BIOPOLITICS AND SUBJECTIVITY: THE CASE OF AUTISM SPECTRUM CONDITIONS IN ITALY By M. ARIEL CASCIO Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Anthropology CASE WESTERN RESERVE UNIVERSITY May, 2015 2 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of M. Ariel Cascio candidate for the degree of Ph.D.*. Committee Chair Atwood D. Gaines Committee Member Eileen Anderson-Fye Committee Member Lee Hoffer Committee Member Anastasia Dimitropoulos Date of Defense March 6, 2015 * We also certify that written approval has been obtained for any proprietary material contained therein. 3 Table of Contents List of Tables ...................................................................................................................... 7 List of Figures ..................................................................................................................... 8 Preface................................................................................................................................. 9 Acknowledgments............................................................................................................. 11 List of Acronyms .............................................................................................................. 13 Abstract ............................................................................................................................. 11 Introduction ....................................................................................................................... 16 The Autism Concept...................................................................................................... 16 Experiences along the Autism Spectrum ...................................................................... 16 The Research Questions ................................................................................................ 22 Dissertation Overview by Chapter ................................................................................ 25 Chapter 1: Literature Review ........................................................................................ 29 Chapter Overview ....................................................................................................... 29 Section 1: The Anthropology of Biomedicine ........................................................... 32 Section 2: The Anthropology of Autism .................................................................... 41 Critical Autism Studies ............................................................................................. 42 Cross-Cultural Studies of Autism ............................................................................ 49 Section 3: New Biopolitical Theory............................................................................ 52 Overview of New Biopolitical Theory ...................................................................... 54 Molecularization ....................................................................................................... 58 Somatic Expertise ..................................................................................................... 60 Illness Identities ........................................................................................................ 64 Collective Identities and Biosocialities .................................................................... 65 Cross-Cultural Studies of New Biopolitical Theory ................................................ 66 Section 4: The Anthropology of Youth ...................................................................... 69 Rites of Passage ........................................................................................................ 72 Identity....................................................................................................................... 73 Peer Relationships .................................................................................................... 75 Sexuality .................................................................................................................... 79 Transition to Adulthood ........................................................................................... 81 Conclusion .................................................................................................................... 83 Chapter 2: Background .................................................................................................. 85 Chapter Overview ....................................................................................................... 85 4 Section 1: History of Autism ...................................................................................... 85 Section 2: History of Italian Autism Services ........................................................... 90 Section 3: Management of Italian Autism Services................................................ 100 Chapter 3: Research Design ......................................................................................... 116 Section 1: Conceptual Framework .......................................................................... 116 Section 2: Methods .................................................................................................... 119 Participant-observation .......................................................................................... 119 Staff and Other Professionals ................................................................................ 120 Parents/Guardians .................................................................................................. 121 Youth with Autism ................................................................................................... 125 Data Analysis .......................................................................................................... 127 Dissemination of Results ........................................................................................ 130 Limitations .............................................................................................................. 130 Section 3: Description of Fieldsites .......................................................................... 132 Day Center 1 ........................................................................................................... 133 Day Center 2 ........................................................................................................... 136 Day Center 3 ........................................................................................................... 139 Residential Center 1 ................................................................................................ 142 Residential Center 2 ................................................................................................ 145 Social/Recreational Group 1 .................................................................................. 147 Social/Recreational Group 2 .................................................................................. 152 Results Overview ....................................................................................................... 156 Chapter 4: Professional Conceptualization of Autism ............................................... 157 Chapter Overview ..................................................................................................... 157 Section 1: What is Autism? ....................................................................................... 158 Autism, Asperger’s Syndrome, and Intellectual Disability ................................... 166 What Causes Autism ............................................................................................... 172 Section 2: How Should Autism be Managed? ......................................................... 174 Psicoanalitica .......................................................................................................... 176 Psicologico .............................................................................................................. 177 Ufficiale ................................................................................................................... 178 Psicoeducativo......................................................................................................... 183 Cognitivo-Comportamentale .................................................................................. 184 Relazionale .............................................................................................................. 187 5 Ecologico ................................................................................................................. 188 Psicomotricità ......................................................................................................... 189 Auto-Mutuo-Aiuto .................................................................................................. 190 Specific Approaches................................................................................................ 191 Life Cycle ................................................................................................................ 209 Conclusion .................................................................................................................. 215 Chapter 5: Parents’ Perspectives ...............................................................................