Autism: a social and medical history

Having been interviewed for this book, I anticipated its release with some interest. Mitzi Waltz has many publications to her name, with her latest offering attempting to chart social and medical narratives of autism through history. The early chapters of the book are dedicated to the appearance of autistic-like characteristics prior to the naming of autism. The book then goes on to explore the various early constructions of autism from psychoanalytic, behaviourist and cognitive traditions of clinical psychology. In these pages are startling reminders of the dangers of these psychological conceptualisations of autism, an example being Melanie Klein’s interpretations, which I found particularly chilling. It is perhaps the sections regarding the psychological treatment of autistic people that are most pertinent, seeing how such ideologies are still popular and being practised on autistic people today. The text also shows how psychological traditions and the views regarding autism developed in relative isolation from one another. In doing so, Waltz neatly navigates the reader through the rise of psychological and medical interventions designed to try and ‘cure’ or ‘normalise’, and shows how the ‘silo mentality’ within autism studies (Arnold 2010) developed. Woven through this history is also the story of the continuing professionalisation of parenting autistic people, beginning with the Child Guidance movement, through the period of mother-blaming, to parent activism and ‘parent researchers’. Also shown is how many such parents become unfortunately complicit in the othering (and sometimes abuse) of autistic people by the ‘autism industry’ by embracing a medical model of autism. Waltz talks of the seduction of such approaches with their claims of a scientific evidence base and the false promise of normalcy.

Along with charting the history of psychological conceptualisations and treatment of autistic people, Waltz also delves into the history of medical treatments designed to try and cure people of ‘their autism’, as well as how autistic people were confined to long-stay institutions and the abusive practices that autistic people endured. This included passages on the research of Bender, who trialled the use of LSD, electric shock, and insulin shock injections, with the rationale of trying to break through ‘autistic defences’.

The book differs from other texts on the subject, such as Feinstein (2010) and Nadesan (2005), by dedicating the last chapter of the book to the rise of autistic writers and scholars, and the rise of autistic culture. Unfortunately, I felt that this chapter, like that of the rise of parent activism before it, was somewhat on the short side, and that these latter chapters could well have been developed into full books in themselves. The final chapter deals primarily with the expansion of autistic culture and its burgeoning influence on policy-making. I would personally have liked to have seen more on autistic scholarship and theoretical accounts of autism originating from autistic people themselves. Concepts such as neurodiversity could have been explored in more depth, and how such notions are at odds with some of the parent activism and psychological interpretations that are still dominant today.

Although giving a good historical overview and exploring the social construction of autism in a respectful and insightful manner, the reader is left wanting more. With the content being of good quality, one wonders why the book was not lengthier. If I have a minor quibble, it is that, along with deinstitutionalisation, Waltz suggests that the increase of autistic people speaking for themselves has been in part due to improvements in diagnosis and education. Although such changes have been of fundamental importance, one could say that this gives too much credence to the professional gaze and practice. It may have been more accurate to say this was due to a widening of diagnostic categories, access to technology, and a number of other variables too. The book finishes with utilising the well-known adage that ‘the map is not the territory’. A full historical map of the territory of autism is unlikely to be achievable in one text such as this, but Waltz has certainly added texture to that map. As she herself points out, however, the future mapping of autism and autistic culture will be driven by autistic people themselves. Perhaps what is needed next is an autistic historian to chart the development of our own autistic cultures?

Damian Milton
University of Birmingham, Birmingham, UK
[email protected]
© 2014, Damian Milton
http://dx.doi.org/10.1080/09687599.2014.905281