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Wednesday, October 16, 2013

A Trudge to the Roots of Autism: A Book Review

From The New York Times - Science

By David Dobbs
May 13, 2013

Much of autism’s mystery and fascination lies in a paradox: On one hand, autism seems to create a profound disconnect between inner and outer lives; on the other, it generates what the neuroscientist Oliver Sacks calls an essential and “most intricate interaction” between the disorder and one’s other traits.

In the autistic person, it seems, hums a vital and distinctive essence — but one whose nature is obscured by thick layers of behavior and perception. Or, as Temple Grandin puts it, “two panes of glass.”

For a quarter century, Dr. Grandin — the brainy, straight-speaking, cowboy-shirt-wearing animal scientist and slaughterhouse designer who at 62 is perhaps the world’s most famous autistic person — has been helping people break through the barriers separating autistic from nonautistic experience.

Like Dr. Sacks, who made her famous as the title figure in his 1995 collection An Anthropologist on Mars,” Dr. Grandin has helped us understand autism not just as a phenomenon, but as a different but coherent mode of existence that otherwise confounds us. In her own books and public appearances, she excels at finding concrete examples that reveal the perceptual and social limitations of autistic and “neurotypical” people alike.

In “The Autistic Brain,” her latest book, written with the science author Richard Panek, she shows this talent most vividly in a middle chapter that looks at the sensory world of autism.

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See also Dr. Jerome Groopman's review of "The Autistic Brain," in The N.Y. Review of Books.

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It is a world filled with anomalies, in which everyday sensations can be overwhelming: A school bell can feel like a dentist’s drill, a scratchy shirt like a swarm of fire ants. In other cases the autistic person may feel so little sensation that she’ll try to fill the vacuum and create some sort of order — hence the rocking, twirling, hand-flapping, noisemaking behaviors that can discomfit and alienate onlookers.

All of this further complicates the autistic person’s attempt to connect with nonautistic society. “How,” Dr. Grandin asks, “can you socialize people who can’t tolerate the environment where they’re supposed to be social — who can’t practice recognizing the emotional meanings of facial expressions in social settings because they can’t go into a restaurant?”

These glimpses don’t close the gap between the autistic and neurotypical worlds, but they can make the differences less threatening.

Dr. Grandin shows, for instance, that contrary to long-held dogma, we should not mistake problems with social communication for lack of desire for social connection — a conflation “about as apt,” as the writer Steve Silberman recently put it, “as calling those who don’t speak English deaf.”

Such are Dr. Grandin’s strengths. When they burst upon the scene in her 1995 book “Thinking in Pictures,” they amazed people, as they continue to do in many of her YouTube and TED talks (not to mention the 2010 biopic “Temple Grandin,” in which she was played by Claire Danes).

Alas, in “The Autistic Brain,” her fourth book, she largely abandons these strengths, setting out instead to examine autism via its roots in the brain. It does not lead to rich ground.

The book’s middle part is quite meaty. It includes intriguing material on sensory processing and on the strange tensions between inner and outer life, as well as a strong chapter on autism’s changing definition in psychiatry and popular culture.

Unfortunately, this juicy stuff is surrounded by lesser material. Dr. Grandin revisits ideas about cognitive styles and how to find suitable work that she has presented elsewhere. And her opening chapters seek to deliver on the title’s promise with an uneven and often unconvincing roundup of findings from neuroscience and genetics.

She includes a lot about her own brain, comparing her scans with those of sometimes alarmingly small control samples to draw conclusions that stretch the bounds of credible speculation.

I’ll grant that some of the evidence she draws on (and much she does not) shows that the brains of people with autism are marked by a subtle but distinctive array of anomalies in genetic and neural development. They’re built a bit differently and work a bit differently.

But these findings, from fields quite young, so far show very little about how those anomalies create autism. And alongside Dr. Grandin’s rich observations on how the experience of autism differs from that of others, they make a depressingly sparse repast.

In joining the general craze for flashy, oversimplified neuro-genetico-pop writing, Dr. Grandin has plenty of company. The market for books and articles about “The X Brain” or “The Y Gene” has become a runaway brain train.

This book avoids the spectacular derailments managed by some others, but it is disappointing nonetheless — not just because it starts weakly and briefly gathers steam only to plod home, but because its brain-centric framing takes Dr. Grandin away from the realms where she excels.

1 comment:

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