Professional Documents
Culture Documents
Infancia y Aprendizaje
To cite this article: María Núñez & Juan-Carlos Gómez (2020) Early interaction, communication
and the origins of autism: far-reaching insights by Ángel Rivière (Interacción temprana,
comunicación y los orígenes del autismo: la visión con largo alcance de Ángel Rivière), Journal for
the Study of Education and Development, 43:4, 748-763, DOI: 10.1080/02103702.2020.1811542
CONTACT María Núñez manube1019@icloud.com Dpto. de Psicología Básica, Facultad de Psicología UAM,
C/Ivan Pavlov, 6, Madrid 28049, España.
English version: pp. 748–754 / Versión en español: pp. 755–761
References / Referencias: pp. 762–763
Translation from English / Traducción del inglés: Silvia Montero
© 2020 Fundacion Infancia y Aprendizaje
Early interaction, communication and autism / Interacción temprana, comunicación y autismo 749
prospective studies with babies at high risk of developing autism1 — was not even
imaginable. Rivière’s paper was therefore largely theoretical and hypothetical; his
insights were, nevertheless, rightly informed not only by his profound knowledge of
developmental psychology and his eagle-eyed view on the implications of the findings
on infant’s studies, but also by his own clinical practice.
In a nutshell, Rivière’s story was the following. Early social development in infants is
characterized by two types of mechanisms or programmes — attunement programmes,
which direct and connect infants with their caregivers, and harmonization programmes,
which allow them to respond and enter into reciprocal, coordinated interaction with
others from the beginning of life. For example, babies are preferentially attracted to
human voices (attunement), and they respond to vocal (normally also facial) expressive
addresses with synchronized vocal responses structured in turn-taking bouts, known as
protoconversations2 (harmonization). In this way, typical infants are integrated into
a dynamic interpersonal system that drives and structures their development3.
The infant with autism — Rivière deduced — must fail to build some of these
programmes; for example, they may not attend to the key social features of people, such
as their faces or their voices, and they may have some severe impairments in pro
grammes for early interaction, such as action synchronization or protoconversations.
These alterations would have consequences for later development, preventing them
from experiencing the key transition into triadic patterns of interaction (sharing atten
tion and action upon objects) where prelinguistic intentional communication emerges
in the form of protoimperatives and protodeclaratives (now referring to Bates’s 1979
seminal terms). With these early forms of referential communication, infants pursue
their object-related goals by intentionally recruiting other people’s help, or recruit other
people’s attention to share their interest in objects. This is achieved through specialized
behaviours such as pointing gestures, eye contact and gaze following organized in
coordinated units of social inter-action (that later on often appeared in the develop
mental literature as units of ‘joint attention’). The absence or severe limitation of some
of these advanced communicative behaviours (e.g., in the initiation of joint attention)
was one of the tell-tale signs that led to a diagnosis of autism at three years of age (see
Charman, Baron-Cohen, Swettenham, & Baird, 2001; Mundy, 2016). Most likely, they
were never developed, and most likely their absence could be traced back to alterations
in those earlier precursor patterns if only we could observe the development of children
with autism during their first year of life (see Canal-Bedia, 2020, in this volume).
Much of Rivière’s own later work is already anticipated in this paper, in two different
aspects: (1) the role of early intentional communication as a precursor of theory of mind;
and (2) the role of the early symbols and the symbolization mechanisms rooted in
interaction in the construction of meaning (see Benassi & Rodríguez, 2020, in this volume).
theory of mind4. His own empirical studies with Sarriá showed that (in typically
developing one-year-old infants) the intentional communication behaviours (those
coordinated units of social inter-action) were not related to the non-communicative
intentional actions in the Piagetian sense (Sarriá & Rivière, 1991). A later study with
Canal showed that children with autism present specific deficits in intentional
communication in natural interactions with adults (Canal & Rivière, 1993). Results
of these empirical studies suggested the existence of specific mechanisms for the
sociocognitive domain in typical development that were not present in the commu
nication of children with autism. In this sense, early communication, especially early
intentional communication, could be seen as the first, precursory steps in the
development of that key ability which is theory of mind and the alteration of
which seemed to capture so much of the essence of autism. Rivière’s own research
focused during the nineties on the fast-growing field of theory of mind and was
driven by the main theories (see Rivière & Núñez, 1996/2001). Later on, he shifted
towards a concept that linked such precursors of the human’s interpersonal skills
back to communication through ‘semiotic suspension’ as a developmental system in
the creation of meaning.
low risk (siblings of typically developing children) are showing us a picture that was
unimaginable at the time of Rivière’s key paper (see Palomo, 2020, in this volume).
Furthermore, the fact is that Rivière’s original predictions and ideas have fared astonish
ingly well, capturing the essence of current cutting-edge research on the social develop
mental nature of autism.
Consider, for example, the work of the Yale group, led by Amy Klin and Warren
Jones. This group was pioneering in reporting alterations in visual attention to social
cues in high-functioning adults with autism who showed preferential attention to the
mouth over the eyes area of faces (Klin, Jones, Schultz, Volkmar, & Cohen, 2002). They
then replicated these findings in two-year-old toddlers with early autism diagnosis, who
paid preferential attention to mouths over eyes when watching videos of people
addressing them (Jones, Carr, & Klin, 2008). In their recent work, through prospective
investigation of infants at risk of developing autism, they tried to track the origins of
this altered social attention to the first months of life. To their surprise, they did not
find the predicted lack of tuning in to the eyes of others from the beginning of life, but
typical eye attention during the first six months, with the decline starting only thereafter
(Jones & Klin, 2013). This finding was unexpected and in apparent contradiction with
their cascading effects developmental model, according to which lack of attention to key
social cues derails the development of social cognition in autism.
If attention to the right cues is intact at the beginning, something else must derail the
development in autism. Here Rivière’s notion of programmes of attunement to the
social world implemented conjointly with programmes of harmonization may come to
the rescue. It is not enough to attend to the right thing; one must also respond to it in
particular ways to enter into the sociodevelopmental process. The reason why attention
to the eyes eventually declines in infants with autism might be that it is not sustained by
coordinated mechanisms of social interaction conferring ‘social meaning’ to the eyes.
Attending to the eyes is only a first step — the key is what else do infants do or fail to
do once this visual orientation has been achieved? Indeed, Shultz, Klin, and Jones
(2018), in a revised theoretical formulation to address some of their unexpected results,
propose something uncannily similar to the model sketched by Rivière in 1983. They
emphasize the importance of considering both early social attention and early social
interaction mechanisms (attunement and harmonization in Rivière’s terminology),
essentially reproducing, with the benefit of the plethora of behavioural, cognitive and
physiological studies accumulated during recent decades, the ‘developmental plot’ that
Rivière had already guessed from the first manifestations of the emerging field of early
social interaction.
The attunement + harmonization (or attention + interaction) approach, however,
may not be as straightforward as presented in these formulations. Recently, prospective
studies on infants at risk of autism from other groups not only fail to find early (before
the sixth month of life) sociocognitive markers in the attention (attunement) pro
grammes (see Elsabbagh & Johnson, 2016) but also, apparently, in the early interactions
(harmonization) (Wan et al., 2012; Wan, Green, & Scott, 2019). Although it is still
premature to draw firm conclusions, this seems to indicate that the epigenesis of autism
(and of typical development) is more intricate and multifaceted than captured by
current socioconstructivist models and research methods, and that the key alterations
may not (at least not yet) be traceable to the very beginnings of communicative
Early interaction, communication and autism / Interacción temprana, comunicación y autismo 753
development, as both Rivière’s and the Yale group’s proposals assume. This does not
invalidate the general approach to the constructivist role of interaction in both typical
and atypical development, but forces us to reconsider it.
but rather the construction of human mental processes is permeable to the organism’s
interaction with specific influences of the developmental contexts. Crucially, these are
also core principles of the modern approach to constructivism known as neurocon
structivism (see Campos, 2020, in this volume; Karmiloff-Smith, 1998, 2018).
By looking at the multifaceted, complex network of interactions between the organism’s
genetic prescriptions and the different developmental contexts that build our mental pro
cesses (and the underpinning brain networks), neuroconstructivism has the theoretical tools
to face the main challenge of traditional constructivism: namely, to find the right balance
between flexibility and resilience of developmental outcomes and trajectories. As López
(2015) points out, however, it is fair to say that research based on this model has often not
looked specifically at social interaction itself. Fortunately, the research focus is changing and
an increasing number of prospective studies (based on this theoretical approach) are focusing
on early parent/child interactions (PCI) (see, e.g., Wan et al., 2019) and presenting PCI
interactions as a promising early intervention context (see, e.g., Althoff, Dammann, Hope, &
Ausderau, 2019; Green et al., 2015). A good example comes from Rivière’s closest academic
legacy with a research project where his early socioconstructivist view and the neurocon
structivist model converge currently in a prospective longitudinal study of children at risk of
developing autism (see http://traberitea.wixsite.com/traberitea)6.
In sum, the far-reaching ideas and insights anticipated by Rivière in his 1983 paper are still
at the cutting edge of current research and models on the origin of autism. In essence, the
framework and the road map that he sketched not only anticipated much of the empirical
evidence accumulated over the last years but also inspired a new generation of researchers
that can now contribute, first-hand, to building upon and providing the evidence and
conceptual reformulations that he could only begin to imagine thirty years ago.
Notes
1. Studies that look at the developmental trajectories of siblings of children with
autism (high risk) and compare them with those of siblings of children with typical
development (low risk).
2. Using Trevarthen’s (1979) expression.
3. The description of these mechanisms and programmes was further developed in two
other key papers: Rivière, 1984, and Rivière and Coll, 1987.
4. See Sarriá and Gómez’s (2007) monograph in this journal.
5. In this respect he also anticipated, within the field of autism, a dimensional rather
than categorical approach; currently, a dimensional approach to mental health in
general is becoming the mainstream approach through the Research Domain
Criteria (RDoC) (see Campos, Nieto, & Núñez, 2018).
6. His influence on many other former students and collaborators goes, however, well
beyond his immediate context in Madrid; Rivière’s legacy is present in the work of
many of us who have developed our careers in other academic contexts. His
inspiring influence is also present in the clinical and educational practice in Spain
and Latin America (see, e.g., Valdez, 2019).
Early interaction, communication and autism / Interacción temprana, comunicación y autismo 755
Rivière propuso que los orígenes del autismo deben yacer en las alteraciones de esos
patrones tempranos de interacción social que comienzan con el nacimiento, crecen en
complejidad y alcance durante los primeros meses de vida, y culminan (inicialmente)
con la aparición de una comunicación intencional prelingüística al final del primer año
de vida y (eventualmente) con la producción de comunicación simbólica y significado al
final de la infancia (ver Palomo, 2020, en este volumen). Las implicaciones de cualquier
alteración en estos patrones son potencialmente enormes porque, desde una perspectiva
vygotskiana, pueden afectar la totalidad del desarrollo cognitivo y no solo su ámbito
social.
En el momento en que Rivière escribió su artículo, sin embargo, era imposible
determinar qué iba mal exactamente en el primer año de vida de un niño con
autismo, cuáles eran las alteraciones que le impedían tomar el camino típico del
desarrollo. En 1983 era imposible saberlo de primera mano porque el autismo solo
podía diagnosticarse, como pronto, en los años de la etapa preescolar (y a menudo,
mucho más tarde). La evidencia disponible en la actualidad, gracias a los estudios
prospectivos con bebés con alto riesgo de desarrollar autismo1, no podía ni siquiera
imaginarse. El artículo de Rivière fue, por tanto, en gran medida teórico e hipotético;
sin embargo, sus ideas se fundamentaban, no solo en su profundo conocimiento de la
psicología del desarrollo y su perspicaz comprensión de las implicaciones que tenían
los hallazgos de los estudios con bebés, sino también en su propia práctica clínica.
En pocas palabras, la historia que propuso Rivière fue la siguiente. El desarrollo social
temprano en los bebés se caracteriza por dos tipos de mecanismos o programas: programas
de sintonización, que dirigen y conectan a los bebés con sus cuidadores, y programas de
armonización, que les permiten responder y entrar en interacción recíproca y coordinada con
los demás desde el comienzo de su vida. Por ejemplo, los bebés se sienten preferentemente
atraídos por las voces humanas (sintonización), y cuando alguien se dirige a ellos con
expresiones vocales (normalmente también faciales) reaccionan con respuestas vocales sin
cronizadas estructuradas en turnos, conocidas como protoconversaciones2 (armonización).
De esta manera, los bebés típicos se integran en un sistema interpersonal dinámico que
impulsa y estructura su desarrollo3.
Algo en la construcción de algunos de estos programas, dedujo Rivière, debe ir mal en el
niño con autismo; por ejemplo, es posible que no atiendan a las características sociales clave
de las personas, como a sus rostros o a sus voces, y pueden tener trastornos severos en los
programas de interacción temprana, como la sincronización de acciones o las protocon
versaciones. Estas alteraciones tendrían consecuencias para el desarrollo posterior,
impidiéndoles efectuar la transición clave hacia patrones triádicos de interacción (compar
tir la atención y la acción sobre los objetos) en los que emerge la comunicación intencional
prelingüística en forma de protoimperativos y protodeclarativos (en referencia a los
términos seminales de Bates en 1979). Con estas primeras formas de comunicación
referencial, los bebés persiguen objetivos sobre objetos recabando intencionalmente la
ayuda de otras personas, o atraen la atención de otras personas para compartir su interés
en los objetos. Esto se logra a través de comportamientos especializados tales como los
gestos de señalar con el dedo, el contacto visual y el seguimiento de la mirada, organizados
en unidades coordinadas de inter-acción social (lo que más tarde comenzó a identificarse en
la literatura sobre el desarrollo como unidades de ‘atención conjunta’). La ausencia
o limitación severa de algunos de estos comportamientos comunicativos avanzados (por
Early interaction, communication and autism / Interacción temprana, comunicación y autismo 757
ejemplo, en la iniciación de la atención conjunta) fue uno de los signos clave que permi
tieron el diagnóstico del autismo a los tres años de edad (ver, por ejemplo, Charman,
Baron-Cohen, Swettenham, & Baird, 2001; Mundy, 2016). Lo más probable es que nunca se
desarrollaran, y, lo más probable, era que su ausencia se remontara a alteraciones en esos
patrones precursores anteriores si pudiéramos observar el desarrollo de niños con autismo
durante su primer año de vida (ver Canal-Bedia, 2020, en este volumen).
Una buena parte del trabajo posterior de Rivière se anticipa ya en este artículo en dos
aspectos diferentes: (1) el papel de la comunicación intencional temprana como pre
cursor de la teoría de la mente; y (2) el papel de los primeros símbolos y los meca
nismos de simbolización enraizados en la interacción en la construcción del significado
(ver Benassi & Rodríguez, 2020, en este volumen).
Notas
1. Los estudios que se centran en las trayectorias de desarrollo de los hermanos de niños con
autismo (alto riesgo) y los comparan con los de los hermanos de niños con un desarrollo
típico (bajo riesgo).
2. Usando la expresión de Trevarthen (1979).
3. La descripción de estos mecanismos y programas fue desarrollada en mayor detalle en otros
dos documentos clave de Rivière: Rivière, 1984, y Rivière y Coll, 1987.
4. Ver la monografía de Sarriá y Gómez (2007) en esta revista.
5. A este respecto, también anticipó un enfoque dimensional en vez de categórico dentro del
campo del autismo; actualmente, un enfoque dimensional de la salud mental en general se
está convirtiendo en el enfoque dominante a través de los Criterios de Investigación por
Dominios (Research Domain Criteria, RDoC) (ver Campos, Nieto, & Núñez, 2018).
6. Sin embargo, su influencia en muchos otros antiguos alumnos y colaboradores va
mucho más allá de su contexto inmediato en Madrid; el legado de Rivière está presente en
el trabajo de muchos de nosotros que hemos desarrollado nuestras carreras en otros
contextos académicos. Su influencia inspiradora también está presente en la práctica
clínica y educativa en España y América Latina (ver, por ejemplo, Valdez, 2019).
Acknowledgements/ Agradecimientos
María Núñez was funded by the Beatriz Galindo Programme (BGP18/00186, Ministerio de
Ciencia, Innovación y Universidad). / María Núñez obtuvo financiación del Programa Beatriz
Galindo (BGP18/00186, Ministerio de Ciencia, Innovación y Universidad).
762 M. Núñez and J.-C. Gómez
ORCID
María Núñez http://orcid.org/0000-0001-6046-5457
References / Referencias
Althoff, C. E., Dammann, C. P., Hope, S. J., & Ausderau, K. K. (2019). Parent-mediated
interaction for children with autism spectrum disorder: A systematic review. American
Journal of Occupational Therapy, 73, 7303205010.
Baron-Cohen, S., Leslie, A., & Frith, U. (1985). Does the autistic child have a theory of mind?
Cognition, 21, 37–46.
Bates, E. (1979). The emergence of symbols: Cognition and communication in infancy. New York,
NY: Academic Press.
Benassi, J., & Rodríguez, C. (2020). A pragmatic perspective of autism (Génesis de la referencia
compartida. Una mirada pragmática sobre el autismo). Journal for the Study of Education and
Development, 43. doi:10.1080/02103702.2020.1814600
Bower, T. G. R. (1974). Development in infancy. New York, NY: Freeman.
Campos, R. (2020). Like mermaids or centaurs: psychological functions that are constructed
through interaction (Como sirenas o centauros: funciones psicológicas que se construyen en
interacción). Journal for the Study of Education and Development, 43. doi:10.1080/
02103702.2020.1810942
Campos, R., Nieto, C., & Núñez, M. (2018). Research domain criteria (RDoC) from neuroconstructivism:
A developmental view on mental disorders. WIREs Cognitive Science. doi:10.1002/wcs.1491
Canal-Bedia, R. (2020). Intersubjectivity, joint attention and social referencing in autism. A
developmental explanation according to Ángel Rivière [Intersubjetividad, atención conjunta
y referencia social en autismo. Una explicación evolutiva según Ángel Rivière]. Journal for the
Study of Education and Development, 43. doi:10.1080/02103702.2020.1802151
Canal, R., & Rivière, A. (1993). La conducta comunicativa de los niños autistas en situaciones
naturales de interacción. Estudios de Psicología, 14, 49–74.
Charman, T., Baron-Cohen, S., Swettenham, J., & Baird, G. (2001). Testing joint attention,
imitation and play as precursors of language and theory of mind. Philosophical Transactions
of the Royal Society London, 4, 481–498.
Demuth, C. (2015). Mother child communication: Cultural differences. In J. Wright (Ed.),
International encyclopedia of social and behavioral sciences (2nd ed.). Elsevier Publisher.
doi:10.1016/B978-0-08-097086-8.23209-1
Elsabbagh, M., & Johnson, M. H. (2016). Autism and the social brain: The first-year puzzle.
Biological Psychiatry, 80, 94–99.
Gómez, J. C. (2004). Apes, monkeys, children and the growth of mind. Cambridge, MA: Harvard
University Press.
Green, J., Charman, T., Pickles, A., Wan, M. W., Elsabbagh, M., … Johnson, M. H. (2015).
Parent-mediated intervention versus no intervention for infants at risk of autism: A parallel,
single-blind randomised trial. The Lancet Psychiatry, 2, 133–140.
Jones, W., Carr, K., & Klin, A. (2008). Absence of preferential looking to the eyes of approaching
adults predicts level of social disability in 2-year-old toddlers with autism spectrum disorder.
Archives of General Psychiatry, 65, 946–954.
Jones, W., & Klin, A. (2013). Attention to eyes is present but in decline in 2–6-month-old infants
later diagnosed with autism. Nature, 504, 427–431.
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.
Early interaction, communication and autism / Interacción temprana, comunicación y autismo 763