Going Further with Autism: Assessing Therapies and the Role of Race

Two responses move from Wondrously Wounded to develop constructive proposals about how Christians might think better about autism. Elizabeth Agnew Cochran is interested in how the phenomenon of autism forces an expansion of contemporary accounts of moral agency and human flourishing. Her contribution is to draw together my account of moral agency with that of Grant Macaskill (2019), locating our respective interventions within debates in disability theology about how best to describe the moral agency of people with various sorts of intellectual disability. Cochran’s descriptive work very usefully sets out the convergences (which are many) and differences (a matter of emphasis) in the ways that Macaskill and I theologically account for the moral agency of autistic people. Despite Macaskill and I being colleagues, I found her summary of our points of convergence surprisingly illuminating. Cochran puts her finger on our point of deepest convergence in describing Macaskill’s position. He sees autism in the church “as a concrete context in which individuals negotiate the process of discovering themselves as active moral agents through discerning how to open themselves actively to God’s divine grace.”

Finding herself in agreement, Cochran then suggests that there is more work to be done to specify what this assertion implies about how Christians ought assess various therapies for autism currently on offer. She picks up that both Macaskill and I are leery of attempts to “kill or cure” autism, and that neither of us have presented any work theologically analyzing the different therapeutic options. Cochran is surely right that this work needs to be done, and when it is done will need to pay just the sort of close attention to the concrete techniques being proposed she advocates.

I also wholly agree that the impact of race on the diagnosis and treatment of autism deserves much more analysis than it has received so far. My own experiences as a white parent of a white autistic child while on sabbatical for a year in the southern United States were nothing short of hair-raising. What was shocking was how racially coded the whole system of medical diagnosis and special schooling are in the American South. Our experience with the school system corroborates the story Cochran recounts of Cheryl Mattingly, an African American parent of an autistic child. I buried my observations on racial injustice in a long endnote near the end of Wondrously Wounded, which I introduce here to atone for consigning it to the notes and also to underscore Cochran’s point.

Many of the stories in this chapter originate in the American South. I have made the perhaps indefensible decision not to highlight the significant threads of race that weave through all these stories, in part to protect some of the characters, and in part to keep the stories focused. To be a white disabled child in Durham, North Carolina, for instance, is to be forced across the race line. Adam was picked up by a black taxi driver for his trip to school, driven to the black side of town, where he was one of a tiny minority of white children in a sea of black faces. As white Americans, Adam forced us to learn what it means for a black child to be classed as disabled. One school meeting to consider Adam’s disability classification was particularly memorable in being attended by no less than a dozen white professionals. Only later did we learn that this overwhelming show of expertise had been arranged because African American parents often resist the labelling of their children as multiply handicapped. There is good reason for this resistance, as such a label virtually guarantees a child will never escape the backwaters of social-service provision. The most heartwarming event of that year was the spontaneous volunteering of a few of Adam’s African American elementary school classmates to go through school dining hall trash cans to find a missing hearing aid. That is gratuity.

I would have loved to have done more justice to the racialized aspects of this story. But the subject of disability and race in America deserves its own book. It is a history full of horrors very much ongoing. As J. Kameron Carter once observed to me, the root of these trajectories was the premise of the founding fathers that black people were too intellectually feeble to govern themselves. (Brock 2019, 325-326 n.18)

The impact of the racialized nature of medicine, education, and economy on the most vulnerable in the United States is one of the entrenched cultural configurations I have in mind when I resist giving up the language of divine assault and judgment on human sin. I would even heighten Cochran’s lament that African American children in need of special support are not only being diagnosed later, but differently, and in racially coded terms. This is a recurrent and widespread feature of psychiatric diagnosis and healthcare in the United States, and one intertwined with the disproportionate incarceration of African Americans (Metzl 2009). It is out of a desire to honestly face socially entrenched injustices such as these in all their concrete and ideological complexity that drives my insistence that it is naïve to think that the social changes disabled people deserve will come without confrontation and political conflict. Too many of us have a stake in preserving the racial, medical, and economic status quo. The wellspring of its overturning begins, among Christians, when they become willing first to pray for, and then begin to actively hasten toward, an overturning that seems impossible according to human perception.

Arise, Lord! Lift up your hand, O God.

 Do not forget the helpless (Psalm 10:12, NIV).

I am looking for people who are already passionately praying this prayer and seeking to multiply their numbers.

Praying the canonical scriptures is a tradition-formed resource for getting the discipline of self-criticism as social criticism moving. In contrast to dominant strands of eastern monastic prayer, the Western monastic tradition has emphasized that prayers are the tools of good works (Benedict 2011, chap. 4), and may even be the reason why the west as a whole tends toward an activist ethos (Stolz 2021, 21-22). When we take such canonical prayers on our lips and into our hearts, they become available to us as last and measure on which to form our thoughts and desires, an anvil to hammer our inner world into sanctified shapes. Modern Christians are especially in need of this work of internalizing the hopes and faith of the saints who preceded us because our world trains us to look everything up and internalize nothing. I have offered a few simple prayers in these responses as invitations to meditate on in a contemporary church that has all too obviously forgotten to stand with the least able. Asking whether we can pray these words in good faith is an invitation to face the possibility that we might be ensnared in self-deceit (James 1:22).