A vast extent of popular literature on autism already exists, and with NeuroTribes tech journalist Steve Silberman adds another weighty tome. The book has broadly three strands: (1) revisiting historical figures who have uniquely contributed to our culture and who Silberman suggests would qualify for an autism spectrum disorder (ASD) diagnosis today (retrospective historical diagnosis being fraught with difficulties); (2) a challenge to the conventional ASD origin story; and (3) a politically astute manifesto lobbying for the recognition of the neurodiversity movement with an implicit endorsement of acceptance rather than ‘cure’ or ‘treatment’.
Silberman challenges the conventional origin story of autism that Leo Kanner and Hans Asperger discovered the concept of autism de novo on different continents (in the USA and Austria), both formulating a developmental syndrome of unknown but innate origin without knowledge of each other's work. Kanner published his work in 1943 and Asperger in 1944.
All good stories need a hero and a villain and for Silberman, Kanner is as villainous as they come. Silberman believes Kanner was aware of Asperger's work and denied him due credit. He also charges him with introducing a narrow concept of autism which he claims undermined autism research for decades to come (i.e. anti-spectrum) and espousing the concept of the ‘refrigerator mother’ as causal (although this was much more linked to Bruno Bettelheim). The evidence is mainly that Kanner was a native German speaker so likely to have been aware of Asperger's work, and that Kanner worked closely for a few years with George Frankl, a clinical psychologist and former colleague of Asperger's (Frankl fled Nazi occupation of Austria with Kanner's help).
It would seem likely that Kanner was aware of Asperger's work later in his life but I was not left convinced that Kanner had undermined autism research or had not discovered the underlying concept alone (not to undermine Asperger's similarly unique contribution). Silberman's contempt for Kanner (a man generally regarded as a caring clinician) is puzzling and only acts to undermine the author's credibility. Asperger gets similar – although opposite – treatment, painted in a strangely hagiographic and saintly way.
The other prominent aspect of the book is its account of autism within the framework of a political and civil rights struggle. The language is identity politics and – I think – aimed at US government healthcare funding.
The book aims to ‘cast light on the growing movement of neurodiversity’. It documents the many agencies and think-tanks associated with the movement but fails to investigate the concept critically. On the plus side, Silberman repeatedly puts those with autism and their families, and the very real difficulties they face on a daily basis, at the centre of the book. The historical descriptions are often very moving, particularly of the autistic children written off at an early age to institutions.
In summary, NeuroTribes is interesting historically, fairly well written but unnecessarily long. It is hard to shake the feeling you are being toyed with in the name of a bigger political agenda. I would not recommend it for your reading list.