3E-Cognition: Inclusive Neurodiversity Design
3E-Cognition: Inclusive Neurodiversity Design
DOI: 10.1111/ejn.16463
1
Centro de Estudios en Neurociencia
Humana y Neuropsicología (CENHN), Abstract
Facultad de Psicología, Universidad Diego The conventional medical paradigm often focuses on deficits and impairments,
Portales, Santiago, Chile
failing to capture the rich tapestry of experiences and abilities inherent in neu-
2
Escuela de Diseño, Facultad de
Arquitectura, Arte y Diseño, Universidad
rodiversity conditions. In this article, we introduce the 3E-Cognition perspec-
Diego Portales, Santiago, Chile, Salvador tive, offering a paradigm shift by emphasizing the dynamic interplay between
Sanfuentes 2221, Santiago, Metropolitan, the brain, body, and environment in shaping cognitive processes. The perspec-
Chile
3
tive fosters a more inclusive and supportive understanding of neurodiversity,
Institute of Cognitive Science,
Universität Osnabrück, Osnabrück, with potential applications across various domains such as education, work-
Germany place, and healthcare. We begin by introducing the 3E-Cognition principles:
4
Laboratorio de Neurociencia Social y embodied, environmentally scaffolded, and enactive. Then, we explore how the
Neuromodulacion, Centro de
Investigaci
on en Complejidad Social
3E-Cognition perspective can be applied to create inclusive environments and
(neuroCICS), Facultad de Gobierno, experiences for neurodiverse individuals. We provide examples in the realms
Universidad del Desarrollo, Santiago, of education, workplace, and healthcare. In all of these domains, spaces, meth-
Chile
5
odologies, epistemologies, and roles that cater to diverse needs and strengths
Universidad San Sebastian, Facultad de
Educaci
on, Concepcion, Chile can be designed using the 3E principles. Finally, we discuss the challenges and
benefits of implementing the 3E-Cognition perspective. We focus on the need
Correspondence
for technological advancements and research in complex real-world scenarios;
Francisco J. Parada, Ph.D., Centro de
Estudios en Neurociencia Humana y we suggest mobile brain/body imaging is a possible solution. We furthermore
Neuropsicología, Facultad de Psicología, highlight the importance of recognizing and valuing the diverse manners of
Universidad Diego Portales, Vergara
275, Postal code: 8370076, Santiago, Chile.
experiencing and interacting with the world, the promotion of diverse well-
Email: [Link]@[Link] being, and the facilitation of innovation and creativity. Thus, we conclude that
the 3E-Cognition perspective offers a groundbreaking approach to understand-
ing and supporting neurodiversity: by embracing the inherent
Abbreviations: ADHD, Attention-deficit/hyperactivity disorder corresponds to a neurodevelopmental disorder characterized by persistent patterns of
inattention, hyperactivity, and impulsivity that interfere with daily functioning or development.; HRV, Heart rate variability is the measure of the
variation in time intervals between consecutive heartbeats, reflecting the autonomic nervous system’s regulation of the heart.; VR, Virtual reality is a
technology that creates immersive, computer-generated environments that users can interact with using special equipment like headsets and
controllers.; STEAM, Educational approach that integrates science, technology, engineering, arts, and mathematics to foster creativity, critical
thinking, and problem-solving skills.; ASD, Autism spectrum disorder refers to a neurodevelopmental condition characterized by challenges in social
interaction, communication, and repetitive behaviours or restricted interests.; MoBI, Mobile brain/body imaging is a technological and
methodological framework that combines mobile neuroimaging, behavior, and motion capture technologies to study brain activity in conjunction
with physical movement in real-world environments..
A 3E perspective on neurodiversity
© 2024 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
Funding information
FJP is funded by the Agencia Nacional de interconnectedness of the brain, body, and environment, we can create a more
Investigacion y Desarrollo (ANID) inclusive and supportive world.
through Fondo Nacional de Desarrollo
Científico y Tecnologico (FONDECYT) KEYWORDS
Iniciacion en Investigaci
on program neurodiversity, 3E-Cognition, 4E-Cognition, applied neuroscience, mobile brain/body
project no. 11180620. AR is funded by the
imaging
Agencia Nacional de Investigaci on y
Desarrollo (ANID) through FONDECYT
regular project no. 1190610. AGC receives
funding from the Deutsche
Forschungsgemeinschaft (DFG, German
Research Foundation), project number
GRK 2185/2. MCE is funded by the
FONDECYT Regular project no. 1220113.
PSI is funded by the Agencia Nacional de
Investigacion y Desarrollo (ANID)
through FONDECYT Iniciaci on en
Investigacion program project
no. 11230607, project CONICYT PAI
PAI77190047, and from the Vicerrectoría
de Investigacion y Doctorados,
Universidad del Desarrollo, Concurso
Interno Proyecto Folio 23400178.
The historical underemphasis of philosophical practical implications, advocating for inclusive practices
primers such as ontology1 and epistemology2 in human and policies that recognize and accommodate the diverse
neuroscience has significantly impacted our understand- ways individuals experience and interact with the world.
ing of cognition and — of course — neurodiversity. As This article seeks to contribute to this evolving dia-
addressed by several classical, recent, and current theo- logue, highlighting the potential of the 3E-Cognition4 per-
retical discussions (Krakauer et al., 2017; Poeppel & spective for the understanding of neurocognitive processes
Adolfi, 2020; F. J. Varela et al., 1991; Cisek & in fostering a more inclusive and supportive society for
Hayden, 2022; Rose, 2012), it would be reasonable to say neurodiverse individuals (Grasso-Cladera et al., 2023).
that the philosophical foundations of neuroscience have This perspective is a pragmatic adaptation of the more
not been a central focus in the typical neuroscientist’s complex 4E-Cognition5 perspective (Gallagher, 2023;
agenda. However, by simply accepting the biomedical Newen et al., 2018), and it integrates the embedded and
model’s ontology, neuroscience has inherited a con- extended principles of the 4E perspective into a unified
strained comprehension of neurological diversity and its environmental scaffolding principle. In our quest to rede-
place in human existence.3 This lack of historical and fine the boundaries of psychological sciences, it becomes
critical perspective has inadvertently consolidated the imperative to underscore the significant potential that
biomedical model, propelling a narrow conceptualization lies in the 3E perspective for reimagining applied design
of ‘normal’ and ‘healthy’ brain function based on out- principles from the outset. We furthermore want to move
dated philosophical premises; a uniform standard of neu- away from traditional paradigms that have long inhibited
rological functioning without sufficient scrutiny of how innovation, proposing a shift towards a framework where
research methodologies and interpretations underpin design is not merely an afterthought but a foundational
these norms. This oversight not only simplifies ‘normal’ consideration. We envision psychologists and neuroscien-
to potentially reflect dominant socio-cultural standards— tists closely collaborating with architects, designers, clini-
implicitly biased towards certain racial, socio-economic, cians, urbanists, and others to develop research agendas
gender, and health conditions—but also neglects the that will inform the creation of new objects, devices,
richness of neurological diversity. Embracing more holis- spaces, experiences, and procedures with an inclusive
tic, complex, and modern philosophical frameworks, perspective.
human neuroscience and related fields can broaden their Hence, in this article, we will first delve into how the
scope to more comprehensive understanding of living 3E-Cognition offers a framework that acknowledges
beings. This shift is not only theoretical but has profound the interplay between brain, body, and environment, pro-
viding a more comprehensive view of neurodiversity.
1
Ontology refers to what objects will exist from a given perspective. For Then, we will focus on how the 3E-Cognition can be
the modern neuroscientist, a naturalist/materialist ontology applied to create inclusive environments in various sec-
(in opposition to dualist or idealist ontologies) allows the existence tors, specifically educational, workplaces, and healthcare.
of — say — brain circuits underlying cognition and can therefore can
The discussion will also touch on the practical challenges
and must be studied. In contrast, no form of ‘animal spirits’ or ‘élan
vital’ exists, and therefore, those entities cannot and should not be of implementing the 3E-Cognition, including technologi-
studied (Myers, 1900). Thus, ontology is about understanding the cal innovations and the need for empirical research that
‘being’ of things. For example, when we say ‘cognition’, what do we accommodates complex real-world situations.
mean? Is it just the brain in operation, or is it something more?
Regardless of the answer, given their ontology, for the modern
neuroscientist, élan vital will have nothing to do with it.
2
Epistemology refers to how we will acquire knowledge about the
1.1 | The 3E-cognition perspective for
objects that exist in the world. For the modern neuroscientist, brain the understanding of neurocognitive
circuits exist and can be studied using several neuroimaging methods in processes
combination with mathematical tools. In contrast, élan vital do not exist
and therefore there is no knowledge to obtain. However, since we know
Rooted in the broader and more intricate 4E-Cognition
that vitalism is part of our historical roots, we can study vitalism
through — say — history of philosophy.
perspective, 3E-Cognition6 simplifies and streamlines
3
Simply put, for the biomedical model, diseases and clinical conditions these concepts to create a more accessible and applicable
exist in the world and do not have a relational nature; they are intrinsic framework. The perspective incorporates the principles
properties of a system or being. Hence, being healthy can be clearly of embodied, enactive, and environmentally scaffolded
defined as not having such property, naturalizing the ontological objects cognition, focusing on the dynamic interplay between the
underlying the biomedical model. Those objects are biased towards the
ways of being of the late 1800s and early 1900s white rich cisgendered
4
heterosexual European males who thought and wrote most of the Embodied, environmentally scaffolded, and enactive.
5
concepts and ideas underlying the biomedical model. By accepting the Embodied, embedded, extended, and enactive.
6
biomedical model, human neuroscience also accepts its ontology. From now on, we will simply refer to the perspective as 3E-Cognition.
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PARADA ET AL. 4151
brain, body, and the environment. The 4E-Cognition per- the significant influence of the agent’s environment on
spective is a comprehensive framework that views cogni- cognitive functions (A. Clark, 2000; Thompson, 2010;
tion as not just a brain-centric phenomenon but as a F. J. Varela et al., 1991). In this sense, cognition is an
process that extends beyond the neural substrate. As emergent phenomenon that arises from the interaction
articulated by Bennett and Hacker (2022), a common and organization of multiple components (i.e., the mind-
mistake is to attribute psychological/cognitive properties brain, the organism’s biological sphere, and the ecologi-
or functions to individual parts of the brain, when those cal context in which it inhabits). By doing this, the 4E-
properties, functions, and/or processes actually belong to Cognition perspective understands the interaction
the whole organism. Furthermore, cognitive processes are between these components as the origin of properties,
inherently holistic, as no isolated brain region or body behaviours, and/or functions that cannot be predicted by
part would ever possess intrinsic functions analysing one of their components in isolation (i.e., it
(Pessoa, 2022). This is known as the mereological fallacy does not fall in the mereological fallacy — mistakenly
in neuroscience and emphasizes the need to understand attributing properties of the whole to individual parts —
the limitations of attributing human psychological and by offering a non-dualistic view to interpret brain activity
phenomenological experiences to individual brain parts as evidence of a whole organism’s active engagement
(Bennett & Hacker, 2022). Hence, the 4E-Cognition per- with its environment).
spective is a more comprehensive model that comprises The 3E perspective emerges as a pragmatic adaptation
four key principles: cognition is an embodied, embedded, of 4E-Cognition, integrating the embedded and extended
extended, and enactive phenomenon (Gallagher, 2023; principles into a unified environmental scaffolding princi-
Newen et al., 2018). The 4E perspective on cognition ple (Grasso-Cladera et al., 2023). This approach makes
highlights the dynamic interplay between the mind, the the complex principles of 4E more approachable and rele-
body, and the environment of the agent by (1) embracing vant to applied human neuroscience (Figure 1). In the 3E
the essential role of the brain and the agent’s biology and perspective, embodiment suggests that cognitive processes
ecological niches in shaping cognition, (2) addressing the are deeply rooted in the body’s physiology and are influ-
possibility of extending the cognitive processes beyond enced by the physicality of the body and its capabilities
the boundaries of the agent’s body, and (3) considering for action in the world. This challenges traditional views
F I G U R E 1 Graphical representation of the shift from 4E-cognition to 3E-cognition. Panels left and right show the components of the
4E and 3E approaches to the understanding of cognition, respectively. The embodied (i.e., the recognition of the integral role of the organism
in cognitive processes and the inseparable connection between the body and cognitive activities) and enactive (i.e., the active engagement of
individuals with their surroundings, viewing cognition as an ongoing, co-constructed process between the organism and its environment)
components present continuity between the 4E-3E cognition shifting. The notions of embeddedness (i.e., the significant influence of the
agent’s environment in cognitive processes) and extendedness (i.e., the possibility of extending cognitive processes beyond the boundaries of
the individual’s body), which are considered separately in the 4E perspective, are combined in the environmentally scaffolded concept
(i.e., the emphasis of supportive structures and resources provided by the environment, as a provider of cognitive scaffolding that shapes and
facilitated cognitive processes), offering a more precise and practical understanding of the relation of the ecological niche sphere of
cognition.
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4152 PARADA ET AL.
of cognition as solely internal information processing. 1.1.1 | Flesh and thought intertwined:
Environmental scaffolding refers to the idea that the envi- cognition unfolds within organisms
ronment plays a crucial role in shaping and supporting
cognitive processes. This includes all: natural, built, digi- The emphasis on the embodiment principle is one of the
tal, social, cultural, political, symbolic, and relational elements of continuity in the 4E- to 3E-Cognition shift.
environments where the organism is situated. These envi- Both perspectives highlight the fact that our cognitive
ronments can be actively used to configure and regulate processes are deeply rooted in the very physiology of our
specific cognitive abilities. Finally, enaction argues that bodies as autonomous organisms. As Varela et al. (1991)
cognition arises through active engagement and interac- argued, this means that the body, along with all its
tion between the organism and its ecological niche. It (neuro)physiological states arising from interactions
suggests that cognitive processes are not isolated within with the world (i.e., natural, built, digital, social, cul-
the brain but are dynamically shaped by the organism’s tural, political, symbolic, relational), is mechanically
body and environment (Figure 1). Under the premise of and constitutively linked to our experience (Parada &
the 3E perspective of cognition, the understanding of cog- Rossi, 2021). In simpler terms, all our cognitive pro-
nition as an emergent phenomenon from the interaction cesses, from thinking and reasoning to memory, are
of the different aspects of the organism finds a conceptu- influenced by our physicality and the possibilities it
alization that allows its practical implementation affords for action (Djebbara et al., 2022; Purdon
(Grasso-Cladera et al., 2023). This perspective emphasizes et al., 2013). This implies that visceral, sensory, and
the participatory nature of cognition, where the organism motor aspects are not mere outputs of cognitive proces-
actively explores and interprets its surroundings. sing, but rather play a central role in both its develop-
The 3E principles are in line with the concept of epi- ment and function.
stemic justice, which implies the just and equal treatment This emphasis on embodiment challenges traditional,
of people in the domain of knowledge and information. computational views of cognition that suggest it is pri-
The concept encapsulates the idea that everyone has the marily an abstract information processing activity
same chances to engage in the exchange of knowledge, (Adams & Aizawa, 2009; Gallagher, 2023). Recognizing
sees their viewpoints acknowledged and appreciated, and that our physiology forms the very foundation of our
does not face unjust biases or discrimination that experience (Purdon et al., 2013), cognitive research
impedes their capacity to contribute to or gain from the should therefore always include measures that capture
sharing of knowledge (Fricker, 2007). This both the mental and the physical, such as psychophysio-
neurodiversity-affirmative7 approach sees neurodiversity logical and neurobehavioral data (Azzalini et al., 2019).
as (i) a natural physiological variation in how the brain Following the premise of embodiment, research has
and body system operates, showcasing unique strengths investigated the bidirectional relationship between the
and challenges rather than deficits; (ii) a way of being brain and the organism’s physiology by examining
that does not require correction, but tailored support to the interactions among different systems. The autonomic
individual needs without enforcing conformity to stan- nervous system (ANS) has been pivotal in understanding
dard norms; (iii) particular neurobiological makeups, how various physiological activities influence the brain
inviting individuals to gain insights into their needs, (L. A. Shapiro, 2014; Foglia & Wilson, 2013;
developing strategies that suits them, advocating for their M. Wilson, 2002; A. Wilson & Golonka, 2013). For
rights to self-representation, and decision-making regard- instance, electrodermal activity (EDA) serves as a mea-
ing their lives; and (iv) a systemic issue that also goes sure of emotional regulation and stress (Caruelle
beyond personal factors, seeking to reform spaces like et al., 2019; Greco et al., 2021), while heart rate variability
schools, workplaces, and communities to be more wel- (HRV) is utilized as a physiological marker for stress,
coming, mitigating obstacles and barriers for people with emotion regulation, and cognitive processes (Azzalini
neurodiverse traits (Fricker, 2007; Pellicano & den et al., 2019; Laborde et al., 2017; Thayer et al., 2012). At
Houting, 2022). Considering the articulation with episte- the same time, different pathways, primarily afferent
mic justice and neuro-affirmative approaches, we will routes, have been explored to understand the embodied
now proceed to provide a more detailed description of dynamics associated with cognition. These include the
each one of the 3E principles. gut-brain axis (Azzalini et al., 2019; Breit et al., 2018;
Dinan & Cryan, 2017; Palacios-García et al., 2022;
Rebollo et al., 2021; Sarkar et al., 2018) and the heart-
brain axis (McCraty, 2019; McCraty et al., 2009; Tahsili-
7
Or simply, neuro-affirmative framework. Fahadan & Geocadin, 2017).
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PARADA ET AL. 4153
1.1.2 | Shaping minds by shaping worlds: contextual factors to better explain specific cognitive abil-
the power of environmental scaffolding ities. However, educational and urbanistic approaches
that embrace complexity still require stronger evidence.
Environmental scaffolding, a novel principle within the Therefore, within environmental scaffolding, the
3E perspective, bridges the gap between extendedness and active modification of certain aspects of the agent’s rela-
embeddedness. It encompasses all environments an tionship with the environment (Bertolotti &
organism interacts with, including the natural, built, digi- Magnani, 2017; Colombetti & Krueger, 2015; Laland
tal, social, cultural, political, symbolic, and relational et al., 2016; Odling-Smee et al., 2003) underscores the
domains. These environments essentially form the organ- crucial point that cognitive research should always con-
ism’s niche, a dynamic and interconnected space where sider environmental features as significant influences on
various modalities and dimensions intersect and influ- cognition (Charalambous & Djebbara, 2023; Djebbara
ence each other (Phoenix & Pattynama, 2006). Environ- et al., 2022).
mental scaffolding allows us to leverage and configure
environmental factors to shape, facilitate, or regulate spe-
cific activities or abilities (Coninx & Stephan, 2021; 1.1.3 | Enaction: bridging the gap between
Shvarts & Bakker, 2019; Sutton et al., 2010; Varga, 2019). organism and environment in the 3E
The 3E perspective emphasizes that we do not need to perspective
determine whether the skill or capacity facilitated by the
environmental scaffold is actively implemented by Similar to embodiment, the enaction principle remains
the agent, passively serves as a backdrop, or has a causal when shifting from the 4E to the 3E perspective. Enaction
link to the environment. The key takeaway is that cogni- stands as the final and integral principle of the 3E per-
tion is inherently situated and relational, and reducing it spective, merging the organism with its surrounding eco-
to a single dimension is reductive. Furthermore, environ- logical niche. Enaction builds upon the foundation laid
mental scaffolding emphasizes the bi-directional interac- by the embodiment principle, which states that the body,
tion between the organism and its environment. This along with all its neurophysiological states influenced by
means that agents actively shape their environments, the natural, built, digital, social, cultural, political, sym-
adapting to their niche while simultaneously shaping it bolic and/or relational environments, is intricately tied to
through their actions and interactions (Sterelny, 2010; the organism’s experiential reality (Parada &
Gibson, 1979; Varela et al., 1991; Lewontin, 1983; Odling- Rossi, 2021). Furthermore, the environmental scaffolding
Smee, 1988). Evidence supporting the environmental principle asserts that the intersection and interactions of
scaffolding principle can be found in different fields. For these diverse environmental aspects play a pivotal role in
example, in education, the concept of the environment as shaping, facilitating, and guiding specific activities or
the “third teacher” (e.g., Tarr, 2014) indicates how the capacities (Grasso-Cladera et al., 2023). Thus, the enac-
design and conceptualization of spaces can encourage, tive approach not only links but also coherently articu-
obstruct, or support interactions in early childhood. A lates the relationship between an organism and its
concrete example is the Reggio Emilia approach to edu- ecological niche. This means that cognition is seen as a
cation (Moss, 2016), where the use of environmental cues phenomenon not restricted to the brain’s intrinsic areas
(i.e., ‘provocators’) triggers curiosity, exploratory behav- but as a process deeply intertwined with the body and
iour, and discussion among children (Mäkelä et al., 2014; the environment through active engagement
Robson & Mastrangelo, 2018). Another concrete example and interaction.
of environmental scaffolding is the design of interactive Echoing the thoughts of Varela et al., (1991), Di
installations in public parks — such as sensor-activated Paoloet al., (2017), Gallagher, (2023), and others, cogni-
water fountains or musical playgrounds — that facilitate tion is understood not as a mere product of internal brain
physical activity and strengthens community bonds by computations or representations but as a result of the
bringing people together in playful and cooperative envi- organism’s dynamic interaction with its environment.
ronments (Masullo et al., 2021; Rubegni et al., 2011; Van This perspective emphasizes that the psychophysiological
Renswouw et al., 2021). Certainly, more empirical and neurobehavioral mechanisms underlying cognition
research is needed, and that is one of the main reasons are actively shaped by the organism’s exploration and
the neuroscience community must embrace the complex- interaction with its world. This ongoing engagement
ity and hypotheses that concepts such as environmental implies a process of participatory sense-making, where
scaffolding afford. Recent work by the neuroergonomics the organism’s historical context, needs, and goals play a
(Wascher et al., 2023) or the spatial navigation (Coutrot crucial role in interpreting and assigning meaning to its
et al., 2018) communities uses spatial features and socio- ecological niche (De Jaegher & Di Paolo, 2007).
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4154 PARADA ET AL.
Consequently, research in cognition should aim for a bal- facilitates the enactment of daily physical movements
anced approach that incorporates both laboratory studies and activities, promoting recovery through active engage-
and real-world experimental settings (Gramann ment and adaptation.
et al., 2014; Makeig et al., 2009; Parada, 2018; Stangl
et al., 2023).
Thus, the 3E-Cognition principles provide a robust 2 | FOSTERING I NCLUSIVE
and holistic framework for understanding the complexities E N V I R O N M E N T S T H R O U G H TH E
of human cognition. It acknowledges the significant roles 3E-C OG NITION PERSPECTIVE
of the body and environment in cognitive processes,
thereby offering a more inclusive approach to studying, The 3E-Cognition perspective — grounded in the under-
understanding, and supporting neurodiversity. This per- standing that cognitive processes are deeply intertwined
spective not only enriches theoretical understanding but with the body, the environment, and active engage-
also holds the potential for practical applications in creat- ment — can revolutionize the way different settings and
ing more inclusive and supportive environments for neu- systems are designed and implemented. These philosoph-
rodiverse individuals across various domains. In the next ical principles for understanding cognition can truly
section, we will explore the application of the 3E- become design principles.
Cognition model in crafting inclusive environments across
various sectors. For the sake of space, we will only focus
on educational settings, workplaces, and healthcare facili- 2.1 | Learning unbound: the 3E
ties. The following section will also address the practical framework for inclusive and effective
challenges associated with implementing the 3E-Cognition education
framework, such as the need for technological advance-
ments and empirical research that effectively captures and During childhood and adolescence, school becomes an
responds to the complexities of real-world scenarios. important environment in which all kinds of social inter-
Evidence supporting the enactive approach is still actions take place. As a natural environment replication,
scarce as neuroscientists need to further engage in these schools should be the place in which social encounters
types of research programmes. Nevertheless, evidence can occur among individuals with different cultural back-
can be found in fields such as education and neuroreh- grounds, racial and sociocultural origins, religious beliefs,
abilitation. Within education, interactive learning strate- learning abilities, etc. However, — historically — formal
gies have shown enhanced teaching and learning education has tended to standardize and homogenize stu-
processes (Abykanova et al., 2016). Even when different dents, moulding them to fit predetermined expectations
strategies are implemented (e.g., active non-flipped class- in terms of characteristics, outcomes, behaviour, and
room compared against active flipped classroom), the responses to teaching methods (Johnson &
benefits observed in both classroom types likely stem Majewska, 2022). In this context, certain marginalized
from engaging teaching methods rather than the groups, including individuals with disabilities, ethnic,
sequence of instructor involvement (Jensen et al., 2015). and linguistic minorities — as well as girls and women —
This — according to the enactive principle — suggests were at a heightened risk of being excluded from the edu-
the key factor in enhancing learning is active engage- cational space (Blanco, 2004). Educational inclusion aims
ment, not the format of the classroom. Another concrete to overcome this conventional approach by transcending
example can be found in the field of neurorehabilitation mere access to traditional schools for traditionally mar-
of patients with stroke, traumatic brain injury, or cerebral ginalized student groups. It involves a transformation of
palsy, where survivors of brain lesions or motor impair- the educational system to recognize and address the
ments have engaged in virtual reality (VR) environments diverse learning needs of every student. The core of an
designed to simulate daily activities (de Araújo inclusion perspective in education lies in fostering
et al., 2019; Montalban & Arrogante, 2020; Ravi an inclusive environment that goes beyond merely elimi-
et al., 2017). Meta-analyses of studies indicate that neu- nating barriers. It involves an active promotion of a
rorehabilitation using virtual reality can enhance physi- seamless integration and participation of all students,
cal function in lesion survivors. The effectiveness of VR is regardless of their backgrounds (Johnson &
influenced not only by technological aspects but also by Majewska, 2022). Adopting the 3E-Cognition perspective
its ability to simulate real-life activities in a controlled, can lead to a radical transformation on how education is
adaptable environment. This allows patients to practice implemented, making it more inclusive and effective for
and regain movements in a manner that closely mirrors students with neurophysiological and neuro-
their daily routines (Voinescu et al., 2021). Thus, VR morphological diversity.
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PARADA ET AL. 4155
Formal traditional educational settings are an unbal- affect the construction of learning, motivation, and inclu-
anced mixture of late-1800s infrastructure,8 late-1900s sion of students; therefore, modeling of the physical envi-
power relationships,9 and some wide-ranging ronment of learning is essential, since it is a third
10
technology, all blended in a bizarre, non-intended man- educator (Barrett et al., 2017; Ferguson et al., 2013;
ner! Environmentally scaffolded learning spaces imply Lewinski, 2015; Li & Sullivan, 2016; Manns et al., 2016;
that schools and other educational environments have to Mehta et al., 2015; Naïr, 2016; O’Donnell Wicklund
be designed based on robust evidence (e.g., systematic Pigozzi and Peterson, Architects Inc, VS Furniture, and
reviews, meta-analyses) in order to cater to a variety of Bruce Mau Design, 2010; Piderit-Moreno et al., 2023).
neurodiverse needs, incorporating elements like sensory- Physical space will furthermore provide a range of mate-
friendly zones or technology-assisted learning for stu- rials that appeal to the different perceptual and learning
dents who benefit from these adaptations. Research on capacities, such as visual aids, auditory tools, and hands-
the future architectural and design principles for educa- on materials. All of these can support the diversity
tional environments is still much needed (Young & encountered in modern educational settings, providing
Cleveland, 2022). In fact, there is evidence on how the the physical space to recognize and accommodate the
characteristics of the infrastructure, furniture, and layout unique learning needs of neurodiverse students through
of the space impact the quality of education, since they individualized teaching methods and support systems
(R. Martin & Wilkins, 2022; C. S. Martin, 2016). For
8
Educational built spaces are typically rigid, imposing structures that example, Susquehanna University’s library transformed
resemble incarceration or hospitalization environments. This situation its space for neurodiverse students by adding fidget toys,
is very common in the global south. Furniture design is outdated, often occupancy counters, and sensory-friendly study rooms
assuming passiveness in learning. Classrooms are often composed of (Boyer & El-Chidiac, 2023). Such reorganizations
rigid layouts with rows of desks pointing towards the educator, and
increase engagement among both students and teachers,
limited access to technology that hamper active learning and
collaboration. Economic disparities limit investment in educational
enhance attentiveness, and promote interactive behaviors
infrastructure and resources, perpetuating the cycle of disadvantage for (Boyer & El-Chidiac, 2023; Kokko & Hirsto, 2021;
neurodiverse individuals and completely ignoring any special needs. Nordquist et al., 1991). Similarly, environmental changes
Furthermore, conflict-affected areas (e.g., the Yemen and Ukraine wars; in the classroom regarding sound (e.g., installation of
the Nagorno Karabakh, Ethiopia, Democratic Republic of the Congo sound absorbing walls) and luminosity
and Great Lakes conflicts; the Haiti, Iran, Pakistan, Sahel crises; and the
(e.g., incorporation of halogen light) had a positive
Gaza genocide, to name a few) often struggle to provide even basic
education, with schools destroyed or repurposed. Furthermore, the impact on attention and engagement of students with
increasing conservative and fascist global resurgence means retrograde autism or dyspraxia (Kinnealey et al., 2012). For example,
cultural values at all levels, implying resistance to new pedagogical improving acoustic quality significantly impacted autistic
approaches and/or a lack of awareness about their benefits. students, further highlighting the need for improved
9
The traditional ‘sage on the stage’ model, where teachers hold all the design and material specifications and/or reorganizing
knowledge and students passively receive it, still prevails in many
classroom environments (Lekan-Kehinde et al., 2023).
classrooms (McWilliam, 2009). This implies that students have little-
to-nothing to say in curriculum design, learning activities, or classroom Another relevant aspect of traditional educational
rules, reinforcing and perpetuating hierarchical structures. models is the prioritizing of disciplines with direct
Unfortunately, corporal punishment or harsh sanctions for impacts on economic growth, often sidelining arts,
disobedience in the classroom is present worldwide: in the humanities, and social sciences. STEM (science, technol-
United States, school corporal punishment is currently legal in 19 states
ogy, engineering, and mathematics) educational models
leading to over 160,000 children to be subjected to corporal punishment
in schools each year (Dietz, 2000; Gershoff & Font, 2016; Humble, 2013;
perfectly reflect this tendency (Videla et al., 2021). The
Sanapo & Nakamura, 2011; Sultana et al., 2019). 3E-Cognition perspective challenges this reductionist
10
Interestingly, a wide range of technologies are being integrated in view on societal growth by emphasizing the holistic
worldwide classrooms, fueled — in part — by the recent COVID-19 development of students. It advocates for an integrated
pandemic (Chandra et al., 2022; Haleem et al., 2022; Han & Sa, 2022).
approach that values the arts and humanities as crucial
Highly dependent on economic status of the educational communities’
actors, range from interactive projectors to smartboards and chalk
components in fostering meaningful education, where
blackboards, and from virtual reality to online platforms and low- self-awareness, empathy, and interpersonal skills, ques-
resolution paper photocopies; these technologies have evidenced tioning, and exploration are encouraged. In contrast,
significant structural gaps and inequalities: in digital access and usage; STEAM education appears as a stronger model, where
urban–rural; educator skills; language barriers; and gender, to name a students engage in physical activities such as art creation,
few (Brussevich et al., 2019; Elena-Bucea et al., 2021; Lembani
dance, and/or drama, linking cognitive processes with
et al., 2020). More recently, artificial intelligence applications such as
OpenAI’s chatGPT, Anthropic’s Claude, or Google’s Gemini are being bodily experiences (Videla et al., 2021). Additionally, the
used in supervised and unsupervised manners worldwide, presenting sensory benefits of engaging in the arts cannot be over-
relevant opportunities and challenges to education (Rasul et al., 2023). stated. Activities such as painting, sculpting, and music
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4156 PARADA ET AL.
stimulate multiple senses, enhancing sensory integration morphological makeup will provide a unique richness to
and motor skills (King & Parada, 2021; Schneider each class project, where each learner is the zone of prox-
et al., 2007; Wan & Schlaug, 2010; Zatorre et al., 2007). imal development (Lee, 2012). Curiosity will finally
Creativity and expression through the arts allow students emerge as a driving force in education (Zurn &
to explore and communicate their emotions, fostering Shankar, 2020).
self-awareness and empathy (Corral et al., 2023; Jin & Thus, the 3E-Cognition perspective can enhance crea-
Ye, 2022; Tsatsou-Nikolouli & Mavrogeni, 2021). For tivity, critical thinking, and emotional intelligence, which
instance, in a recent randomized control trial, special are essential skills in today’s complex world. In a 3E-
needs students went through a weekly 10-week struc- Cognition educational setting, students are not just pas-
tured group art therapy program. Results show the effi- sive recipients of information but active participants in
cacy of art therapy in an educational context for their learning journey. This approach cultivates a sense
improving social–emotional competencies in this group of wonder and active inquiry, encouraging students to
of students with neuro-psycho-motor deficiencies engage with their learning environment in a more mean-
(Lavric & Soponaru, 2023). ingful and personalized way, and agency development
Furthermore, meaningful learning can happen (Vaughn et al., 2020). As with inclusive education, in the
through activities that connect cultural heritage, local 3E-Cognition educational setting, neurodiversity is no
historical events, or narratives to physical experiences, longer an issue, but an asset. Inclusive education is not
such as reenactments or interactive storytelling. In this merely an ambition exclusive to a specific school popula-
sense, the approach of funds of knowledge and identity tion facing (dis)ability or various learning difficulties. It is
in education can contribute to valuing and including in a perspective aimed at transforming educational systems
teaching practices and school curriculum family and so that all students, without restrictions or limitations,
community knowledge and experiences that students have comparable and quality opportunities for the full
bring from contexts outside of school and that support development of their personalities (Ainscow, 2020;
the strengthening of their identities (Moises Esteban- Sarrionandia, 2017). The above will allow us to overcome
Guitart et al., 2023; Muñoz et al., 2022). Hence, using the the deficit approach and value the diversity of practices
funds of knowledge approach has significantly impacted and ways of feeling, thinking, and learning of students
fostering students’ reflection, appreciation, and reinter- (Lillis, 2019; Sito & Mosquera, 2021).
pretation of their families and communities (Castillo Taking all of these together, we can envision a middle
et al., 2023), as well as shaping prejudices and stereotypes school whose classrooms are designed with movable fur-
(Templeton, 2013). Likewise, active and experiential niture and sensory-friendly zones (e.g., adjustable light-
learning, such as project-based learning where students ing to reduce sensory overload). This would allow
actively participate in social surveys or community pro- teachers to reconfigure the space for various activities,
jects, field trips, role-playing, and simulations allow stu- from group work to individual study, accommodating dif-
dents to actively engage with the material, making ferent individual styles and sensory needs. The curricu-
learning more dynamic and meaningful. Such practices lum is based on active learning and STEAM (science,
will directly lead to interdisciplinary learning, where technology, engineering, arts, and mathematics) educa-
learners are encouraged to explore connections between tion, emphasizing the arts alongside traditional STEM
arts, humanities, and social sciences fostering a culture of subjects to foster technical, scientific and humanistic
curiosity and broadening their understanding of complex development. Activities such as painting, sculpting, and
concepts. The natural immersion in complexity will pro- music, stimulating multiple senses and enhancing motor
mote diverse ranges of critical thinking and analytical skills (King & Parada, 2021; Videla et al., 2021) are
skills, encouraging students to question, analyse, and hands-on projects that connect learning to real-world
synthesize information from various sources, developing experiences and their cultural backgrounds (Moisès
their multiliteracies (Baez-Bargellini & Meneses- Esteban-Guitart & Moll, 2014).
Arévalo, 2023; Kalantzis et al., 2020; Zhang et al., 2019).
In this sense, the promotion of multiliteracies has shown
potential for the development of critical thinking, the 2.2 | Beyond accommodation, embracing
integration of technologies, the inclusion of those who potential: 3E-cognition for
are more disadvantaged, and even for increasing the stu- neurodiverse teams
dents’ engagement in their learning processes, among
other benefits (Kesler et al., 2016; Kohnen & Lacy, 2018; Embracing the 3E-Cognition principles can be a game-
Reyes-Torres & Raga, 2020; Zammit, 2011). Hence, each changer for both neurodiverse employees and the organi-
learner’s background and neurophysiological/ zations they work for. This framework emphasizes
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PARADA ET AL. 4157
understanding and supporting the unique cognitive, scaffold their employees’ abilities, disabilities, and styles
physical, and sensory experiences of individuals in the using inclusive communication tools, such as visual aids,
workplace. This is not just about doing the right thing for written instructions, mobile applications, artificial
individuals; it is about unlocking the immense talent and intelligence-based assistants, and text-to-speech software
diverse perspectives that neurodiversity can bring to any (Coplan et al., 2021). By creating an environment that is
team. Research by de Beer, Scott, and others (de Beer responsive to the needs of all employees, organizations
et al., 2022; Scott et al., 2019) highlight how the work can foster a culture of inclusivity and diversity that pro-
environment, including both physical and social aspects, motes wellbeing. Furthermore, growing evidence indi-
plays a critical role in enabling neurodiverse individuals cates that wellbeing in the workplace is conducive to
to thrive. Their ability to find and maintain meaningful productivity and efficiency (Isham et al., 2021; Isham
employment hinges on it. This is where 3E-Cognition et al., 2019; Papagiannidis & Marikyan, 2020).
design principles come in. By applying them, we can Beyond the physical/structural scaffolding, the enac-
effectively bridge the gap between individuals and their tion principle means providing opportunities for all
surroundings. We can break down barriers and build up employees to actively participate and contribute their
facilitators, ultimately leading to improved employability unique perspectives and skills. This is particularly impor-
rates and job satisfaction for neurodiverse people. Specifi- tant for neurodiverse employees, who may be creative
cally, the environmental scaffolding principle can guide and may have unconventional — yet valuable —
the efficient and evidence-based design of workspaces approaches to problem-solving. Hence, offering tailored
that are adaptable to diverse neurological and neurophys- support for neurodiverse individuals to excel in their
iological needs. roles, such as assistive technologies, mentorship pro-
Designing physical environments is not only func- grams, and customized training sessions, can have a rele-
tional but also supportive of various cognitive styles and vant impact on innovation and efficiency
preferences, promoting mental health in the work envi- (Honeybourne, 2019). For example, organizations can
ronment, as well as performance and an increase in job invest in research to develop specific software applica-
retention (Kropman et al., 2023). A systematic review tions that can aid in organizing tasks or goals, or can
conducted by Weber et al. (2022) indicates that environ- adapt flexible schedules for certain workers, significantly
mental accommodations can lower sensorial stress levels improving the work experience for neurodivergent
generated by noise and visual stimulation. Economic individuals.
changes such as earplugs and/or noise-cancelling head- Organizations can also leverage the unique strengths
phones make a significant difference. Likewise, flexible and talents of neurodiverse individuals by creating roles
lighting options exemplify environmental adaptations by or projects that align with their specific skills and inter-
allowing employees to tailor their lighting conditions to ests. This not only maximizes their potential but also con-
individual sensory preferences, enhancing comfort and tributes to innovation and growth within companies.
productivity. Studies have shown that neurodiverse indi- Evidence shows that work-related strengths of neurodi-
viduals often have heightened sensory sensitivities, mak- verse and neurotypical individuals can be combined in
ing traditional lighting setups potentially distracting or work teams, improving the overall performance of the
discomforting. Adjustable lighting systems, including group (Austin & Pisano, 2017; Hendricks, 2010;
dimmable lights and a choice between different light Tomczak & Kulikowski, 2023). For example, monotonous
temperatures (e.g., warm, cool, or natural daylight), and repetitive tasks might be highly demandant for neu-
enable employees to create a workspace that minimizes rotypical employees, but they can be an asset for neurodi-
sensory stress and maximizes focus (Joines et al., 2015). verse individuals since might promote high
Furthermore, providing quiet spaces can help neurodi- concentration for longer periods of time conducting well-
verse employees to escape the — sometimes chaotic — structured and repetitive tasks (Hendricks, 2010; Scott
ambience of open-plan offices to concentrate or manage et al., 2015). Hence, embracing neurodiversity in this way
sensory overload, as well as lowering stimulation over- can lead to the development of novel solutions and per-
load and social requirement (Petty et al., 2023). Adapting spectives, driving forward-thinking and competitive
the environment to individuals inhabiting and using advantage.
those spaces can also have a cumulative beneficial impact Additionally, organizational wellness programs that
on other aspects of work, as it can decrease sensory pro- acknowledge the interplay between physical health and
cessing demands for employees. For example, by reduc- cognitive functioning are essential. These could include
ing the distraction, discomfort and/or stress generated by ergonomic workstations designed to reduce physical
some elements of the environment, such as flickering strain, stress management programs tailored to individ-
lights or noises. Moreover, inclusive organizations can ual needs, and activities that promote physical well-
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4158 PARADA ET AL.
being, such as yoga classes, sensory restriction spaces, abilities, and needs that characterize neurodiverse
and/or walking meetings. Such initiatives can mitigate individuals.
work-related stress, which is often a significant barrier to Training healthcare providers in this ethico-
productivity, particularly for neurodiverse individuals onto-epistemology is a critical step towards achieving this
who might experience stress differently. Thus, applying goal. The 3E perspective goes beyond mere understand-
the 3E-Cognition principles in the workplace is not just ing of clinical symptoms and treatment protocols; it
about creating a supportive environment for neurodi- involves empathizing with the patient’s lived experience,
verse employees; it is about recognizing the value and considering their narratives, and valuing their unique
potential that neurodiversity may bring to an organiza- perspective (de Haan, 2020). Indeed, expressive and auto-
tion. By embracing and accommodating the varied cogni- biographical writing has been shown to have therapeutic
tive and sensory experiences of their workforce, properties and contribute to the personal development of
companies can foster a culture of inclusivity, innovation, individuals, the processing of their life experiences, and
and diversity. This approach may lead to enhanced the improvement of their health (Jean Clandinin, 2006;
employee satisfaction and well-being, increased produc- Pennebaker, 2018; Pennebaker & Smyth, 2016; Moisès
tivity, and more dynamic, modern, creative, and adapt- Esteban-Guitart & Moll, 2014). This training would equip
able organizations. healthcare professionals with the skills to see beyond the
Taking all of these together, we can envision a com- conventional diagnostic categories and appreciate
pany that — at the global level — communicates using the individuality of each neurodiverse patient. Such a
visual aids, written instructions, uses technology effi- perspective is not only more respectful but also more
ciently, and has implemented AI-based assistants to sup- effective, as it leads to a deeper understanding of the
port diverse communication styles. This allows patient’s condition, resulting in more accurate diagnoses
employees — regardless of their cognitive abilities — to and more personalized treatment plans. Personalized
access, use, and process information effectively. At the treatment plans — crafted with an understanding of the
local level, each workstation is equipped with dimmable patient’s unique context — are essential in catering to
lights and adjustable colour temperatures, adjustable the specific needs of neurodiverse individuals and realis-
desks, and ergonomic chairs, ensuring physical comfort tic, meaningful possibilities for scaffolding. These plans
and reducing strain. Furthermore, similar to smoking would consider not only the medical or behavioural
rooms at airports, there are several soundproof quiet aspects of neurodiversity but also the social, emotional,
rooms as well as incorporating activities such as walking and environmental factors that affect the individual’s
meetings. Also, new employees receive tailored training well-being. For example, sensory sensitivities —which
sessions and mentorship programs — with experienced are common in autistic individuals — might be over-
mentors — supporting diverse employees in developing looked in a standard treatment approach but are crucial
their skills and confidence, as well as providing guidance for their comfort and well-being (Morgan, 2019). Recog-
and support, enhancing their professional and personal nizing and accommodating such needs can drastically
growth. improve the healthcare experience for neurodiverse
patients.
Furthermore, improved patient-provider communica-
2.3 | From deficit to diversity: how the tion is another significant benefit of the 3E perspective.
3E perspective can revolutionize Effective communication is foundational to quality
neurodiversity healthcare healthcare (de Haan, 2020), and this is especially true for
neurodiverse individuals, who may have unique ways of
Healthcare systems and providers stand at a pivotal point processing information and expressing themselves.
where the adoption of the 3E perspective could signifi- Healthcare providers trained in the 3E-Cognition per-
cantly enhance the support and care for neurodiverse spective would be better equipped to adapt their commu-
individuals. However, adopting the 3E principles implies nication style to meet the needs of their neurodiverse
a paradigm shift in how healthcare professionals perceive patients, fostering a more inclusive and supportive
and interact with cognitive phenomena in general and healthcare environment. This could involve the use of
neurodiversity in particular. Traditionally, the medical visual aids, simplified language, or allowing more time
model has often viewed neurodiversity through a deficit for patient responses, among other strategies. Moreover,
lens, focusing primarily on the challenges or impairments advocating for patient-centred care, where the voices of
associated with these conditions. The 3E perspective, neurodiverse individuals are not just heard but actively
however, advocates for a more holistic and inclusive integrated into decision-making (De Jaegher, 2023), is a
approach, recognizing the rich tapestry of experiences, crucial aspect of supporting ethical and epistemological
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PARADA ET AL. 4159
integrity in healthcare. This involves respecting the improved social fluency, as these rules can overlook the
autonomy of neurodiverse individuals and acknowledg- complexity and lived experience of social interactions
ing their right to be active participants in their healthcare (Koenig et al., 2009). Moreover, evidence has shown that
(Milton & Moon, 2012). It also means involving them in the attempts to camouflage, mask, or conceal certain per-
discussions about their treatment options, considering sonality characteristics related to a neurodevelopmental
their preferences and concerns, and working collabora- condition are associated with worse mental health out-
tively to develop care plans that align with their values comes (Cook et al., 2021). Specifically, in the case of
and life goals. autism spectrum disorder (ASD), these efforts to ‘cover’
Taking all of these together, we can envision a health- certain autistic features involve a significant cognitive
care clinic that is designed with sensory sensitivities in effort, which can lead to heightened stress responses and
mind. Waiting areas and consultation rooms are diminished mental well-being (Cook et al., 2021). In addi-
equipped with adjustable lighting, soundproofing, and tion, it can negatively impact self-identity development
calming décor to create a comfortable environment for (Costa-Cordella et al., 2023; Hull et al., 2019, 2017). This
patients. Among the services that are offered, expressive evidence reveals that a limited perspective to consider
and autobiographical writing therapies are a part of its individuals in terms of exclusive and hierarchical catego-
mental health services. Patients are encouraged to ries (abilities and disabilities, typical and atypical) is not
express their experiences (via writing or any other media capable of responding with equity to neurodiversity
of their preference), improving emotional regulation and (Sarrionandia, 2017). In this context, the 3E perspective
self-awareness and directly impacting their health pro- criticizes traditional models of cognition for precluding
cesses. Likewise, healthcare providers are trained to use researchers from recognizing and appreciating the
inclusive communication strategies (e.g., visual aids, sim- engagement of neurodiverse individuals as social capaci-
plified language) and allowing extra time for patient ties cannot be captured by abstract rules but are
responses. This ensures that patients can express their grounded in lived social experiences (e.g., physical and
needs and preferences effectively. Treatment plans are sensory experiences, contextual and environmental fac-
developed with a comprehensive understanding of each tors, and interactions and tools that extend cognitive pro-
patient’s unique context, considering medical, social, cesses). Finally, because cognitive phenomena are shaped
emotional, and environmental factors (e.g., an ADHD by the organism’s history and environment, the 3E per-
patient receives a personalized care plan including beha- spective acknowledges how each individual experiences
vioural therapy, environmental adjustments at home and and interacts with the world. A key concept of the Enac-
work, and regular follow-ups to monitor progress tive approach — participatory sense-making11 — is a
and adjust the plan as needed). concrete strategy to counter the homogenizing tendencies
of traditional approaches to cognition (De Jaegher & Di
Paolo, 2007), encouraging us to value the diverse ways
3 | DISCUSSION both neurotypical and neurodiverse individuals engage
with their surroundings. This is, the importance of recog-
The 3E-Cognition perspective offers an approach to nizing and valuing the diverse lived experiences, partici-
understanding and supporting neurodiversity, fundamen- patory interactions, and context-dependent ways both
tally differing from traditional models. Unlike conven- neurotypical and neurodiverse individuals engage with
tional deficit-focused frameworks, the 3E perspective their environment and with others.
recognizes the rich tapestry of experiences, abilities, and Thus, the 3E-Cognition perspective on neurodiversity
contexts that shape cognitive phenomena. The 3E- offers a profound and transformative framework for
Cognition perspective criticizes the objectivist and individ- understanding and supporting neurodiverse individuals
ualistic theories in traditional neurobehavioral research across various contexts such as education, workplace,
that informs neurodiversity theories. These often start and healthcare. This approach, grounded in recognizing
from a detached view of the human psyche and social diverse forms of participation, engaged epistemology,
world. These theories, exemplified by the well-known countering deficit-based views, and supporting ethical
Theory of Mind (Baron-Cohen, 2000), tend to view neuro- and epistemological integrity, provides a comprehensive
diverse individuals primarily in terms of deficits, espe- roadmap for creating more inclusive and respectful envi-
cially in social interactions. Such an approach is seen as ronments for neurodiverse individuals. Nevertheless,
limited because it overlooks the lived experiences and human neuroscience still needs to provide specific
social engagement of neurodiverse individuals. It is often
suggested that teaching social interaction ‘rules’ to neu- 11
The active and dialogical creation of meaning through interaction
rodiverse individuals does not necessarily lead to with others and the environment.
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4160 PARADA ET AL.
paradigms and approaches for applied research. We think participation of neurodiverse individuals. By understand-
that the mobile brain/body imaging (MoBI) framework is ing and valuing different forms of engagement and com-
an exciting and innovative avenue for advancing our munication, employers and coworkers can create a more
understanding and support of neurodiverse individuals in inclusive and supportive workplace culture. This perspec-
the real world (Gramann et al., 2021; Makeig et al., 2009; tive urges organizations to implement policies and prac-
Parada & Rossi, 2021; Stangl et al., 2023). MoBI is a tices that acknowledge the unique talents and needs of
cutting-edge framework that combines brain imaging neurodiverse employees, such as flexible work arrange-
with lightweight neurobehavioral sensors ments, tailored communication strategies, and supportive
(e.g., electroencephalogram (EEG), functional near- social environments (Milton & Moon, 2012). Emphasiz-
infrared spectroscopy (fNIRS), eye-tracking, electrocar- ing ethical and epistemological integrity, businesses can
diogram (ECG); Grasso-Cladera et al., 2023), allowing for foster a workplace where neurodiverse individuals are
the study of cognitive processes in mobile and real-world not only employed but also empowered and valued for
settings. MoBI aligns perfectly with the 3E perspective, as their unique contributions. MoBI can be used to study
it can be used from the laboratory to the real world, the dynamic interactions between neurodiverse
e.g., inside the classroom (Davidesco et al., 2021; Dikker employees and their work environments (Ahn
et al., 2017), in workplaces (Chuang & Ihme, 2018; et al., 2018; Dumas et al., 2011; I. Clark & Dumas, 2015).
Wascher et al., 2023), and with individuals, dyads, and Understanding how different workplace settings, such as
groups conducting singular or multiple simultaneous lighting, noise levels, and spatial arrangements, impact
recordings (Parada & Rossi, 2021). the cognitive and emotional states of neurodiverse indi-
We have highlighted the recognition of diverse forms viduals can lead to the creation of more accommodating
of participation as crucial in future educational settings. and productive workspaces (Doyle, 2020; Weber
By embracing the 3E perspective, educators can move et al., 2022). Employers can use these insights to imple-
beyond traditional neurotypical expectations and appreci- ment changes that not only enhance the comfort and effi-
ate the unique ways neurodiverse students learn and con- ciency of neurodiverse employees but also foster a more
tribute. This involves creating learning environments that inclusive and innovative workplace culture. Future
acknowledge and adapt to the varied sensory, cognitive, research should focus on the effect of reasonable adjust-
and social needs of autistic and other neurodiverse stu- ments to the physical work environment on the sensory
dents. Furthermore, educators are encouraged to develop and social stress of neurodiverse people.
curricula and teaching methods that are inclusive, partici- Finally, healthcare systems and providers can greatly
patory, and responsive to the strengths and interests of benefit from adopting the 3E perspective to better support
each student; innovative educational settings, such as neurodiverse individuals. This entails a shift from viewing
STEAM education, appear as a powerful framework to neurodiversity through a deficit lens to recognizing the
accomplish this (Videla et al., 2021). This shift can help diverse experiences and needs of neurodiverse individuals.
counter the prevalent deficit-based views in education, Healthcare providers trained in 3E-Cognition can offer
replacing them with a focus on the individual strengths more empathetic and effective care by understanding the
and potential of neurodiverse learners. MoBI can be used patient’s perspective, leading to more accurate diagnoses,
to explore how neurodiverse students interact with their tailored treatment plans, improved patient-provider com-
learning environments in real-time. By modeling scalable munication, and treatment adherence. In this context,
neurobehavioral dynamics during different educational supporting ethical and epistemological integrity means
activities (Parada, 2018), researchers can gain insights into advocating for patient-centred care, where neurodiverse
how individuals and groups process information, respond individuals’ voices are heard, respected, and integrated
to sensory stimuli, and engage with their surroundings into their care plans. MoBI’s potential to provide a com-
(Dikker et al., 2017; Janssen et al., 2021; Rowland prehensive view of how neurodiverse individuals experi-
et al., 2019). This data can inform the development of ence and respond to different stimuli and interactions can
more effective, personalized learning strategies and envi- revolutionize patient-centred care and precision medicine
ronments that align with the diverse cognitive and sensory (Fernandes et al., 2017). For example, by observing how
needs of neurodiverse students. Additionally, integrating neurodiverse patients’ neurobehavioral dynamics correlate
MoBI findings with innovative educational settings could with their bodily responses in various healthcare settings,
provide a holistic view of how neurodiverse students inter- researchers can develop more nuanced and effective
act with interdisciplinary learning, thereby enhancing par- approaches to diagnosis, treatment, and communication.
ticipatory and inclusive educational practices. This is one of the core tenets of the 3E-Cognition perspec-
Furthermore, in the context of employment, the 3E tive; healthcare practices that respect and integrate the
perspective can significantly enhance the integration and lived experiences of neurodiverse individuals.
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PARADA ET AL. 4161
In summary — for healthcare — adopting the 3E per- based, inclusive, and supportive environments. The 3E-
spective means moving towards patient-centred care that Cognition perspective celebrates the rich tapestry of
respects and incorporates the lived experiences of neuro- human diversity, leading to a more equitable and under-
diverse individuals. This involves training healthcare pro- standing society.
viders to empathize with patients’ narratives and view
their conditions through a holistic lens, ultimately lead- ET HI CS AP P RO VAL S TAT EM EN T
ing to more accurate diagnoses and personalized treat- No ethical approval was needed for developing the
ment plans. In educational settings, the 3E-Cognition present work.
perspective advocates for inclusive environments that
recognize and accommodate diverse learning needs. AUTHOR CONTRIBUTIONS
Implementing sensory-friendly spaces and integrating FJP generated the main concepts. AR, FJP, and AGC
arts and humanities into the curriculum can enhance stu- wrote the initial manuscript. AGC design and drew
dents’ engagement and holistic development. Such Figure 1. FJP design and drew the Graphical Abstract.
approaches not only improve academic outcomes but also MAP contributed her knowledge as an expert in work-
foster self-awareness, empathy, and critical thinking place ergonomics. PSI contributed her knowledge as an
skills. In the workplace, the 3E principles guide the expert and clinician in autism and neurodiversity. MCE
design of adaptable and inclusive environments. Provid- contributed her knowledge as an expert in education and
ing flexible lighting options, quiet spaces, and assistive mental health. AR, AGC, MAP, PSI, MCE, and FJP edi-
technologies can significantly improve job satisfaction ted the final manuscript for publication.
and productivity for neurodiverse employees. Moreover,
fostering a culture that values diverse cognitive styles and A C KN O WL ED G EME N T S
encourages active participation can lead to innovative The authors acknowledge the use of chatGPT (powered
solutions and a more dynamic organizational environ- by OpenAI’s language model, GPT-3.5; [Link]
ment. The application of the 3E principles not only com) for improving the grammatical and language accu-
enhances theoretical understanding but also holds signif- racy of the submitted manuscript.
icant practical implications for creating more inclusive
and supportive environments across various domains. C O N F L I C T O F I N T E R E S T S T A TE M E N T
The authors declare the research was conducted in the
absence of any commercial or financial relationships that
4 | C O N C L U D IN G R E M A R K S could be construed as a potential conflict of interest.
Funding sources had no involvement in any steps of the
In the present article, we suggest that the 3E-Cognition present work.
perspective for the understanding of neurocognitive pro-
cesses represents a significant conceptual shift in under- PE ER RE VI EW
standing the mind. The 3E-Cognition perspective provides The peer review history for this article is available at
a powerful framework for understanding and supporting [Link]
neurodiverse individuals across various domains. We have review/10.1111/ejn.16463.
briefly addressed some aspects of educational settings,
workplace, and healthcare. However, this ethico- DA TA AVAI LA BI LI TY S T ATE ME NT
onto-epistemology can be potentially applied to any Considering this is a theoretical article, only biblio-
human endeavour. Furthermore, the natural combination graphic data compiled in a non-systematic way was used.
of the 3E perspective and MoBI opens numerous possibili- All bibliographic material used is properly listed in the
ties for future research. MoBI is a powerful tool for under- References section. Permission to reproduce material
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