Loads of Learned Lumber

Wednesday, September 6, 2023

Steve Silberman, _NeuroTribes: The Legacy of Autism and the Future of Neurodiversity_

 AN OUTSTANDING BOOK and an important one, I'd say. Silberman provides not exactly a history of autism, but an history of how it has been known, named, and treated by western medicine from the early twentieth century to the present. It's a history full of bad guesses and unintended harm, but still gradually making progress.

Silberman's first chapter is about Henry Cavendish, an 18th century Englishman and scientist of very eccentric habits; his second is about Leo Rosa, a boy in the contemporary USA, also of very eccentric habits. Leo has been diagnosed as being on the autism spectrum, while Henry lived and died before "autism" was known and named, but both thrived because they were given the space and accommodation they needed. 

The knowing and naming went on between Henry and Leo, and it's a story of both progress and regress, of illumination  in  unlikely partnership with darkness. Hans Asperger and his associates in a Vienna do crucial pioneering in identifying autism, but their work is fatally compromised by association with Nazism and eugenics. Leo Kanner makes comparable progress in the United States, but gets balled up in assumptions about causes and cures (and his own infallibility) to damaging effect.

Causes and cures are the recurring bugbears of the middle of the book. Whose fault autism is and how to fix it becomes the sole topics of interest among professionals. Eventually, gradually, the parents of autistic children and the autistic themselves start getting their say, and some light breaks through. Rain Man comes out, and a little more light comes through. Adjustments get made, handbooks get rewritten, and children like Leo Rosa are no longer doomed to a lifetime of misunderstanding.

Not that everything is all better for everyone on the spectrum. Progress remains to be made. It's a hopeful story, though, of people eventually being heard and getting something like what they need.

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