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Self-awareness is a specific type of autoclitic discriminative behavior and inferential generalization to similar performances exhibited by other people. Brain imaging findings take on special importance within behavior analysis when they indicate that dysfunctions in these areas are related to differential effects of our interventions, with some acquiring substantially typical self-awareness skills and others failing to do so. It appears that those individuals whose brain dysfunctions are limited to these areas, and are not part of more generalized brain abnormalities, are amenable to substantial acquisition of those most basic of human skills called self-awareness, whereas individuals with more generalized brain dysfunction are not so disposed. Through a combination of less or more effective teaching contingencies during childhood, and degrees of dysfunction of those brain structures, some children grow up lacking self-reflective abilities and self-insight, whereas others are extraordinarily astute at those capacities. Among children with autism spectrum disorders who lack those skills due to abnormal brain development, approximately half of them can acquire those skills, at least to some degree through the use of effective, intensive, early behavior therapy methods.