Abstract
Cohen, D, Volkmar F, eds. Handbook of autism and pervasive developmental disorders. 2nd ed. New York: John Wiley and Sons, 1997.
Harris J. Developmental neuropsychiatry. Vols I–II. New York: Oxford University Press, 1995.
Howlin P. Autism—preparing for adulthood. New York: Routledge, 1997.
Schopler, E. Parent survival manual—a guide to crisis resolution in autism. New York: Plenum Press, 1995.
Siegel, B. The world of the autistic child. New York: Oxford University Press, 1996.
Grandin, T. Thinking in pictures. New York: Vintage Books, 1995.
In selecting these books, we first chose those texts which will provide the general psychiatrist with an overview of current critical information derived from research into the causes, manifestations, complications and treatments of autism and other developmental disorders. Second, we sought to recommend books the psychiatrist could confidently recommend to parents and carers of persons with these disabilities. For this purpose, we asked Amanda Golding, librarian of Autism Victoria, to suggest those books parents and carers found most helpful, and we include some of her comments. Third, there are two books which provide an insight into the personal experience of adults and children with autism. These are not only fascinating, but should serve to increase our empathy with the needs of these patients.
The Handbook of Autism and Pervasive Developmental Disorders has a broad international authorship and comprehensively covers the field with sections on: diagnosis and classification; development and behaviour; neurobiology; assessment; interventions; public policy; theory; international practice; chapters written by persons with autism, parents, siblings and teachers about their own personal experiences.
There has been an exponential increase in knowledge regarding pervasive developmental disorders over the past decade. This has been assisted by international agreement on diagnostic criteria reflected in both DSM-IV and ICD-10. This taxonomy is still vigorously debated. For example, the chapter by Klin and Volkmar on Asperger's Syndrome highlights the uncertainty and confusion that surrounds this at least clinically useful construct.
The section on neurobiology points to a lack of replicated neurochemical studies other than a consistent finding of an increase in whole blood 5HT. It also points to the potential of further studies of peptide secretion, control dopamine turnover, diurnal rhythms and the effects of stress on autonomic activity. It is now understood that genetic factors play a central part in causation, probably involving the interaction of a small number of chromosomal abnormalities. The risk for the same biological parents having a second child with autism is increased at least 50 times to become a 1 in 20 chance. The chapter by Mineshew, Sweeney and Bauman describes the four main avenues of neuropathological research: frontal systems and executive function, attention and frontal-neo-cerebellum connections, limbic system and representational memory, and information processes and the neo-cortex.
Companion chapters on cognition, information processing, theory of mind, language and social comprehension link what is known of the neuropathology with clinical presentation.
Debate and differences of opinion are evident throughout the volume, which add to the fascination of the topic. However, care is taken to present the scientific evidence for the various educational, behavioural and psychopharmacological interventions in order to challenge blind acceptance of a range of ‘miraculous’, often costly, scientifically unsubstantiated ‘cures’ that regularly emerge.
This volume also provides the clinician with a practical guide to assessment, diagnosis and treatment. Educational, behavioural and communication skills interventions are central to the best current management but pharmacotherapy has a place in treating specific symptoms such as clomipramine for repetitive behaviours and haloperidol for aggression.
This volume encourages many different avenues of future research that may not only help those affected with this serious condition and their families, but is also likely to increase our understanding of normal developmental processes.
Developmental Neuropsychiatry is a magnum opus which consists of two volumes and promises to become the Lishman of child and adolescent psychiatry. It is a remarkable achievement for a single author text. Although scholarly and comprehensive, its treatment of each topic reads as succinct and lucid. The first volume addresses the fundamentals of developmental neuropsychiatry, covering genetics, sleep, anatomical and functional brain development from embryo to maturity, development of emotion and cognition, as well as ethology and temperament. There is even a chapter on palaeolinguistics, from which I learned that Broca's area is first apparent in Homo habilis, from two million years ago, but is not seen in Australopithecus. The second volume describes the assessment, diagnosis and treatment of developmental disorders. It describes clinical, psychometric and brain imaging assessment and investigation techniques. This is followed by chapters on specific developmental disorders including mental retardation, cerebral palsy, specific learning disorders and brain injury. There is a section on the emerging field of behavioural phenotypes: that is, the relationship of particular genetic syndromes to particular behavioural patterns. It provides the most comprehensive survey of syndromes known to us. The chapter on the neurodevelopment of schizophrenia exemplifies the expanding knowledge of the early neurological origins of adult mental illnesses. The final section surveys treatments for developmental disorders, covering the range from psychotherapy to genetic counselling. This book should be in every psychiatric library and on the shelves of child psychiatrists and all interested in neuropsychiatry.
Autism—Preparing for Adulthood focuses on adults with autism and their families. It provides a resource for parents, carers and autistic people themselves. Howlin writes lucidly and is one of the leading authorities on treatment strategies. The book will help carers to distinguish substantiated treatments from the many extreme and unproven claims which assail families of persons with developmental disorders. Parents of teenagers and adults with an autism spectrum disorder will appreciate this book.
Parent Survival Manual—A Guide to Crisis Resolution in Autism has been compiled from 350 anecdotes told by parents of autistic and developmentally disabled children and analysed by professional behaviour therapists. Each analysis describes effective solutions to various behaviour problems such as aggression, communication, perseveration, play and leisure, eating and sleeping, and toileting and hygiene. The contents are clearly set out enabling the reader to access comments on a particular behaviour (e.g. biting, eating behaviour, disruptive behaviour, night time wandering and such).
The World of the Autistic Child helps parents to see the world from their autistic child's perspective, ‘what it means to have autism’. A major source of stress for parents and carers is the apparent illogicality and unpredictability of the behaviour of persons with autism. Parents often experience a sense of relief when they can understand their child's behaviour. If the behaviour has a meaning or communicative intent, then parents are able to respond appropriately and behavioural improvement follows and stress is reduced.
Thinking in Pictures is an autobiographical account and provides one of the best descriptions of perception of the world by an autistic person. Temple Grandin, the author, is now well-known, even more so since the publication of Oliver Sacks’ book, ‘An anthropologist on Mars’, the term used by Grandin to describe her experience. Grandin is an academic in animal husbandry, a field in which she has made major contributions. Her obvious high intelligence does not lessen the relevance of her insights to the appreciation of the experience of the more common autistic person with intellectual handicaps.