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Book Review   |    
Adults With Autism: A Guide to Theory and Practice
Clara Claiborne Park, M.A.
Psychiatric Services 1998; doi:
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by Hugh Morgan, with contributors; New York City, Cambridge University Press, 1996, 290 pages, $90 hardcover, $32.95 softcover

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A book designed to provide practical help and guidance specifically for those who work with, and for some who live with, autistic adults is a valuable addition to the literature. Whatever the current interventions, children with autism are still likely to grow into adults with autism, and increasing awareness, both public and professional, of the autistic syndrome guarantees that the number of identified adults in need of supportive services will continue to increase.

It is the strength of Hugh Morgan's book to show how these services—residential, educational, vocational, recreational—largely developed for a heterogeneous population, must be adapted to meet the very specific cognitive and emotional needs of autistic adults. The author is affiliated with the West Midlands Autistic Society, and certainly several of the book's 12 chapters are too rooted in the situation in Britain to be applicable outside it. Other chapters, however, make the book well repay attentive, though selective, study.

The opening international survey stretches from Chile and Australia, and India and Japan, to Luxembourg and Iceland. American experience is not covered in this chapter, but is present throughout, particularly in reference to Schopler and Mesibov's influential work with adults at the University of North Carolina Medical School's Division TEACCH. A second chapter discusses issues in the prevailing "ideology of normalisation," arguing that a rhetoric of individual rights and choices may shortchange the very people it is meant to benefit when it disregards the "specific restrictions people with autism have in making sense of their world," thus "deflect[ing] attention from the very areas in which [they] need most support." Anyone who has lived, or worked, with autistic people knows that they are not "just like us" in the way they experience the world, and that respect lies in the recognition of difference, not in its sentimental denial.

This point is vividly illustrated in a chapter by Rita Jordan and Stuart Powell, "Encouraging Flexibility in Adults with Autism." Ways of addressing their "difficulties with change," "lack of spontaneity and initiative," "difficulties with creativity and imagination," and "stereotypical thought and behaviour"—all subsections of the chapter—are not only inventive and useful in reducing anxiety and making day-to-day living endurable, but are based on a humane and knowledgeable empathy with the autistic person's experience of a confusing and largely inexplicable world. A similar informed empathy is evident throughout the book, notably in the chapter on bereavement and loss, where Morgan reminds us that an autistic adult may be as devastated by the unmediated loss of familiar places and objects as of people.

Selectively used, Adults With Autism should be extremely useful in promoting necessary understanding among those who work with this challenging population. Vignettes of actual cases and situations give the book immediacy and life. Full references at the end of each chapter point to the relevant literature. An unusually detailed table of contents as well as opening and closing chapter summaries makes it easy for the reader to select what will be most useful.

Ms. Park is senior lecturer emerita in English at Williams College in Williamstown, Massachusetts, and is the author of The Siege: The First Eight Years of an Autistic Child.

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