Those readers who have read 'The Man who Mistook his Wife for a Hat' will be familiar not only with Oliver Sacks' inimitable prose but also his view of his neurological patients not so much as disordered but as having a valid alternative perception of the world. This latest book is no disappointment. In it Sacks looks at a further seven cases with which he has been involved. These range from an artist who lost all perception of colour after an accident to a surgeon with Tourette's syndrome who miraculously loses all his tics the moment he starts to operate.
ALAS members will be most interested in the final two studies which concern two well known individuals with autism, the savant artist Stephen Wiltshire and Temple Grandin, who has a highly successful business designing cattle handling equipment. Sacks spent some time travelling with Stephen Wiltshire and describes not only his prodigious artistic talent but also his attempts to get to know Stephen as a person. He feels that he does not really succeed in this and that Stephen's art, though showing remarkable perceptual gifts, is not truly creative.
I was particularly fascinated by the chapter on Temple Grandin as it gave a chance to compare her self- perceptions in her autobiography with the observations of an outsider. Whereas Temple tends to describe her autism largely in sensory and biological terms Sacks also looks at cognitive and affective factors. There are many amusing touches - I particularly like the passage where Sacks is sitting in Temple's office after a long journey gasping for some coffee. After an hour of being talked at, he finally has to ask for a drink. Temple hasn憈 thought to offer!
The title of the book comes from Temple Grandin's own description of herself - she is an alien still engaged in trying to puzzle out our strange world. I heartily recommend this book, as it is entertaining as well as informative and I am pleased to see that Oliver Sacks treats people with disabilities with respect not pity.
Lesley Black
(From ALAS newsletter Feb 94)
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Some readers will already know of Tony Attwood as the author of the excellent NAS pamphlet 'Why does Chris do that?' The same practical note is continued in his recent book on Asperger's Syndrome. This book will be a godsend to all parents who do not have the time or energy to wade through weighty academic tomes or who need something to thrust into the hands of uncomprehending relatives or school staff.
Although based on sound research and on the author's extensive clinical experience, the book is refreshingly free of obscure jargon - full references are available as an appendix for those who want them.
Tony Attwood starts off by looking at how a diagnosis of Asperger's Syndrome is made. He considers that there are six likely pathways to a diagnosis, ranging from children who receive a diagnosis of autism in early childhood but who then develop in a way more consonant with AS to adults who perhaps have a relative with the syndrome and then begin to have doubts about themselves. Further chapters explore social behaviour, language, interests and routine, motor clumsiness, cognition and sensory sensitivity. Each chapter ends with a brief summary of strategies for that particular area of difficulty, set out in bullet point form.
The last section of the book consists of 23 frequently asked questions. There is no subsidiary table of contents for this section and in order to find a specific piece of information one would need to read it right through or use the general index. Much of the information e.g on causes, relationship to other disorders would have been better incorporated into the main body of the book. Many of the questions in this last section are to do with adult life - very refreshing in a field where the emphasis often seems to be on young children.
One of the strengths of the book is the use made throughout of quotes from people who have Asperger Syndrome. Tony Attwood lets them speak for themselves in order to illustrate the ways they have found of coping.I felt that the book was very positive in its outlook. Asperger Syndrome is seen as a difference, not a tragedy and so this book could usefully be read by people with the condition, as well as parents and professionals.
Lesley Black
(From ALAS Newsletter - May 1998)
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A fascinating and in some ways disturbing book, which is part of Donna Williams' ongoing journey to self-understanding. This book develops some of the ideas on sensory mapping and self-other understanding that are mentioned in her previous book 'Autism - an inside out approach' (see ALAS newsletter June 1996).
Donna Williams argues that autistic people apprehend the world in a totally different way, though 'sensing' rather than though 'interpretation'. She sees this as a relic of an earlier evolutionary and developmental state, hence the 'unlost instinct' of the title. 'Sensing' similar to the instincts of animals, enables Williams to go directly to the essence of people and situations. 'Mind' and 'interpretation' on the other hand may only serve to overlay a socially constructed meaning on events or to to encourage people to develop a false self. The author claims that she is now able to move between the two systems and so act as a bridge between autistic and non-autistic culture. However since she also has much more sensory involvement than many other people with autistic spectrum disorders, I would be wary about the validity of extending her conclusions to all autistic people.
All in all, I have mixed feelings about this book. It does pose important questions about the self and what it is to be a person, on the other hand when Donna Williams talks about spiritualism and not yet fully incarnated beings. I did feel uneasy. Much of the language is religious in tone and I wondered if the book might not belong more in the spiritality section rather than psychology. Interesting, certainly, but not primarily about autism, and certainly not for the unwary.
Lesley Black
(From ALAS Newsletter - October 1998)
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In this new book Donna Williams has moved on from describing the events of her own life to trying to explain what autism feels like from the inside and to help those on the outside towards a greater understanding of autistic people.
Throughout the book Donna Williams refers to 'autism' in inverted commas as she appears to see the very different causes as being more important than the symptomatology. She replaces the conventional 'triad of impairments' by her own triad of causes of autistic difficulties, namely problems of 'connection', 'tolerance' and 'control'. These are fleshed out somewhat by taking examples from a hypothetical class of autistic children, though I must admit I found this quite heavy going as the categories were unfamiliar. I was not sure what effect this has on the concept of autism as a syndrome. Is there indeed such a beast?
Donna Williams also runs through some of the current therapeutic interventions in autism. She has clear favourites here. Irlen tinted lenses are in but AIT is a non- starter. Her main emphasis is on biochemichal interventions as she clearly feels these have helped her. This section could have done with more precise references to existing research.
It was interesting to see what links could be made with other explanations of autism. In fact there were more than I expected. The children in the fictional classroom are described as not demonstrating awareness of other minds though unfortunately this theme is not further developed. The section on information processing contains a lot of material on triggered serial memory as opposed to personally significant memory. this appears to have a lot in common with recent writing by Jordan and Powell on personal episodic memory and the experiencing self.
Donna Williams gives practical advice on helping autistic people to make connections in a chapter entitled 'artificial limbs' This is excellent and would provide a useful focus for parents and teachers. the metaphor is telling; indeed one of the delights of the book is the way that Donna Williams uses extended metaphors to explain her points. One such is that of a telephone call with crossed lines wrong numbers and disconnections. The author is also at times wonderfully direct. If words such as 'yucky' and 'poo' express her meaning then she is not afraid to use them.
Throughout the book the message comes across loud and clear that one must look beyond the surface behaviour and that one must show respect for the autistic person. Donna Williams rightly emphasises the danger of merely forcing the autistic person to 'act normal' - though this may sometimes have its place - as what we see as problems may in fact be hard won compensations to a world often devoid of meaning.
On the whole the book is at its strongest where it is personal and practical. I am not so sure about the theoretical underpinnings. I felt that it is still about Donna Williams trying to understand herself and to put her experiences into a framework which will make sense to herself and to other people. I also have not quite worked out her relationship to her autism, whether she feels it is an integral part of her personality or something to be overcome.
The book is certainly interesting and challenging and I would recommend it to all professionals working with autistic people, if only to shake them for a time out of their preconceived ideas. Likewise it would help parents who have been living with autism for a bit to take a fresh look at their child and try to work out what is going on in that particular individual. I would not particularly recommend it as a 'first read' for parents of newly-diagnosed children.
Lesley Black
(From the June 96 newsletter)
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The book is intended to provide an overview of current thinking on autism for psychology students but some parents would find it interesting. I certainly did.
Dr Happé begins by carefully distinguishing explanations of autism at the biological, cognitive and behavioural levels. After chapters looking at autistic behaviour (and how it fits with current diagnostic schemes) and biology, the rest of the book focusses on psychological aspects. There is a lot of material on theory of mind but problems with executive function and central coherence are covered as well. I think that Dr Happé does an excellent job of refining the Theory of Mind hypothesis so that it becomes much less of an all or nothing thing. She looks in particular at those autistic people who do pass standard Theory of Mind tests either at a first order level (understanding beliefs about the world: Sally - Anne test) or at a second order level (understanding beliefs about beliefs: ice-cream van test). She claims that there are real differences in social functioning between autistic people who fail the tests and those who pass at different levels.
Also, while she agrees that some individuals with autism do eventually develop Theory of Mind and can pass the tests she argues that this does not mean that they use this capability in the same way as other people.
To test this idea further, Dr Happé has devised a set of 'strange stories' which test understanding of speakers' intentions. They come under headings such as White Lie, Lie, Pretence, Irony etc. The stories represent situations which are more akin to normal social interaction than the highly structured Theory of Mind tests. I won't go into details here, but the autistic people tested performed worse on the stories than on the tests. According to Dr Happé, this may be because of difficulty in using contextually embedded information (weak central coherence). This would account for difficulties in using theory of mind skills in real life.
Personally I think she has a good point here. My son Matthew was tested by Dr Happé last year and as I expected was able to pass both 1st and 2nd order tests - he is well able to talk about states of mind - but his answers in the strange stories were not what one would expect from a child of his intelligence and mirror his continuing social difficulties.
The book also contains a chapter on Asperger Syndrome and the confusion surrounding the meaning of this term. Dr Happé seems to think that at present the disorder is ill-defined and the diagnostic schemes are unclear, particularly where it comes to differentiating it from autism. She would like to restrict the term to those autistic people who have acquired real Theory of Mind competence though may still have difficulty in applying those skills. This is an interesting suggestion - any opinions?
The final chapter looks at weak central coherence, which the author sees as possible responsible for some of the non-social features of autism e.g.restricted interests, islets of ability.
I don't think I have done the book justice, as it has an awful lot of information packed into it. You will just have to try and track it down yourselves.
Lesley Black
(From ALAS newsletter October 1994)
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This excellent book fills a gaping hole in the literature as most books on autism are still written with children in mind. Pat Howlin's particular focus is on adults and adolescents at the higher end of the spectrum as they are more likely to be living independently in the community, less likely to obtain specialist services and the demands made by the world much greater.
The author looks at the specific autistic difficulties with communication, social functioning and obsessive behaviours and how they affect adults. All examples are taken from real life and I must admit some had me laughing out loud as they illustrate so well the far-reaching effects of even subtle misunderstandings. One such is the young man who when the clean underwear in his drawer ran out, started taking dirty pants out of the washing basket. After all he had only been told to 'change' his underwear every day.
There are lots of extremely practical and helpful ideas in the book which also has chapters on secondary and further education, employment, legal issues, sexual relationships and fostering independence.
The overall message of the book is that there will be difficulties into adult life, but that low expectations can be damaging too. Dr Howlin insists on the necessity of gaining academic qualifications as a prerequisite to an independent life.
In short, as the parent of a 14 yr old I found this book one of the most relevant things I have read for a long time and would heartily recommend it.
Lesley Black
(From ALAS Newsletter - February 1997)
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This is an excellent book which I wish had been available for us. Having spent days submerged in clinical textbooks and been thoroughly depressed by their content, I would recommend it to all parents as the first book they should read.
First of all, it gives comparative pictures of two children with autism, illustrating some of the wide variations of abilities and behaviour that exist within the condition. It goes on to describe how a diagnosis is reached and what criteria are used. I think many parents will read the description of the assessment with a wry smile as such a well-defined procedure is frequently not the case, due mainly to the lack of professionals experienced in recognising autism. However, since the parents are reading this book, that hurdle, at least, will presumably have been cleared. The book covers parents' reactions to the news and ways of coping, and how to tell the aware autistic child about their condition, as well as siblings. There is discussion of the possible causes of autism, and how genetics might be involved. Various therapies are described and whether they have been found to be helpful.
There is a very useful chapter on education in which the authors describe the progress which children can make when placed in a teaching environment geared to their specific needs.
The use of drugs is also described, and the last chapter deals with what one's expectations might be for the child with autism as he or she grows up and reaches adulthood.
Throughout, the authors' positive approach is apparent. They give sound and sensitive advice, and encouragement based on realistic expectation. It is easy to read and avoids jargon. As an introduction for professionals who do not have experience of autism, but work in areas where they might come across this baffling condition, it should be obligatory reading.
Jenny Ronayne
(From ALAS newsletter June 1993 - This review first appeared in
Communication June 1993)
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One of the books recommended to me following my son's diagnosis in 1990 was 'Treatment of Autistic Children' by Howlin and Rutter (et al.) I remember sitting down very seriously and starting to make notes on the book, as if for academic study. Well, the notes didn't get beyond chapter 1, but the book was incredibly useful for the practical advice which we could adapt to our own situation, although nowadays I find it somewhat overly behavioural.
This new book by Pat Howlin is in direct succession to the earlier volume but has taken account of recent developments in research and is less of a research study and more of a practical handbook. In 300 fairly densely packed pages the book covers most aspects of autism, from diagnosis and genetic factors to improving communication and social understanding, from managing obsessive behaviour to finding suitable education. There is also a useful overview of 'named' interventions.
There is quite a high emphasis on fostering communication skills and social understanding which will in turn have a positive effect on behaviour. Providing a structured, autism-friendly environment is also stressed, though never at the expense of the the family as a whole. Indeed the focus throughout the book is on finding solutions which work for the whole family, including the parents and siblings, not on 'fixing' the autistic child in isolation.
A considerable strength of the book is the extensive use made of references to individual cases, the fruit of Prof Howlin's long clinical experience. The frustrations and triumphs of real families shine through the pages. The book does not offer pre-packaged solutions but more of a toolkit so that families can work out an individualised approach to help them and their child.
Professional readers will find extensive tables and references as well as a sensitivity towards autistic people which they would do well to emulate. Advice given includes the observation that, given the genetic basis of autism, many parents who appear to be awkward and uncooperative may well be on the spectrum themselves and will benefit from clear and unambiguous communication. For parents I would hesitate to recommend it as an introductory read as the amount of material may seem somewhat daunting. It is more a 'moving on' type of book. For those who are willing to put in some effort to work out their own solutions for their individual child, it should prove an invaluable companion over many years.
Lesley Black
(From ALAS newsletter February 1999)
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Julie Davis
Child Development Research Unit, University of Nottingham
Both these booklets have been thoughtfully and sympathetically compiled. They are one outcome of a series of meetings of groups of children who have a brother or sister with autism. Aimed at children of 7 years and up, the booklets begin by describing Asperger's Syndrome and autism and what this might mean to the person who has it.
For a sibling reading these booklets, it is comforting to be able to identify with other children who also have a brother or sister with autism. The booklets contain many useful points for consideration by the sibling (and parent), for example, both how and when we might want to explain the disorder to other people (a new friend, for instance); thinking about how it might feel to have autism; how to advise a friend or visitor to respond to the sibling with autism.
Children are encouraged to express their feelings and list what they feel is good about their brother or sister, as well as what they find difficult and what they would like to change to make things better for themselves as well as for their brother or sister. I am sorry that in the booklet about Able Autistic Children, it is stated that 'autism is quite rare... only about 6 children in 10 000 have autism'. It might be that when these booklets were compiled, this was still the accepted figure. The more recent suggested figure of 1 in 300 for children at the able end of the continuum would be, I think, a comforting fact for their siblings.
At the end of the 'Children with Autism' booklet, there is a touchingly realistic poem written by a 9 year old sibling about how it is to have a brother with autism. It would have been nice to have included a poem, either by a sibling or perhaps even by a child with Asperger Syndrome also at the end of the booklet for siblings of Able Autistic Children.
I would recommend these books to parents even if they feel their other children are coping without too much difficulty. I read it through with my eldest son (9) and it gave him the opportunity to compare how he felt to how others felt who were also in his position. It gave me another opportunity to explain, reassure and inform on aspects of autism and the problems of having a brother or sister with autism in a way that was a natural consequence of having looked through the book together.
Jenny Ronayne
From ALAS newsletter Dec 94. This review also appeared in
Communication Winter 94.
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If there is an adolescent or adult with Asperger Syndrome in your family, buy them a copy of this booklet now. Based on his own experience, the author, himself a young man with Asperger Syndrome, has set out in blow by blow form the unwritten rules which the rest of us tend just to pick up.
There are sections on Worrying, Distortions of the Truth, Conversations, Sex, Friendship and Coming Clean about one's disability amongst other things. The tone is wonderfully direct and the information set out in short manageable chunks.
Reading the book from a non-autistic viewpoint, I was shocked at the amount I take for granted e.g. "An invitation to a party does NOT mean that you have to go if you don't want to".
I would highly recommend this booklet for any young person with Asperger Syndrome aged about 15 upwards. Its big advantage is that it is written by someone who has been through the same difficulties. It is not advice by a bossy parent or interfering teacher. Sadly, Marc Segar died at the end of last year. He has left a fitting legacy in the shape of this book
Lesley Black
(From ALAS Newsletter - May 1998)
'Coping' is available from the Early Years Diagnostic Centre, 272 Longdale Lane, Ravenshead, Notts NG159AH Tel: 01623 490879
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Paul Dickinson and Liz Hannah
published by the National Autistic Society, price £5 + 75p p&p from the
NAS publications dept.
This is a book written by two (almost) local authors in response to a need for easily accessible material for parents. Paul Dickinson was until recently Clinical Psychologist at the Sheldon CDC in Camberwell and Liz Hannah works in Southwark as an outreach teacher with young autistic children and those in mainstream primary schools.
The pre-school years can be the most trying for parents of children with autism and this slim volume will be a boon to many harrassed parents. Much of the existing literature is somewhat dense and can be daunting if you do not have an acamedic background, so it is refreshing to find a book that is clearly laid out with much of the text in a bullet point format.
Some useful general points are given at the beginning - such as the need for consistent handling by all and the fact that miracles do not happen overnight. These are even in a larger print to hammer them home.
The perennial problems of tantrums, sleeping, eating and toileting are well covered as well as self-help skills, obsessional behaviour and dangerous and agressive behaviour. The authors show great empathy with the difficulties faced by parents and are quite clear about the need to ask for help if things are tough.
Although the book is excellent on general behavioural principles, I felt that more emphasis could have been given to understanding the child's behaviour in the light of his or her autism; tantrums as communication are dismissed in one brief paragraph! If you are a parent of a young autistic child feeling at the end of your rope, then 'It can get better..' will help put you back in control. However my hope is that parents will then use it as a spring board to find out more.
I cannot finish without mentioning the wonderfully humorous illustrations, which are a real high point of the book. If you can stand aside from some of the dreadful things your child does and laugh the battle is halfway won.
Lesley Black
(From ALAS newsletter February 1999)
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My first impressions on leafing through the book were of alphabet soup. Can you tell your EDD from your ID, your ToMM and your SAM, to mention but a few? When I settled down to read the book properly I found it highly interesting though I wouldn憈 say that autism is the main focus of the book so the title is slightly misleading in that respect.
Simon Baron-Cohen uses evolutionary and developmental psychology to explore the concept of mind-reading or 恌olk-psychology (i.e. the tendency to explain people憇 actions in terms of imputed beliefs, desires etc.). He hypothesises that this developed in humans as a survival mechanism to cope with living in increasingly complex social organisations. He also looks at the development of these skills in infants and young children.
According to Baron-Cohen there are four mechanisms which form the basis of human mindreading capacity. These are Intentionality Detector (ID), Eye Direction Detector (EDD), Shared Attention Mechanism (SAM) and Theory of Mind Mechanism (ToMM). These develop at different phases in babies and toddlers. To illustrate what happens when development doesn憈 proceed in the usual way, Simon Baron-Cohen takes the examples of congenital blindness and autism. Blind children have no EDD (for obvious reasons) and when very young can display some autistic behaviour. However they do develop shared attention through other senses and are well able to impute mental states. There follows an account of Theory of Mind Experiments on autistic children. (The usual stuff - Sally-Anne and Smarties test etc). Baron-Cohen does state that some autistic people can pass these tests, even at a higher level.
The book also contains a chapter on the possible localisation within the brain of the different mechanisms described and there is a fascinating account of 恡he language of the eyes describing how EDD is used to gauge people憇 intentions (lots of poetic references here). There憇 also a description of how gaze regulation is used by various non-human primates.
Finally Baron-Cohen comes back to autism and examines the example of an autistic person who appears to have developed competence in mindreading - Temple Grandin. This account is based not on personal interview but on the information given in the New Yorker article by Oliver Sacks. Simon Baron-Cohen concludes that Temple Grandin's mindreading is not like non-autistic people憇 as it is based more on logical computation than intuition. So much for a summary of the book. Any misrepresentation is entirely my own. I would say that many ALAS members would find the autism content very familiar. I wouldn憈 rush out and buy the book for that reason. However if you have an interest in Theory of Mind research from a wider perspective it is well worth reading.
Lesley Black
(From ALAS newsletter Sep 95)
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It's hard to know how to begin to tell you about this book. Every parent of a child with autism should read it (as well as every professional involved with autism). Donna tells us of her journey towards understanding herself and others, and describes lucidly how autism is experienced from the inside.
Her lack of understanding of social rules often resulted in her being rejected by others, or worse, led other people to enjoy inflicting horrific treatment on her. Parts of the book are extremely distressing. And yet she was able to take even these nightmare experiences and use them as stepping stones on her journey.
There also are people whose kindliness shines out of these pages. The Miller family, who took great pains first to understand her difficulties and then to find ways of explaining the world in a way that would make sense; and Dr Marek who, as well as helping to clarify a bewildering world, was also instrumental in enabling Donna to overcome her fear of touch enough to be able to use it to communicate simple warmth when she wanted to (rather than at the request of others).
One of the most moving passages is where she is meeting with her Auntie, a woman who has always cared about Donna and tried to communicate with her. During their conversation, Donna reaches out and touches her Auntie's arm, with real and intended meaning. Not surprisingly (to the reader, though Donna may have been surprised by the reaction), her Auntie bursts into tears, overcome by the direct communication which comes so clearly from Donna herself.
Donna meets and recognises other people like herself, but who do not know their problems have a name. Each is relieved to discover that their condition does have a name, and happy to meet another with whom they don't have to pretend to be someone else. The descriptions at the end of the book about how it is to perceive the physical world through the senses of a person with autism made me feel I was being lifted up into a swirl of colours and sounds - unpredictable, intoxicating, irresistible: another world.
Donna also tells us about the growth of a 'specialship' (in our terms a close, special friendship). She lets us see how different are the needs of this relationship compared to what we might need for ourselves. I was left with a feeling of respect for those needs, and also some joy in the knowledge that people with autism don't have to be like us to be happy.
Jenny Ronayne
(From ALAS newsletter June 1994)
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'Adrian wanted a book about trains' At one time the repetition of this phrase was enough to reduce members of the Black household to fits of laughter. One of the first things I did when I got hold of this new book was to check whether Adrian and his trains were in it. Rest assured, they are.
To backtrack a bit... Way back in the summer of 1992, Matthew (as well as some other ALAS children) took part in a research study at the Institute of Psychiatry into the teaching of 'Theory of Mind' skills to children with autistic spectrum disorders. The study was quite successful and the present book is an attempt to make the methods and materials available to a wider audience.
'Mindreading' refers to the ability that most people have to make sense of the behaviour of other people by reference to what they might be thinking and feeling. This is an area which autistic people find notoriusly difficult. So far most of the material written on the subject has been rather theoretical and academic.. This new book is an attempt to redress the balance and provide some practical materials for parents and teachers to use.
The book covers three main areas, understanding emotions, understanding beliefs and pretend play. The section on emotions is much the longest; this was also the most successful in the original research study. Levels range from recognising simple facial expressions to predicting people's emotions based on what they think is the case. A wealth of graded pictorial examples is provided for people to work through. Desires and beliefs are represented by a small inset picture, demonstrating that they may differ from the actual situation. For instance, Adrian may be getting a book about cars but want and think that he is getting one about trains. In the original study the pictures had blank faces but there were pull out strips which revealed a face with the correct emotion. It's a shame this isn't suggested in the book, as not only is it fun for the child, there is also less opportunity to argue about the 'right' answer.
The other two sections are somewhat disappointing and provide general principles rather than specific material. Teachers wanting to work on understanding of beliefs will have to be more imaginative in producing their own material. It would also have been useful to include more tips on how to foster 'mindreading' skills in everyday life.
The book is however worth getting for the emotion material alone, which can be used 'off the shelf'. It will be interesting to see how it is used in practice. I am probably not the best person to judge as the materials were already familiar and in any case Matthew is well past the stages covered. If anyone is using the book practically with their child, do write to the ALAS newsletter and let us know how you get on.
Lesley Black
(From ALAS newsletter February 1999)
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This book is no less than an inspiration. The author, Jasmine Lee O'Neill is severely autistic and does not use spoken language. However she writes and draws delightfully and has a sense of her own worth and of her particular place in the world which many so-called 'normal' peole would be hard put to equal.
The author draws us into her own inner world and explains the threatening and confusing nature of the outside world for a young autistic child. We are given insight into their often overwhelming emotions and sensory sensitivities.
The whole book is suffused with a sense of gentleness and of respect for the autistic person's differnce. There is also understanding that it can be difficult for parents, particularly during the teenage years.
I do not agree with everything that Jasmine Lee O'Neill says. I do for instance believe that people with autism do need to some degree to learn to adapt to an alien world. However the plea for acceptance of people who are different is one that desperately needs to be heard.
This is a short review, but then it is only a slim volume. Do read it, especially if you feel that people with autism should be changed into what they are not. Your perceptions may be altered.
Lesley Black
(From ALAS newsletter February 1999)
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This book, published very recently is written by two people who are trained teachers as well as specialists in autism. The book is aimed at professionals who are concerned with children with autism but it would be useful to those working with adults as well as parents. It considers the fundamental problems of autism, including social and emotional aspects plus communication, language and thinking. There is a chapter on behaviour and the book tries to offer strategies which could be used both at home and at school.
There is some discussion of current research and how this may affect our methods and a final chapter which reminds us that before we can provide successful education we must first understand the children themselves. The authors are concerned to remind us that we do not yet have all the answers and must continue to respect those with whom we work. This book contains much information that is useful and is well set out although initially may appear somewhat daunting as there are no pictures or diagrams.
Gill Stephenson, Specialist Speech and Language Therapist
(From ALAS newsletter Nov 95 )
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Those readers familiar with the work of Uta Frith and Simon Baron-Cohen will know of their hypothesis that autistic people fail to develop a 'theory of mind', that is to say they do not take account of other people's knowledge, beliefs and intentions.
This new book brings together current research in the field of 'theory of mind' such as can normally only be found in academic journals. It is therefore a boon to those like me who have no access to a research library. Contributors come from all over the world; names familiar to British readers will be: Simon Baron-Cohen, Uta Frith, Peter Hobson, Patricia Howlin and Michael Rutter. The book is particularly interesting in that it covers a wide range of opinion. While most of the contributors acknowledge that people with autism do have difficulty understanding other minds, not all agree that this is the primary cognitive deficit.
The main body of the book is made up of chapters on language, pretence, deception and social development in autism among many others. All these areas are examined with reference to 'theory of mind'. There are also perspectives from normal child development, animal studies, philosophy and psychoanalysis. On the whole this is a detailed academic text, highly recommended if you have a theoretical interest in 'theory of mind' research. There is not much of direct practical value to the average parent. However ch.21 by Simon Baron Cohen and Pat Howlin on questions of teaching and diagnosis might be of interest, particularly to those whose children took part in Julie Hadwin's study last year.
I think that Understanding Other Minds is a brilliant book as it caters for my own special interest. I might consider hiring out my copy when I have finished reading it in about a year's time!
Lesley Black
(From ALAS newsletter June 1993)
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Bryna Siegel is a very experienced clinician whose aim in this book is to distil her own experience for the benefit of others. Her comprehensive account of theoretical aspects of diagnosis and treatment is fleshed out by many anecdotes from her own caseload, which will strike a chord with families.
The early chapters of the book focus on diagnosis and aftermath. Siegel acknowledges the wide range of symptoms present in autistic spectrum disorders, pointing out that no child is going to exhibit all of these.
The chapter on diagnostic definitions may be slightly confusing to a non- American audience as Siegel sticks to the American DSM IV diagnostic scheme and makes frequent use of the term PDD which is not so common here. PDD is equivalent to atypical autism or 'somewhere on the autistic continuum'.
Family issues are very well covered, including subjects such as guilt and denial and different ways of coping with the diagnosis. The stress that an autistic child can place on the family is fully acknowledged. Bryna Siegel stresses that treatment is the best way to acceptance and that diagnosis should never be in a vacuum but always linked to a treatment plan. Different parenting styles are also examined with no-nonsense authoritarian parents seen as the best for an autistic child. I didn't feel Dr Siegel would rate me very highly, not only do middle-class liberals get short shrift; she also discourages parents from getting into the research literature
As this is an American book much of the detail in the resources section is not relevant. However the descriptions of having to fight to obtain services and the areas of conflict e.g. over getting a place in a specialist private school will be familiar. Although the SEN categories are different there is useful advice on what to look for in a school and good hints on observing classes as well as the constraints on and prerequisites for mainstreaming. Behaviour management in the classroom is well covered as are communication skills. However I found the overall emphasis reflected a very behavioural attitude and the approach to education was overwhelmingly vocational.
Finally Dr Siegel covers a number of 'think-twice' non-mainstream treatments as well as a comprehensive accounts of different medications which can be used in autism (this is an American book, after all).
The overall quality of this tome is sadly somewhat marred by frequent typos such as 'autsitic'.
All in all I would recommend this book as a reference work to come back to again and again rather than to be read in a single sitting.
Lesley Black
(From ALAS Newsletter - February 1997)
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