Open Society

Question  Is the amount of intervention provided to young autistic children associated with improved child development? Findings  Data from 144 studies of early childhood autism interventions featuring 9038 children gathered in a prior systematic review and meta-analysis were analyzed to determine whether the effects of common interventions were associated with any of 3 indices of intervention amount (ie, daily intensity, duration, cumulative intensity). None of the models evidenced a significant association between intervention amount and intervention effects. Meaning  There is not robust evidence that the benefits of early childhood interventions to young autistic children increase when those interventions are intensified; practitioners recommending interventions should consider what amounts would be developmentally appropriate.

This commentary on a case argues that antimicrobial stewardship requires an intersectional disability justice approach if it is to be equitable, particularly for multiply marginalized patients with disabilities residing in nursing homes, who are more susceptible to antibiotic under- and overtreatment. Disability justice concepts emphasize resistance to structural and capitalist roots of ableism and prioritize leadership by disabled persons. A disability justice perspective on antimicrobial stewardship means prioritizing clarification of presumptive diagnoses of infection in vulnerable patients, clinician education led by disabled persons, and data collection.

One of our findings from the meta-analysis is that we haven’t conducted enough high-quality studies on any given intervention to make bold claims about what works. The term ‘evidence-based’ is a bit arbitrary, and different research groups have different quality standards they use when categorizing an intervention as evidence-based.

Authors described stigmatisation of some of their movements, causing censorship. However, movement provided personal benefits, including enhanced thinking and focus, routine, sensory regulation, release of energy, increased body connection and awareness, regulated emotion, and time without self-restraint. Examples included stimming or self-stimulating behaviour, dancing, and physical exercise. Movement was accompanied by qualifying descriptions of being natural and harmless. Moving freely, expressively, and sometimes repetitively, strengthened self-identity. In conclusion, body movements have both stigmatised and non-stigmatised appearances for autistic adults, but these cannot be distinguished by the function of the movement. Expressive, regulating and repetitive movements can be a well-being resource for autistic people. Implications for practice are discussed.

First, their models are almost entirely based on personal context, by way of an on-device semantic index. In broad strokes, this on-device semantic index can be thought of as a next-generation Spotlight. Apple is focusing on what it can do that no one else can on Apple devices, and not really even trying to compete against ChatGPT et al. for world-knowledge context. They’re focusing on unique differentiation, and eschewing commoditization.

Unable to see shades of lived nuance and constitutionally lacking organs of exquisite sensitivity, the truncated, neurotypical gaze rakes over the bodies of (neuro-holographic) life — whether designated autistic, animal, any other undesirable caste, or nature itself — they assess them only in terms of cost, threats, or utility. They can’t or won’t see them. Modern, connectively truncated influence has driven an obsession with homogeneity and increasingly raised a maniacal rejection of inward and outward difference to a hellish art form. The lives (and deaths) of sentient, (neuro-holograhpic) beings is foundational to daily life and underscores the danger of using gifts evolutionarily tooled for a better, more compassionate future are pressed into service for the structure we were put here to change. (Dawn Prince Hughes, 2023) *neuro-holographic = my edits.

I have intentionally used a hyphen between the words neuro and holographic to represent the in-between of neurology and holographic ways of being and experiencing the world, a pause for tuning in, an embodiment, a space of Ma. I have resisted using the word “neuro-holographism as that could imply another new theory or concept. Neuro-holographic is not a concept; rather I feel like it IS the plane of immanence on which neuroqueer theory breathes and lives; it is the ‘wave that rolls and unrolls’ other concepts (Deleuze & Guattari, What is Philosophy, 1994, p36). To resonate with the term neuro-holographic is to resonate as souls, with your core self, perhaps with your spirit.

Perhaps the beauty lies in the way that the word neuro-holographic can only be felt or experienced in a luminescent, undefinable iridescent way, which creates a holographic energy of light and vibration that expands and ripples beyond our singular bodyminds to connect with other bodyminds, it creates multiplicity from the friction between us as humans. Connecting with others enables an expansion of our community rhizomes in ways that are exciting and full of radical inclusive neuroqueer possibilities.

According to Blood and Heavy Head’s lectures (2007), 30-year-old Maslow arrived at Siksika along with Lucien Hanks and Jane Richardson Hanks. He intended to test the universality of his theory that social hierarchies are maintained by dominance of some people over others. However, he did not see the quest for dominance in Blackfoot society. Instead, he discovered astounding levels of cooperation, minimal inequality, restorative justice, full bellies, and high levels of life satisfaction. He estimated that “80–90% of the Blackfoot tribe had a quality of self-esteem that was only found in 5–10% of his own population” (video 7 out of 15, minutes 13:45–14:15). As Ryan Heavy Head shared with me on the phone, “Maslow saw a place where what he would later call self-actualization was the norm.” This observation, Heavy Head continued, “totally changed his trajectory.” (For the reader wondering what self-actualization is, Maslow offered this definition, influenced by Kurt Goldstein, in his 1943 paper: “This tendency might be phrased as the desire to become more and more what one is, to become everything that one is capable of becoming.” The word itself does not exist in the Siksika language, but the closest word is niita’pitapi, which Ryan Heavy Head told me means “someone who is completely developed, or who has arrived.”)

Maslow then wondered whether the answer to producing high self-actualization might lie in child-rearing. He found that children were raised with great permissiveness and treated as equal members of Siksika society, in contrast to a strict, disciplinary approach found in his own culture. Despite having great freedom, Siksika children listened to their elders and served the community from a young age (ibid, minutes 16:35–17:07). According to Heavy Head, witnessing the qualities of self-actualization among the Blackfoot and diving into their practices led Maslow to deeper research into the journey to self-actualization, and the eventual publishing of his famous Hierarchy of Needs concept in his 1943 paper.

Maslow appeared to ask, “how do we become self-actualized?”. Many First Nation communities, though they would not have used the same word, might be more likely to believe that we arrive on the planet self-actualized. Ryan Heavy Head explained the difference through the analogy of earning a college degree. In Western culture, you earn a degree after paying tuition, attending classes, and proving sufficient mastery of your area of study. In Blackfoot culture, “it’s like you’re credentialed at the start. You’re treated with dignity for that reason, but you spend your life living up to that.” While Maslow saw self-actualization as something to earn, the Blackfoot see it as innate. Relating to people as inherently wise involves trusting them and granting them space to express who they are (as perhaps manifested by the permissiveness with which the Siksika raise their children) rather than making them the best they can be. For many First Nations, therefore, self-actualization is not achieved; it is drawn out of an inherently sacred being who is imbued with a spark of divinity. Education, prayer, rituals, ceremonies, individual experiences, and vision quests can help invite the expression of this sacred self into the world. (As some readers have commented, this concept appears in other belief systems, such as Paulo Freire’s challenge to the “banking concept of education” and the Buddhist notion that all beings contain Buddha-nature.)

As Maslow witnessed in the Blackfoot Giveaway, many First Nation cultures see the work of meeting basic needs, ensuring safety, and creating the conditions for the expression of purpose as a community responsibility, not an individual one. Blackstock refers to this as “Community Actualization.” Edgar Villanueva (2018) offers a beautiful example of how deeply ingrained this way of thinking is among First Nations in his book Decolonizing Wealth. He quotes Dana Arviso, Executive Director of the Potlatch Fund and member of the Navajo tribe, who recalls a time she asked Native communities in the Cheyenne River territory about poverty: “They told me they don’t have a word for poverty,” she said. “The closest thing that they had as an explanation for poverty was ‘to be without family.’” Which is basically unheard of. “They were saying it was a foreign concept to them that someone could be just so isolated and so without any sort of a safety net or a family or a sense of kinship that they would be suffering from poverty.” (p. 151)

The triangular models above suggest that there’s a place to start meeting our needs and a place we end up. But is it true that our needs follow Maslow’s hierarchy of “prepotency”, where some needs consistently take priority over others? Maslow (1943) himself indicates there are many exceptions to his hierarchy and Blackstock (2011) agrees, citing Seneca First Nation member and psychologist Terry Cross: Cross (2007) argues that human needs are not uniformly hierarchical but rather highly interdependent […] [P]hysical needs are not always primary in nature as Maslow argues, given the many examples of people who forgo physical safety and well-being in order to achieve love, belonging, and relationships or to achieve spiritual or pedagogical objectives. The idea of dying for country is an example of this as men and women fight in times of war.

As Seneca First Nation member and psychologist Terry Cross defines it in this keynote presentation, “culture is one group or people’s preferred way of meeting their basic human needs.”

Because it has affected us all and exposed fissures in our structural underpinnings, this pandemic may be our moment to interrupt our old story. It’s prompted us to embrace previously heretical ideas like reparations, universal basic income in the form of stimulus checks, and mutual aid. This is our moment to step out of our lonely struggle to fend for ourselves, a story maintained by those winning in the status quo. This is our moment not to create something new, but to return to an ancient way of being, known to the Blackfoot the Lakota, the Natives of the Cheyenne River Territory, and other First Nations. It’s a story that leaves no one without family: a story in which we begin by offering each other belonging, and continue by teaching our descendents how we lived: together.