Book Review: Autism’s Stepchild, by Phyllis Grilikhes

Though there are many narratives about children on the autism spectrum told by professionals and specialists, Phyllis Grilikhes’s Autism’s Stepchild (2016) stands out because of its historical perspective on the interpretation of autistic traits before the diagnosis became commonplace. Grilikhes’s narrative tells the story of a young girl, Jean, who would be diagnosed with autism nowadays, but in the 1940s and 50s was treated as a psychological oddity, a medical curiosity to be examined and scrutinised with no conclusive explanations for her seemingly abnormal behaviour. Jean’s story is told primarily through her mother, Dora, whom Grilikhes interviewed to capture her perspective as a mother navigating a frequently baffling and hostile medical system in order to secure appropriate care and education for Jean. Dora’s fight is interwoven with Grilikhes’s account of her personal relationship with Jean; Grilikhes worked as an aide for Jean for some years in Berkeley, California, before losing touch with the family after changing careers. We find out about Jean’s relationship with the famed psychologist Erik Erikson; her experiences with institutions and specialised schools that were entirely at sea when faced with somebody whose disability profile did not match the common diagnoses of the day; her abiding friendship with Grilikhes, who nurtured her creativity; and her tumultuous transition from childhood to adolescence and adulthood. Grilikhes has an engaging prose style, effortlessly drawing the reader into her narrative. One gets the sense that one knows Dora’s experiences intimately through Grilikhes’s retelling. Jean, however, is portrayed as mysterious – something of a black box, really – and this comparative lack of insight into Jean’s interpretation of the world may stem from Jean’s struggles with expressive language and Grilikhes’s own prejudices regarding autism.

Though Grilikhes is well-intentioned and seems to care genuinely for Jean and her family’s welfare, Autism’s Stepchild occasionally reflects common—and misguided—cultural tropes about autism and other disabilities. Some of these errors can be explained by the time in which the narrative takes place, but when Grilikhes is speaking in the present tense, it is glaring and mars an otherwise sympathetic narrative. She routinely refers to autistic people and other people with developmental disabilities as being ‘disturbed’ or having ‘mental illnesses’, showing a surprising ignorance of current language used about and by people with developmental disabilities. This would be somewhat more understandable in a layperson, but Grilikhes is a psychologist with years of experience working with people with disabilities and should be aware of changing terminology. She also falls prey to the ‘puzzle of autism’ narrative, in which autistic people are treated as inscrutable oddities—she even uses the word ‘inscrutable’ towards the beginning of the book—rather than fully ensouled people.

Most gallingly, Grilikhes cites the work of Ivar Lovaas – a research psychologist and the creator of what is now known as Applied Behaviour Analysis – as a positive, humanising figure who helped autistic people come into their own and navigate the world more adeptly than they would have without his treatment. According to Grilikhes, Lovaas played an instrumental role in helping Jean adapt to her environment more successfully than she had before. The laudatory treatment that Grilikhes gives Lovaas whitewashes the cruelty that he often inflicted on his patients. At the beginning of his career as a behaviourist, Lovaas used cattle prods and electric shocks to ‘correct’ his students’ behaviour. Though he later shifted to less physically harmful methods, there is no evidence that he fully recanted. Lovaas also collaborated with the disgraced George Rekers, a Christian Right therapist, on ‘conversion therapy’ that used electric shocks and other abusive methods to make gay and gender-non-conforming boys seem straight. The abuse that Lovaas inflicted on generations of students does not merit applause. What was done to these young people was cruel and inhumane, and it is morally irresponsible to ignore his record of maltreatment.

Autism’s Stepchild is worth reading to understand historical approaches to autism identification and treatment; however, Grilikhes’s uncritical treatment of Ivar Lovaas’ therapeutic methods, the inaccurate language, and the ‘puzzle’ stereotype of autism make it difficult for me to recommend it without reservation.

(Disclosure: the author sent me a copy of the book to be reviewed.)

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