Autism and Asperger syndrome in adults

‘Being autistic does not mean that there is anything wrong with you. You are not ill. You are not disordered. You are not impaired’ (64). These words are at the centre, literally and figuratively, of Dr Luke Beardon’s Autism and Asperger Syndrome in Adults, distancing discussion from the still dominant medical reading of autism, a reading the author robustly refutes. In this way he joins a growing number of writers interrogating and troubling the ways in which knowledges about autism are created, and the assumptions on which they may be built (see, for example, Chown et al. 2017; Milton 2016).

While analysing everyday situations and making suggestions for understanding and dealing with them, the author is at the same time advocating for nothing less than ‘a paradigm shift in thinking about and understanding autism’ (18). Beardon calls for a de-medicalisation, a shift away from the ‘negative value judgements’ (65) that an impairment-based diagnosis peddles. He suggests instead a concept of identity, of autistic people as part of a minority group of diverse individuals belonging to a neurotype that processes and perceives information about the social and sensory environment in differing ways to the non-autistic ‘predominant neurotype (PNT)’ (14). Beardon considers autistic people to be disadvantaged by this minority group status and a lack of accommodation and acceptance of their difference, rather than being impaired by a medical condition. The author explores these concepts of disadvantage, and ways to overcome it, through 12 short chapters in which he both deconstructs common assumptions about autism and offers practical solutions to navigating the sometimes-strange world of the PNT.

While the rejection of autism as disorder lies at the heart of this volume, an injunction to criticality when thinking, listening or reading about autism is the starting point, and remains a leitmotif throughout. ‘Never believe anything you read about autism’ (1; original emphasis) are the provocative first words of Chapter One, and act as either promise or threat, depending on the reader’s viewpoint. Anyone coming to this volume carrying the baggage of deficit-based assumptions about autism will need to hold this opening phrase as a mantra in their minds as they read.

Indeed, both the introductory first chapter and Chapter Two ‘What Autism Is (and a Bit of What it Isn’t)’ will, I suspect, make challenging reading for many professionals and researchers. However, as Beardon states while discussing the terms used throughout his book ‘[y]ou pertains to autistic readers’ (3; original emphasis): the author is not playing to the sensitivities of non-autistic readers, but speaking directly to those who identify as being autistic. And these people are not to be considered as a generic type, for there is, says Beardon, ‘no such thing as a “typical autistic person”’ (1). In stating this, and in critically discussing notions such as ‘mild’ and ‘severe’ autism (11), he is on the one hand directly challenging any ‘one size fits all’ approach to autism, and the validity and helpfulness of conceptualising autism on a ‘scale of severity’ on the other. By the same token Beardon echoes what many autistic commentators have been saying for a long time, denouncing the all too common use, in the face of both logic and protest from those most directly concerned, of labels such as ‘high-functioning’ and ‘low-functioning’ (see, for example, Sequenzia 2013). These terms, ‘rife with ambiguity – or even inaccuracy’ (6) at best, hugely damaging at worst, overlook the possible needs for support for some, while hiding the potential of others behind the cloak of an assumption of deficit. What is important, Beardon suggests, is to consider not ‘levels of functioning’ but the ‘impact that being autistic has on a person at any given time’ (11; original emphasis). This allows for a pragmatic and social reading of autism, rejecting the medical model without denying the reality that being autistic in a non-autistic world can have serious repercussions.

This reading necessarily critiques the arguably unethical approach of unfavourably comparing difference with a supposedly superior norm, and assuming deficit as a consequence. One area in which this is both flagrant and common is that of the lack of empathy often attributed – quite wrongly, as Beardon points out – to autistic people, and often discussed in academic and popular literature as fact. As the author says, while ‘autistic people might have problems with understanding the thoughts, feelings, beliefs and behaviours of the PNT’ (16), this is a two-way street, and understanding autistic ways of being are no less of a challenge for non-autistic people. This mutual incomprehension, which Milton (2012, 883) calls the ‘double-empathy problem’ and Beardon refers to as ‘cross neurological theory of mind’ (16), is discussed further in Chapter Three dealing with social relationships. Here Beardon notes that while autistic people may be ‘inherently impaired in PNT social skills’ (21), then logically, if the premise of ‘different not less’ is paid more than just lip-service, it has to be accepted that the PNT is impaired in autistic social skills. Impairment becomes a redundant concept, or at least applicable to all groups, dependent on context.

In Autism and Asperger Syndrome in Adults Luke Beardon combines detailed practical suggestions to reduce the effects of disadvantage with a questioning of the assumptions that contribute to create them. He keeps an eye on the end-game, on a change in social attitudes towards autism that would ultimately benefit all individuals, while at the same time considering concrete, although not superficial, solutions to specific situations; in doing so he casts a wide net.

Firstly, for autistic people (as already illustrated by comments from some autistic online commentators; see, for example, Rhi [2017] discussing this volume) this is an enabling, hopeful and pragmatic guidebook to negotiating a world that may have trouble understanding or accepting them. Secondly, while written with adults in mind, the writer makes clear from the start that it is also relevant for children and teenagers, and this book’s inclusion as required reading for anyone looking to work with autistic children could have a real and immediate positive impact on their lives. On the same basis, it could usefully be on the reading list of all parents of autistic children. Finally, this seems to me to be an important book for writers, researchers and practitioners: while many of the assumptions and myths about autism have a depressingly long life, it is becoming increasingly clear that a slow change in the tide of autism knowledge may be taking place, a shift from diagnosis to identity, from deficit to difference. Beyond the ideas and concepts expressed here, the accessibility, humanity and sheer optimism of this book make it an important part of that shift.

David Jackson-Perry
School of Social Sciences, Education, and Social Work, Queen’s University, Belfast, UK
[email protected]
Twitter: @IntersectQUB
© 2017 David Jackson-Perry
https://doi.org/10.1080/09687599.2017.1362181