‘It cuts both ways’: A relational approach to access and accommodation for autism

Social Science & Medicine 70 (2010) 305–312

Contents lists available at ScienceDirect

Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed

‘It cuts both ways’: A relational approach to access and accommodation for autismq Joyce Davidson* Queen’s University, Geography, Mackintosh-Corry Hall, Kingston, Ontario, Canada K7L 3N6

a r t i c l e i n f o

a b s t r a c t

Article history: Available online 2 November 2009

Drawing on a qualitative study of 45 autobiographical texts by authors with autism spectrum disorders (ASDs), this paper examines and attempts to aggregate recommendations for challenging barriers to socio-spatial inclusion. The autobiographies were selected by means of purposive sampling and subjected to a sequential process of detailed annotation, manual coding for emergent themes, and ongoing critical discourse analysis until data-saturation occurred. Resulting findings reveal that the extraordinarily heightened senses typically associated with ASDs mean that those on the spectrum often struggle to process environmental stimuli in a way that makes sense. Negotiating the sensory geographies of daily life requires considerable work, and while the access afforded by such cognitive and emotional labour may be rewarding, ASD authors reveal that their efforts are rarely understood – or assisted – by non-autistic others. Many proposed accommodations could, however, be made with relative ease, and ASD texts provide good reasons and recommendations for toning down ‘toxic’ stimuli – such as fluorescent lights – and for redesigning or reorganizing the shared sensory ‘furniture’ of social space. The paper thus suggests that by attending closely to voices from the spectrum, the non-autistic majority might ensure responsibilities to open access are taken seriously, and do indeed ‘cut both ways’. Crown Copyright Ó 2009 Published by Elsevier Ltd. All rights reserved.

Keywords: Autism Autobiographies Accessibility Disability geographies

Introduction A challenge for the disability rights movement materializes: how do you include people who may need the benefits of inclusion, but cannot bear the physical and emotional presence of it? (Singer, 1999, p. 67). Recent years have witnessed significant growth in awareness about Autistic Spectrum Disorders (ASDs) across all sectors of society. This is no doubt linked, at least in part, with the ‘explosion of information about autism via the Internet’ (Shore, 2003, p. 137), and with the expansion of published accounts of ASDs from various perspectives, including professionals’ (Baron-Cohen, 2003; Szatmari, 2004), relatives’ and carers’ (Gray, 2002; Grinker, 2007; Iverson, 2006). This increasing sense of familiarity with autism and its diagnostic ‘cousins’ (such as Asperger’s Syndrome) is advanced further by the many fictional representations currently in circulation, including Mark Haddon’s (2004) best selling novel, and

q Thanks to all authors whose work inspired and informed this paper, and to the Social Sciences and Humanities Research Council of Canada for funding the study on which it draws. Thanks also to Sarah Curtis and two anonymous referees. * Tel.: þ1 613 533 6000. E-mail address: [email protected]

numerous instances of ‘autism at the movies’ (Waltz, 2005, p. 432). That those of us ‘off the spectrum’ are becoming more acquainted with ASDs should in any case be unsurprising, given that the disorders’ actual incidence is increasing at a rate variously described as ‘exponential’ and ‘epidemic’ (Nash, 2002). However, one further, related increase may be considered less predictable, at least from the ‘outsider’s’ perspective; that ‘explosion’ of first-hand accounts, or ‘autobiographies by people on the autism spectrum’ (Shore, 2003, p. 137). Autistic autobiographies are often described as ‘astonishing’ and ‘extraordinary’ by professionals and reviewers alike (see promotional text on dust-jackets for Stillman, 2006; Williams, 1998), precisely because they confound widely circulating stereotypes of autistics as, if not always or entirely incapable (for we all know of ‘splinter skills’ and savants), surely incommunicative and indifferent to the social world of others. On such accounts, why would – and how could – autistics write books of their own? The study from which this paper is drawn (see discussion of methods, below) has found that ASD authors’ motivations for writing, as well as aptitudes and interests, are almost as diverse as the individuals themselves (Davidson, 2007a, 2007b, 2008). There are great variations among authors in terms of personal contexts of all kinds – family background, educational experience, current relationship status, among many, many others – and of course, personality

0277-9536/$ – see front matter Crown Copyright Ó 2009 Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.socscimed.2009.10.017

306

J. Davidson / Social Science & Medicine 70 (2010) 305–312

(Bagatell, 2007; Williams, 2005, p. 206). However, the tendency to share autistic traits – such as obsession with detail, repetitive behaviour and preference for sameness (McKean, 2001) – means there are certain common threads among authors’ experience, recurrent themes of the kind that textual analysis can disclose. One of the most significant emergent themes identified by this study to date concerns questions of access and accommodation. ASD authors frequently report experiencing a sense of exclusion, of being (and being perceived as) ‘out of place’ in mainstream space. Many suggest such exclusion stems in large part from sensory and ‘processing’ differences from what are termed the neuro-typical (NT) majority (e.g., Miller, 2003, p. xix; see Talay-Ongan & Wood, 2000). However, and in accordance with social rather than medical models of disability (Freund, 2001; Imrie & Edwards, 2007), authors recognize that barriers to access are present in the environment itself, through the construction and positioning of what has been termed ‘sensory furniture’ (Darius, 2002, p. 35) by non-disabled others (Gleeson, 1999). In addition to such materially significant reflections (and further mirroring those of critical geographers, e.g., Parr, 2008), ASD authors report feeling extraordinarily sensitive to the multiple ways in which space itself is ‘constructed’ by NT others’ in/actions and attitudes. Such insights about the complex nature and culture of barriers to access for conditions other than autism are prominent in social science and disability studies of various hues. This includes numerous contributions from disability geographies, which constitutes the disciplinary background for the current study. Geographers have provided accounts of physical and social accessibility among groups and individuals variously described as disabled or disordered (Gleeson, 1999; Parr, 2008), impaired or chronically ill (Butler, 1994; Moss & Dyck, 2003), some of whom see themselves simply as ‘different’ (also see Hansen & Philo, 2007, for recent overview of disability geographies). Many such studies draw on qualitative methods and first-hand accounts to bring the voices and experiences of excluded others to the forefront of debates about social and spatial inclusion. To date however, there has been no significant treatment of autism in this regard by geographers, or indeed other disability scholars (but see Marcus, Garfinkle, & Wolery, 2001, on adapting educational environments for autistic children). This paper seeks to contribute to and extend the insights of the significant body of research on adult exclusion from mainstream social space in relation to access and accommodation for autism, and it does so through treatment of autistic autobiographies as primary source materials. As we might expect, those with the considerable resources required (e.g., cognitive, social and financial) to publish their personal accounts tend to have valuable experience to pass on to similarly ‘different’ others. ASD authors are certainly not representative of the majority of those on the spectrum, which has methodological implications, and indeed limitations for the current study (see below), but their non-representative status also points to potential benefits for more typically autistic individuals, and perhaps those concerned with their care. ASD authors belong to a significant minority who have negotiated their way to a point in their lives where – while still on the spectrum – they posses the substantial skills and coping tactics required to manage at least partial involvement with the world of others. Such experience is obviously valuable, and many write to impart their hard-won navigational skills, so that others with ASDs need not re-invent their own set of wheels. Many ASD authors have developed, of necessity, remarkable skills as sociologists (Dave, in Osborne, 2002, p. 68) and anthropologists (Grandin, in Sacks, 1995, p. 256), so they might study and better understand ‘the natives’, and learn to ‘fit’ in a society which makes little space for mind/body difference (Hansen & Philo, 2007).

While few manage to ‘pass’ as ‘normal’ all or even most of the time – and many would not want to (Gevers, 2000) – by learning the unwritten rules of socio-spatial involvement, they can lessen the extent of their otherwise overwhelming exclusion. ASD authors employ scores of strategies, such as the construction and maintenance of ‘files’ – often mental though not always metaphorical (Williams, 1994) – that allow them to access information on, for example, when it is appropriate to smile, to speak, to enter or leave a room (Grandin & Barron, 2005). These skills – ‘the mannerisms of how to be a person’ (Sanders, 2004, p. 13) – seem to be available to NT others thoughtlessly, ‘almost by instinct’ or even ‘magic’ (Nazeer, 2006, p. 74). For those unable to perform similar feats of ‘mind-reading’, whose environment is perceived and processed according to very different rules, fitting in or getting by involves ‘unnatural’, exhaustive efforts: ‘I sometimes get so tired – you have such complicated rules in your world. And all the time I have to think and think and think about them’ (Gerland, 2003, p. 255). While the access afforded by such cognitive and emotional labour is often described as rewarding, for many, it also seems that the work is overwhelmingly, and disappointingly, one-sided. Some, such as Grandin and Barron (2005, p. xvii), suggest that steps can be taken to redress this balance by non-autistic others, and ASD authors themselves are willing to facilitate the relational work involved: Successful social relationships require a healthy ability to take another person’s perspective; in most cases, it is teaching the person with autism to take the NT perspective. [.In] this book, we sought to reverse that trend by explaining our perspective on social relationships [.] Hopefully, it will be a bridge to new understanding between both our cultures. Outline for a relational approach to autism In what follows, I explore and attempt to aggregate some of the ways in which ASD authors suggest that their socio-spatial exclusion might be challenged, and not just by themselves. That is to say, I aim to examine the implications of authors’ insights for ‘us’, the non-autistic majority who might help negotiate accommodations for the differences described, and crucially, in respectful relation with those who describe them. My use of the term ‘relational’ in this paper is then intended in a ‘common’ rather than ‘technical’ sense to connote mutually informing ‘give and take’ (whereas Conradson, 2005; Crooks & Chouinard, 2006; Cummins, Curtis, Diez-Rouz, & Macintyre, 2007, advance alternative and insightful constructions of specifically ‘relational geographies’). One aspect of the paper’s rationale (and indeed its title) is thus inspired by ASD authors such as Stephen Shore (2003, p. 165): ‘Inasmuch as people on the autism spectrum need to understand and interact in a largely non-spectrum world, people who are not on the autism spectrum need to work on understanding those who are on the spectrum. [It] cuts both ways’. Pursuing Shore’s recommendations, this paper attends closely to the exhaustive and imaginative lengths that ASD authors are willing to go to, to communicatively share their worlds with outsiders. In their attempts to further understanding of what it feels like and what it means to live in such experientially different terms, authors provide access to, and act as navigational guides through their own ‘alien’ environments: ‘We invite you to travel in parallel with us for while, and see how the world looks from our angle’ (Singer 2003, p. xi). Further, and stressing the responsibilities that such privileged access and relationships entail, this author requests that visitors ‘[b]ear witness to the violations of human rights that we have suffered’ (Singer, 2003, p. xi). Singer thus emphasizes the extent to which the task at hand requires an empathetic open-mind that attempts to see things first and

J. Davidson / Social Science & Medicine 70 (2010) 305–312

foremost from the perspective of the autistic other/author. Moreover, bearing witness requires willingness to take action, and do more than simply see. Before exploring ASD authors’ sense of struggle in another(’s) world, I first outline the methods employed by this study, and demonstrate that using autobiographies as primary source materials is an accommodating means for involving those on the spectrum with social science research. In the findings sections that follow, I consider in some detail first-hand accounts that demonstrate how sensorially toxic mainstream social space can be for those on the autism spectrum. I begin by presenting accounts of global sensory themes, including connections, confusions and pressures to conform to environmental demands as well as expectations to (at least appear to) be ‘normal’. I then attempt to tease apart accounts of and insights around single-sense themes that might help to disrupt ableist approaches, in ways taken up by the discussion and recommendations section that follows. Here, I explore how ‘we’ might begin to render the environment less toxic, based on authors’ suggestions for ways to accommodate their extraordinarily heightened sensitivities. In conclusion, and following Hansen and Philo (2007), the paper suggests that while there are no ‘magic solutions’ to exclusion, there are important and often more or less intuitive actions that can be taken to render public space more inclusive and accessible. While never forgetting the fleshy (Hall, 2000) and sensory realities of embodied autistic individuals, I argue that attention should be focused on civilizing sensory and social environments, rather than bodies and behaviours of those judged to be different, and so seemingly ‘out of place’. As Chouinard argues, we need ‘to continue to fight for spaces in everyday life in which differences such as disability are not viewed as something to be ‘‘corrected’’ and avoided, but as part of the spectrum of human experiences that enrich all of our journeys through life and society’ (Chouinard, 1999, p. 155, quoted in Hansen & Philo, 2007). I aim to take up such geographers’ challenge to be alert and sensitive to diverse ‘other’ ways of being in hopes of facilitating meaningful and sustained conversation, and also future research, about different and enabling ways of occupying space. Such a relational approach takes seriously socio-spatial responsibilities that cut at least two ways. Methods This study (funded by the Social Sciences and Humanities Research Council of Canada) draws on 45 ASD autobiographies and edited collections of autobiographical accounts identified through academic search engines, by snow-balling from academic research papers and first-hand accounts, and via non-academic literature searches (e.g., Amazon.com and the New York and London Review of Books). The autobiographical texts identified were subjected to a sequential process of detailed annotation, manual coding for emergent themes (Pope, Ziebland, & Mays, 2000), and ongoing critical discourse analysis (Fairclough, 1995) until data-saturation was judged to have occurred. While it is difficult, if not impossible to estimate the exact number of autobiographical accounts published, and while there are limitations to such purposive sampling (Curtis, Gesler, Smith, & Washburn, 2000), I would suggest that the results of this broad-based and inclusive technique are reasonably representative of available first-hand accounts. Life narratives such as these provide an invaluable, accommodating, yet under-explored qualitative resource for those interested in understanding ‘insider’ accounts of ASDs (Davidson, 2007a, 2008; Smith 1996), and this view is explicitly supported by many of the ASD authors whose work informs this paper. Not only do such texts present insider accounts but the very communicative and social challenges that typify the condition also mean that those

307

with ASDs often prefer to interact with others via the written rather than spoken word (which goes some way towards explaining the popularity of ASD Internet chat rooms (Davidson, 2008; Miller, 2003). As Donna Williams explains: ‘With written or typed expression one is face to paper, in the company of oneself, not face to face as with speech, in the company of another person’ (2005, p. 119). Typing, for Williams, feels a far more comfortable ‘medium’ and ‘means of communication’ that provides an important ‘meeting place’ when physical or vocal proximity is simply intolerable (2005, p. 119). Moreover, many authors identified were explicitly engaged in their own research and advocacy projects, publishing on the basis of a rationale similar to that informing the work of some social scientists. Shore, for example, writes that ‘‘‘mass’’ communications of this important issue will speed positive change in public constructs of the autism spectrum’ (2003, p. 138). The specific methodological implications of using autobiographies as primary source materials are discussed at length in several recent texts, for example Smith (1996), Smith and Watson (2001), Avrahami (2007). Most significantly for the current study, it should be noted that extending conclusions drawn from ASD biographies to autism in general is problematic. However, and as noted above, while ASD authors are not typical of all those on the spectrum, similar problems around representation occur with other methods geared towards gathering insider accounts, for example, focus groups and semi-structured interviews (Davidson, 2003). ASD authors represent their own experience only, in and on their own terms. Often, however, they do so in ways more than merely insightful and educational for autistic and typical others, ways that might also create space for mutually informative relations between them. Making sense of autism Global sensory themes: connections, confusions and pressures to conform When viewed from the outside, autistic responses to environmental stimuli might seem unreasonable or even ‘bizarre’ (Tidmarsh & Volkmar, 2003, p. 518): ‘Because NT people look at the mannerism of the autistic with their own world-view and according to their own values, they often tend to misinterpret what they see’ (Schneider, 2002, p. 22). ASD authors do, however, work hard to extend apparatus for access to something approaching an ‘inside’ view that might aid understanding. First-hand accounts demonstrate that both internal and external stimuli are experienced very a-typically and have powerful, overwhelmingly bewildering affects. Addressing a common theme of sensory confusion or co-mingling, Gerland (2003, p. 78), for example, explains that in her world: ‘A sudden bark, or a dog jumping up at me, made my sensory faculties distort my perception, so that the dog became the size of an elephant and everything solid around me seemed to dissolve away and float.’ Providing further insight into how frightening such sensory mixing can be, Gerland describes a situation in school, when teachers tried to force her to use deafening and dangerous equipment during lessons in woodwork: the noise ‘hurt inside me, and I kept on and on losing all sense of direction and of myself’ (2003, p. 115). Gerland ran away from class, in an obvious (at least to her) act of ‘self preservation. Who would voluntarily stand by a band-saw, with hands near the blade, and lose the feeling of where their body was?’ (2003, p. 115). Other insider accounts suggest that sensory experience and also connections are different, in every imaginable sense. Stephen Shore is among those who write at length about difficulties with senses that can be ‘hyper or hypo’, ‘in other words, some of the senses are turned up too high and create an overload whereas others receive

308

J. Davidson / Social Science & Medicine 70 (2010) 305–312

information from the environment at too low a level to be perceived’ (2003, p. 47). Further illustrating the potential for confusion and problems with sensory integration, Hernandez (2003, p. 132) refers to autistic experience of ‘super sensitive, dulled, distorted and hyper-perfect senses, all at the same time.’ However, for many, Williams (2005, p. 96) included, senses can often only be accessed or experienced singly, never more than one at a time: ‘Most people can use all of their senses simultaneously. When they tune into the meaning of what they are hearing, they still continue to make sense of what they see and feel emotionally and physically.’ Williams is unable to do this, and details the extensive problems and exclusions this entails for those such as herself, who are: receptively mono-tracked information processors in a world of majority multi-track processors who often fail to provide forms of education, communication, social activities/networks, occupation and employment most appropriate to this form of information processing (2005, p. 206). It is obviously very challenging to function never mind fit when one’s own world ‘view’ clashes so violently with the majority of those others with whom space is ‘shared’. The multi-track world can be wildly inaccessible, and even the limited information one is able to retrieve can be so distorted and full of ‘static’ as to be completely unreliable. Often, even with senses ‘shut down’, information continues to accrue, but in a manner entirely devoid of sense. Thus: it isn’t the sound or picture that goes away, it is the meaning or significance of the sound [.] or the picture. [.] Systems shutdowns can affect the processing and monitoring of body awareness, touch, taste, smell, vision or hearing and can also effect the ability to process, monitor or access your own thoughts or feelings or connection to action or expression (Williams, 2005, p. 131). The person may thus continue to be bombarded with sensory information, but has no way to ‘process’, or access its meaning. All of which might help to explain seemingly strange behaviours and rigidity about routines. Often, viewed as if from the inside, such ‘symptoms’ are simply attempts to cope with a world that refuses to make sense: If you were blind, I’m sure you would also develop a ‘‘preference for sameness’’ for the placement of the furniture, for instance. I don’t want the furniture of the sensory stimuli moved around too much either, because it makes it difficult to navigate the social and learning environment in much the same way (Darius, 2002, p. 35). ASD authors’ sensory impairment is rarely straightforward or even predictable. It is not as though the world simply cannot be seen or otherwise sensed. Rather, it is seen, sensed and made sense of in other worldly ways, and authors suggest that recognition of such difference would decrease individuals’ sense of ‘alienation’ and perhaps also, perceived pressures to conform: To acknowledge these feelings of alienness is to verify a felt reality instead of skirting around it and unintentionally contributing to people feeling invalid or even shamed at feeling an alienness that cannot be denied but is not verified or acknowledged (Williams, 2005, p. 280/1). Taking seriously the person on the spectrum’s perspective – and not just visual, but auditory, tactile and so on – might help others understand how ‘strange’ self-stimulating (‘stimming’) behaviours can help re-order the environment in more manageable terms.

Authors suggest that stereotypical yet ‘inexplicable’ autistic actions – such as rocking, hand-flapping or humming – are intended to provide a rhythm of sorts against which the world can be more easily accessed and made sensible. They may depart from behavioural norms, but authors’ accounts suggest ‘harmless’ repetitious activities of all kinds can create more stable and less frightening sensory contexts, and often involve ‘inner’ – proprioceptive and vestibular – as well as ‘outer’ senses. Presumably well-meaning but misunderstanding others often attempt to close down such coping tactics, as when Darius is stopped from engaging in consol(idat)ing behaviour during break time by his teacher: He told me not to do it and I remember not understanding why I could not bounce, as it was such a reassuring feeling. I had already decided to stop publicly engaging in some of the more clearly autistic ‘stimming’ behaviours and only did them in my room. This was the last one to go (2002, p. 13). Pressure to be normal often entails letting go of assistive strategies specifically designed by the individual for their own specific needs, and this can obviously be counter productive for their wellbeing as well as burn bridges to access: ‘Voluntary strategies can be [.] like artificial limbs in place of non-autistic functions that either aren’t there or don’t work efficiently’ (Williams, 2005, p. 147). Lawson (2005, p. 1) illustrates such disabling attitudes when she states: ‘I have been often treated as if I am either deaf or stupid. I am neither. I simply find the world around me difficult to comprehend.’ It may be more than merely difficult, but Lawson (2005, p. 2) reveals the extent of her hard-won self- and social-awareness, as well as her continuing struggle to make sense and space, by and for herself: I realize that I do not see the world as others do. Most people take the routines of life and day-to-day connections for granted. The fact that they can see, hear, smell, touch and relate to others is ‘normal’. For me, these things are often painfully overwhelming, non-existent or just confusing. In Shore’s (2003, p. 50) discussion of the ways in which NT others might begin to understand such painful sensory difference, he suggests: ‘Imagining that one’s senses are 1000 times more sensitive than reality.’ Further, ‘Considering each sense individually can assist with organization of both the issues caused by the sensitivity and the remedies for relief.’ While bearing in mind the kinds of sensory connections and confusions outlined above, the following sub-sections follow Shore’s strategic advice and address each sense in turn. Single sense themes Sight In discussion of visual challenges, references to a particularly problematic form of lighting recur frequently, and unfortunately, fluorescents tend to dominate public and especially institutional spaces. Darius (2002, p. 18) explains that, faced with ‘fluorescent lighting [.] my brain simply goes into jelly-mode’ and Shore (2003, p. 50) helps explain why: Fluorescent lights ‘cycle on and off 60 times per second [which can feel] like sitting in a room with a strobe light’. However, while muted lighting can be helpful for some, the effects may not be predictable when dimmed to a logical conclusion: ‘What made the dark so horrible was that it blinded me, because my eyes never got used to it [.and it] made me lose all sense of direction’ (Gerland, 2003, p. 109). It is not just degree and source of light that presents often exhausting visual challenges, however, as Darius (2002, p. 25) explains: ‘Because my visual channel is so disturbed, it needs an enormous amount of energy to have it function at even a basic level.’ Moreover, and making sense

J. Davidson / Social Science & Medicine 70 (2010) 305–312

of his a-socially ‘strange’ habit of talking to himself: ‘Visual stimuli simply don’t enter my brain in a meaningful way. This was probably the reason why I used to talk to myself all the time. I translated everything explicitly into language’ (Darius, 2002, p. 15). For Gerland (2003, p. 65) too, what she sees does not ‘automatically’ make sense, and steps have to be taken to manage this visual ‘meaning blindness’: ‘My vision was rather flat, two-dimensional in a way, and this was somehow important to the way I viewed space and people. I seemed to fetch visual impressions from my eyes. Visual impressions did not come to me.’ Here, the efforts involved in managing just one aspect of sensory stimuli can make environments feel tiring and uncivil, affects compounded by other senses that (over)work with no effort at all. Hearing For some ASD authors, aural sensitivities are such that it is possible, indeed unavoidable, to ‘hear the hum of electrical apparatus [.and] sounds that other people don’t even notice are disturbing and even painful to me. I have huge problems filtering out what I want to hear’ (Darius, 2002, p. 12). Sounds can feel highly invasive and fully embodied, as with Gerland’s (2003, p. 28) description of the disturbance of passing cars: ‘They would explode inside me and make me lose all sense of the way my body related to my surroundings. It was like being flung out into space – whoosh – quite without warning. Sometimes I screamed and covered my ears.’ When sensitive ears are bombarded, they struggle to prioritize appropriately, which has led some authors to be accused of ‘selective deafness’. Gerland (2003, p. 94) describes how, in her old stone school building with high ceilings, there was a ‘constant murmur’, which was ‘torment to me, as if eating into my mind. The teacher prattling on was a background to other noises in my ears – the rustle of paper, scraping chairs, coughing. I heard everything. The sounds slid in over each other and merged together. For some, it seems as though sounds can be felt. Touch Tactile acuity presents significant daily challenges for many ASD authors, whose oversensitivity is such that even the lightest touch can feel like ‘an open wound or getting an electric shock’ (Shore 2003, p. 49). Cowhey (2005, p. 3) for example explains that ‘touch and texture have a profound impact on me’ and that this extends to her ability to cope with food. It is the ‘feel’ as opposed to the taste of food which leads her to mix and mash her meals in a way seen as ‘eccentric’ and so always discouraged by others. For Gerland (2003, p. 54), tactile hypersensitivity involves a great fear of jewellery, hairclips and metal buttons: ‘they were frightening, detestable and revolting. If I was made to touch jewellery, I felt a sharp, whistling, metallic noise in my ears [‘like a note falsely electrified’] and my stomach turned over.’ This sensitivity also meant Gerland was unable to stand the painful feeling of water drops on her skin. She refused to shower, but eventually discovered that baths could be surprisingly pleasant: ‘It was necessary to have as much water around me and all over my body as possible for it to be bearable’ (2003, p. 101). As with other senses, preference and tolerance for touch differs among ASD authors, and Barron could only bathe standing upright under a quick, light shower of water. He ‘felt acutely uncomfortable’ taking a bath. ‘It was the same feeling I used to have when I couldn’t stand to touch our rug with my bare feet’ (in Barron & Barron 2002, p. 96). Tactile sensitivity obviously has implications for clothing preference, and Sanders (2004, p. 36) writes of a furiously intense dislike of restrictive garments, such as belts: he ‘never wore them on any pants. I hate ties and refuse to wear them to this day. I think society is really absurd in terms of how picky some people can be, and how some places of business, and even restaurants require them’. He is not alone in making

309

repeated reference to unconventional clothing preferences or practices, and Prince-Hughes (2002, p. 216/7) states: ‘When I speak publicly or at conferences, I must always wear the clothes I will wear to bed the night before and sleep in them to condition them properly.’ Touch is often used in ways that enhance such a sense of ‘conditioned’ familiarity or sameness Lawson (2005, p. 109) for example, writes that by touching ‘something with continuity [or] wearing my hat and feeling the definition on my head [‘even though it was a summer hat I wore it in the snow’]’ (2005, p. 109) she can tolerate change that is ‘felt as less powerful’ as a result. Smell Heightened olfactory ability means that for those like Shore (2003, p. 19), the presence of perfume can feel like ‘taking a deep breath from a Clorox [bleach] bottle’. This presents problems for him at work, and he describes the ‘olfactory assault’ that leaves him with headaches and watering eyes whenever his scent-wearing colleague arrives in her office on the floor below. Sanders too describes life-long problems with painful intolerance of strong odors, and how this became caught up with difficulties at home, particularly in his relationship with his sister. Growing up: ‘I would complain and get upset about smells, such as hairspray, or the use of her electric curlers or her hair dryer, and the putrid smells they would make from cooking the hair’ (Sanders, 2004, p. 51). This problem persists through and impacts on his years in higher education, as when he asks his professor not to smoke in the classroom. The unsympathetic response – Sanders (2004, p. 125) thought the professor was going to throw something at him – lead to his dropping the class. Taste In considering the last single sense theme, experiential connections with other senses are again unavoidable, as the appearance, texture, and smell of foods are significant contributors to ASD authors’ problems with eating. Shore (2003, p. 44), for example, strives to avoid anything remotely resembling the tomato that once responded shockingly to his bite: ‘The sensory stimulation of having that small piece of fruit explode in my mouth was too much to bear and I was not going to take any chances of that happening again.’ Barron also describes complex inter-sensory experience that helps make sense of his intolerance for culinary diversity: ‘I had a big problem with food. I liked to eat things that were bland and uncomplicated [.] I really hated it when food had things mixed with it, like noodles with vegetables or bread with fillings to make sandwiches. I could never, never put any of it in my mouth’ (in Barron & Barron 2002, p. 96). Prince-Hughes (2002, p. 18) suggests that many autistic people ‘are very picky eaters’, but this can have consequences more far-reaching than one might at first assume. Sanders (2004, p. 129) for example, thinks that his lunch-time habits may have been one (among other) ‘factors that led to my dismissal [from his job], for example, taking marinated chicken into the bathroom to wash off the hot sauce. They probably thought that was abnormal’ (2004, p. 131). Pressures to be ‘normal’ in relation to habits of taste have led to similarly severe problems for others, including several women authors who have been misdiagnosed with anorexia, a disorder more stereotypically ‘feminine’ than autism (Davidson 2007a). Making space for autism: discussion and recommendations Many of ASD authors’ recommendations for making environments less sensorially toxic for those on the spectrum could be considered rather intuitive – if not exactly ‘common sense’ – for the sensitive, imaginative outsider. Addressing the ableist construction of global sensory contexts – and issues of confusion, connection and

310

J. Davidson / Social Science & Medicine 70 (2010) 305–312

pressure to conform – authors suggest that shared sensory ‘furniture’ can often be redesigned or reorganized, and stimuli muted or toned down to more tolerable levels. In addition, ASD authors reveal considerable capacities for self-help, and simple awareness of different ways of managing sensory involvement in social space can go a long way to challenging barriers to access. Part of nonautistic attempts to accommodate sensory difference might entail assisting – or simply ‘allowing’ – such capacities, however inimical of normality associated practices might be. As we have seen, enabling coping tactics include ‘stimming’ or soothing by rocking or hand-flapping. While autistic (and other disabled) individuals might do things differently, ‘more clumsily or slowly, with ‘‘unusual’’ body movements or ‘‘unexpected’’ sensory cues,’ Hansen and Philo (2007, p. 502) stress the importance of recognizing the ‘wholly unexceptional normality of doing things differently, and acknowledging, tolerating, and maybe even (cautiously) celebrating the many and hugely varied ways in which things can be done.’ They suggest this entails a thinking with, rather than simply about, disability, and so support arguments in favour of a relational approach to accessibility, one that recognizes and respects, rather than denies or derides, difference of whatever kind. Beyond heightened acceptance that makes space for difference, appropriate accommodations require that other bodies – individuals, institutions and so on – take action to dismantle inaccessible environments. That is to say, it is not sufficient to merely assist or more passively ‘allow’ the person who is challenged to identify, design, construct and maintain their own means – mechanical or otherwise – of managing disabling space. A responsible, relational approach to accommodating complex sensory impairments takes steps to bring about change, steps that begin with a geographical imagination. As Shore (2003, p. 50) explains, imagining how it feels to be autistic – as attempted above – ‘can help a person to design environmental accommodations for those on the autistic spectrum.’ I now return to imagining each single-sense theme in turn. Many ASD authors explain that making sense of their visual surroundings can be much easier when extraneous information and visual stimuli are kept to a minimal level. The most tolerable environment might be simply decorated, devoid of complex patterns, though distinctive colours for walls and floors are to be welcomed, as they assist navigation (Williams, 2005, p. 284). The room’s inhabitants should avoid making the excessive visual demands associated with sudden movements and expansive body language, not to mention garish or complexly patterned clothes. ASD authors’ accounts suggest that these distractions require extra visual ‘filtering’, and detract energy and attention from the ability to make sense of important visual stimuli, such as whose mouth is moving when speech is heard, and where the stairs or chairs are. If one imagines – as Shore (2003, p. 50) suggests – one’s visual channel ‘turned up’ to produce the most psychedelic, kaleidoscopic effects, then anything that effectively ‘mutes’ the intensity of impression will weaken barriers to processing what is seen. Attention to lighting is obviously crucial, and while incandescent lighting can be prohibitively costly, authors’ accounts strongly suggest that it should be considered as perhaps the most straightforward way of creating more accessible environments. (Lawson is perhaps only half-joking when she states that fluorescent lighting should be banned by law (pers.com). Unfortunately, due to policy concerns about incandescent energy inefficiency, the opposite is occurring, and fluorescents are fast becoming the only option; this has serious implications for public access.) Williams recommends experimenting with different coloured and low wattage light bulbs, and states that using ‘lamps that reflect light upwards rather than downwards can create less visual distortion’ (2005, p. 211). And, given that ‘[s]unglasses can help some people

cope with hypersensitivity [.] (including indoors)’ (2005, p. 211) tolerance of ‘stylistic’ difference can be enormously enabling. Somewhat paradoxically given the visual sensitivities outlined above, and underlining the importance of making informed plans for accommodations in relation and in context, visual acuity can be turned to productive use: Shore states that rather than focusing on disabilities, it is ‘better to work with the person’s strengths, which often are visual. Communication boards and sign language are often better paths to communication and commonly serve as a bridge to verbal communication’ (Shore, 2003, p. 40). Williams (2005, p. 251) and others (see Nazeer, 2006) in fact often prefer to communicate through signing, using diagrams or mediating objects that can be less sensorially exhausting – and easier to turn away from when fatigued – than noise. For those with hypersensitivity to sound, many of the most useful accommodations are intuitive. However, background noise is often difficult to control for in public space; aural barriers to access cannot all or easily be ‘designed out’, and attempts at noise reduction may require creativity and sensitivity on the part of non-autistic others. Given common difficulties separating out relevant sounds, time spent in busy, badly sound-proofed or ‘echoey’ rooms should obviously be kept to a minimum, but ASD authors also suggest others should be imaginative about what might constitute ‘noise’ (such as electricity). While some individuals might appreciate the provision of ‘[e]ar plugs, headphones or cotton wool [as] sources of self-control’, Williams that ‘[s]lowing down auditory input and cutting down distraction can help a person to process and comprehend that input now it is at a bearable pace’ (Williams 2005, p. 210). Social space can be made more accessible when non-autistic others, quite simply, ‘speak more calmly, with less intonation, more slowly, concisely and economically, and cut down on any unnecessary background noises’ (2005, p. 203). The taken-for-granted and ‘hidden geographies’ of disabling environments can thus be identified and challenged through temporal, as well as spatial, means of accommodation, recalling Hansen and Philo’s (2007) emphasis on recognizing different ‘timings’ as well as ‘spacings’ of embodied efforts. This might entail planning interaction in relation to others’ more sensitive schedule, as Darius (2002, p. 34) explains: ‘When I am doing something and another person starts talking to me it simply doesn’t register. I may hear every word he says but it doesn’t sink in.’ Simple patience can thus be enormously assistive, and prevent debilitating intrusion on others’ time and space. Recommending NT behaviour modification in relation to timing and touch, Williams (2005, p. 203) suggests: ‘Touch should be slow and as predictable as possible and only used where necessary. This will stop people using up so much processing capacity in being on guard.’ Planning for predictability can also be helpful in other regards, and Prince-Hughes (2002, p. 127) suggests that friends might help an autistic person ‘set up a schedule and method of bathing that works for the individual.’ There should, however, be careful limits placed on pressures to conform by others – for good accommodating reasons – and this extends to matters of encouraging ‘appropriate’ dress: as Williams (2005, p. 210) explains: ‘If someone insists on a coat or jumper where it seems socially inappropriate, the person may have good sensory reasons for this that go beyond mere habit.’ Apparently ‘picky’ peculiarities often stem from tactile sensitivities, and greater tolerance of sartorial eccentricity – or simple untidiness – can reduce barriers to access in many social environments: Many autistic people need to wear baggy cotton clothing, giving them a ‘‘rumpled’’ appearance. Trying to encourage them to

J. Davidson / Social Science & Medicine 70 (2010) 305–312

wear better-fitting clothing is a mistake. If they are uncomfortable in their clothes, they will be unable to concentrate (Prince-Hughes 2002, p. 127). Prince-Hughes (2002, p. 127) thus suggests that NT efforts to civilize ‘unruly’ autistic bodies are often misguided and oppressively ableist. She states, quite simply: ‘If they don’t care about their appearance, respect that.’ Heightened sense of touch can, somewhat paradoxically (but akin to the use of visual strengths, above) be used to the autistic person’s advantage, and help to create assistive strategies. Describing how autistic people ‘constantly tap everything’, Grandin (1996, p. 66) explains that ‘they may be doing this to figure out where the boundaries are in their environment, like a blind person tapping with a cane.’ Williams (2005, p. 151) also describes a touch-based technique of ‘sensory mapping’, where the feel of a wall, or of a person, triggers other sensations and memories in a way that helps environments feel more familiar, and thus more easily navigable. With imaginative effort, uncommon senses can become strengths, but unfortunately, Grandin (2005, p. 147) explains that autistic people are often actively ‘trained’ out of ‘using our senses to map out places, people and objects [.] in the ignorant pursuit of non-autistic ‘‘normality’’ ’. Grandin is clearly resistant to the imposition of civilizing strategies on autistic bodies, although she explains some are more understandable and accommodating than others. For example, she does not regret being discouraged from one childhood sensory habit she finds embarrassing to recall, that of ‘sniffing people, like a dog’ (Grandin, 1996, p. 116). Given how many of those with ASDs ‘are very sensitive to odors’, Prince-Hughes states that those in a position of authority over public space have a responsibility to help make it less toxic. Teachers, for example, should ‘[a]sk other students in the class to avoid using cologne and perfume’ (2002, p. 128; Prince-Hughes also advises against using ‘dry-erase markers or industrial cleaners’). The removal of such barriers to access are becoming increasingly common in growing numbers of countries as awareness and incidence of multiple chemical sensitivities increases, leading to the banning of scents from public buildings. In Canada, for example, ‘share the air’ campaigns have resulted in significant increases in accessible scent-free environments, including the majority of hospitals and many university and other workplace settings (Coyle, 2004). In considering accommodations for individuals relating to taste, imaginative efforts to adopt the perspective of the person on the spectrum are again key. There are, as we have seen, understandable reasons why someone ‘will often eat one item almost exclusively’, and to accommodate the needs of, for example, college students or office workers with autism, it is obviously ‘a good idea for the cafeteria to stock plenty of that item’ (Prince-Hughes 2002, p. 128). Also – and obviously – to render public eating places accessible for those on the spectrum, ‘broad minded approaches to eccentricities around eating are essential’. The insights that unfold through careful consideration of firsthand accounts are many and varied, and there are no doubt numerous others yet to be reported or imagined. However, and as the preceding sections make clear, the challenges associated with facilitating access for many of those with autism should not be overstated; there is much that can be achieved with relative ease. Closing thoughts: on being open to embodiments of autistic sensory difference As we have seen throughout this paper, and as ASD authors’ diagnostic label suggests, there is considerable variation in experience and opinion among those on the spectrum. All, however,

311

are to some extent challenged by the need to negotiate the complex sensory geographies of everyday life. In an attempt to advance a relational approach to understanding the world from something approaching an ASD ‘angle’, this paper has followed calls for what Williams (2005, p. 20) has termed ‘[e]xperiencesbased approaches [that] try to understand not so much the ‘‘appear’’ of a condition (what it looks like) but the ‘‘be’’ of a condition (what it feels like)’. It has utilized what might be termed an empathetic and geographical imagination, to try and preempt unnecessarily challenging sensorial encounters. As we have seen, if individuals on the spectrum are given the time and space to communicate what the world feels like for them, and if typical others are willing to take relational responsibilities seriously and really hear such accounts, we can go some way towards dismantling barriers to access largely imposed by ‘NT ignorance’ (Schneider, 2002, p. 12). For Schneider, this ignorance and its affects are at least partially ‘curable by information and understanding’ (2003, p. 12), and this paper has focused on relational cures for such (uncivilized) absence of knowledge and/or empathy, rather than ‘fixes’ for the minds, bodies and behaviours – however supposedly ‘uncivil’ – of those with ASDs. In its consideration and re-communication of ASD authors’ recommendations for accommodations, the paper aims to contribute to autistic advocacy for acceptance and accessibility (Prince-Hughes, 2002). As far as possible, it has tried to accomplish this in and on ASD authors’ own – often ‘quirky’ – terms (Bumiller, 2008). In closing, I will quote Singer’s (1999, p. 67) response to the trick(y) question of autistic ‘inclusion’ with which this paper began: The answer from their/our point of view is that we don’t want to be included, we want mutual understanding [.] based on what we can do, not on what we can’t. Perhaps as the voices of the ‘neurologically different’ are heard more loudly, a more ecological view of society will emerge: one that is more relaxed about different styles of being. Space for genuine difference and diversity is crucial for those on the spectrum, and future research is required to advance the project ASD authors themselves have begun. Such studies might further imagine what relational approaches respectful of difference might look like. They might also explore how mutually ‘inclusive’ societies could re-conceptualize real difference in terms other than deviancy or deficit (Hansen & Philo, 2007). In the words of Stephen Shore (2003, p. 180): ‘the future for people on the autism spectrum looks promising but much remains to be done’. Finally, in considering potential implications for other geographies of disability and emotional health, this paper contributes to a growing sense of how much can be learned about other kinds of different/disordered experience from interpretations of published autobiographies. It also highlights the need for researchers of other conditions to be extraordinarily sensitive to variations in perceptual experience among different individuals in order to better understand their interactions with their environments.

References Avrahami, E. (2007). The invading body: Reading illness autobiographies. Charlottesville: University of Virginia Press. Bagatell, N. (2007). Orchestrating voices: autism, identity and the power of discourse. Disability and Society, 22(4), 413–426. Baron-Cohen, S. (2003). The essential difference: Male and female brains and the truth about autsim. New York: Basic Books. Barron, J., & Barron, S. (2002). There’s a boy in here: Emerging from the bonds of autism. Arlington, TX: Future Horizons. Bumiller, K. (2008). Quirky citizens: autism, gender, and reimagining disability. Signs, 33(4).

312

J. Davidson / Social Science & Medicine 70 (2010) 305–312

Butler, R. (1994). Geography and visually impaired and blind populations. Transactions of the Institute of British Geographers, 19, 366–368. Chouinard, V. (1999). Life at the margins: Disabled women’s explorations of ableist spaces. In E. Kenworth Teather (Ed.), Embodied Geographies: Spaces, Bodies and Rites of Passage (pp. 143–156). New York: Routledge. Conradson, D. (2005). Landscape, care and the relational self: therapeutic encounters in rural England. Health and Place, 11, 337–348. Cowhey, S. P. (2005). Going through the motions: Coping with autism. Baltimore, MD: Publish America. Coyle, F. (2004). ‘Safe-space’ as counter-space: women, environmental illness and ‘corporeal chaos’. The Canadian Geographer, 48(1), 62–75. Crooks, V., & Chouinard, V. (2006). An embodied geography of disablement: chronically ill women’s struggles for enabling places in spaces of health care and daily life. Health and Place, 12, 345–352. Cummins, S., Curtis, S., Diez-Rouz, A. V., & Macintyre, S. (2007). Understanding and representing ‘place’ in health research: a relational approach. Social Science & Medicine, 65, 1825–1838. Curtis, S., Gesler, W., Smith, G., & Washburn, S. (2000). Approaches to sampling and case selection in qualitative research: examples in the geography of health. Social Science & Medicine, 50, 1001–1014. Darius. (2002). In D. Prince-Hughes (Ed.), Aquamarine blue 5: Personal stories of college students with autism (pp. 9–42). Athens, OH: Swallow Press. Davidson, J. (2003). Phobic geographies: The phenomenology and spatiality of identity. Burlington VT and Aldershot: Ashgate Press. Davidson, J. (2007a). ‘‘More labels than a jam jar.’’ the gendered dynamics of diagnosis for girls and women with autism. In P. Moss, & K. Teghtsoonian (Eds.), Contested illness. Toronto: University of Toronto Press. Davidson, J. (2007b). ‘‘In a world of her own.’’ re-presentations of alienation in the lives and writings of women with autism. Gender, Place and Culture, 14(6), 659–677. Davidson, J. (2008). Autistic cultures online: virtual communication and cultural expression on the spectrum. Social and Cultural Geography, 9(7), 791–806. Fairclough, N. (1995). Critical discourse analysis: The critical study of language. London: Longman. Freund, P. (2001). Bodies, disability and spaces: the social model and disabling spatial organizations. Disability and Society, 16, 689–706. Gerland, G. (2003). A real person: Life on the outside. London: Souvenir Press. Gevers, I. (2000). Subversive tactics of neurologically diverse cultures. The Journal of Cognitive Liberties, 2(1), 43–60. Gleeson, B. (1999). Geographies of disability. London: Routledge. Grandin, T. (1996). Thinking in pictures: And other reports from my life with autism. New York: Vintage Books. Grandin, T. (2005). Animals in Translation: Using the Mysteries of Autism to Decode Animal Behaviour. Orlando: Harcourt. Grandin, T., & Barron, S. (2005). Unwritten rules of social relationships: Understanding and managing social challenges for those with Asperger’s/autism. Arlington, TX: Future Horizons. Gray, D. E. (2002). Everybody just freezes. Everybody is just embarrassed’: felt and enacted stigma among parents of autistic children. Sociology of Health and Illness, 24, 734–749. Grinker, R. (2007). Unstrange Minds: Remapping the World of Autism. Cambridge, MA: Basic Books. Haddon, M. (2004). The curious incident of the dog in the night-time. Toronto: Anchor Canada. Hall, E. (2000). Blood, brain and bones: taking the body seriously in the geography of health and impairment. Area, 32(1), 21–29. Hansen, N., & Philo, C. (2007). The normality of doing things differently: bodies, spaces and disability geography. Tijdschrift voor economische en sociale geografie, 98(4), 493–506. Hernandez, E. A. (2003). No duty to retreat: The stories of Tourette’s syndrome and Asperger’s autism. Frederick, MD: PublishAmerica. Imrie, R., & Edwards, C. (2007). The geographies of disability: reflections on the development of a subdiscipline. Geography Compass, 1(3), 623–640. Iverson, P. (2006). Strange Son: Two Mothers, Two Sons, and the Quest to Unlock the Hidden World of Autism. New York: Riverhead Books.

Lawson, W. (2005). Life behind glass: A personal account of autism spectrum disorder. London and Philadelphia: Jessica Kingsley Publishers. Marcus, L. M., Garfinkle, A., & Wolery, M. (2001). Issues in early diagnosis and intervention with young children with autism. In E. Schopler, N. Yirmiya, C. Shulman, & L. M. Marcus (Eds.), The research basis for autism intervention. , New York: Kluwer. McKean, T. (2001). Soon Will Come the Light: A View From Inside the Autism Puzzle. Arlington. Texas: Future Horizons Inc. Miller, J. K. (2003). Women from another planet: Our lives in the universe of autism. Bloomington, IN: Dancing Minds. Moss, P., & Dyck, I. (2003). Women, body, illness: Space and identity in the everyday lives of women with chronic illness. Lanham, MD: Rowma and Littlefield. Nash, J. M. (2002). The secrets of autism: the number of children diagnosed with autism and Asperger’s in the US is exploding. Why? Time, 159, 47–56. Nazeer, K. (2006). Send in the idiots: Or how we grew to understand the world. London: Bloomsbury. Osborne, L. (2002). American normal: The hidden world of Asperger’s syndrome. New York: Copernicus Books. Parr, H. (2008). Mental health and social space. Oxford: Blackwells. Pope, C., Ziebland, S., & Mays, N. (2000). Analysing qualitative data. In C. Pope, & N. Mays (Eds.), Qualitative research in health care. London: BMJ. Prince-Hughes, D. (2002). Aquamarine blue 5: Personal stories of college students with autism. Athens, OH: Swallow Press. Sacks, O. (1995). An anthropologist on Mars. London: Picador. Sanders, R. (2004). On my own terms: My journey with Asperger’s. Murfreesboro, TN: Armstrong Valley. Schneider, E. (2002). Living the good life with autism. London and Philadelphia: Jessica Kingsley Publishers. Shore, S. (2003). Beyond the wall: Personal experiences with autism and Asperger syndrome (2nd ed.). Shawnee Mission, Kansas: Autism Asperger Publishing Company. Singer, J. (1999). ‘Why can’t you be normal for once in your life?’ From a ‘problem with no name’ to the emergence of a new category of difference. In M. Corker, & S. French (Eds.), Disability discourse (pp. 59–67). Buckingham: OU Press. Singer, J. (2003). Foreword: travels in parallel space: an invitation. In J. K. Miller (Ed.), Women from another planet? Our lives in the universe of autism (pp. xi–xiii). Bloomington, IN: Dancing Minds. Smith, S. (1996). Taking it to a limit one more time: autobiography and autism. In S. Smith, & J. Watson (Eds.), Getting a life: Everyday uses of autobiography (pp. 226–248). Minneapolis: University of Minnesota Press. Smith, S., & Watson, J. (2001). Reading autobiography: A guide for interpreting life narratives. Minneapolis: University of Minnesota Press. Stillman, W. (2006). Autism And the God Connection: Redefining the Autistic Experience Through Extraordinary Accounts of Spiritual Giftedness. Naperville, Ill.: Sourcebooks Inc. Szatmari, P. (2004). A mind apart: Understanding children with autism and Asperger syndrome. New York and London: The Guilford Press. Talay-Ongan, A., & Wood, K. (2000). Unusual sensory sensitivities in autism: a possible crossroads. International Journal of Disability, Development and Education, 47(2), 201–212. Tidmarsh, L., & Volkmar, F. R. (2003). Diagnosis and epidemiology of autism spectrum disorders. The Canadian Journal of Psychiatry, 48(8), 517–525. Waltz, M. (2005). Reading case studies of people with autistic spectrum disorders; a cultural studies approach to disability representation. Disability and Society, 20(4), 421–435. Williams, D. (1994). Somebody somewhere: Breaking free from the world of autism. New York: Random House. Williams, D. (1998). Like colour to the blind: Soul searching and soul finding. London and Philadelphia: Jessica Kingsley Publishers. Williams, D. (2005). Autism: An inside-out approach: An innovative look at the mechanics of autism and its developmental cousins. London and Philadelphia: Jessica Kingsley Publishers.