I was recently invited to provide a guest blog post to the Cortical Chauvinism blog where I outlined some of my concerns with Silberman’s Neurotribes. It gives brief overview of some of the concerns which I have written about in various publications. Here is the link.
Back in April I presented alongside Rachel Cooper at an event set up by Accrington and Rossendale College. I wrote this blog post for the Lancaster University Bioethics and Philosophy of Medicine Blog but I thought I would reproduce it here since I mainly spoke about the History of Autism. Details on Rachel’s talk can be found on the Blog post.
My talk was entitled Lessons for today from the history of autism. The first half of my presentation was largely a re-cap of my previous criticism of Neurotribes (https://www.sciencedirect.com/science/article/pii/S1369848616300954). In this book Silberman (2015) argues Leo Kanner’s original description of autism (1943) was of a disorder that was “vanishingly rare” and “monolithic by definition”. Silberman argues that Kanner’s ‘autism’ was quite unlike the condition described as autism today. He claims that modern notions of autism have a significantly better scientific foundation and are much more suitable for neurodiversity than Kanner’s approach was.
However, in this paper I argued that when properly understood Kanner’s autism is much more like the autism that is described today than Silberman acknowledges. I argue that it is crucial to appreciate that Kanner considered autism to be a subtype of childhood schizophrenia (Kanner 1969). I argue Kanner thought it was only vanishingly rare in the sense of it being a rare subtype of the fairly common childhood schizophrenia. I accept that Kanner’s autism did have quite restrictive symptoms (even if it was not monolithic) but I situated it as being a subtype of a much less monolithic childhood schizophrenia which shared many symptoms of Kanner’s autism but did not require the stringent diagnostic criteria. Silberman claims that adherence to Kanner’s views prevented the full autistic spectrum being recognised for many decades but, if you consider Kanner’s views on childhood schizophrenia, it looks like Kanner endorses a position quite like a spectrum.
In the second half of my presentation I discuss some of my more recent research. I outlined Lauretta Bender’s (1956) approach to childhood schizophrenia and considered how elements of her approach fit modern psychiatric evidence surprisingly well. Additionally, they could be used to formulate alternative approaches to neurodiversity, one based around meaningful subtypes with nuanced inter-relationships between them, rather than an account of neurodiversity based around the DSM-5 spectrum which lacks subtypes.
As far as I was aware, none of the audience were professional historians or philosophers. I found it positive to deliver my work to a wider audience, getting the findings of my research out to a wider audience. Some of that audience were mental health professionals or training to become mental health professionals, thus some are or would be interacting with autistic people regularly in their line of work. As a historian and philosopher my work often can be a bit removed from actual practise, thus it was good to be speaking to and opening dialogue with individuals who have much practical hands on experience of working with autistic individuals. The audience were engaged and asked interesting questions. These included questions about alternative ways of thinking about diagnosis, what the value of diagnosis was, how to keep in focus the aspects of the individual not covered by the diagnosis and even if diagnoses were needed at all. I think these are all important questions and it was good to see questions about them. Overall, I feel that academics often do not engage sufficiently with the world outside academia. It was very encouraging to attend a talk which was so well attended by an audience who asked engaging questions so I feel the whole process was very much a worthwhile experience.