The Myth of Autism: medicalising men’s and boys’ social and emotional competence is a new book by Sami Timimi, Neil Gardner and Mr Brian McCabe. Timimi  is a Consultant Child and Adolescent Psychiatrist who has written previously on the medicalization of behaviour, particularly in relation to ADHD. See, for example,
Naughty Boys: Anti-Social Behaviour, ADHD and the Role of Culture.Gardner and McCabe both have a diagnosis of Asperger Syndrome and have found that disclosure of their diagnosis has impeded their career prospects. A full review will follow when I have read the book. What follows are my initial impressions based on the Introduction which is available to download from the publishers, Palgrave Macmillan.

The tone is iconoclastic from the start.

Our book does not merely seek to critically analyse current thinking on autism – it challenges the very idea that a wide range of behavioural patterns and hypersensitivities share the same aetiology, course, treatment and outcome. Indeed we question whether today’s definition of autism reflects a disorder at all, let alone a genetic, neurobiological one.

They invite us to dissect and critically appraise the idea of an autistic spectrum. They question whether “autism” can be usefully applied even to those children who regress into autistic isolation after initial normal development. Autism is a label that should be abolished because there is insufficient evidence to support some of the basic premises of the autism industry such as

• genetic/biological inheritance
• life long persistance of the condition
• the ability to reliably diagnose autism both in relation to “normality” and to other conditions
• the efficacy of current interventions and therapies.

There is a case to be made for all their arguments. In particular, many of us in the “autism industry” are concerned about the lack of empirical evidence to support many of the interventions for autism, both medical and educational. This has led in the UK to the development of Research Autism which has a specific remit

to carry out high quality, independent research into new and existing health, education, social and other interventions. Our goal is the improvement of quality of life and outlook for the individuals affected and those around them.

They are also right to raise the question of the lack of emphasis on ethical considerations for the rights of the subjects in the design and implementation of many scientific studies of autism. But I am concerned that the authors are setting up the terms of the debate in a manner designed to preempt any possible criticism of their conclusions. They refer to the “so-called science” of their critics and its ideological underpinnings. But to what extent are they prepared to acknowledge their own ideological underpinnings? Their argument that the failed science of the autism industry is a reflection of the values of neo-liberal capitalism and owes its current hegemonic status to this fortuitous coincidence is a bold claim. It draws strength from the Marxist idea of base and superstructure whereby the fundamental, socio/economic structure of any given society influences the status of ideas that exist within the ideological superstructure that arises from the economic base.

They lean heavily on the work of Habermas, who, as a Marxian rather than a Marxist philosopher took the concept of (economic) base and (political) superstructure and developed it as a tool to appraise the role of ideology in subverting science. Ironically, they also rely upon Karl Popper‘s criteria of refutability to dismiss the scientific merit of much autism research. Popper, most famously in “The Open Society and its Enemies,” set out to dismiss the intellectual merit of Marx and his successors. I look forward to reading how they resolve this apparent contradiction in a Marxian/Popperian synthesis.

Despite these misgivings I look forward to reading “The Myth of Autism” in the hope and expectation that it will deliver valuable insights into our understanding of autism. Whether or not it succeeds in refuting the concept of autism remains an open question.