I am taking the liberty of publishing the comments made by John Elder Robison regarding our book, “Defining Autism”. John was kind enough to read the book and send us his review. I appreciate the time he took for this endeavor. For those interested, the book made the #1 new release in Behavioral Disorders/Special Education in Amazon.
Defining Autism, by autism researchers Emily and Manny Casanova, is destined to be a controversial work. The community of autistic people and their families are divided by those who believe in the neurodiversity paradigm, and those who reject it in favor of the medical model of autism as disability. The authors of this new book encapsulate that dynamic in their own family, and by extension, in this book.
Defining Autism begins with new insights into the evolving tale of Leo Kanner and the creation of the autism diagnosis we know today. The Casanovas describe some Kanner observations that are largely overlooked today, but which show how many of the ideas we think are “new” actually occurred to the first autism researchers seventy-some years ago. The Casanovas, Silberman, Donvan/Zucker, and other historical writers all have different interpretations from that era, and a historian of the subject will benefit from reading them all.
From there the book moves into how autism affects the brain, or perhaps how a different brain conjures autism as a result of how it’s formed. The idea of neurodiversity posits that autism is part of a range of neurological variation that has been part of humanity forever, as opposed to being an injury or defect that happened to an otherwise ‘normal brain’. The Casanovas do a good job of explaining the many ways autistic brains differ from the typical, and what that may mean.
Every proponent of neurodiversity must reconcile the idea that there is a point where benign difference shades into pathology for all forms of diversity, including autism. Supporters of the medical model of autism (like Manny) benefit from recognizing that autism confers exceptionality as well as disability, and so presents a unique challenge to medicine, which has traditionally focused on cure.
The best approach for autistic people may eventually integrate both views, by seeking support to foster and bring out exceptionality, and treatments for the aspects that cause genuine suffering today.
Supporters of the neurodiversity model tend to believe autism pe se is not harmful; rather, the conditions that accompany it are. In chapters like Epilepsy and Regression, the Casanova book does a good job of explaining for a lay person how those things are inextricably intertwined. In a neurodivergent person we may not be able to have one without the other, and we may not be able to treat the one without treating the whole.
The Casanovas explain some of the different biological pathways into autism, which gives a scientific basis for the sometimes-dramatic differences between two individuals having the same diagnostic label.
Having known the Casanovas for some time, I have seen the ideas that form this book take shape. If read with an open mind their work will give any student of autism a lot to think about. Readers with a strong neurodiversity bent may find parts of this book lacking but the breadth of medical issues covered is something no student of autism should be blind to, however their meaning may be interpreted.
John Elder Robison
The College of William & Mary