NeuroTribes: The Legacy of Autism and the Future of Neurodiversity by Steve Silberman

My rating: 4 of 5 stars


This was a very interesting book in many ways, although I thought it was poorly structured in places. Much of the book is devoted to a history of diagnostic procedures and the definition of autism as constructed by psychology. However, there were also chapters on historic figures the author considers might have been autistic, such as the scientist Henry Cavendish. These were interesting as vignettes, but the length of them distracted from the coherence of the book's narrative. It isn't obvious what the reader should derive about the 'legacy of autism' from Cavendish's limited food preferences, or tendency to avoid company.

As regards the history of the diagnostic procedures of autism, there are two main points of interest that I derive. Firstly is the complete lack of intellectual credibility of the leading practitioners in the field. The doctrines of many of the people described lack empirical support, lack diagnostic validity, and are contrary to the basic tenant of medicine, in that they make no distinction between on the one hand, bodily states that reflect ill health, and on the other hand, behaviours that might be considered social unacceptable in some contexts, but are not intrinsically harmful. The likes of Lovaas and Rimland took the view that 'x child is conducting x behaviour that is considered unusual, meaning that they are degenerate'. I don't see how that thinking can be classified as anything other than pseudoscience. It is no different than pointing to someone wearing red trousers in a society where blue trousers are the custom and saying 'yuck'. Obviously, red trouser wearing in those circumstances might cause problems, but that seems more relevant to sociology, or the fashion of hosiery, rather than medical science.

For the sake of clarity, some of the neurodivergent children described in the book (and in general) are prone to behaviours that do properly fall under the province of medicine, such as self-harming or depression. However, psychology seems to have historically been much more interested in trying to force people to follow the social norms of their time, rather than restoring them to good phycological health. I think there is a genuine science in this area that is gradually emerging, but also a tendency to absolute drivel, including the view described in the book that children became autistic because of their 'cold-hearted' parents. It is hard to imagine any other science where speculation of this kind with no credible empirical support would form any part of theory.

The second point that I derive results from the first, which is the extent to which neurodivergent people are de-humanized in much of phycology. Lovaas is described as conducting an experiment with a child in which affection was withdrawn to encourage socially acceptable behaviour. He also conducted multiple physical torture techniques, such as electrical shocks. His victims were often children or people with intellectual abilities. With great irony, he had the temerity to suggest that autistic people lacked empathy. The book contains a passage in which he inveighs against criticism of electric shocks by accusing his critics of 'sentimentality'.

Usually, torturing people only happens after they have been de-humanized, and that is evident in the language used to describe neurodivergent people both historically and currently. Again, Lovaas in the best example of this, claiming that autistic people "are not people, in the phycological sense". This attitude is essential to justify torture, just as regimes that have sought to commit genocide against particular ethnic groups invariably describe them as inhuman animals. This language has been normalised to a disturbing degree, such that it is described in passages in the book without authorial comment. As a measure of how unusual this is, one might consider a hypothetical analogy. Suppose one was to posit that the behaviour of phycologists needs to improve, given the harms their views have often caused, and that the best way to achieve this is to progressively burn them until they abandon their anti-social views. Such a suggestion would almost certainly be considered the fantasy of a mad or evil person. The reason for this, of course, is that phycologists are not a dehumanised group, and as such, even if burning them could be demonstrated to have a socially beneficial impact, harming them wouldn't be socially acceptable. 'Sentimentality' would prevent such an outcome.

There are contemporary echoes of this type of thought, described in latter sections of the book, in a discussion of vaccine 'controversy'. Putting aside the obviously pseudo-scientific nature of the claim that vaccines cause autism, even if it was true, it is grotesque to claim that children should be put at risk of death from infectious disease rather than being turned autistic. The eliminationist nature of 'anti-vax' positions as regards neurodivergent people has been too little commented on.

Despite that I enjoyed much of the book, there were many sections where I thought the author was overly journalistic, in flatly describing the views and behaviours of noteworthy figures, without giving a wider analysis. For example, the book described Nazi beliefs about the burden that disabled people pose to society, often described in monetary terms. There was a distinct echo of these views in eugenicist programmes in the USA to sterilize disabled people, and in the justifications given to forcibly 'normalize' neurodivergent people. Although the book contained a lot of interesting information, the reader was often forced to conduct such analysis themselves. Nevertheless, it was a compelling book, and I learnt a number of interesting facts from it.



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