This was a substantial read, and at times a meandering journey, but for someone interested in neurodiversity (a fairly modern phrase) it is an important history of autism and a reminder that neurodiverse people are about as different to each other as neurotypical people, if not more so. There is no ‘typical’ autistic person. Rainman did autism a great service in bringing it to the public attention via film, but also a great disservice as not all autistic people are like Dustin Hoffman’s character, Raymond Babbitt, based on the life of the savant, Kim Peek (who may have been wrongly diagnosed, anyway).
Now, we are beginning to accept that neurodiversity is a good thing, but autism had a fearful past. There are countless horror stories within this book of children with autism, who stimmed, hand-flapped and developed language late, so were diagnosed as having childhood psychosis, juvenile schizophrenia, or retardation. Many were sadly institutionalised when they really shouldn’t have been.
1 in 100 people are said to be on the autistic spectrum but in 1943, when Kanner was conducting his research, it was considered a rare disorder. This book trawls through the various battles, medical, political, cultural, educational, charitable and self-help/parental which have developed over the years. Approaches to autism have varied from perceptions as a cruel life-limiting condition, to praise of specific skills and abilities, such as those needed to create Silicon Valley. The book covers the key players in defining autism, such as Asperger (kind) Bettelheim (demon) and Wing (modern advocate).
Autism, therefore, is not new, and we can probably all think of people from our pasts or our present who exhibit(ed) autistic traits. One example given by the author is of the eighteenth-century scientist, Henry Cavendish, a brilliantly focused mind but a seriously ‘eccentric’ individual, with habits like eating the same food every day and wearing the same clothes or walking the same route.
Parents were often blamed for their role in creating ‘autistic children’, especially mothers. No surprise there then. Those women who worked or had interests outside the home were termed ‘refrigerator mothers’, obviously contributing to their child’s condition. These were the heady days of attachment theory where mothers were blamed for most things, and parenting styles were scrutinised so that children could be removed from ‘pathogenic’ families; this was also the home of ‘holding therapy’. Later, the vaccine controversy created further difficulties for parents. Parents have taken more than their fair share of criticism. In the 1960s, autism was perceived as neurological treated by psychological interventions.
In the 1970s-80s, it became a ‘developmental disorder’ but by the 1990s, sensory issues were considered a key component. Currently, research is focusing on metabolic, immune system and gastrointestinal issues. Many people with autism also struggle with ADD/ADHD/OCD and dyspraxia, so there are questions relating to whether autism’s aetiology is much more complex than anyone ever thought, relating a number of conditions.
Two key players in raising public awareness of autism were Dustin Hoffman in the fictional film Rainman and Professor of Animal Science, Temple Grandin. She reckons Einstein, Tesla, Sagan and Mozart were all autistic. Certainly, to have such amazing talent, over and above the norm requires some special characteristic but we should not assume that all autistic people are on the genius scale. Many autistic people struggle with day to day social interaction and conversation; some are non-verbal.
The current thinking seems to be that rather than make autistic individuals conform to neurotypical norms (some of which are not that great, to be honest) we should accommodate difference and encourage all to thrive and contribute in whatever way they can. It has taken a good while to get to this point but hopefully, we can now be optimistic that society, on this issue at least, is moving forward.