Ian Hacking on Autism

Read Hacking's review of The Science and Fiction of Autism by Laura Schreibman and Send in the Idiots: How We Grew to Understand the World by Kamran Nazeer in the London Review of Books. (subscription or fee required.)

Hacking is an interesting writer on the history and philosophy of science, and this brief treatment of autism is interesting in terms of knowledge systems. He points out that autism is defined in terms of developmental problems, and was recognized as a syndrome only after Gessell (and others) published standards for normal rates of development in childhood. Hacking suggests:

Autism ranges in at least three dimensions: language deficit, social deficit and obsession with order. We should talk of an autistic space.

Thus any "autistic child" might be associated with a trajectory of points in this space representing the progression of his level of language, his level of social ability, and his level of obsession with order at different times in his development. We know that there are different kinds of autism, including what Hacking terms “core autism”, ‘high-functioning’ autism, and Asperger’s syndrome. One assumes that these correspond to clusters of trajectories in this autistic space. Thus one might seek by cluster analysis of the points representing children at a given age to examine if there were other sub-syndromes of autism.

Our understanding of the basis of behavior requires that we perceive autism as related to the development of the brain. Hacking notes:

A vigorous school of cognitive science holds that many human capacities are innate and modular, that a distinct neural organization will correspond to each group of abilities. According to this view, autistic children lack the mental module that enables us easily to understand others. They lack ‘a theory of mind’.

Thus, again, we seek to understand this specific condition or set of conditions in light of modern theories of brain functioning.

Of course, scientists must further reduce the issues. Is the brain malfunction due to organization or function of the neural circuitry? How do genetics, chemical exposures and education cause the fundamental problem, and are there ways that autism can be prevented, or detected earlier, or that autistic children can be helped more.

Hacking points out that the diagnosis of autism began in the second half of the 20th century. Without the clinical category, clinicians didn’t recognize the problem. Without clinical recognition of autistic children as forming a class, there could be no statistics.

Now, developed countries are seeing an explosion of the numbers of autistic kids. Is this a function of better diagnosis, of better record keeping, or of more programs in which autistic kids can be enrolled? Or is it really that a greater percentage of kids exhibit the development problems we call autism? Understanding the basis for this trend is fundamental if we are to make good public policy vis a vis autism.

Thus Hacking presents two knowledge-related aspects of the subject:

· Autism is clearly related to the knowledge capacity of individual children, and we have to better understand the workings of the brain to deal with the problem.
· Society’s understanding of autism depends on the way we define the syndrome and its sub-syndromes, as well as the existence of systems to identify and treat autistic individuals, and the quality of the statistics we keep on such people.