Enactive Mind Autism: Autopoietic enactivism as a practical framework for autism healthcare

Autism healthcare has traditionally focused on individual biological and behavioral factors. In recent decades, there has been growing recognition that the outside world also plays an enabling if not constitutive role in the development of support needs. This broader view complicates healthcare delivery as the traditional person-centered focus 'diffuses' into the environment. An integrative approach, rooted in autopoietic enactivism, can provide guidance here - aimed at establishing stable, authentic, and health-promoting patterns of engagement between an autistic individual and their surroundings. Although the application of autopoietic enactivism has gained popularity among philosophers of psychiatry, its clinical consolidation remains limited. In addressing this gap, this paper presents a preliminary practical framework called Enactive Mind Autism (EMA). EMA consists of five dimensions to explore the relevance and implications of an autopoietic-enactive approach in autism healthcare: aspects of (1) ecological, (2) historical, (3) tangible-embodied, (4) intersubjective, and (5) socio-cultural life. To conclude, this paper draws a connection with design research to imagine new methodological directions for clinical research and practice, which, from an autopoietic-enactive perspective, is encouraged to take a phenomenological, pragmatic, and material turn.