Autism is devastating - to the family. Children can be born with all manner of problems. Some begin life in great pain that can never be relieved, but at least there is a child there. An autistic child - and here I am talking about what's known as core autism - is somehow not there. 'Nobody Nowhere', as the title of Donna Williams's autobiography (1992) has it. Very often physically healthy (though there is a high incidence of other problems) he - and it is usually he - just does not respond. It is not merely that he does not learn to speak until years after his peers, and then inadequately. He has no affect; he never snuggles. He is obsessed with things and order, but does not play with toys in any recognisable way, and certainly does not play with other children. He mercilessly repeats a few things you say. With no comprehension. He has violent tantrums, not the usual sort of thing, but screaming, hitting, biting, smashing. This alternates with a placid gentleness, maybe even a smile - but not really for you. Serious Down's syndrome is pretty bad too, but despite all the difficulties, physical and mental, there is a loving little child there. That is what is so dreadful about core autism: your child is an alien. Parents who guide their autistic infant through to adulthood, who create a human being who can be loving, who can to some extent compensate for his deficits, who can find some dignity and maybe a modest type of respected work - they are, in my opinion, heroes.

LRB 11 May 2006 | PDF Download