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终身神经差异的感觉运动基础:深入了解自闭症

Sensory-movement underpinnings of lifelong neurodivergence: getting a grip on autism.

作者信息

Kapp Steven K

机构信息

Centre for Interaction, Development and Diversity, School of Psychology, Sport and Health Sciences, Faculty of Science, University of Portsmouth, Portsmouth, United Kingdom.

出版信息

Front Integr Neurosci. 2025 Apr 14;19:1489322. doi: 10.3389/fnint.2025.1489322. eCollection 2025.

Abstract

While the autism diagnosis emphasizes "deficits" in social communication, the article advances that sensory-movement differences underpin autism through a review of the following sources of evidence. This account critically challenges "autistic regression", with evidence that sensory-movement features appear by birth as the earliest signs of autism and underlie the behavioral differences used for diagnosis, which may reflect adaptations to inherent differences and misunderstandings from others. Sensory and motor differences are salient to autistic people, but they often go underrecognized by others. They cause cascading effects in infancy on behavior and communication through differences in sensorimotor learning, automatic imitation, eye contact, sensory perception, and interests. The article then explains how sensory processing differences may influence reduced perceptual narrowing, which involves a bottom-up information processing style grounded in the surrounding environment. Furthermore, this bottom-up processing may grow from reduced sensory integration in feedback loops potentially involving the cerebellum of the brain. The article then moves into implications for the widespread consequences of these inherent differences on quality of life. The article closes with implications for autism as a construct (including underestimated empathy and pain), testing the theory, providing sensory-sensitive support and acceptance of autistic people, and applications to diverse autistic people. The theory may apply particularly well to autistic women and girls, autistic people with speech divergence, autistic people with ADHD, and autistic people with co-occurring sensory and motor-related neurodivergences. Throughout the article, the theory also provides clinical, neurological, and experiential evidence for sensory and motor differences as lifelong, challenging the notion of "losing" (an) autism (diagnosis) as instead reflecting (risky and not necessarily "successful") camouflaging.

摘要

虽然自闭症诊断强调社交沟通方面的“缺陷”,但本文通过对以下证据来源的综述提出,感觉运动差异是自闭症的基础。这一观点对“自闭症退行”提出了严峻挑战,有证据表明,感觉运动特征在出生时就已出现,是自闭症最早的迹象,并构成了用于诊断的行为差异的基础,而这些行为差异可能反映了对自身固有差异的适应以及他人的误解。感觉和运动差异对自闭症患者来说很显著,但往往未被他人充分认识到。它们在婴儿期通过感觉运动学习、自动模仿、眼神接触、感官知觉和兴趣方面的差异,对行为和沟通产生连锁反应。然后本文解释了感觉加工差异如何可能影响感知缩窄的减少,感知缩窄涉及一种基于周围环境的自下而上的信息处理方式。此外,这种自下而上的处理可能源于潜在涉及大脑小脑的反馈回路中感觉整合的减少。接着本文探讨了这些固有差异对生活质量产生广泛影响的意义。文章最后阐述了对自闭症这一概念的影响(包括被低估的同理心和痛苦)、对该理论的检验、为自闭症患者提供对感觉敏感的支持和接纳,以及该理论对不同自闭症患者的应用。该理论可能特别适用于自闭症女性和女孩、有言语差异的自闭症患者、患有注意力缺陷多动障碍的自闭症患者,以及同时存在感觉和运动相关神经差异的自闭症患者。在整篇文章中,该理论还为感觉和运动差异是终身存在的提供了临床、神经学和经验证据,挑战了“失去”自闭症诊断这一观念,认为这反而反映了(有风险且不一定“成功”的)伪装。

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