‘I move therefore I am’: The anoetic ideomotor theory of autism

To the Editor

The emergence of the human capacities for self–other differentiation, bodily self-awareness and the capacity to imitate are arguably developmental phenomena. Based primarily on clinical observations of patients with autism and intellectual disability over a 25-year period, I propose a novel theory of autism: the ‘anoetic ideomotor theory’. It states that many of the characteristic features of autism can be explained by impairments in early consciousness and specifically in the embodied sense of self. Anoetic consciousness is defined as ‘the rudimentary state of affective, homeostatic, and sensory-perceptual mental experiences’ (Vandekerckhove et al., 2014). It precedes knowledge-based consciousness (known as ‘noetic’ awareness) and is critical to the development of higher forms of consciousness. In autism, I have observed that the embodied and psychological senses of self are in varying degrees poorly integrated and relatively undifferentiated. Impaired development of the anoetic, foundational awareness is proposed to arise from limitations in cortical processing of motor actions, particularly imitative behaviours. Paulus’ work in neurotypical infants demonstrates the fundamental importance of a functionally connected motor planning (ideomotor) system for social and emotional learning (Paulus, 2014). The theory differs from Ayres’ sensory integration theory in that the core impairment in the anoetic theory is the disordered development of a basic sense of self. The anoetic ideomotor theory also predicts an absent or poorly developed sense of personal agency and difficulties in self-referential cognition. Movement studies and interventions that broaden the memory store of motor actions and facilitate ideomotor processing, such as the work of Torres et al. (2013), not only provide a possible biological marker for autism, but also hint at novel intervention strategies. By facilitating motor praxis and a sense of body-based self within a neurorelational paradigm, it appears possible to enable or ‘kickstart’ other developmental processes, including socio-emotional development and communication. The missing link between social learning, embodied self-awareness, self–other awareness, awareness of ‘other’ as affectively arousing, and empathy is our sense of self arising through the activity of our ideomotor processing system and its functional connections in infancy. While genetic and environmental factors play multifactorial aetiological roles in causing autism, it is proposed that the impaired early development of self-awareness represents the central neurobiological mechanism underlying the autistic endo-phenotype.