Michael Baron reviews a lively, opinionated attempt to understand and explain autism.
Understanding and Evaluating Autism Theory By Nick Chown Published by Jessica Kingsley Publishers (2016) ISBN 978 1 78592 050 9 £ 20
This is an excellent study of theory. It is not a study of the day-to-day reality of ‘autism’ as experienced by the one in 100 persons in the United Kingdom estimated to have an autistic spectrum disorder (ASD), or autistic spectrum condition (ASC) as defined by Section 1 of the 2009 Autism Act. It is not a guide to interventions, treatment, care, or lifelong learning , nor to genetics. One may read this 367-page book and find no challenge to the widespread use of the A-word today.
The word ‘autism’ is the most convenient shorthand label at present for a complex group of behavioural difficulties which in their effect range from mild to severe. For how much longer is another question. Chown, correctly, in explaining ‘alternative interpretations of behaviour’ acknowledges the ‘ongoing debate… as to whether autism is a synonym for disability or difference or both’. In his view, which colours his approach, ‘autism’ is a social learning disability involving certain cognitive differences. But when he considers the adjectives ‘mild‘ and ‘severe’, severe is in italics and prefaced by ‘so-called’. It is surely both. Hence it is complex.
The debate is given new life by the findings of an Australian study, published in Autism Research in January 2017, that while numbers in diagnosis have risen ‘the proportion with severe features have declined‘. Therefore, as we strive for a better and more accurate definition of the central or core features of ‘autism’ (italicising it thus, is a way of expressing the underlying question – ‘is it the right word?’) , this book, is timely. An ever-expanding industry of academics, care homes, schools, charities, medical, educational and social work professionals, publicists, fiction and film writers and others needs to know. It was not like this once.
The first generation of parents of today’s middle-aged adults, for the most part, were convinced their ‘ineducable’ children were at sea in an uncaring society by their condition of strangeness. Time was when psychiatrists, ignorant of Kanner and Asperger, preferred the diagnosis of juvenile schizophrenia, or childhood psychosis – a testament to the historic narrowness of their vision. The National Autistic Society said: “‘Autism’ was devastating to parents who across the world experienced their children as ‘mentally handicapped’.” No neuro-diversity then, no mental health issues, no idea of the centrality of a fundamental communication disorder. And no concept that, given the continuing changes in diagnostic criteria, this might well be a hydra-headed social learning difficulty.
This book betrays its origins in lectures at Sheffield Hallam University. Other than its reluctance to consider the contemporary validity of the A-word, and the absence of any reference to brain studies, it is necessary, lively and refreshingly opinionated.
Chown knows his subject. This is an essential accompaniment to teachings and literature on the work in mainstream schools, special units, by support workers, in care homes: the daily interventions in the lives of thousands of men, women and children One day there might be a cure, which some, because of the singular gifts of a segment of the ‘autistic’ community, argue against. But for now we need acceptance of difference. And we need, too, a great leap forward in knowledge of the psycho-biology of the human brain, and thus of causation. This comprehensive understanding of ‘autism’ theory is a step on that journey.