Professional Documents
Culture Documents
Infancia y Aprendizaje
Mercedes Belinchón
To cite this article: Mercedes Belinchón (2020) Theoretical definition and explanation of
autism: the narrative of Ángel Rivière and his reflections (Definición y explicación teórica del
autismo: la narrativa de Ángel Rivière y sus reflejos), Journal for the Study of Education and
Development, 43:4, 696-712, DOI: 10.1080/02103702.2020.1810944
In his famous tango Volver, Carlos Gardel affirmed ‘that twenty years is nothing’. However,
in the twenty-two years during which Ángel Rivière studied autism (1978–2000) and in the
twenty more that have elapsed since his death (2000–2020), enormous changes have
occurred in this field. Research, professional practices and the social image of autism
have successively reflected ideas ‘established by consensus or by the most persuasive or 30
influential experts at each moment’ (Donvan & Zucker, 2016, p. 370). And, in the Spanish-
speaking world, one of those experts was Ángel Rivière.
The impact of both his research studies and tenacious work of dissemination was
enormous. In addition to presenting the ‘state of the art’ (something inherently quite
meritorious, given the inexistence then of the Internet), Rivière pioneered thinking and 35
making others think about autism as a challenge for knowledge, a personal, family and
social problem but also a scientific one that demanded answers based on reliable
research, a situation that challenges the capacity of the human mind to rationally
understanding itself. He gave theoretical significance to the uncertainties that autism
raises by shaping those questions and their answers into an understandable narrative, 40
from both an intuitive psychology (i.e., spontaneous) as well as from a broad-spectrum
scientific psychology (i.e., based on different approaches). Furthermore, presenting all of
it more as an invitation for sharing his reflections than as dogmas, he achieved that his
explanations function as only ‘good stories’ do: connecting with deeply human uni-
versal drives (as is the ‘need to know’ the unknown), engraving in the memory of 45
thousands of people a coherent representation of the facts, dilemmas and main actors in
the history of autism, and making possible the critical evocation of that representation,
its social transmission and performative application (i.e., its use as a guide for scientific
and professional action).
research? To what extent have those ideas spread or converged with more recent
theoretical approaches?
As this monograph presents, many specific lines of research that Rivière promoted or 125
in which he was involved remain active. However, applying a more comprehensive look
at the evolution of autism-related studies and theories, we find that in this ‘liquid’ (that
has radically transformed, among other things, our modes of communication in both
personal and scientific realms) twenty-first century, the picture is already different from
the one he knew. By annual rate and volume of publications, autism is now a condition 130
as studied as cancer or Alzheimer’s disease. Specialized research programmes and
networks (many multicentre) exist on all continents.1 New narratives have emerged
and the previously instituted ones (psychodynamic, behavioural and neuroscientific)
have evolved considerably. Details have been revealed of the history of autism and its
protagonists, ignored to date and which permit other accounts. Increasingly, as well, 135
more ‘critical’ voices from different angles advocate for replacing the biomedical frame-
work dominant in the twentieth century with others of a psychosocial and/or socio-
cultural nature. In this fusion of ‘voices’ and data, we may recognize tendencies in tune
with Rivièrian proposals, but also other divergent ones.
One of the ‘attuned’ tendencies is the impressive advance of aetiological studies. On 140
the neurobiological plane (see, e.g., Courchesne et al., 2019), the use of increasingly
sophisticated research methods (neuroimaging logs, genome mapping, genetic engi-
neering with other species, etc.) has broadened in multiple directions the knowledge of
the mechanisms and systems involved in the pathogenesis of autism. Hundreds of
participating genes as well as the cerebral bases of what the now nonagenarian Eric 145
Kandel, Nobel Prize in physiology, calls ‘our intensely social nature’ (the one that is
characteristically affected by autism and that so interested Rivière) have been identified.
Atypical activation and brain connectivity patterns have been described, while studies
on biomarkers and endophenotypes are identifying subgroups with diagnostic and
prognostic value that enable ‘precision or personalized’ medical treatments. In parallel, 150
on the neurocognitive plane (see, for example, Charman et al., 2011), versatile measures
such as eye-tracking now support detailed models of the processes of perception,
attention, memory, language, mentalization, etc., that allow for better understanding
of both clinical symptoms as well as the habitual functioning of people with a diagnosis
of autism in different contexts. The interactions between cognitive, motivational and 155
emotional processes, and how the gender variable influences many of these processes,
are better known. Furthermore, combining clinical, experimental and developmental
evidence has allowed for proposing neuropsychological theories that complement or
reformulate previous ones, using constructs such as social motivation, complex informa-
tion processing, empathy or hypersystematization. 160
Another ‘attuned’ tendency is the adoption of an evolutive perspective. Taking
seriously — as Rivière did — the idea that autism is a developmental disorder, and
seeking mechanisms responsible for changes in different time scales, it is now common
in the neurobiological and psychological studies of autism, but also poses considerable
theoretical challenges. This is evidenced by, for example, prospective studies of babies 165
at risk for developing autism, which are refuting previous hypotheses (e.g., about when
and how the first signs of autism arise) derived from retrospective information
contributed by the parents (see Palomo, in this volume). In many prospective studies
700 M. Belinchón
(e.g., those carried out by the BASIS Team, led by Mark Johnson in the UK, and the
TRABERITEA Team, led by Ruth Campos in Spain), the influence of the neurocon- 170
structivist approach is obvious, a broad research programme initiated in the 1990s by
the British psychologist Annette Karmiloff-Smith that addresses the ontogenesis of
human psychological functions from a multilevel, dynamic and non-linear perspective
(see Campos, 2018, for a splendid synthesis of this approach). However, whether or
not it is justified from neuroconstructivism, assuming the importance of the develop- 175
mental processes for the theoretical understanding of autism itself represents
a transcendental paradigm shift. The pre-, peri- and postnatal risk factors and epigenetic
mechanisms (not only genotypes) are now the focus of many research studies. The
developmental trajectories of all of the phenotypic variants of autism attract increasing
interest. Furthermore, heterogeneous evolutionary-adaptationist hypotheses are also 180
emerging. How these studies can affect the scientific explanations of autism remains
unknown, but obviously understanding when and how autism emerged during the
long humanization process (a topic which also interested Rivière enormously) is no
minor issue.
A final ‘attuned’ tendency worth highlighting is the growing demand for definitions 185
and analytical frameworks alternative to the ‘standard’. During the 1990s, renowned
psychologists from the UK, such as Uta Frith, Francesca Happé and Simon Baron-
Cohen, interpreted certain results of their studies on the visual and linguistic processing
of people with ‘high-functioning autism’ or the ‘broad autism phenotype’ as examples
of a different — but not deficient or pathological — cognitive style. That is when the 190
proposal emerged to conceptualize autism as a range of ‘Conditions’ (ASC) and not
only as ‘Disorders’ (ASD). Tasks and measures, useful for both research and clinical
evaluation, sensitive to highly evolved and subtle aspects of human functioning (e.g.,
perceptual-cognitive biases, pragmatics, ʽadvanced’ mentalizing, among others), were
designed. In parallel, other phenomena were also displayed (e.g., the intensity of 195
sensory disturbances, peculiar learning and memorization strategies, or chronic stress
and suffering of people with autism).
Thereby, we learned (as Rivière also anticipated and Fletcher-Watson & Happé,
2019, now explain) that it is not necessary to have a diagnosis of PDD/ASD to be in
the autism spectrum. In addition, no single autistic brain nor mind exists, but rather 200
a constellation of brain-mind types, with fuzzy boundaries between each other, of which
only a few meet the diagnostic criteria in force. As the millennium has advanced, the
verification of the extraordinary clinical, cognitive and neurobiological variability of the
‘autism spectrum’ has demonstrated the urgent need for redefining this construct
(Rutter, 2011). The diagnostic and operative definitions that serve as a reference for 205
both clinical practice and research have been modified several times (Volkmar &
MacPartland, 2014). Furthermore, other changes that extend beyond the research
field have also occurred.
Knowing the testimonies and studies of ‘high-functioning’ people ‘got a lot of people
thinking about behaviour in a new way — the behaviour of autistics, certainly, but the 210
behavior on nonautistic too’ (Grandin & Panek, 2013, pp.104–105). Autism began to be
identified not only with limitations but also with strengths (e.g., excellent perception of
details, strong adherence to rules, among others). That identification, furthermore,
actively disseminated in forums, blogs and websites, and also projected in successful
Autism: definition and explanation / Autismo: definición y explicación 701
novels and television series, offers an increasingly more positive and less stigmatizing 215
image that counteracts the traditional view of autism as only a psychiatric or mental
health disorder.
This new view of autism, compared to what the ‘standard’ narrative suggests, does
not derive solely from research evidence, despite its decisiveness. The change also owes
much to non-academic movements that emerged in the late twentieth century, such as 220
those based on the constructs of developmental disabilities and neurodiversity. Many
people with this diagnosis and also ‘high-functioning’, as well as their families and the
professionals who work with people with great needs, have enthusiastically joined
these movements (of non-autism origins). They do not question the usefulness of
neuroscientific studies, rather quite the opposite: some because they consider them (as 225
Rivière did) necessary sources of evidence for designing effective supports; and others
because, as Nadesan (2005) and Ortega (2013) point out, they are discursively con-
structing their identity as ‘autistic individuals’ (a term they prefer over ‘with autism’)
specifically using neurocognitive vocabulary as the basis. However, these move-
ments — and others — also demand research approaches that do not perpetuate (as 230
the ‘standard’ version has historically done) the vision of autism as an individual
phenomenon (i.e., socially and culturally decontextualized). Thus, diverging from the
zeitgeist that dominated the twentieth century (of which Rivière was also
a participant), the search for ‘situated knowledge’ drives the increase of ethnographic
studies to date, the analysis of ‘life stories’ and projects focused on autism in cultures 235
and countries that are not Anglo-Saxon from different social sciences (see, e.g., the
studies of Dawn Eddings Prince, 2013, from her privileged ‘voice’ as an autistic
anthropologist). All these investigations, from a common postmodern logic (post-
positivist) and using qualitative research methods, are promoting greater recognition
and respect for individual differences and deconstructing the image of autism as 240
something universal and timeless that the ‘standard’ programme also projected for
decades.
In contrast, however, with that increasingly clear acknowledgement of autism’s com-
plexity and the need for expanding its research frameworks and methods, I cannot resist
ignoring a few tendencies (scientific and narrative) that diverge from the Rivièrian ideas. 245
One of these is the apparent popularization in certain fields of reductionist definitions
and explanations. Thus, we witness how many therapists (e.g., adherents of radical
behavioural models, such as Lovaasian models) assimilate autism with the list of
observable clinical symptoms or with low scores in diagnostic tests, such as the ADOS,
social competency scales or others defined on the basis of their own theoretical model. 250
We also witness how, in public presentations and blogs, some neurobiologists express
either a dualist perspective of mind-brain interactions (placing the psyche and cognition
in a metaphysical realm accessible only through introspection — and therefore off
limits to objective science) or an eliminative perspective (nurturing the idea that
cognitive processes are nothing more than brain activity). 255
From a ‘critical’ epistemological position, Bianchi (2014) pointed out that these two
forms of reductionism (behavioural and implementational-biological) mutually feed
upon one another and also impregnate the new international diagnostic classifications
because, by conceptualizing autism as a ‘neurodevelopmental disorder’, they accentuate
the physicalist shift towards biological psychiatry initiated by the DSM-III in 1980. 260
702 M. Belinchón
Another ‘critical’ epistemologist (Verhoeff, 2012) has likewise reported the exacerbation
of a naturalized perspective of autism (i.e., the idea that it is a physical phenomenon
whose causal mechanisms can only be known through mechanistic models of brain
operations). This ‘naturalization’ of autism and its research (implicit in the ‘standard’
programme since its origin) was remarkably boosted during the so-called decade of the 265
brain (1990–2000), an ambitious initiative of the Library of Congress and the National
Institute of Mental Health in the United States that sought to promote awareness of the
benefits and applications of the scientific study of this organ in different fields.
Furthermore, it has been reinforced by a parallel cultural process and a broader
geneticization (i.e., of an ‘increased tendency for researchers, clinicians, and the media 270
to interpret psychological problems and individual behaviors in terms of genetic
determinism’, Nadesan, 2005, pp. 6–7).
Recent bibliometric studies clearly reflect these processes. Thus, Whyatt and Torres
(2018) show how since the 1990s, and especially since 2006 (as a result of another US
government initiative in the same direction), there was an increase in scientific articles on 275
the genetics-genomics, neurology and physiology of autism while there was a decrease of
those from psychology (except those referring to diagnostic tools such as the ADOS, which
stagnated). Furthermore, anyone could verify the increasing assimilation in the discourse of
‘scientific’ and ‘neurobiological’ research, ‘scientific’ and ‘quantitative-experimental’ stu-
dies, of autism. (Of course, Rivière never ‘perpetrated’ these assimilations, which implicitly 280
transmit an also reductionist model on how to make and communicate science.)
The biological and behavioural hypertrophies are undesirable, given their reflection
of impoverishing epistemological and methodological reductionism and, also, because
they eclipse the explanatory value of cognitive analyses (considering that these are, as
Rivière pointed out, the only ones that allow for functionally linking clinical and 285
neurobiological data). As Whyatt and Torres (2018) observed, this situation danger-
ously enlarges the historical gap existing between the language inherent to physiology
(which grounds the neuroscientific explanations on ‘increasingly more fine-grained’
measures) and the language of observational psychology (that bases diagnoses and
clinical-educational treatments on much more ‘molar’ constructs). In turn, that gap 290
perpetuates the use of two languages (one for researchers and another for professionals,
families and the rest of society), distancing basic science from non-medical interven-
tions and shrinking the broad space of interconnection and collaboration that the
twentieth century (neuro)psychological theories foster in the professional realm
(Verhoeff, 2015). 295
The reductionist positions, furthermore, are undesirable because they favour scientifi-
cally and/or ethically questionable societal expectations. Thus, we witness how some
organizations (e.g., Cure Autism Now) finance studies on biological treatments ‘to prevent
autism’, predicting short-term ‘solutions’ and implicitly reinforcing the narrative that
considers autism a disease that would spread like an epidemic. We also witness how ABA 300
(applied behavioural analysis) behavioural treatments, if they reduce the symptoms of their
students or these improve their scores on certain tests, advertise that these children no
longer have autism (a message that, although incapable of withstanding a rigorous data
analysis, profoundly impacts the parents — see Broderick, 2009). Even more surprising, we
witness how, in what seems to be a new reductionist narrative, the detection and diagnosis of 305
autism is advertised — even in babies under one year of age — using only software that
Autism: definition and explanation / Autismo: definición y explicación 703
analyses eye-tracking recorded while viewing certain stimuli (e.g., Klin, Jones, & Lewis,
2018).
Finally, another ‘divergent’ tendency currently challenges the ‘standard’ programme’s
core (and, by extension, the core of Rivièrian narrative): the increasing questioning of 310
the usefulness of maintaining the diagnostic construct of ‘autism’ as a reference in
research. Given that the nosological validity of this construct as it was defined since
the 1960s has not been demonstrated and, especially, that the DSM-5 has grouped all of
its clinical expressions into a single category, increasingly more voices propose doing
without this construct in neuroscientific studies, and replacing it with others of greater 315
transdiagnostic utility. In what is already a heated academic debate, some have even
acidly affirmed that:
The diagnosis [of autism] is an arbitrary unscientific “convenient fiction” that has blocked
the discovery of replicable neurobiological variation among individuals with serious
neurodevelopmental social impairment. […] Maintaining the diagnosis supports the 320
impossible research goal of finding a unitary cause for ASD, and supports the public’s
belief that a single cure for ASD will be found. ASD diagnosis will also continue to support
the reifying business of ASD research funding, journals, and societies. (Whaterhouse,
London, & Gillberg, 2017, p. 1,182)
I think that the brilliant scientist and skilled debater who was Rivière would have been 325
intellectually impassioned by this controversy (although it would have put him in an
awkward position professionally). Perhaps he would have proposed debating about it in
a public colloquium to seek a point of convergence based on scientific and argumenta-
tive rigour. Rivière blindly trusted the usefulness of language as a tool for expression
and approaching mental states. Therefore, I believe that he would have abhorred seeing 330
how also in the last two decades the different forms of reductionism have narrowed the
spaces for debate between the different epistemic communities that arose around autism.
Each one consuming only the information that reinforces their already held theories
and beliefs … while people with autism, their families and professionals continue to
trust that scientific investigation will be capable of providing them useful clues as to 335
what to do.
Note
1. Feinstein (2010) offers numerous testimonies in this regard, and Belinchón, Boada,
García, Fuentes, and Posada (2010) offer quantitative data on Spain.
340
704 M. Belinchón
En su célebre tango Volver, Carlos Gardel afirmaba ‘que veinte años no es nada’. Sin
embargo, en los veintidós años en que Ángel Rivière estudió el autismo (1978–2000) y en
los veinte transcurridos desde que falleció (2000–2020), los cambios en este ámbito han 345
sido enormes. La investigación, las prácticas profesionales y la imagen social del autismo
han reflejado sucesivamente ideas ‘establecidas por consenso o por los expertos más
persuasivos o influyentes en cada momento’ (Donvan & Zucker, 2016, p. 370). Y en el
ámbito hispanohablante, uno de esos expertos fue Ángel Rivière.
Tanto sus investigaciones como la tenaz labor de difusión que realizó tuvieron un impacto 350
enorme. Además de presentar ‘el estado del arte’ (algo de por sí muy meritorio cuando aún no
existía Internet), Rivière fue pionero en pensar y hacer pensar sobre el autismo como un reto
para el conocimiento, un problema personal, familiar y social pero también científico que exige
respuestas basadas en investigaciones fiables, una situación que desafía la capacidad de la
mente humana para entenderse racionalmente a sí misma. Le dio un sentido teórico a las 355
dudas que suscita el autismo ahormando esas preguntas y sus respuestas en una narrativa
comprensible, tanto desde una psicología intuitiva (i.e., espontánea) como desde una psicología
científica de amplio espectro (i.e., basada en enfoques diversos). Y, presentando todo ello más
como invitación a compartir sus reflexiones que como dogmas, logró que sus explicaciones
funcionaran como sólo lo logran las ‘buenas ‘historias’: conectando con pulsiones universales 360
profundamente humanas (como lo es la ‘necesidad de conocer’ lo ignoto), fijando en la
memoria de miles de personas una representación coherente de los hechos, dilemas y actores
principales de la historia del autismo, y posibilitando la evocación crítica de esa
representación, su transmisión social y su aplicación performativa (i.e., su uso como guía de
acción científica y profesional). 365
un amplio espectro de condiciones; (2) que las causas de ese síndrome (i.e., su etiología)
pueden ‘descubrirse’ usando los métodos de la ciencia positiva (i.e., falsando teorías con
datos empíricos objetivos y replicables, no mediante los métodos hermenéuticos del 380
psicoanálisis); (3) que las evidencias científicas disponibles ‘abocan’ a conceptuar el
autismo como un trastorno del desarrollo neuropsicológico de etiología compleja, par-
cialmente genética; y (4) que aunque el autismo como tal no es directamente tratable ni
curable, sus síntomas y limitaciones derivados pueden mejorarse sustancialmente me-
diante programas clínicos y educativos, farmacología, ajustes de los entornos y otros 385
tratamientos.
Rivière explicó exhaustivamente este programa ‘estándar’ introduciendo en español
los constructos explicativos que en cada momento contaban con mayor soporte
empírico (modulación sensorial, refuerzo contingente, hiperselectividad estimular, inter-
subjetividad, mentalización, coherencia central, funciones ejecutivas y otros). Pero 390
a mediados de 1970, cuando él inició su actividad, los métodos de investigación de la
Psicología cognitiva, la Neurología y la Genética llevaban aplicándose al autismo muy
pocos años. Él entrevió lúcidamente que esas disciplinas permitirían neutralizar la
brutal metáfora psicoanalítica que equiparaba a los niños con autismo con una ‘for-
taleza vacía’. Pero entrevió también, no menos lúcidamente, que las conductas mos- 395
tradas por esos niños, con su sorprendente mezcla de déficits y de habilidades, suponían
un reto científico excepcional.
¿Cómo puede describirse el autismo? — se preguntaba — ¿Cómo puede la ciencia
natural capturar su singularidad? ¿Cómo pueden explicarse funcionalmente esas con-
ductas tan inusuales, tan impredecibles, tan desconcertantes? Ninguna otra 400
condición — nos decía — parece alterar tan profundamente los mecanismos
psicológicos propios de la ontogenia humana (particularmente, aquéllos que nos con-
vierten en seres sociales intencionales). Pero tampoco ninguna teoría científica cono-
cida — nos insistía también — podría dar cuenta por sí sola de una afectación tan grave
de tantas funciones críticas para la humanización. 405
Intentando responder esas preguntas, Rivière exploró con admirable libertad intelectual
qué podrían aportar a la explicación científica del autismo distintos paradigmas psicológicos
(enfoque del procesamiento de la información, Gestalt, conductismo, epistemología
genética, enfoque socio-histórico y finalmente conexionismo), pero no desdeñó a priori,
como hacen esos enfoques, las ‘descripciones fenomenológicas/en primera persona’ (ver 410
Valdez et al., en este volumen). Así, compuso una narrativa original, más poliédrica
y evolutiva que la que ofrecía por aquel entonces la ‘versión estándar’. Y, desbordando
tanto los paradigmas originales como los usos lingüísticos más ‘académicos’, empleó una
retórica compasiva, empática con el sufrimiento de las personas con autismo y de sus
familiares, y comprometida con intentar mejorar sus vidas aplicando los avances de la 415
investigación.
Se distanció además Rivière de las narrativas coetáneas sobre el autismo empleando otras
estrategias inusuales. Por ejemplo, para evitar cualquier forma de reduccionismo, combinó
datos clínicos, conductuales, cognitivos y neurobiológicos cuando el marco de las
Neurociencias Cognitivas apenas estaba emergiendo. Adoptó el constructo función como 420
organizador analítico cuando la Psicología anglosajona hablaba casi exclusivamente de
‘estímulos’, ‘respuestas’ y ‘procesos de cómputo’. Y, anticipando premonitoriamente un
planteamiento ahora generalizado, desarrolló la idea (quizá tomada de trabajos de Luria
706 M. Belinchón
recién traducidos al español aquellos años) de que las alteraciones en los procesos
y funciones ‘elementales’ generan efectos en cascada sobre los ‘superiores’. 425
Esta lógica teórica resulta reconocible desde sus primeras publicaciones (Rivière,
1978; Rivière & Belinchón, 1981). Pero su expresión más madura y elaborada se
encuentra en un extenso y cuidado texto posterior en el que, desplegando toda su
maestría, propone una original definición multidimensional de autismo basada en 12
capacidades psicológicas evaluables (e.g., mediante el Inventario IDEA, presentado en esa 430
misma publicación) (Rivière, 1997). Ahí también Rivière justificaba la doble necesidad
de superar las explicaciones simplistas del autismo basadas en un único déficit y de
asumir una definición ampliada del constructo espectro autista. En este constructo se
incluían por entonces sólo los ‘Trastornos Generalizados del Desarrollo’ (TGD) descri-
tos en las clasificaciones psiquiátricas vigentes. Pero él atesoraba una amplia experiencia 435
clínica y conocía también el ‘fenotipo ampliado’ (subclínico) que presentan algunos
familiares de personas diagnosticadas de autismo. Por ello, propuso agregar al ‘espectro
autista’ todas aquellas condiciones que alteran alguna de las dimensiones incluidas en
su definición, explorando posteriormente cómo situar dichas dimensiones en un mapa
general de las funciones psicológicas y su desarrollo (ver Campos, en este volumen). De 440
nuevo, perspicazmente, había detectado el maestro que en puertas del siglo XXI nuevas
formas de entender el autismo estaban gestándose, algo que, como ahora veremos, no
podía ser más verdad.
XX (del que también participó Rivière), la búsqueda de ‘conocimientos situados’ motiva 560
que ahora se realicen cada vez más estudios etnográficos, análisis de ‘historias de vida’
y proyectos sobre el autismo en culturas y países no anglosajones desde Ciencias
Sociales diversas (ver, e.g., los publicados por Dawn Eddings Prince, 2013, desde su
privilegiada ‘voz’ como antropóloga y autista). Todas estas investigaciones, desde una
común lógica postmoderna (post-positivista) y empleando métodos cualitativos de 565
investigación, están favoreciendo un mayor reconocimiento y respeto de las diferencias
individuales desmontando además esa imagen del autismo como algo universal
y atemporal que proyectó también durante décadas el programa ‘estándar’.
Contrastando, sin embargo, con esa cada vez más clara toma de conciencia de la
complejidad del autismo y de la necesidad de ampliar los marcos y métodos de su 570
investigación, han cobrado fuerza también algunas tendencias (científicas y narrativas)
‘divergentes’ con los planteamientos ‘rivièrianos’ que no me resisto a obviar.
Una de ellas es que parecen estarse popularizando en ciertos ámbitos las definiciones
y explicaciones reductivas. Así, vemos cómo muchos terapeutas (e.g., los adscritos
a modelos conductistas radicales como el lovaasiano) asimilan el autismo bien al listado 575
de sus síntomas clínicos observables bien a puntuaciones bajas en pruebas diagnósticas
como el ADOS, escalas de habilidades sociales u otras definidas desde su propio modelo
teórico. También, vemos cómo, en presentaciones públicas y blogs, algunos
neurobiólogos expresan bien una visión dualista sobre las relaciones mente-cerebro
(situando el psiquismo y la cognición en una esfera metafísica sólo accesible mediante 580
introspección — y por tanto vedada a una ciencia objetiva) bien una visión eliminativa
(alimentando la idea de que los procesos cognitivos no son más que actividad cerebral).
Desde una posición epistemológica ‘crítica’, Bianchi (2014) ha señalado que esas dos
formas de reduccionismo (conductual e implementacional-biológico) se retroalimentan
entre sí e impregnan también las nuevas clasificaciones diagnósticas internacionales, 585
pues conceptuando el autismo como un ‘Trastorno del Neurodesarrollo’ acentuarían el
giro fisicalista hacia la Psiquiatría Biológica que en 1980 inició el DSM-III. Otro
epistemólogo ‘crítico’ (Verhoeff, 2012) ha denunciado igualmente que se ha ido exacer-
bando una visión naturalizada del autismo (i.e., la idea de que es un fenómeno físico
cuyos mecanismos causales sólo pueden conocerse mediante modelos mecanicistas del 590
funcionamiento cerebral). Esa ‘naturalización’ del autismo y de su investigación
(implícita en el programa ‘estándar’ desde sus orígenes) se potenció extraordinaria-
mente en la llamada década del cerebro (1990–2000), una ambiciosa iniciativa de la
Biblioteca del Congreso y el Instituto Nacional de Salud Mental estadounidenses que
buscaba promover la toma de conciencia sobre los beneficios y aplicaciones del estudio 595
científico de este órgano en distintos ámbitos. Además, se ha visto reforzada por un
proceso cultural paralelo y más amplio de genetización (i.e., de una ‘creciente tendencia
de los investigadores, clínicos y medios de comunicación a interpretar los problemas
psicológicos y las conductas individuales en términos de un determinismo genético’ —
Nadesan, 2005, p. 6–7). 600
Los estudios bibliométricos recientes reflejan estos procesos nítidamente. Así,
Whyatt y Torres (2018) muestran cómo desde los años 90, y especialmente desde
2006 (a raíz de otra iniciativa gubernamental estadounidense en la misma dirección),
crecieron los artículos científicos sobre Genética-Genómica, Neurología y Fisiología del
autismo mientras disminuyeron los de Psicología (salvo los referidos a herramientas 605
710 M. Belinchón
Creo que al brillante científico y hábil polemista que fue Rivière le habría apasionado 655
intelectualmente esta controversia (aunque profesionalmente le habría colocado en una
situación incómoda). Quizá habría propuesto afrontarlo en algún coloquio público
para buscar algún punto de acercamiento desde el rigor científico y argumental. Él
confiaba ciegamente en la utilidad del lenguaje como herramienta de expresión
y acercamiento de estados mentales. Por eso, creo que habría aborrecido también ver 660
cómo en las últimas dos décadas las distintas formas de reduccionismo han achicado
los espacios de debate entre las diversas comunidades epistémicas surgidas en torno al
autismo. Cada cual consumiendo únicamente la información que refuerza sus teorías
y creencias previas … mientras las personas con autismo, familiares y profesionales
siguen confiando en que la investigación científica podrá aportarles claves útiles sobre 665
qué hacer.
Nota
1. Feinstein (2010) ofrece numerosos testimonios al respecto, y en Belinchón, Boada, García,
Fuentes, y Posada (2010) se ofrecen datos cuantitativos sobre España.
ORCID
Mercedes Belinchón http://orcid.org/0000-0001-5367-279X
Charman, T., Jones, C. R., Pickles, A., Simonoff, E., Baird, G., & Happé, F. (2011). Defining the 690
cognitive phenotype of autism. Brain Research, 1380, 10–21.
Courchesne, E., Pramparo, T., Gazestani, V. H., Lombardo, M. V., Pierce, K., & Lewis, N. E.
(2019). The ASD living biology: From cell proliferation to clinical phenotype. Molecular
Psychiatry, 24, 88–107.
Donvan, J., & Zucker, C. (2016). In a different key. The story of autism. UK: Penguin Books. 695
Feinstein, A. (2010). A history of autism. Conversations with pioneers. London: Wiley. (ed. esp.
revisada y ampliada, Ávila: Ed. Autismo Ávila, 2016).
Fletcher-Watson, S., & Happé, F. (2019). Autism. London: Routledge.
Grandin, T., & Panek, R. (2013). The autistic brain. London: Random House. (ed. esp.,
Barcelona: RBA, 2014). 700
Klin, A., Jones, W., & Lewis, P. (2018). Systems and methods for detection of cognitive and
developmental conditions. Atlanta, GA: Children’s Healthcare of Atlanta Inc. https://patents.
google.com/patent/US10022049B2/en
Nadesan, M. H. (2005). Constructing autism. London: Routledge.
Ortega, F. (2013). Cerebralizing autism within the neurodiversity movement. In J. Davidson, & 705
M. Orsini (Eds.), Worlds of autism (pp. 73–95). Minneapolis, MN: University of Minnesota
Press.
Prince, D. E. (2013). Autoethnographic reflections on academic writing and autism. In J. Davidson, &
M. Orsini (Eds.), Worlds of autism (pp. 319–330). Minneapolis, MN: University of Minnesota
Press. 710
Rivière, Á. (1978). Minusvalía del lenguaje y de las funciones perceptivas. Minusval, 26. [reed. en
M. Belinchón, A., Rosa, M. Sotillo & I. Marichalar, I. (Eds.) (2003), Ángel Rivière: Obras
Escogidas (Vol. I, pp. 1–5). Madrid: Ed. Médica-Panamericana].
Rivière, Á. (1997). El tratamiento del autismo como trastorno del desarrollo. In Á. Rivière, &
J. Martos (Eds.), El tratamiento del autismo (pp. 23–160). Madrid: IMSERSO-APNA. 715
Rivière, Á., & Belinchón, M. (1981). Reflexiones sobre el lenguaje autista. I. Análisis descriptivos
y diferencias con la disfasia receptiva. Infancia y Aprendizaje, 13, 89–120.
Rutter, M. (2011). Progress in understanding autism: 2007–2010. JADD, 41, 395–404.
Verhoeff, B. (2012). What is this thing called autism? A critical analysis of the tenacious search
for autism’s essence. BioSocieties, 7, 410–432. 720
Verhoeff, B. (2015). Fundamental challenges for autism research: The science-practice gap,
demarcating autism and the unsuccesful search for the neurobiological basis of autism.
Medicine, Health Care and Philosophy, 18, 443–447.
Volkmar, F., & MacPartland, J. (2014). From Kanner to DSM-5: Autism as an evolving diag-
nostic concept. Annual Review of Clinical Psychology, 10, 193–212. 725
Whaterhouse, L., London, E., & Gillberg, C. (2017). Letter to editor. Autism Research, 10, 1182.
Whyatt, C., & Torres, E. (2018). Autism research: An objective quantitative review of progress
and focus between 1994 and 2015. Frontiers in Psychology, 9, 1526.