Michael J. Scharr, MS; Norman A. Wieseler, Ph.D.; Ronald H. Hanson, Ph.D., Minnesota Department of Human Services
Making Sense of Autism, by Travis Thompson. Paul H. Brookes Publishing, 2007, 266 pages, $29.95
A professor once quipped in his doctoral seminars that the most effective committee ever formed in America was Thomas Jefferson sitting in a room by himself. In doing so, Jefferson drew upon his personal beliefs as a politician and philosopher, and the diverse views of dozens of other patriot revolutionaries, to craft the Declaration of Independence. In a similar fashion, albeit with much less profound and liberating ramifications, Dr. Travis Thompson has written Making Sense of Autism. He has drawn upon his extensive knowledge of developmental disabilities, behavior analysis, psychopharmacology, and the scientific findings from hundreds of research investigations to prepare this well crafted book.
Referred to on the cover as The authoritative guide for non-experts, the book reviews the biology of autism, the family and social implications, and the treatment approaches that empirically demonstrate a reduction of the behavioral concerns associated with Autism Spectrum Disorder (ASD). The first chapter is titled, Is it Oughtism or Autism? The author relates that the original title was to have been Oughtism based upon the individual with ASDs intense need for control, structure, and predictability that can be so demanding for family members, teachers, and other care providers.
In Chapter 2, the history of the disorder is discussed, along with the challenge of differential diagnosis, and how autistic behavior can mirror the behavior seen in other mental health disorders. The question of why there has been such a dramatic increase in the number of children being diagnosed on the spectrum is addressed. The alleged association with the immunization bacteriostatic Thimerosal is specifically examined. The importance of early intervention is the topic of Chapter 3. Brain development, the symptoms of ASD, and the need for early intervention are highlighted. A logical framework for evaluating the major treatment modalities is also provided in this chapter.
In Chapter 4, the author creatively explores the commonalities between typical American family life and the improvisational nature of jazz music. Briefly, to illustrate one parallel, the behaviors associated with ASDs can be spontaneous and unpredictable, while each family member is playing and building upon the performances of each other. Another focus in this chapter is the high level of stress created for the family; familial and marital stress are often overlooked accompanying aspects of the disorder. The chapter provides appropriate emphasis on reducing the debilitating effects on the family when one or more children have an ASD.
The principles of early behavioral intervention are the subject of Chapter 5. The timelines and process of early behavioral intervention are elucidated. Numerous examples are provided to guide families in their quest of obtaining the most effective therapy. Chapter 6 is devoted to the transition from home to school. Many recommendations are offered for establishing a collaborative relationship between school personnel and the parents or alternative care providers.
Chapter 7 addresses many of the behavioral challenges children with ASDs face, along with empirically tested treatment methods. The roles of positive behavior support, social skills training, and cognitive behavior therapy are analyzed. Pharmacotherapeutic agents are the topic of Chapter 8. Their use in the development of a comprehensive treatment plan is reviewed. Chapter 9 examines other syndromes that might be associated with ASDs, including Fragile X syndrome, dyslexia, and Prader-Willi syndrome.
Making Sense of Autism concludes with Chapter 10, which strikes a cautionary note for consideration by all care providers, in determining what works and what does not. Skepticism concerning miracle cures and other remedies more quietly touted is urged. For example, anecdotal reports of success can be seductively appealing, but often the techniques rely on a charismatic therapist and do not hold up to scientific replication. Biological interventions and drugs can be advanced as cures, but when subjected to well designed, double-blind evaluations, they prove no more effective than the placebo. Take for instance the broadly and dramatically proclaimed benefits of the gastric enzyme secretin. Thompson provides a great service instructing the reader in how to evaluate therapeutic claims. Money spent for therapy services that do not work represents scarce resources unwisely allocated. It often falsely raises the hopes of the families and then disappoints them with a lack of meaningful change. At present, the popularization of a new, untested remedy can have worldwide distribution electronically within a matter of hours.
This book is recommended for care providers, as well as professionals involved with the care of persons with ASDs. Care providers will find it appealing as it provides a useful and practical bridge between what is known of ASD and the treatment approaches. The knowledge this book contains should assist with thoughtful planning. Professionals will find it appealing because it assimilates decades of research and provides concrete treatment recommendations and considerations for enhanced care. In addition, the book contains a helpful glossary and many suggestions for more in-depth study.
The views are those of the reviewers and do not represent an official endorsement of the Minnesota Department of Human Services or any of its agencies.