Customer Reviews

Can the World Afford Autistic Spectrum Disorder?: Nonverbal Communication, Asperger Syndrome and the Interbrain

5 star:		(9)
4 star:		(7)
3 star:		(10)
2 star:		(8)
1 star:		(2)

 

 

The title made me feel very uncomfortable; it seems to suggest that the world can choose not to encounter autistic spectrum disorder (ASD). Once I got into the book, the author's viewpoint became less unclear. He proposes that the one fundamental problem underlying ASD is "impaired nonverbal communication." He discusses the concept from research and from anecdotal examples, and distinguishes cases that don't seem to fit the premise. I understand him to say that even though his premise cannot at this time be proven with science through neuroimaging data, that the concept will help in the understanding of ASD.

I was left unimpressed with the author's repeated usage of computer terms for the human brain, such as the "interbrain connection" being similar to the network that is the Internet; "cache" for certain abilities or knowledge, being socially "offline"; and the section on "cybernetic parallels for networks mediated by nonverbal communication." Certainly, many people with ASD would be comfortable with Dr. Tantum's terminology, given the predilection of many to focus comfortably on computers, but I had difficulty keeping track of what he meant.

That said, I absolutely reveled in the section near the end that discussed the psychology of bullying and why society cannot afford bullying. The Aspie in my family who was bullied throughout the seven years he spent in the K-12 public school system emerged with post-traumatic stress disorder. This played a large part in his needing a medical withdrawal from graduate school a few years later, which is a tragedy. I would love to have every teacher & school administrator required to study the psychology of bullying to the extent they would start protecting the victims actively and not be afraid to sanction the bullies.

Can the World Afford Autistic Spectrum Disorder?: Nonverbal Communication, Asperger Syndrome and the Interbrain by Digby Tantam, Ph.D., is a penetrating look by a practicing scientist at the known science and personal observations of the operation and struggles of those afflicted with this type of brain structure.

Tantam describes the behavioral and social functioning of the person with Autistic Spectrum Disorder (ASD) with some technical terminology yet with good translation of that terminology so that readers with broad educational backgrounds and experience can well understand his discussions.

In his Introduction (P. 20), Tantam states, "What the world affords to most of us [those with what he describes as 'neurotypical brains' or normal brains] is a structure, or a web of subliminal nonverbal communication that points us in directions to go, regulates our minds, indicates whether our beliefs have, or have not, social approval, and generally guides us."

He uses the analogy of a computer connected to the Internet in a continuous, ongoing process of gathering and exchanging information with other similarly connected computers occasionally receiving software upgrades that alter how our computer functions, possibly permanently, in a flowing dynamic process, of which we are mostly unaware.

Contrariwise, the person with ASD is analogous to a person with a computer that is not connected to the Internet. They don't have the benefit of communication with other computers in a network with the give and take allowing them to remain continuously "in touch" with one another and benefiting from the occasional operation-altering software updates that affect the whole community.

He carefully points out that the person with ASD is unaware of the customary nonverbal social cues, such as facial expressions, gestures, and body positioning, governing the behavior of most of us in society. In other words, the person with ASD simply doesn't "get it" when it comes to interpersonal relationships. Persons with ASD are aware that something is missing; they just don't know what it is. They are confused and often embarrassed. It is as though they have done something wrong, and they understand that they are not to do "it" again; they simply don't know what "it" is. Of course, there is a broad range of degrees of the impairment of nonverbal communication from mild to severe.

Tantam goes on to discuss channels of communication such as voice pitch and volume, body posture, gaze direction, and gesture as well as their respective functions of relative social status, alertness/arousal/engagement, emotional expression, and commentary on the production of speech and its focus. It is apparent that when these methods of communication are impaired, the person with ASD is dysfunctional in the social setting to a varying, possibly severe, degree.

His illustration of the profound importance of the specialized functions of many gestures we take for granted is seen in the hand gesture of the circle formed by the thumb and index finger presented with the palm opened in the direction of the listener. It means "OK," of course, yet we use it and see it frequently without ever analyzing it to any degree.

He gives many examples to illustrate that impairment of nonverbal communication is the fundamental brain problem in the person with ASD, showing the struggles those persons have in everyday living in society but especially in the family setting.

In Chapter 7 he focuses on getting the diagnosis and getting it right for the sake of all concerned. The proper diagnosis is vitally important in helping the ASD patients so that those around them properly deal with the results. Tantam uses the example that society will make some accommodations for the partially deaf person, but it is the responsibility of that patient to let the rest of us know what the problem is so we can respond appropriately. At the same time, it is primarily the responsibility of the deaf person to make the necessary adjustments needed to function in society.

A proper diagnosis, properly explained to the patient and any family members, needs to provide a new way of dealing with old problems. Once a person with an ASD and those caring for him begin to see now so many apparently disconnected problems come together as getting consequences of impaired nonverbal communication, there is often a sense of having finally gotten a problem to deal with.

Can society afford to formally "recognize" ASD and those who suffer it? Tantam gets back to this point in Chapter 8 and points out how some of the more severely affected people are usually bullied and that that can have longterm adverse consequences. He also points out that many are unable to find regular work. Furthermore, the medications available are expensive and not recognized by all authorities as being effective. However, there are intervention techniques that are effective if applied properly and early in the patient's life.

Certainly persons affected by ASD will not simply go away; so the real issue is, "Can society afford to exclude people with ASD?" Tantum makes a very convincing argument that we cannot afford to exclude them.

There are editing deficiencies. Here are two examples:

No page numbers in the Table of Contents

Pg. 16: "... of individual's capacity to immerse themselves in social groups..."

I highly recommend this book. It is a very well-written and comprehensive book for the layman - the person with ASD, family members and friends, and other members of society. It also gives excellent insight into the patients' struggles for those professionals who may care for them and to the educators, politicians, and community leaders who are faced with dealing with these patients and their struggles.

Review of Digby Tantam's book: "Can the World Afford Autistic Spectrum Disorder?: Nonverbal Communication, Asperger Syndrome and the Interbrain."

I ordered Dr. Tantam's book purposefully to read his research on nonverbal communication, subliminal or overt.

Starting in the early 1980's Dr. Tantam began studying the related condition of Asperger Syndrome to classic autism. Dr. Tantam' book focuses on one of the core symptoms of autism and Asperger Syndrome, that of non-verbal communication.

Dr. Tantam's discussion includes chapters on "What is nonverbal communication...;" "What is the importance of gaze and shared attention;" "What do people make of nonverbal communication;" and aspects of how impairment of nonverbal communication may be caused by a brain problem and other factors in diagnosing and dealing with Autism Spectrum Disorder (ASD) and Asperger Syndrome.

The value in this book lies in it's ability to communicate advanced concepts to the layperson. Excerpt from the chapter "What is the specialized function of nonverbal communication," on page 33:

"The competition for effectors can be resolved, as we have seen, by sharing, that is by combining different messages in one communication. the availability of multiple channels helps with this, in that some may carry more of the content, leaving others to carry more of the burden. A famous example of this was provided by Ekman and Friesen (Ekman and Friesen, 1969). They asked a volunteer to play the part of a psychiatric in-patient requesting home leave. He was told that he was to play the role of a patient who had been aggressive on the ward in the previous week, and he would have to lie about his suitability for leave. The subject was able to control his face so that it gave little away, and he largely controlled his trunk, but his anxiety 'leaked out' in his legs and feet, which moved about restlessly."

A very insightful and probably ground breaking book that should not be overlooked by anyone interested in human communication. Well done.

JP

This book was totally dry and uninteresting. I could not bring myself to finish it. It may be interesting to academics studying ASD, but for lay people or even parents of children, this is just too boring and complex.

A well-written study of autistic spectrum disorder. Dr. Tantam, the author of many books and articles on the subject, here examines the current theories of the causes of the disorders and evaluates some of the successful treatments.

There are enlightening endnotes and a substantial bibliography is included.

This book is an exploration of the mental systems that are affected by autism spectrum disorders. Tantum is a recognized expert on the subject, and he founded an Asperger's syndrome clinic in the United Kingdom. In this book, he examines the hypothesis that the problems that people with autism spectrum disorders have relate to a specific deficit in non-verbal communication. Making an analogy to the Internet, he proposes that there is an Interbrain shared by neurotypicals, and that people with autism spectrum disorders have difficulty connecting to the Interbrain. Sources are cited with endnotes, and the book includes an extensive reference list.

For me, it seemed that communication fell short throughout the book--it was hard to deduce Tantam's ideas from his words. Tantum tends to use technical terms without explaining them, and occasionally comments on research without first explaining the basic findings. Even the book's title, "Can the world afford autistic spectrum disorder?" is hard to parse, since Tantum makes use of a little used meaning of "afford"--in the sense of "make room for." Similar stretches of vocabulary meanings appear throughout the text. Tantum is from the UK, hence uses British spellings ("neurone" for "neuron"?) and British societal examples that may miss the mark for American readers (eg. cricket scenarios). Internal consistency is another weak point in the book, with Tantum at times suggesting that people with ASDs cannot connect to his hypothesized Interbrain, and at other times suggesting that such people can connect but have problems with reduced bandwidth. He also makes some odd logical leaps, noting that eye gaze is impaired with ASDs, and that many blind people have ASDs, suggesting that in the case of blind people, it may be the lack of sight which somehow causes the ASDs. He doesn't consider the possibility that the lack of sight and the ASD characteristics might be independent results of a brain that has suffered damage or not developed according to ordinary patterns.

Throughout the book, Tantum builds and explores an analogy of communication as related to computers and the Internet, and people with ASDs as having problems with communication hardware or network connections. At one point, he discusses the idea of cache and a correspondence to working memory. He notes that people with ADHD seem to have trouble with working memory (no citation given; it would be an interesting claim to follow up on). In writing this section, Tantum seems to implicitly suggest that people with ASDs behave as if they had an impaired cache. Interesting idea--is there any research showing that people with ASDs have measurable short term memory deficits? If so, it would be better to cite the research in this section; if not, then it might be better not to even include the section since it mentions ADHD, not ASDs. But I'm not sure that the types of problems that Tantum discusses in this connection, namely, lack of regrets for impulsive behavior, are indicative of working memory deficits; it seems to me that if working memory isn't working, a person would have no thoughts at all, rather than simply no regrets. (Wasn't there a famous case of a woman whose short term memory was temporarily shut down? When she regained her short term memory and was asked what she had been thinking about during the time her short term memory was shut down, she said "Nothing ever came to mind." That's a long way from "I didn't consider how my behavior might affect other people). In general, how well Tantum's analogy of the mind as a computer and part of the Interbrain depends on how well he understands the technology he is using for comparison. His discussion of cache is on shaky ground, since cache is not exactly short-term memory in the psychological sense, but rather temporary storage for information that is being processed by the CPU. Perhaps humans have such a facility as well, but it isn't the same as the working memory that is posited by such researchers as Baddeley. Some of Tantum's discussion of technology slides into the bizarre, however, when he classifies software updates as "tolerable" computer viruses. How is a software update a virus? Further elaborations on the analogy of human communication including viruses of the Interbrain hinge on this odd terminology or classification, and hence also fall short. Overall, it seems like this book was rushed into production without giving much thought to audience or putting enough attention into editing. Perhaps some people with a penchant for technology and a strong interest in ASD hypotheses may find Tantum's present proposals intriguing, but I don't see how it is likely for general readers to improve their understanding of ASDs by reading the book.

The title of Digby Tantam's book - Can the Wold Afford Autistic Spectrum Disorder - is a bit of a misnomer. The question only comes up, and is answered in the affirmative, in the book's last chapter. The majority of the book is devoted to a novel theory the author expounds that the primary impairment encompassed by ASD is that of nonverbal communication (rather than, say, mindblindness).

Theorists have debated for the past 10 years (at least) what the main impairment of autism was. Is it trouble with language? Lack of ability to see others as persons with intentions? Lack of ability to process emotions in self and others? The dominant theory, with Simon Baron-Cohen as its progenitor, is that autism is primarily a disorder marked by "mindblindness," or, lack of ability in tke autistic to see others as intentional agents, and hence, be able to "understand" people AS people.

Tantam offers a different, and quite convincing, theory. Tantam suggests that autism is a disorder (sticky term, that) marked first and foremost by difficulty reading non-verbal communication. To use his term, autistics have difficulty with things involving the "interbrain" connection between people. Most of us are born with and have no trouble developing our ability to "read" people and the subtle cues - gaze, body language - that autistics often cannot pick up. He uses a computer analogy; if the interbrain is like the internet (that non-physical connection that we have between each other), then the autistic is the one who cannot log on.

The first two chapters of the book are devoted to illuminating to us neurotypicals how important nonverbal communication is to everyday life (as we often forget because nonverbal communication is so automatic to us). The next few chapters are devoted to outlining and defending the interbrain theory. Tantam finishes off by suggesting some things that autistics and particularly those who care for them can do to help them cope with this lack of ability to access the "interbrain" world of nonverbal signals.

I would suggest that anyone reading this also read Simon Baron-Cohen's book "Mindblindess," which outlines the main theory Tantam is arguing against. To my mind, I think that Tantam's theory, while still quite speculative, is interesting and suspect that mindblindess (inability to see others as intentional actors) and the lack of ability to "access the interbrain" are quite connected. When one cannot appropriately read nonverbal communications, it becomes all the harder to "see what others are thinking." If one has trouble telling that someone is angry (recognizing their arms crossed, their face turn red, and their voice get tense), then it stands to reason that it would be very hard to predict what that person will do. In other words, I suspect that one will not need to choose between Baron-Cohen's theory and Tantam's theory. I suspect that mindblindess and lack of "interbrain ability" are quite related (whether one causes the other or they simply develop in parallel.

The last few chapters will be the chapters most helpful for caretakers of autistics (like myself). The author suggests that caretakers can help autistics navigate the world of nonverbal communication by acclimating them to it strategically - at once making sure they are not bombarded, but stay connected to others. We can also monitor out own behavior to be as literal and as verbal as possible, making sure that we cut down on the number of nonverbal cues we personally send out.

And as to the question of whether the world can afford autistic spectrum disorder, the author's answer is an unambiguous: "We better." He acknowleges the difficulty in expecting neurotypicals to accommodate themselves to such a large degree to the autistic, but also argues that autistics often have traits that it would be a shame for the world to go about. In the author's own words, "If the future lies more and more in collaboration with machines, then we may need more people with ASD, not less." For all the difficulties (both for autistics and neurotypicals) that ASD can cause, it would be a real shame to deprive ourselves of the unconventionality, originality, and often outstanding intellect and talent often associated with ASD.

This book is about Autistic Spectrum Disorder and what it is that ASD people lack that neurotypical people have. It is interesting but I'm not sure how informative it is. The author seems to have a theory he is defending -- and sometimes he even sounds defensive. I'm not sure, as an Aspie, I have any basis with which to refute his theory; however, it does seem a bit farfetched and "sci-fi" that neurotypical people have a "wireless network" rather similar to the Internet by which they communicate to each other but from which Aspies and others with an ASD are excluded. He calls this the Interbrain. While it would be nice to say that is why I don't understand people, while it would explain the feeling that I am on the wrong side of a glass wall looking at the rest of the world, it such seems a little too much like science fiction. Perhaps science can research the idea and prove or disprove that such a communication exists.

While this book bills itself as a resource for parents of children with ASD's (among others), I found the vocabulary and references to be completely inappropriate for this purpose. While I consider myself well-informed about my children's diagnoses, I found the book too full of terminology with no explanation (including some the author readily admits to coining himself with little definition) to be of much use. This book may be useful for professionals, I couldn't say as I am not one, but it is not likely to be much use to average people who simply wanted another perspective on the social and communication challenges of ASD.

Occasionally I'm drawn to literature on autism, and I'm not entirely sure why, except that I've wondered if various family members might have mild symptoms, along with super-high intelligence to mask it. Could the daughter with intense separation anxiety, who once screamed as if being tortured when I'd uncharacteristically painted my toenails, be exhibiting some neurological clues? No one alive would give this creative, highly-verbal child an ASD or Asperger's diagnosis, yet I've sometimes wondered if she has empathy, and her need for my presence to translate the world seems pathologically intense at times. Less certain is my father,someone given to monologues, who had to learn early on in his marriage to a highly-empathic woman how to make eye contact, the kind of guy who forgets his 35th anniversary and then gets irritated with his wife for feeling hurt; shouldn't she know by now that he loves her? If my father had mild symptoms of Asperger's, it would clarify the thing I've found oddest about him: how someone so intelligent could be content with a highly-routinized, rather boring life. I could never make sense of the puzzle, as he sometimes shows real empathy. In any event, high I.Q. people are not "neurotypical," a word that made me wince every time I read it.

I found the book's extended metaphor of the "interbrain" fascinating; I was reading concurrently an article in the "New Yorker" about the neurological effects of extended isolation on prisoners, and it made sense to me that those with autism would be affected similarly because of lack of bandwidth sufficient to tap into the nonverbal web. Most fascinating to me was Tantam's idea of how best to utilize available bandwidth and his assertion that some folks, say with Asperger's, have learned to optimize those moments of connection and even to learn empathy. I've wondered why my mother always carefully chose times to communicate with my father, and it makes perfect sense to me now that she instinctively did this. And that my father could have learned empathy from her, creating some supremely ironic moments. For example, at a certain point, my mother was deeply grieving and accepting the inadequacies of her marriage, and she became self-absorbed in the way sensitive and empathic people can. I was suffering extreme sleep-deprivation from a colicky infant, and my dad was the one with empathy who awoke my mom to my need for help.

If I have a criticism of the book, it's that it tends toward being myopic at times; the author clearly identifies positively with his autistic clients, yet I was often uneasy when, in championing neurodiversity, he used metaphors of the interbrain and of neurotypicals as bees, borg or slime mold, as opposed to the heroic individuality of the autistic person. Maybe we could use "entanglement," borrowed from quantum physics, as a metaphor, instead. I happen to be one of those highly-original people who always stands alone and pays a price for it, yet I'm also empathic. How would the interbrain metaphor work for someone like me? I have really good bandwidth, but I don't like to be on-line for long at all; I'm sensitive, I need lots of time alone, and as a kid, I found myself sticking up for those (obviously in retrospect) Aspies and ASD types who were taking abuse, mistakenly identifying with them and assuming that, like me, they were plugged in to the emotional world around them but simply needed a break from it.

I'm all for neurodiversity, and I dig the existential riffs on autism. Look, my kids were just watching "Happy Feet" with its blatant yet embedded message of diversity, evolution and giftedness, and I've got images of dancing penguins before me. At the same time, Tantam can run the risk of sounding like a government mouthpiece, like my pediatrician when I queried her about immunization and she said, we've always had autism, there's not an autism epidemic, the rise in diagnoses is due to improved methods of diagnosis. I would advocate both an appreciation for neurodiversity, along with a desperate search for ways to minimize suffering, and my reading has persuaded me that immunizations, whether or not autism is genetic, cause neurological damage; after doing the cost-benefit analysis, I decided no longer to immunize my children. If you add amalgam fillings, which leach mercury, to the mix, I believe there are children who are suffering from autistic symptoms to a greater degree than necessary, and on my reading list I've got Natasha Campbell-Mcbride and Aajonus Vonderplanitz who write on healing autism.