Autism: A Very Short Introduction

Very Short Introductions #195

by Uta Frith

What causes autism? Is it a genetic disorder, or due to some unknown environmental hazard? Are we facing an autism epidemic? What are the main symptoms, and how does it relate to Asperger syndrome?

Everyone has heard of autism, but the disorder itself is little understood. It has captured the public imagination through films and novels portraying individuals with baffling combinations of disability and extraordinary talent, and yet the reality is that it often places a heavy burden on sufferers and their families.

This Very Short Introduction offers a clear statement on what is currently known about autism and Asperger syndrome. Explaining the vast array of different conditions that hide behind these two labels, and looking at symptoms from the full spectrum of autistic disorders, it explores the possible causes for the apparent rise in autism and also evaluates the links with neuroscience, psychology, brain development, genetics, and environmental causes including MMR and Thimerosal. This VSI also explores the psychology behind social impairment and savantism, and sheds light on what it is like to live inside the mind of the sufferer.

Genres: Nonfiction, Psychology, Autistic Spectrum Disorder, Science, Medicine, Audiobook, Health

144 pages, Paperback

First published May 28, 2003

About the author

Uta Frith, DBE (Hon), FRS, FBA, FMedSci (née Aurnhammer) is a German developmental psychologist working at the Institute of Cognitive Neuroscience at University College London. She has pioneered much of the current research in autism and dyslexia, and has written several books on these issues.

Her book Autism: Explaining the Enigma provides an introduction to the cognitive neuroscience of autism. Among the students she has mentored are Tony Attwood, Margaret Snowling, Simon Baron-Cohen, and Francesca Happé.

Reviews

[Sarah Bloem · Rating 1 out of 5]

Language matters, but apparently not to Frith. A few examples: "being autistic could be in many ways worse than being born blind or deaf" (is this really necessary?) - "It is not enough to be a loner"- "Lining blocks or cars up in neat little patterns may be cute just once or twice, but it becomes very sad when this is done day after day without exploring other possibilities of playing with blocks or cars." - "Only from about the second year of life do the consequences of the tiny fault emerge with rather major and sometimes devastating effects" - "the child can show this dependence in a most pathetic way" - "retarded" (all over the place) - "It needs to be spelled out that only (?) 10 per cent of individuals with ASD have a truly astounding gift" - "Perhaps [autistic teenagers] don’t care about how they appear to others, and this may be why they now begin to look more handicapped. Now you notice the ungainly gait, the lack of facial expressions. Of course, in a sad way, this is helpful because it is an obvious signal to others that there is a problem" - "Many old people see their partners and friends die before them and they have to get used to being lonely, a very hard adaptation for most of us. Is it easier if you never had any friends?" (on the lack of knowledge on older autistic people, which is indeed an issue)

"Some campaigners go even further and say that for the whole of the autism spectrum it is wrong to talk of brain abnormalities, wrong to focus on deficits in the mind, and wrong to highlight impairments in behaviour. Instead there should only be talk of differences in brain and mental make-up, some of which represent the autistic mind. This is a strange proposition. To someone who is familiar with classic cases and other severe cases of autism, and knows of the suffering that is associated with autism, it seems perverse . You may disagree, but then this book is not for you."

Frith offers a rather simplistic version of the position she rejects, nevertheless, the warning is warranted. While this book might initially be a logical choice if you want a short overview of (at times, problematic) views about autism in the past and the present, I would urge you to stay away from it if you are looking for a perspective that is a bit more humane.

[Julia Rodas · Rating 2 out of 5]

From the book:

"There are now a number of people who have diagnosed themselves as having Asperger syndrome. ... They do not need the attention of a clinician. ... To them it is merely a difference, and a difference to be proud of.

"Some campaigners go even further and say that for the whole of the autism spectrum it is wrong to talk of brain abnormalities, wrong to focus on deficits of the mind, and wrong to highlight impairments in behaviour. Instead there should only be talk of differences in brain and mental make-up, some of which represent the autistic mind. This is a strange proposition. To someone who is familiar with classic cases and other severe cases of autism, and knows of the suffering that is associated with autism, it seems perverse. You may disagree, but then this book is not for you."

Um, you can say that again!

Persistently uses dehumanizing and objectifying language to talk about autistic people, including relentless use of narrative "we" to address a presumably neurotypical readership and "they" to identify autistic people. Ugh.

[Rachel · Rating 2 out of 5]

The author warned that I wouldn't enjoy the book if I were one to call autism a syndrome of mental differences rather than deficits or impairments. She was right. She persistently used language that enforced an "us and them" attitude. The "them", autistic people, were presented as being subhuman, a drain on society, disappointments to their parents, incapable of connecting with others in any meaningful way no matter what their level of functioning.

The science reported here was quite interesting, if inconclusive. It is sad that it was let down by such an offensive depiction of the very people the book was about.

[Aurélien Thomas · Rating 4 out of 5]

Reflecting the psychiatrisation of our society, we live in a time where everybody seem to proudly have some sort of trauma or disorders of some kind, be it a mental illness or a disability or whatever. The autism spectrum is subject to such trend too, ranging from people self-diagnosing with Asperger to campaigners even demanding autism to be recognised as a difference and not a disorder! Uta Frith, Emeritus Professor of Cognitive Development at the Institute of Cognitive Neuroscience (University College London) has no patience for such cruel diluting of what is a real condition, and so you better be warned:

'Some campaigners... say that for the whole of the autism spectrum it is wrong to talk of brain abnormalities, wrong to focus on deficit in the mind, and wrong to highlight impairments in behaviour. Instead there should be only be talk of differences in brain and mental make-up, some of which represent the autistic mind. This is a strange proposition. To someone who is familiar with classic cases and other severe cases of autism, it seems perverse. You may disagree, but then this book is not for you.'

Sure, with an estimate of about 1% of the general population being on the autism spectrum it still is a common neurodevelopmental disorder. She obviously acknowledges that, as well as that one doesn't have to be a severe case to deal with the harrowing difficulties faced by being autistic. As she says of Asperger:

'It is not necessarily correct to call it the mild part, because these people have disabilities. They are sometimes rather thinly covered up by compensatory efforts... their autistic features are mild compared to the classic cases.'

'It is hard to imagine what it is like not to have social sense, not to be tuned in to other people, their actions, reactions, and the signals they give out to you and each other.'

But the autism spectrum implies some very specific characteristics which, sadly these days, tend to be mitigated among the general public. The author clearly here put it all forwards, clarifying a lot of misconceptions. She explains what the spectrum is, and what are the major differences between each features -PDD-NOS, autism, Asperger. She tentatively advance some explanations for the condition (mostly genetics), even speculating with her own. She debunks many of the silliness that have become dangerously popular (being a loner or introvert with narrow interests or an atypical personality doesn't make you autistic; and, no, there is no connection with the MMR vaccination...). She also dabbles with other questionings, like why is it more prevalent among boys than among girls; why there seems to be more diagnosis being made; or, again, touches upon 'savant syndrome' in very engaging passages…

In a word, ranging from brain science and psychology to our social perception, she offers a more than needed introduction to a supposedly well-known yet unknown disorder. Remarkable!

[Steven Walle · Rating 5 out of 5]

This was a very informative book about autism. The book describes the development of the disease and the treatments. I was inlightened by this read and I would recommend it to all.
Enjoy and Be Blessed!
Diamond

[Stefan Gugler · Rating 2 out of 5]

Uff, okay. I don't know Uta Frith, she seems to be a nice person from skimming her Wikipedia page but just judging from the book now, it feels at times a bit boomer-y. Maybe it's a matter of taste but modern intersectional approaches to identity and and privilege could really supplement Frith's approach to autism. At some point for example, she mentions the international community of Asperger's people (who call themselves the Aspies) who are a bit reluctant to the ways they are and have been treated. Now, Frith doesn't really appreciate that, it seems and says that she won't lose any words on that. Some people would be offended, if we didn't label ASD as a disease because it's such a burden to them. I'm not an expert in Autism and its forms but from other readings of mentioned intersectional theory, what seems to be really good for the person in question are methods that grant maximal agency as well as not pathologize them. Of course, we can all stand behind the idea that we should help the people for whom Autism is a big burden but that doesn't preclude us from not othering/disAbleize (Lann Hornscheidt, 2013) all of them. One step might be to not constantly write "normal people do x and Autistic people do y" etc.

I think the exposition on the medical part was as good as it gets in a Very Short Introduction but the way it touched on the societal aspect of Autism, which feels as important in such a text, felt really off and unreflected. Can't recommend.

[barbs (don't friend me) · Rating 1 out of 5]

I couldn't even finish this, what a terrible book!

"Research is desperately needed to find out what exactly is wrong in the brains of these individuals" (p. 27) -> COMPLETE disregard for language use...what is "wrong" with autistic brains??

"Actually, in most developmental disorders more males are affected than females" (p.50) -> uhm...I wasn't even sure I was reading this on a book written in the 21st century. How completely stupid can you be to just take mental disorder diagnosis at face value without taking into account the history of sexism in psychology? Does she really think that males are diagnosed in bigger numbers because females are less affected? Or does she have the mental capability to understand that women are severly underdiagnosed even though they have mental disorders too??

Unbelievable!!!

[Max · Rating 1 out of 5]

A boring, harsh history lesson on autism. The book is very dehumanizing, discussing autistic people in a way as if they were truly retarded (author uses this word..). This doctor has clearly done a lot of "old school" research on folks with autism, but has never lived with, or interacted with in a non-professional way, with autistic people.

I understand when people are against seeing autism as a quirk, as a personality trait rather than a disorder. Not everything has to be called a disorder. But this book goes too far. It's common knowledge that autism is a spectrum, but even the "worst cases" are humans with a good heart, talents, love and intelligence. It's just not expressed in the neurotypical way this world is built for.

Ugh. This goes in the paper bin. Yes, it's not even worth putting it in the Little Free Library. This book hurts more people than it helps/educates.

[Amirography · Rating 4 out of 5]

A good book. It showed me how unsettlingly we know so little about neurodevelopmental disorders such as ASD and ADHD. That being said, it also showed how closely related these deficits are.

[Mared Owen · Rating 3 out of 5]

Really improved as it went along - I enjoyed the last few chapters much more than the first few, which I thought were a bit simplistic.

[Gijs Limonard · Rating 3 out of 5]

This was pretty good, not great; still a lot the writing on the subject is on the phenomenological level; what is experienced by people with autism and those around them, and those interested in researching the subject; not much insights into genetics or pathophysiology, which was something I was hoping for but that seems to be the state of things in autism research for now.

[DeWereldvanKaat · Rating 4 out of 5]

Zeer vlot leesbaar en een goed - maar ondertussen deels gedateerd - overzicht over de inzichten van autisme.
Het dateert van 2008, toen men nog onderscheid maakte tussen Asperger, PDD-NOS en 'klassiek autisme', een onderscheid dat bij het verschijnen van DSM5 niet meer wordt gehanteerd.

Het boek komt tegemoet aan vele vragen die gesteld kunnen worden over autisme: wat is het, van waar komt het, hoe kan je het begrijpen, waarin verschilt iemand met autisme met iemand anders? Verwacht op al deze vragen geen antwoorden, niet omdat Frith het niet wéét, maar omdat nog veel wetenschappelijke kennis ontbreekt.

Uta Frith weet wel heel goed centrale begrippen als Theory of mind, zwakke centrale coherentie, zwakke executieve functies etc. uit te leggen.

Uta Frith, volgens de omslag van het boek 'internationaal toponderzoeker op het gebied van autisme en voormalig hoogleraar (Londen)', durft het aan om vragen te stellen en mogelijke pistes te verkennen waarvan ze zelf heel eerlijk zegt dat men het (nog) niet weet, maar dat hier of daar mogelijkheden zijn tot verder onderzoek.

[emre · Rating 1 out of 5]

konu ettiği kişileri neden bu kadar indirgeyici ve kaba bir şekilde tasvir ettiğine anlam veremediğim için kitabın bilgilendirici kısımlarını değerli bulamadım. günümüzde otizmin değişen doğası, spektrumun kavramsal olanakları ve açmazları gibi konularda pek az şey söylüyor. otizm hakkında hiçbir şey bilmeyen bir ebeveyn olsam (kitabın genel hitabı sık sık ebeveynlere yöneldiği için) çok korkar ve karamsar hissederdim herhalde. kısacası, çok bilgi içermesi, iyi bir derleme sunması bir kitabı iyi yapmaya yetmiyor.

[Ali Gülüm · Rating 5 out of 5]

otizm hakkında daha önce çok okuduysanız bu kitap size yeni çok şey söylemeyecektir. bununla beraber anlaşılırlık, kapsamlılık, bilimsel yaklaşım, yaklaşımların olası zayıf yanlarının ne olduğu gibi konularda oldukça iyi. Türkçe olarak otizmle ilgili şimdiye kadar gördüğüm en derli toplu ve kolay anlaşılır kitap.

[Wendelle · Rating 5 out of 5]

This book is a good learning resource, I learned many things from it such as,
a) the origins of the 'vaccines cause autism' movement. A superficial correlation between vaccines and autism sprouted from the coincidence of the onset of the signs of autism (age 2 years) and the usual age for vaccinations. However, many studies have dispelled the possibility that vaccines cause autism. Not the least of this was the epidemiological study that showed that the withdrawal of vaccination schedules in Japan did not lessen the occurrence of autism in the population.

b) the common signs exhibited by children with autism, including living in their own world, social withdrawal, and a compulsive need to arrange their environment

c)the big four ideas about what autistic people experience, such as the lack of the theory of mind or understanding that other people have minds of their own with independent thoughts and interests, the lack of ability for social interaction, the lack of mirroring abilities in grasping intentions and actions, and the inability to see the wider picture in place of narrow interests

d) the difference between autism and Asperger's

e) the history of the field

[Daniel Wright · Rating 3 out of 5]

Dr Frith's engagement with her subject is eye-opening. Her knowledge is clearly gained by one-to-one, real-life experience, as demonstrated by her numerous and judicious case studies, and her emotional involvement with the people who are affected. In addition to this, she sees them with the observant and analytical eyes of an academic, and enters into dialogue with various popular representations of autism, whether novels or films. The combination of all this is a quite enlightening and informative book.

[Ozan · Rating 3 out of 5]

Otizm açılımı kapsamında bozukluklar hakkında bildiklerimi doğruladığım ve pek çok şey öğrendiğim bir okuma oldu. Otizm hakkında pek çok bilinmezin olduğu bir gelişimsel bozukluk, buna bağlı olarak kitapta kimi araştırmalarca desteklenen kimi tarafındansa yanlışlanan birçok spekülasyon vardı.

Kitabın beğenmediğim yanlarından biri Asperger sendromu gibi işlevselliğin görece daha iyi olduğu hastalara, işlevselliği kötü olan otizmlilere kıyasla çok daha fazla yer ayrılmış olmasıydı.

[Cameron · Rating 4 out of 5]

A very good book on the history and current thinking on Austism Spectrum Disorders. It is very upfront that there is a lot that is not known and that is likely to change in our understanding. It is sad to see how ASD is used as a scientific and political funding football.

[Simon · Rating 5 out of 5]

A useful introduction which introduces other psychological concepts in a manner which can be understood. This books is not a manual of how to raise an autistic child and it doesn't pretend to be. As introductory material, it serves its purpose and almost demands further study after reading.

[Franzine · Rating 3 out of 5]

I think this book is a wonderful, short introduction to the topic of Autism. Personally, I didn't always agree on an emotional level on the way she expressed her personal opinions / didn't agree with her way of writing about the concerned people.

[Andy · Rating 5 out of 5]

Excellent primer that gives an overview of ASD research, how it presents and how it affects cognition.

[Ximing · Rating 4 out of 5]

short but comprehensive; easy to read.

[Emma Rowntree · Rating 4 out of 5]

Great introduction into autism with interesting facts which leads to further reading

[Nika Kapanadze · Rating 4 out of 5]

Well-written, informative, even entertaining in some ways. The best of the very short introductions that I have read. Definitely recommended.

[heptagrammaton · Rating 1 out of 5]

About as well-aged as pig's bladder left out on the asphalt in a heatwave.

Utterly oblivious, if not willfully dismissive, of the humanity of people with autism. Plagued by some of the worst, patronizing, repetitive writing I have ever seen in non-fiction. Ignorant of well-argued-over issues in categorizing disability and normalcy. Ableist. Alarmist. Philosophically and clinically irresponsible: exemplifying academic paternalism, and thus one of the most pervasive and problematic aspects of the culture of modern medicine. Bizarrely neutral in tone about its covering of the MMR vaccine mania - which I consider downright malicious considering the enormity of harm the antivaxxer movement and its adjacents have done to public health, societal scientific literacy and their own (sometimes autistic) children. It is bloated by very dubiously useful and gimmicky attempts at analogy and metaphor like a corpse half-full of formaldehyde a'swim upon the Amazon - which ultimately creates the impression that Frith has chosen to read the Very Short Introductions' intended audience as one not laypeople, but Lumpen idiots.

Ultimatelly, it is telling that Dr. Firth spend less time quoting actual people with ASD> than the questionably representative and by the author's own admission shallowly researched Christopher, the protagonist ofThe Curious Incident of the Dog in the Night-Time and Hans Asperger's ( A literal collaborationist of Nazi eugenic efforts! ) thoroughly fallacy-ridden opinions relating autism and his own gender stereotypal bullshit. Simultaneously, the reader is cautioned to beware how indicative are verbal high-functioning individual's accounts of the experience of all people on the autistic spectrum. No such warning need apply to neurotypicals, of course.

One dreads what gems of thought the reader might be made privy to had publication not preceded The Big Bang Theory's Sheldon and Sia's 2021 Music.

Furthermore, to quote her (bolded formatting by me), in the context of the language and stances adopted by the online community mainly represented by high-functioning autists:

... [some autistic advocates] say that for the whole of the autism spectrum it is wrong to talk of brain abnormalities, wrong to focus on deficits of the mind, and wrong to highlight impairments in behaviour. Instead there should only be talk of differences in brain and mental make-up... This is a strange proposition. To someone who is familiar with classic cases and other severe cases of autism, and knows of the suffering that is associated with autism, it seems perverse. You may disagree, but then this book is not for you.

"DoN't LiKe, DoN't ReAd. Lol. Lmao," says the knighted psychologist and fellow of the Royal Society. (Say what you will about teenagers writing on Wattpad, you don't have any high expectations that they can disappoint.) Heaven forbid if one were to acknowledge that neurodevelopmental disorders, like all of nature's chicanery, always exists in gradations and variance, rarely offering the rigid borders a diagnostician might wish for, and acting otherwise might be harmful, actually. Heaven forbid one were to the stigma and governmental support network of disability might prove more of a hindrance and a wholly dehumanising affair to someone actually disabled. Heaven forbid one suggest that measures to universally accommodate common autistic needs might actually be generally valid, even helpful to those that are neurotypical. Heaven forbid societal convention not be a zero-sum game! Heaven forbid one pay attention to the lived experiences of people who have experienced - and been traumatised by - ABA. Or, like, bring up the fact that verbalism is not the only way to fully communicate - and which is something, Mrs. Dr. Firth, even the aforementioned Aspies can struggle with when in the midst of a meltdown.

So... any upsides? Disregarding research developments that have occurred in the 15 years since publishing, Firth gives a decent-ish overview of the neuropsychology of autism, potential cause and ways of thing of interrogating it by further research. It is the minimum one would hope for, from a developmental psychologist and neurological researcher.

However, no introduction to autism can be complete with mere pathology. Nor does Firth restrict herself to that. Leave this off, and read a metareview, or watch that Tempel Grandin biopic, or something. Anything, really.

(Frankly, do rather take the asphalt-baked pig's bladder. You might learn some anatomy and proper waste disposal for it. Or use it for ball sports; it literally would count as experimental archaeology.)

II. An Obligatory cover art analysis: Introduced by Autism Speaks, an organization with its own history of eugenics undertones and child abuse overtones, blue is the shorthand colour of autism. 'Cause something something 4:1 boys:girls ration, something something gender stereotypes(?)

(I beg you, don't pay attention to the way girls are socialised to be much better at masking, or the biases of sampling across gender lines, or that autistic women are much more likely to be erroneously diagnosed as one of the disguising comorbidies. Don't you mind the statistically disproportionate variance of gender identity amid people on the spectrum; by this point, you should have gotten the clue that is the level of squishy psychological nuance this book is pathologically incapable of engaging with. (Thanks for small mercies, this might be one of the rare good ways in which it is showing its age.))

A pretty and inoffensive enough exercise in a minimal colour palette. The reddish lapis lazuli central stripe is quite lovely, reminiscent of my favourite blue inks.

An ultimately uninspired cover design choice. There's a metaphor of the cover as a microcosm for the text behind it in there, or something.

[Toqa Medhat · Rating 3 out of 5]

even though I had some issues with the way language was used at the beginning of the book as it felt kinda derogatory (in my opinion) towards autistic people and it gave me the feeling as they were being stripped of their autonomy in a way, I also had some problems with the excessive use of "retarded" to refer to people; I felt like that was "fixed" in the second half of the book and it was further clarified that this is the current perspective on the matter based on the knowledge we had back in 2003\2008 (when the book was written), and I know for a fact that we came a long way since then and we have more information right now and we're continuing to learn more on the subject everyday.
I was hoping that the author would write about other cases on the spectrum not just the extreme cases.
"However, we can also look at these black spots of ignorance as
white spots on an as-yet-unexplored continent. Explorers of all
kinds, especially those who can combine psychological
experiments and techniques of neuroscience, and can work hand
in hand with cell biologists and geneticists, will fill in the map and
will come back with answers that promise rich rewards. These
answers will not only make us able to understand people with
autism better, they will make us understand why all of us are who
we are."

[victoria marie]

definitely do not recommend. only a couple things that were beneficial for understanding people I know with autism more, but wayyyyyy too outdated, especially with current negative/false feelings towards it & bs causes…

[vxx]

informative, though the negative connotations towards people with autism are a no-go!!!

[Tim Pendry · Rating 3 out of 5]

If you want a basic guide to the state of scientific research into the alleged nature of autism twenty years ago (and an insight into the attitudes of somewhat cold and clinical positivists) then this may be the book for you but I found it mildly creepy and even sinister at times.

What were the problems that I had with it? Partly it was a matter of the arrogance of tone towards those who had a view of autism closer to that of the much later book by Devon Price ('Unmasking Autism') which tried to claim autism as yet another 'identity' in a society already reeking of them.

There was an odd point (like an upsurge of atavistic feminism) where the author seemed to be playing with the idea of men being autistic simply by being men. She moves swiftly on but it gives us a clue to an attitude that sees 'normality' as 'normative' along lines that are peculiar to her own world.

In my earlier review, I criticised Price for going too far in accepting the language of victimhood and identity politics but Frith takes us to the other end of the spectrum in what appears to be an alliance of interest between a profession seeking research grants and worried middle class mummies.

Cultural alliances fascinate me because of their distorting effects within liberal democracies and the fact that they emerge without a central point of control. They are certainly not conspiracies but emerge naturally, like that between Greens and business, to distort reality.

Autism has certainly 'exploded' in terms of 'diagnosis' (always a reason to be suspicious in the world of clinical psychology) and in cultural awareness. It has become a blank sheet on to which fears, interests and ambitions may get projected with social and political consequences.

Now, do not get me wrong here. I do accept that autism in its extreme forms can and will be dysfunctional and that, if truly dysfunctional, it requires sensitive intervention to help individuals become functional - but this begs the question of what we may mean by functional.

Frith is undoubtedly expert in analysing, understanding and developing solutions to truly dysfunctional autistic behaviour. The quarrel here is not with her expertise (which is substantial and demonstrable) but its extension from the particular to the general.

I noted in an earlier review the insights of Richard Bentall in 'Madness Explained' where he suggested that professional diagnostics may have got out of hand so that (he speaks of classical insanity) we fail to see that much behaviour classed as 'mad' is, in fact, on an extensive spectrum.

There is no reason to consider all 'abnormal'behaviours as dysfunctional. Neuro-diversity is often not a problem at all. People have, in fact, often become dysfunctional because of social demands and expectations. 'Sufferers' could often get on adequately with reassurance and a different society.

We should not have to sit there, whoever we are, and accept society when it clashes with our essential given nature or our existentialist ambitions so long as we offer no threat to others. Normalising us can be one of the nastiest forms of human oppression because it is so insidious.

We willoften see a power struggle between an individual who is who they are and a society who demands that they be something else. The obvious example in history were the demands made on LGBTQ+ people. Dysfunctionality in any situation requires careful analysis in this context.

Normality is a conceptual trap because what is normal shifts and changes according to culture. It would be normal to hate Jews in Nazi Germany, to believe in the virtues of the proletariat in the Soviet Union and to believe in a Christian commitment to marriage and corporation in 1950s America.

From this perspective, Price, although he/she goes far too far, is correct that many autists (like many people who hear voices) can and should kick back against attempts to diminish and control them, force them back into normality as once we tried to force gay people into binary sexual situations.

I must admit to something here. Everyone around me seems convinced that I am 'on the spectrum' when it comes to autism although it is fairly mild in my case. I am very high functioning. When it comes to matters of 'madness', I am possibly even hyperrational to my own distress.

This makes me believe that it is normality that is often dysfunctional. When it comes to human survival, it is normal to accept being conscripted for absurd wars and to deny your own desires sexually to maintain a historically-generated Judaeo-Christian mythic culture. But that is how it is.

Interest in Autism in certainly relatively recent - it possibly has not yet reached its half century of serious professional engagement. In this, it is unlike 'madness' which has troubled humanity in some form since the days of shamanism. A fully balanced approach seems yet to be developed.

So, neither Price nor Frith's books are entirely helpful because both tell only half the story. Both are polemical and rather rigid. Neither is prepared to critique the special interests and social conditions that define functionality (Frith) or the post-modern ideology that denies social reality (Price).

Just as I advised the Price-ians to persist in dropping their masks on their terms but without wasting time on constructing a group identity, so I would advise the Frith-ians to step back and define dysfunctionality with more care and to consider social dysfunctionality as of equal concern.

In the ideal situation, in dealing with the 'mad' and the 'autistic', individuals would be left to self-develop as much as possible with as much reasonable non-invasive support as possible. Those who collapsed into true dysfunctionality should receive the bulk of what resources there are.

It is the idea that autism is necessarily a disorder that most concerns me. To be fair, Frith does point out the aspects of autism that might be regarded as positive but her language of disorder always privileges some reified order to which it is necessary to adapt. Order is not the human condition.

The book retains throughout a certain implicit arrogance about the extent of neuro-diversity as disorder. The normal brain is treated as a biological and essentialist absolute, abandoning all awareness of the adaptiveness and resilience of the mind (and so of the underlying brain).

Perhaps 'normies' need to be taught more not to fear or to panic (especially middle class mums) and to loosen up a little. Nevertheless, boundaries need to be agreed where it becomes clear that the safety of the individual and of society might require someone to step in.

There is another consideration against enforced normality of any kind where there is no significant suffering or harm to the wider world or to the individual themselves. This is that (as we seem to forget) we are evolved animals and not machines or gods. We are a species with massive variation.

Neuro-diversity is not an aberration from some Platonic form of the brain, pickled in aspic for eternity (this is pre-Darwinian thinking) but variation. Neuro-diversity may be truly dysfunctional we have accepted, but it may also be massively creative as we see in Elon Musk.

OK, some people may consider Musk dangerous and abnormal (we have reviewed his biography at length elsewhere) but that is frankly a political decision or one based on classic 'ressentiment'. Whatever one thinks of him, he has made exceptional advances in business and engineering.

Variation is vital to the survival of a species. It may be become very important as our species, which has a weird aspect in being part-hive (a socialised unthinking culture) and part consciously individualist (the creative yeast in society), adapts to new technological conditions.

The bits of humanity that seem dysfunctional to 'normies' may contain the genetic seeds to future survival. Attempts to treat moderate autism or 'madness' as a 'disorder' and to seek to cure it may gain grants for ambitious academics but it may also lead us in a very dark direction.

This dark side would be genetic intervention to normalise our species within a narrow band. This would be a conservative attempt to preserve an existing order that may be doomed to fail. It is implicit in liberal panic at the fact that people keep coming up with the wrong political answers.

To identify serious dysfunctional abnormality in the brain is one thing (action to deal with this is beneficial) but contemporary professional liberal capitalist society is constantly engaged in mission creep - whether as NATO or human resources managers or clinical psychology.

This mission creep is the unthinking 'hive' at work. It is the sort of thinking by 'normal people' that tends to lead to problems like risking nuclear war, debt crises or the rise of populism in reaction to 'norms' imposed without true consent from above.

The point is that all attempts of authoritarian science to control humanity generally end in disaster for the professional classes and society in general (Adam Curtis' 'Pandora's Box' documentary series is good on this). Humanity is always best guided rather than forced. The 'hive' must be challenged.

Now, let us be clear, Frith is not (at least overtly) directing us to the dark side at all but the positivist attitudes and essentialism implicit in her account make things just that bit easier for those who might. For facts, this a good book. For ideological sophistication, go elsewhere.

[Teo · Rating 3 out of 5]

2016.01.25–2016.01.25

Contents

Frith U (2008) (03:16) Autism - A Very Short Introduction

List of illustrations
• 01a. Key feature 1: In a world of his own
• 01b. Key feature 2: Unable to communicate
• 01c. Key feature 3: Restricted and repetitive
• 02a. Rainman
• 02b. Kim Peek
• 03. The Curious Incident of the Dog in the Night-time
• 04. Increase in cases diagnosed autistic
• 05. Increase in cases without mental retardation
• 06. Demonstration against MMR
• 07. Connectivity in the brain
• 08. Very large brain
• 09. Sally–Anne test
• 10. Triangles interacting
• 11. The brain's mentalizing system
• 12. Patterns of eye gaze
• 13. Imitation of hand movements
• 14. Contagious yawning
• 15. London cityscape, by Stephen Wiltshire
• 16. Attention to detail
• 17. Tasks showing superior performance
• 18. In the supermarket
• 19. Temple Grandin
• 20. Thomas the Tank Engine

1. The autism spectrum
• Is it autism?
• The enigma of autism
• The autism spectrum
• Three cases
• The three core features of the autism spectrum
• When does autism start?
• What is joint attention?
• Regression or lack of progress?
• How early can we push the diagnosis of autism?

2. The changing face of autism
• A little bit of history
• At the feet of the great pioneers
• Urgent practical questions: what to do about the children?
• The many faces of autism
• Autism compounded by learning difficulties
• Classic autism
• The autistic child grows up
• Increased adaptation
• Asperger syndrome
• Another chapter in the history of autism

3. A huge increase in cases
• Will there be more and more people with ASD?
• Widening the criteria
• What are the numbers now?
• If there was a 'real' increase–what would cause it?
• Scare stories
• More reasons for further increases in numbers
• Empathizing and systemizing
• The excess of males
• After all–is there a real increase?

4. Autism as a neurodevelopmental disorder
• Why is autism a neurodevelopmental disorder?
• Why look in the genes?
• Why do several disorders often occur together?
• The brain in autism
• Under the microscope
• In the scanner
• Bigger brains
• Some preliminary conclusions

5. Social communication: the heart of the matter
• What are the problems in social communication and why are they there?
• The first big idea: reading minds
• Mentalizing in the brain
• Problems with the first big idea
• The second big idea: driven to be social
• A world of faces, bodies, and eyes
• Problems with the second big idea
• The third big idea: the human mirror system
• Emotional resonance
• Problems with the third big idea
• Language and communication
• There is no blanket social failure

6. Seeing the world differently
• The savant mystery
• Unexpected strengths
• Narrow interests and restricted behaviour
• Weak central coherence
• Problems with the idea
• Trouble at the top
• Getting stuck
• Captured by incidentals
• Lack of inhibition
• Disaster zones
• Problems with the idea
• A link between the five big ideas: a mismatch between top-down and bottom-up processes
• The cook and the diner
• Top-down modulation
• The absent diner
• Some preliminary conclusions

7. From theory to practice
• A trick with three boxes
• What we find in the biology box
• What we find in the behaviour box
• What we find in the mind box
• How the boxes might fit together
• Connections and miconnections in the brain
• Tensions in the concept of the autism spectrum
• If you met someone like Temple Grandin
• If you met someone with autism and intellectual disabilities
• What does it cost to have an autism spectrum disorder?
• Education and remediation
• What kind of educational and social provisions are needed?
• Medical treatments
• Charlatans
• Stress
• Things we need to know more about

Specialist references
• On prevalence
• On causes
• On impairments of social interaction
• On non-social features

Further reading
• Classic readings
• Introductions
• Edited volumes presenting research
• Biographical accounts
• Guide books