On difference

Steve Silberman’s was the last of my holiday reading, just finished. It is as excellent as you’d expect from all the reviews and prizes. As well as being a fascinating account of the intellectual history of psychiatric/medical approaches to autism, including the dramatically changing approaches to diagnosis and treatment/support, it’s very well written. For instance, I liked the description of Leo Kanner, a central character, as having “the woebegone countenance of a sad beagle.” The book also has sections on the links between autism and the technology and sci-fi fan communities, dating back well before SIlicon Valley. The book quotes an expert on science fiction as describing the “subversive impulse at the heart of science fiction as an expression of ‘cognitive estrangement’ from the mainstream.

[amazon_image id=”1760113638″ link=”true” target=”_blank” size=”medium” ][amazon_image id=”1760293288″ link=”true” target=”_blank” size=”medium” ]Neurotribes: The Legacy of Autism and How to Think Smarter About People Who Think Differently[/amazon_image]

I was frustrated to learn on page 375 that, throughout the disputes and discoveries in the US I’d been reading about so far, British researchers and doctors were “light years ahead of their American peers in their understanding of autism”; this is a highly US-centric book. British readers might also be surprised that Simon Baron-Cohen gets just two passing mentions. I’m certainly no expert but think he’s quite well known on this side of the Atlantic. The despicable Andrew Wakefield does get appropriately – ie. highly critically – described. My other frustration was that – given my lack of knowledge of the subject – there wasn’t more of a summary of the state of play at the end of the book. It’s clear enough that there is no ‘epidemic’, but rather a better understanding of the character of autism and much more diagnosis; and that the explanations are to be sought in genetics, not environmental factors. Still, I’d have liked a bit more.

Of course, wanting more of a 520 page book is a good sign. Interesting, compelling and important.