Neurotribes by Steve Silberman

In our new review series, we will be looking at inspirational reading for those who live or work with anyone with autism or a learning difficulty. Our second book, Neurotribes by Steve Silberman, is an impressive and wide-reaching book, tracing the history of autism in depth and with a humanity that led him to being awarded the Samuel Johnson Prize for non-fiction.

At the beginning of the book Silberman hypothesises that historical figures known for their unusual behaviour, such as Einstein and Dirac, may have experienced autism. This discussion is speculation of course, but shows that such behaviours were not unheard of in the past. The perceived surge in diagnosis in recent times, Silberman maintains, is due to acknowledgement of the scale of experiences and greater understanding of autism.

“Nothing exists until it has a name.” wrote Lorna Wing and so Silberman begins his history tracing the work of Hans Asperger and Leo Kanner – the two doctors who outlined the syndrome separately at a similar time, and gave autism its name. Many have argued since whether the two were categorising the same condition, as Asperger’s work highlighted gifted children on the autistic spectrum whereas Kanner described exclusively low functioning children.

Working under the shadow of Nazi euthanasia programmes, Silberman argues that Asperger over-played the high functioning patients on purpose in the hope that they might save the rest from the brutal regime. His “little professors” championing the rights of the majority of his patients who didn’t express these exceptional abilities. Asperger is also quoted stating the syndrome was not rare, existing on a varying scale and with the appropriate care, those diagnosed could flourish. This perceptive view point is painted starkly against the work of Kanner.

Silberman exposes evidence Kanner suppressed Asperger’s research and denied or downplayed any links in their work knowingly and that Asperger was lecturing on these cases five years before Kanner ‘discovered’ autism. Kanner’s work was more widely circulated and became the dominant thinking on autism for much of the 20th Century. An insistent voice that the condition was rare and untreatable, aligned with psychosis and characterised as only affecting children. His motivation, Silberman argues, so he could be famed for discovering a new field in child psychiatry.

Continuing this catalogue of historical figures, Silberman discusses the impact of Bruno Bettelheim. Bettelheim became a leading expert on autism despite having faked his medical credentials. Labelling women joining the workforce as “icebox mothers” he linked this move with the rise in cold and withdrawn children. Silberman further discusses other debunked theories and treatments that have been hailed to cure those with autism but is sympathetic to those who clung to the hope they gave.

Expansive in remit, the book also charts the impact of new technology and those who have autistic traits on the development of this technology. With the opportunity to communicate and interact with others without the complications of face to face interaction, many people with autism eagerly adopted amateur radio and the internet.

After decades of silencing, this book will be appreciated by many as a story of the autistic community overcoming adversity. Outlining the campaigning work carried out by those in the autistic community, Silberman discusses the political movement and feelings around the language of autism. Silberman champions the use and acceptance of ‘neurodiversity’, a difference to be accepted and accommodated.

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