
BOOK REVIEWS
"It
is a deeply moving and fascinating book because it provides a bridge between
our world and hers and allows us a glimpse into a quiet other sort of
mind"
--Dr. Oliver Sacks, MD, FRCP
Thinking in Pictures
and other reports from my life with autism
Author: Dr. Temple Grandin
Foreword by Oliver Sacks
Publisher: Doubleday
(New York), 1995
Reviewed by Prof. Talaat I. Farag
The story of Dr. Temple Grandin, is one of perseverance
against all odds and using her special skills to improve the livelihood of
others. Grandin, PhD, is a gifted animal scientist who is credited for designing
nearly one-third of all the livestock-handling facilities in the United States.
Her success and accomplishments she credits not only to her education, but to
her medical condition! Temple Grandin is autistic, a woman who
thinks, feels, and experiences the world in ways that are incomprehensible to
the rest of us--she thinks in pictures! Her autobiographic book records her
journey in the quest to conquer autism!
Grandin's
222-page book features 11 chapters and narrates the story of a lady with autism
who earned a PhD in animal science and behaviour. In her lifework at Colorado State University
on cattle behaviour, she fell in love with cows and she was fortunate to meet
Dr. Oliver Sacks who first wrote about her in an Anthropologist on Mars. His
groundbreaking description of people with various neurological disabilities has
improved our understanding of the often enigmatic workings of the human mind.
Today, Grandin lectures regularly all over the US on handling livestock and
autism. She has also addressed the annual meeting of the Autism Society of
America.
In this unprecedented book, published when she was 47 years of age, Dr. Grandin delivers a report from the "country" of autism. Writing from the dual perspectives of a scientist and an autistic person, she tells us how that country is experienced by its inhabitants and how she managed to breach its boundaries to function in the "outside" world. What emerges in Thinking in Pictures is the document of an extraordinary human being, one who, in gracefully and lucidly bridges the gulf between her condition and our own, shedding light on the riddle of our common identity.
At
age 2 and a half, while she looked normal, she showed symptoms of autism in
having no speech, poor eye contact with no interest in communicating with
people. While she had the appearance of deafness, she often threw tantrums in
frustration for being unable to communicate with others, and spent much time
staring off into space. She was taken to a neurologist and when tests revealed she was
not deaf, she was labelled as brain damaged. She mentioned in her 1995
book that most doctors over 40 years prior had never heard of autism. Today
autism is regarded as an early childhood disorder and is 3 times more common in
boys than girls. For the diagnosis, autistic symptoms must appear before the age
of 3. The most common symptoms in young children are no speech or abnormal
speech, frequent temper tantrums, oversensitivity to touch, appearance of
deafness, and preference for being alone, rocking and other rhythmic stereotypic
behaviour, aloofness, and lack of social contact with parents and siblings with
inappropriate play with toys. She mentioned a three-year-old child would be labelled autistic if
they lacked social relatedness and speech or had abnormal speech. This diagnosis
is also called classic Kanner's syndrome, after Leo Kanner the physician who
first described this form of autism in 1943. In the year 1944, German Scientist
Han Asperger described "higher" formed of autism. She discussed the
new diagnostic categories: Autism, pervasive developmental disorder (PDD), Asperger's
syndrome and disintegrative disorder. Some consider them to be true separate
entities and other believe they life on an autistic continuum without definite
distinction between them.

Grandin's book discusses the following; autism and visual thoughts, diagnosing autism, sensory problems in autism, emotion and autism, developing autistic talent, medications and new treatments, autism and relationships, connecting with animals, understanding of animal thought, the link between autism and genius, with the final chapter focusing on religion and belief. The book mentioned the stories of celebrities with some autistic traits including Albert Einstein who was interested in relationship between objects rather than relationships between people. Other celebrities exhibited developmental abnormalities during their early childhood include Vincent Van Gogh, the father of modern genetics, Gregor Mendel and Bill Gates, the head of Microsoft and inventor of Windows, and the Austrian philosopher Ludwig Wittgenstein.
Autism Spectrum Disorders (ASDs)
Recent studies show that autism spectrum disorders (ASD's) have a frequency of about 6 out of a thousand which is more than double that of Down Syndrome. In the introduction of the first edition of Grandin's book, Dr. Sacks mentioned that " [i]n 1986, a quiet, extraordinary, unprecedented, in a way, unthinkable book was published, Temple Grandin's Emergence: Labelled Autistic. Unprecedented because there had never been an inside account of autism, and secondly because it had been a medical dogma for 40 years or more. That there was no insight no inner life, in the autistic, or if there was, it would forever be denied access or expression. Extraordinary because of extreme directions and clarity. Temple Grandin's voice came from a place that had never had a voice, never been granted existence before--and she spoke not only for her self but for thousands of other, often highly gifted autistic adults often in our midst. She provided a glimpse, perhaps even a revelation, that there may be people that are no less human than our self, who constructed their worlds, lived their lives, in almost unimaginably different ways."
Interestingly, Chris Burke, the American young actor with Trisomy 21 whose
television series Life Goes On and biography A Special Kind of Hero raised both interest in Down Syndrome
worldwide and care for those with the Down Syndrome. Similarly, Temple Grandin's
book also opened a discussion about autism that changed care-giving for those
with the condition. She spoke, not only for herself, but for
thousands of highly-gifted autistic adults in our midst. Before her writings, we
always spoke about autistic children, never autistic adults, as if such children
never grow up!
In a review of the 2006 edition of the book, the Philadelphia Inquirer described Grandin as "displaying uncanny powers of observation." She was able to chart and describe the "differences between her life and the lives of those who think in words." A personal review from T. Burgess of Indianapolis, Indiana, writes "I have 2 children with Asperger's and Temple Grandin's insight into why people with autism have certain behaviours was eye-opening. It also gave me a whole new perspective on what thought processes may effect their ability to learn abstract things and socialize with others. I would highly recommend this book to anyone. Even if you don't personally know someone with autism it can certainly give you a first-hand look at how different people think differently."
The Ambassadors Magazine advises families with autistic children, medical students, nurses, psychologists, and teachers to read this book and include it in their libraries. It is a unique reference and account of someone who was able to overcome autism and go on to describe her successful journey with the condition. It offers all readers a unique glimpse and optimistic look into the "country of autism."

Prof. Talaat I. Farag, MD, FRCP, FACP, FACMG is a former adjunct professor at Dalhousie University in Canada. He is the founder of The Ambassadors Research Foundation in 1998. Email: tfarag@dal.ca.