Learning to be ordinary

There are many books about autism, but few as original as Kamran Nazeer's. This is a description of a group of autistics struggling to attain the obvious
May 19, 2006
Send in the Idiots by Kamran Nazeer
(Bloomsbury, £12.99)

in 1982, Kamran Nazeer went to a school in New York for children with autism. He ended up studying law at Cambridge University, and after graduating found a good job as a policy adviser in Whitehall, as well as a girlfriend. His outcome is remarkably positive. He has taught himself social skills and the art of conversation when none of these came naturally to him.

Today, he might pass as no different to anyone else, unless you catch him in one of the rare moments when he has to gather himself before facing a social situation. Before going to a pub for a drink he might pretend he has a call on his mobile, just to give himself a few minutes to prepare his "performance": what to talk about, how to entertain, how to keep focused on the others, and how not to withdraw into his own world.

In Send in the Idiots he goes back to trace four of the dozen other children from the same New York school, now that they are grown up. There are many books by parents of children with autism, of what it is like to be faced with a child who does not socialise, whose obsessions take over family life, and whose tantrums following unexpected change can threaten any sense of a peaceful home. Equally, there are lots of first-hand accounts by people with autism of what the condition is like to grow up with—seeing the world through different eyes, and the challenges as well as the remarkable talents that may coexist with the condition.

What makes Nazeer's book more original is that rather than focusing on himself he observes others; he gives an autistic's perspective on others with autism. Craig is a speechwriter in Washington. He can look at text on the page and analyse it in terms of the rules of syntactic impact, political impact and even rhetorical impact—but finds it hard to have an ordinary conversation. This suggests that some aspects of his autism have enabled him to excel, particularly when the material (words) he is working with can be isolated, studied, examined and crafted. It is as if the text is no different to making a perfect piece of furniture. But put him in an unpredictable social situation, where conversation may meander, where the humour and emotional tone may change in seconds, and Craig struggles.

Andre is a computer engineer, living with his sister. When relationships get difficult, he uses hand puppets to act out what he feels or to explore what he should say, just as he did when he was a child. What is this dissociation between a talent for understanding the technical hardware of a computer and the difficulties in communication with real people? The computer stays still until you do something to it, so you can track down exactly what causes what to happen. The rules of the computer are like the rules of syntax—they work the same every time, and one can even make lists of the exceptions to the rules.

Elizabeth was less fortunate. Despite being a "savant" pianist, able to understand the rules of music in a rapid, intuitive way, she must have felt desperately depressed by her situation because she had committed suicide a few years earlier.

Each of these individuals shows the same high ability in systemising—being able to analyse a system in terms of its rules, whether that system is a piano, a computer, a political system or even language—while at the same time finding communication stressful.

The secret of Nazeer's success seems to lie in the fact that he painstakingly analyses what others do in order to figure out what he should do. He says that it was only as a student in Cambridge that he realised that there were different kinds of conversation. The one he had pursued until that point was about pursuit of truth. Nazeer realised however, that when people "chat," they don't do conversation in this way. They talk about things they know nothing about; they answer in ways that have nothing to do with establishing the truth of a statement. So he taught himself the art of conversation: say things that you don't believe are true, change the subject tangentially and so on.

The result is that instead of the autistic (one might say academic, or legal) style of conversation, where one pursues one line of argument to its bitter end, he adopts the conversational style of the butterfly, flitting from one flower to another. Instead of the conversational partner feeling metaphorically pinned up against the wall until the truth has been established unambiguously, the conversation allows for relaxed, flexible, casual chit-chat. Nazeer reminds us how for most people, such social skills develop naturally, effortlessly and without any direct tuition.

He argues that the cause of autism cannot be "mind blindness." But he overlooks the fact that the typical infant comes equipped with a partly innate set of neurological mechanisms for making sense of other people's actions, emotional expressions and vocalisations. The two year old who will comfort his mother when she is looking sad, or who will refrain from hitting his sister because he is aware that she can feel pain, is already mind-reading (or empathising). The 14-month-old child who will look where her father is pointing—without being taught—is already mind-reading her father's intention to direct her to look not at his finger, but at the event across the room that has caught her father's interest. That same 14 month old who will then look back at her father's eyes, to signal that she has seen what he has seen, to acknowledge that the message has been received and the emotional significance shared, is demonstrating extraordinary mind-reading skills—all without words. Such looks and exchanges of smiles and acknowledgment are reduced or delayed in many children who go on to receive a diagnosis of autism or Asperger's syndrome.

Few individuals with autism or Asperger's syndrome have such a good outcome as Nazeer. His high IQ and early diagnosis may be part of the reason why he adapted so well. We need to know more about the kind of support that people like Elizabeth need. We need to keep in mind that the outcomes of Nazeer and his group are more typical of those suffering from the milder Asperger's syndrome rather than classic autism—many of the latter may never develop language at all. And we need to keep in mind that even for people with Asperger's, in many cases diagnosis would not have been available when they were children, and is hard to obtain in adulthood. This book will help to raise awareness of the condition, and the untapped potential of those who suffer from it.