Systemizing and empathy in forensic ASD talk

Purpose - Since often missed in forensic care settings, little is known about how the autism spectrum disorder (ASD) social and communication deficit impacts on rehabilitation work, particularly when accompanied by intellectual disability. The purpose of this paper is to show how Baron-Cohen's empathizing - systemizing theory can elucidate common processes in the interaction-based risk-reduction work carried on between ASD forensic patients and their clinicians. Design/methodology/approach - Conversation analysis (CA) is used to analyse the talk of two ASD men engaged in risk reduction work with their clinicians on a forensic intellectual disability ward in a medium secure psychiatric hospital in the UK. The clinicians include two forensic nurses and a speech and language therapist. Findings - Clinicians adapt to their patients' systematic processes particularly with regard to helping them understand complex social phenomena such as others' emotional displays and their understanding of empathy. Practical implications - Since ASD in forensic care is poorly researched, clinicians have little in the way of guidance about the interactive strengths and weaknesses of their ASD patients, despite risk reduction work being carried out by means of conversational interactions. This paper demonstrates some key aspects of ASD clinical interactions which may be used to inform treatment strategies elsewhere in the forensic establishment. Originality/value - By using Baron-Cohen's empathizing systemizing theory in combination with CA, this paper aims to bring understanding of ASD interaction up to date. This is of particular importance for this poorly researched patient group, who, because of the way in which they differ to standard psychiatric patients, are at risk of being detained for lengthy periods where treatment strategies are not designed to fit their social and communicative profiles.