, pp. 270–279) who found strong links among sleep problems, sensory responsivity and anxiety. Furthermore, our results show that adolescents have a wide range of personalized sleep habits which help them to accommodate a good night’s sleep. For example, they feel that predictable interactions with family members may facilitate a relaxing routine before bedtime while daytime factors such as physical activity, positive school experiences and sufficient time for hobbies will also result in good nocturnal sleep. The results emphasize the humanistic value and holistic contextuality of lived experience in sleep research. Our results suggest that it is imperative to facilitate sleep autonomy during bedtime and shift from generalized sleep hygiene practices created and used by non-autistic people to personalized sleep practices for the autistic population.

Sleep is a strong predictor of quality of life and has been related to cognitive and behavioral functioning. However, research has shown that most autistic people experience sleep problems throughout their life. The most common sleep problems include sleep onset delay, frequent night-time wakings and shorter total sleep time.

Several self-reported practices that facilitate better nocturnal sleep were identified. Those were organized into two thematics: Evening/bedtime factors and Day time factors. These included practices such as personalized sensory and relaxation tools before bed and during night-time, engaging in a range of physical activities during daytime and accommodating personal time to engage with highly preferred and intense focus activities and hobbies. It also included spending time in predictable and fun ways with family members before bedtime.

The outcomes from the current study showed that sleep facilitating factors are in a direct contrast to the sleep hygiene recommendations. Therefore, it is thus important for the sleep practitioners and healthcare providers to move beyond providing standardized sleep hygiene interventions. A Lifeworld led care model that pays attention to personal experiences, promotes sense of agency, evaluates both autism-specific strengths and struggles could and should complement biomedical approaches.

Our results highlight that sleep should be treated individually and in relation to the environmental and personal factors that affect each autistic person. Hence, researchers and professionals may benefit from working collaboratively with autistic adolescents with the aim to identify individual strengths and adopt a positive narrative around sleep. Furthermore, it is important to further examine both the daytime and evening factors that may affect bedtime and the quality and quantity of sleep as well as the role of intense focused interests and physical activities that cultivate positive feelings and help autistic people to relax before bedtime.

In this study, based on the autistic adolescents’ personal accounts shared in the results section we have identified 4 key domains who interact with each other and together they have a positive impact on sleep which is discussed below. Focused Interests Activities such as focusing on special interest objects may help autistic people to achieve a flow state (Csikszentmihalyi and Csikzentmihaly, 1991). This type of activity might be interpreted as a meaningless or repetitive behavior by parents and can be interrupted to redirect the autistic person to comply with a sleep hygiene rule. Thus, parents and professionals should consider that focused interest activities, objects, and thoughts might help the autistic person to be in a flow state which is beneficial for reducing stress. Promoting and planning daily activities that incorporate focused interests can be an important area in future sleep management practice. Identifying flow states for autistic people and trying to develop a flow plan during daytime and before bedtime might have a positive impact on sleep. Physical Activity For autistic adolescents, it is important to have opportunities to exercise in their own time and space to avoid experiences which can interfere with their personal space, sensory issues, anxiety-provoking group interactions or body confidence. Exercise has been shown to reduce and stabilize cortisol levels over time (McDonnell et al., 2015, pp. 311–322) which can have a positive effect on sleep. Sense of Agency During Daytime We found potential evidence on the importance of the daytime ‘feel good’ factor as defined by autistic adolescents on sleep. Being able to have more control and choice on how to spend time at school and home may cultivate positive feelings that promote better sleep. Based on the current findings, autistic adolescents are most likely to have a good night’s sleep when they interact with people who meet their needs. The subjective experience and the concept of autistic adolescents’ locus of evaluation should be prioritized if we aim to understand the social determinants of wellbeing. It is thus important for sleep therapists to empower adolescents and their families to evaluate the impact of daily activities and develop a balance between obligatory and desirable activities. Sensory Autonomy During Bedtime It has been well established that autistic people experience unique experiences and a sense of control over sensory stimuli may have an impact (Robertson and David, 2015, pp. 569–586). The autistic adolescent should be seen as the expert of his/her sensory profile and allowed to modify his/her environment. Hence, practitioners need to consider that the parental as well as their own perspective may promote or hinder sleep activity. Sleep should be treated at an individual level in relation to the environmental factors: flexibility, agency and personalization may prove more helpful than manualized approaches that do not consider the autistic perspective. More comprehensive sensory-based assessment through focused conversations with adolescents and their family members may advance the development of sleep management by identifying factors that influence the levels of sensory stress experienced by autistic people before and during bedtime.

Something he calls “pluralism” or the idea that, when it comes to values, there are multiple different ends that people can arrive at using the exact same process of rationality and that both conclusions can, nonetheless, be intelligible and rational simultaneously. The complexity of human experience makes questions of political and moral values destined to have blurry answers. The values of a person or culture are extremely complicated. They overlap. They contradict each other. They’re situational, inconsistent. The values of people are often what he calls “incommensurable.”

Well, what criteria do we use to determine how much mercy we should use and how much justice we should use? His whole point here is that you can never answer this question clearly with some single criterion or single maxim. The fact is, the true complexity of human experience makes this impossible. Monism cannot ever actually mediate the relationship between complex human values like mercy and justice. The mistake of the thinkers of the past has been to try to come up with some single standard that addresses all the complexities of billions of people living together. “The goal of the justice system should be to maximize freedom,” or “balance the scales.” These overly ambitious golden rules are utterly useless when it comes to truly sifting through the blurry, complex relationship between human values like mercy and justice.

To Isaiah Berlin, the fact is, people and cultures often have to hold two, what he calls, “incommensurable values” like mercy and justice simultaneously. These values are sometimes totally incompatible. They sometimes overlap in weird ways. When you abandon the strategy of trying to find a way that billions of human beings can be fit into a neat, little package governed by a single maxim, then you encounter what Isaiah Berlin sees as the true pluralism that lies at the foundation of human values.

And the most under-nuanced approach to thinking in the history of the world is monism. So this is why any attempt to distill the true plurality of human values down into a single maxim always fails miserably in the long run.

See, the change from monism to pluralism is subtle. It changes the way you view people who disagree with you because, when you recognize the pluralistic nature of human values, you realize that there’s no single correct answer. And, even if there was, rationality is not the tool that’s going to get us there. The idea that if only we have more rational discussions about things eventually everyone rational will agree on the same values is a misunderstanding of what rationality is producing for us. Rationality is just utterly incapable of solving all the problems that can exist between cultures that value different things.

This is the true role of rationality for Isaiah Berlin. When it comes to moral and political values, we’re never going to agree on everything. Rationality cannot give us that. But what it can do is mediate the differences between different moral systems and allow us to be more tolerant of each other. You don’t go to war with another culture just because they value something you don’t. You can disagree, try to understand the best you can, but you don’t think they’re stupid or evil just because they don’t do everything the way you do. The same way rationality can regulate the relationships between cultures, it can regulate the relationships between people of the same culture.

So Isaiah Berlin, living in the middle of the 20th century, looks around him and sees totalitarianism in mass claiming to have a universal understanding of human nature or how to structure a society. He sees people viewing themselves as total individuals, completely alienated from people around them, starving for a sense of community. He sees the reality of modern work and how only the most privileged can ever go outside and try to connect with the natural world around them. Most of all though, he sees within the politics of his time the ever-presence of this moral monism that was so popular in our thinking for 2,500 years -- the idea that, when it comes to my moral or political views, there is one single answer to be arrived at, that I’ve discovered that right answer, and that my political views deeply inform a single cohesive worldview that I have that is correct.

We were in such a state of delirium thinking about how great science and reason were that we ignored one of the biggest breakthroughs in the history of human thought, the call by these thinkers of the Counter-Enlightenment for us to move away from monism and towards what Isaiah Berlin called “pluralism.”

There’s a famous essay by Isaiah Berlin titled “The Hedgehog and the Fox.” Now, in this essay he provides a sort of spirit animal for these two very different kinds of thinking. The classic line from the essay is that the hedgehog sees one big thing while the fox sees many things: the hedgehog obviously representing the thinking of a typical monist, the fox representing the approach of a pluralist. To Isaiah Berlin, the hedgehog, or the monist, is operating from a very limited vantage point where they can really only see in one single direction, and they’re assuming that’s all there is. They think about understanding the world always in relation to how it fits into some sort of overarching structure, seemingly just for the sake of having a cohesive worldview which they assume is possible.

But the fox, on the other hand, doesn’t look at the world in the same way as the hedgehog. Berlin says the fox understands that the range and complexity of everyone’s human experience is so massive -- the way different languages orient people with the world, the way our different personalities orient us, the different preferences, feelings, experiences -- what it is to be a human being is far too complex to ever have a single spokesperson.

But, to the initial charge that the pluralist is actually just a relativist, Isaiah Berlin might reply with the famous quote from his work, “I prefer coffee; you prefer champaign. We have different tastes. There’s nothing more to be said. That is relativism. But Herder’s view and Vico’s,” two thinkers of the Counter-Enlightenment, “is not that. It is what I should describe as pluralism, that is the conception that there are many different ends that men may seek and still be fully rational.”

Now, even these two things might be enough for us to take a closer look at monism throughout history but, it just so happens, Berlin is making an even bigger claim here. Think of how this monism applies to that dogma of the Enlightenment within moral or political philosophy that he referenced. The idea that rationality -- that if only we think about things clearly and distinctly enough, we can come up with a single correct answer for how to live as human beings, and that answer is going to fit perfectly into a single cohesive worldview, completing the cosmic jigsaw puzzle -- this is just another example of this monism that’s existed all throughout the history of thought. And it is monolithic; it’s overly ambitious, given what we know about human existence, and ultimately leads to the totalitarianism of the political landscape in the early 20th century. Because if you can believe that rationality will provide us with scientific-like certainty or probability when answering questions about what it's like to live for people with numbers in the billions, then you end up with things like Marxism. You end up with National Socialism. You end up with late-stage capitalism. This attempt to use reason to arrive at something that’s supposed to work well for everyone in the world is an outdated concept.

So, what happens is, Berlin realizes this and then transforms into more of a historian of ideas. He wants to go back and figure out whether there were any thinkers during the beginning of the Enlightenment that saw something like this coming. What he comes across is a group of thinkers that are often referred to as the Counter-Enlightenment. And, simply put, Isaiah Berlin thinks this group of thinkers were some of the most underrated thinkers in the history of the world.

When the Enlightenment focused on universals and an eternal understanding of things, the Counter-Enlightenment called for a focus on particular examples and the historical or cultural influence on our understanding of things. When the Enlightenment focused on the individual, the Counter-Enlightenment focused on community and our identities as members of a tribe. When the Enlightenment produces the possibility of modern factory life, there’s a Counter-Enlightenment revival of romanticism and a call for us to return to an earlier time when human life was more connected to nature.

Two different people using the exact same process of rationality could arrive at very different conclusions about moral or political values simply because of the complexity of human experience. And, here’s the kicker that will make this have such an impact on political thought, both of those conclusions are intelligible and rational. There’s no ultimate organizing principle. There’s no logical conclusion we’re going to arrive at. There’s no mathematical or scientific answer to questions about values. There’s only human rationality and the vast array of experiences and tools that we have to pull from that will determine these “blurry answers” we’re capable of coming up with. Well, that and, to Berlin, everything that’s common among all human beings regardless of culture.