FROM ISOLATION TO INTIMACY

Reviewed by Colin Griffiths

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This book looks at how people without disabilities communicate with those who have intellectual disability or are on the autistic spectrum. The book is divided into two sections, the first of which is entitled ‘Learning the skills of interaction’. This section examines what goes on as we interact with people who mostly do not use language and who view the world as a very different place to the way their carers view it. Caldwell understands that if you are on the autistic spectrum the world appears to you as wholly foreign and unpredictable; she understands that the capacity of many people with severe intellectual disabilities to comprehend the world in which they live is very limited. The author explains some of her theories about why this is so. In brief, she suggests that the way to communicate with such people is to use their utterances and body language as the starting point from which to develop a conversation.

Although Caldwell uses many case studies in the first part of the book, she relies heavily on stories of different individuals in the second section, which gives examples of how she has worked with people with autistic traits and people with intellectual disabilities to make contact with them and to use that contact as a way of communicating with them on their terms, and then of easing the anxiety that many suffer from in encountering the world around them.

Caldwell’s theses is summed up in page 144, where she says: ‘Whatever our state, we take it for granted that others experience the same as we do. It is one thing to be aware in our heads that another person’s experience differs from our own, quite another to take this on board and understand what their experience feels like, how different their perceptions are in the flesh.’ Caldwell thinks that we cannot communicate with people with autism or severe intellectual disability unless we try to see the world through their eyes. We can do this through closely watching the person we wish to communicate with, and by using imitation and intensive interaction as communication mechanisms that enable us to engage with others on their terms and to ‘speak their language’.

The difficulty of the task is evident when one thinks of how easy it is to misunderstand our non-disabled peers who can communicate with words and gestures, let alone the immense difficulty that people with autism or severe intellectual disability present with.

If I have any criticisms of the book they are that Caldwell makes communication seem easy, which it clearly is not. She only describes her successes, never the people with whom she could not communicate. Furthermore, as she points out herself, there is little scientific evidence to support her theories. Hopefully that will come. Indeed it is important that her ideas are tested, quite simply because they are such good ideas. Caldwell makes it clear that if you perceive the world in a wholly distorted way you can only be communicated with by someone who understands that—obvious really. It is fascinating that in all her discourses regarding those on the autistic spectrum she does not mention Applied Behaviour Analysis once. In ways, this is not surprising because her approach is very different. She does mention the use of PECS as being helpful if used thoughtfully, but she does not regard the technique as a panacea.

In short, this is a wonderful book—it challenges current thinking, it makes you want to go straight up to the next person you meet who has communication difficulties and try out the approaches she suggests. It is early days, but if evidence can be produced to support her theories this may just come to be regarded as a book that changed the world.

FROM ISOLATION TO INTIMACY: MAKING FRIENDS WITHOUT WORDS
by Phoebe Caldwell with Jane Horwood. London, Jessica Kingsley (2007). ISBN 978 1 84310 500 8, £12.99.

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