Diagnose, Understand, Embrace

CMAJ Humanities

Books Diagnose, understand, embrace

The Autistic Brain: Thinking Across sensory aspects of autism, especially the Spectrum the importance of visual thinking and Temple Grandin and Richard Panek recognition of patterns. Houghton Mifflin Harcourt; 2013 Even though The Autistic Brain aims to be scientific and objective, it is still a very personal book. It is not possible to hysicians know that human expe- separate Grandin’s narrative from the rience is infinitely complex and subject matter, even though this is not, P variable. The insight that “every- strictly speaking, an autobiography or one is unique” sounds like a T-shirt slo- memoir. She talks about her personal gan or a platitude that a therapist might and professional life throughout, but in recite reassuringly, but doctors have both an incomplete way that leaves many a scientific and clinical perspective that unanswered questions. It is possible affirm the statement’s profound truth. that these gaps could be filled in by Every person is different, inside and out. reading Grandin’s other books or by Our preferences, sensitivities, strengths, watching the film about her life. But for emotions and cognitive processes com- the reader encountering her for the first bine in ways that can never be replicated, time, it is not always easy to piece the even if the effects of varying environ- story together. Even more striking is

ments and experiences could somehow Harcourt Houghton Mifflin the impersonal way Grandin approaches be factored out of the equation. the personal. She repeatedly reports on At the same time, there are ways in nalist. In The Autistic Brain, Grandin and her own cognitive processes and view- which we are more or less similar. The Panek draw heavily on Grandin’s experi- points in a detached, observational man- tension between sameness and differ- ences as a person with autism to provide ner. One could argue that it would be ence may lead us to categorize people. examples and insight relating to the difficult to do otherwise and still be ana- This can be helpful when we identify advances in biological and neurocogni- lytical about her experiences, but the something about group members that tive understanding of the condition. other possibility is that this detachment provides insight into what makes them The book is divided into two sec- is a reflection of Grandin’s cognitive the way they are. But, categorizing peo- tions. The first, titled “The autistic processes. This will interest some read- ple can be harmful if it shuts down our brain,” opens with a historic overview ers, but may be off-putting for others. curiosity, blinds us to within-group dif- of how autism has been diagnosed and This book will likely interest physi- ferences or leads to assumptions about some of the early theories about etiol- cians whose practices focus on autism the capabilities of members of the ogy. It then reviews current neuroimag- spectrum disorders. It may also be appro- group. When categorization is part of ing findings about the brains of people priate for people with autism spectrum making a medical diagnosis, the impli- with autism spectrum disorders, as well disorders and their families, because it cations can be profound for the individ - as efforts to identify underlying genetic includes suggestions on how to capitalize uals and for society. factors. Grandin uses her own neuro - on an individual’s strengths. In general, The problem of how to diagnose, imaging results as a case study as she the authors are optimistic that increasing understand and embrace conditions on discusses how the heterogeneous find- scientific knowledge about autism, com- the autism spectrum is the subject of The ings in the literature can apply to indi- bined with a more nuanced understanding Autistic Brain: Thinking Across the Spec- viduals. She clearly finds it helpful to of the cognitive and sensory processes, trum by Temple Grandin and Richard relate her neuroanatomy to her experi- will lead to more accurate diagnoses and Panek. Grandin is a well-known animal ences; for example, learning she has better quality of life for people with scientist who has autism. She has written enlarged amygdalae helped her make autism spectrum disorders. a number of commercially successful sense of the panic attacks she experi- books about autism and animal welfare enced in the 1970s. In the second sec- Lara Hazelton MD intended for a general audience and is the tion of the book, “Rethinking the autis- Psychiatrist Halifax, NS subject of a biographical film. Her collab- tic brain,” Grandin and Panek explore orator, Richard Panek, is a science jour- what is known about the cognitive and CMAJ 2014. DOI:10.1503/cmaj.140042