Don’t trust Putin

Steve Sil­ber­man, who this week won the Sa­muel John­son Prize for his book on autism, ex­plains why he be­lieves the brain dis­or­der has be­come so preva­lent

The Jewish Chronicle - - LIFE - TES­TI­MONY STEVE SIL­BER­MAN

AFEW YEARS ago, af­ter some­one men­tioned to me about the sup­posed rise of autism in Sil­i­con Val­ley, I started read­ing ev­ery news story about autism I could find and down­load­ing jour­nal ar­ti­cles by the score. It soon be­came clear that the mys­te­ri­ous rise in di­ag­noses was not re­stricted to Cal­i­for­nia, where I live. The same thing was hap­pen­ing all over the world.

To put the ris­ing num­bers in con­text, I fa­mil­iarised my­self with the ba­sic time-line of autism his­tory, learn­ing the story of how this baf­fling con­di­tion was first dis­cov­ered in 1943 by a child psy­chi­a­trist named Leo Kan­ner, who no­ticed that 11 of his young pa­tients seemed to in­habit pri­vate worlds, ig­nor­ing the peo­ple around them.Th­ey­coul­damusethem­selves for hours with lit­tle rit­u­als like spin­ning pot lids on the floor, but they were pan­icked by the small­est changes in their en­vi­ron­ments, such as a chair or favourite toy be­ing moved from its usual place with­out their knowl­edge. Some of th­ese chil­dren were un­able to speak, while oth­ers only re­peated things they heard said aroundthe­mor­spokeof them­selves de­tachedly in the third per­son.

Claim­ing that their con­di­tion dif­fered “markedly and uniquely” from any­thing pre­vi­ously re­ported in the clin­i­cal lit­er­a­ture, Kan­ner named their con­di­tion autism — from au­tos the Greek word for self — be­cause they seemed hap­pi­est in iso­la­tion.

A year later, in an ap­par­ent syn­chronic­ity, a Vi­en­nese clin­i­cian named Hans Asperger dis­cov­ered four young pa­tients of his own who seemed strangely out of touch with other peo­ple, in­clud­ing their par­ents. Un­like Kan­ner’s young pa­tients in Bal­ti­more, th­ese chil­dren spoke in elab­o­rate flow­ery sen­tences while dis­play­ing pre­co­cious abil­i­ties in sci­ence and math­e­mat­ics. Asperger af­fec­tion­ately dubbed them his “lit­tle pro­fes­sors”.

He also called their con­di­tion autism, though it’s still a mat­ter of dis­pute if what he saw in his clinic was the same syn­drome that Kan­ner de­scribed. For decades, es­ti­mates of the preva­lence of autism re­mained sta­ble at just four or five chil­dren in 10,000. But that num­ber started to snow­ball in the 1980s and 1990s, rais­ing the frightening pos­si­bil­ity that a gen­er­a­tion of chil­dren was in the grips of an epi­demic of un­known ori­gin. My re­search was fa­cil­i­tated by the fact that our apart­ment in San Fran­cisco is lo­cated just down the hill from the Univer­sity of Cal­i­for­nia, which boasts one of the best med­i­cal li­braries in the coun­try. I be­came a reg­u­lar browser in the stacks, por­ing through ar­ti­cles on epi­demi­ol­ogy, pae­di­atrics, psy­chol­ogy, ge­net­ics, tox­i­col­ogy, and other rel­e­vant sub­jects.

Mean­while, my shelves at home filled up with books like Clara Clai­borne Park’s The Siege, Oliver Sacks’s An An­thro­pol­o­gist on Mars, and Tem­ple Grandin’s Think­ing in Pic­tures. Each of­fered a view of the di­verse world of autism from a unique van­tage point.

Then my real re­port­ing be­gan. I in­ter­viewed an 11-year-old boy named Nick, who told me that he was build­ing an imag­i­nary uni­verse on his com­puter. Chubby, rosy-cheeked, and pre­co­ciously ar­tic­u­late, he in­formed me that he had al­ready mapped out his first planet: an anvil-shaped world called Den­thaim that was home to gnomes, gods, and a three-gen­dered race called the ki­man. As he told me about the civil­i­sa­tion he was cre­at­ing on his desk­top, he gazed up at the ceil­ing, hum­ming frag­ments of a melody over and over. The mu­sic of his speech was pitched high, al­ter­nately po­etic and pedan­tic, as if the soul of an Ox­ford don had been awk­wardly rein­car­nated in the body of a boy.

“I’m think­ing of mak­ing magic a form of quan­tum physics but I haven’t de­cided yet, ac­tu­ally,” he said. I liked him im­me­di­ately.

But Nick’s mother broke down in tears as she told me that he didn’t have a sin­gle friend his own age. She re­called one ter­ri­ble day when his class­mates bribed him to wear a ridicu­lous out­fit to school.

Be­cause autis­tic peo­ple strug­gle to make sense of so­cial sig­nals in real time, Nick didn’t re­alise that his school­mates were set­ting him up for hu­mil­i­a­tion. I won­dered what would be­come of this bright, imag­i­na­tive, trust­ing boy as he got older and his peers be­came ob­sessed with so­cial sta­tus and dat­ing.

Other par­ents shared the in­ge­nious strate­gies they de­vel­oped to help their chil­dren learn to cope with a world full of un­avoid­able changes and sur­prises. A fam­ily event like a first trip on an air­craft re­quired months of care­ful plan­ning and prepa­ra­tion. Marnin told me about the steps that he and his wife, Margo, an in­tern in the Bay Area, took to help their daugh­ter Leah feel com­fort­able on her first visit to a new den­tist. “We took pic­tures of the den­tist’s of­fice and the staff, and drove her past the

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