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Rigid Therapies, Rigid Minds: Italian Professionals’ Perspectives on Autism Interventions

Culture, Medicine, and Psychiatry volume 39, pages 235–253 (2015)Cite this article

Abstract

Many therapies, interventions, and programs seek to improve outcomes and quality of life for people diagnosed with autism spectrum conditions. This paper addresses Italian professionals’ perspectives on a variety of such interventions, including TEACCH, ABA, Defeat Autism Now!, and Doman–Delacato. Drawing on participant-observation and interviews collected in 2012–2013 in a northern region of Italy, it highlights the theme of “rigidity” that appears in professionals’ discourses about both the characteristics of people with autism and the potential risks of adhering too strictly to any particular treatment protocol. The co-occurrence of the theme of rigidity across different domains demonstrates a way in which diagnostic characteristics become metaphors for medical practice. This paper proposes that such discursive moves may help bridge the gap between people with autism and people who work with them because a key attribute of people with autism—thinking and/or acting rigidly—is also a potential pitfall for people without autism.

Astratto

Varie terapie, interventi, e programmi cercano di migliorare gli esiti e la qualità della vita delle persone con diagnosi nello spettro autistico. Questo articolo presenta le prospettive di professionisti italiani su questi interventi, compresi TEACCH, ABA, Defeat Autism Now!, e Doman-Delacato. La presente ricerca emerge da uno studio etnografico condotto in una regione nel Nord Italia usando i metodi dell’osservazione-partecipante e interviste, condotte nel 2012–2013. Nell’articolo si sottolinea il tema di “ridigità” che emerge nei discorsi dei professionisti, per indicare sia una caratteristica delle persone affette da autismo che i possibili rischi di un approccio terapeutico troppo severo. La co-presenza del tema della rigidità nei vari campi discorsivi mostra come le caratteristiche diagnostiche dell’autismo diventino una metafora per la pratica medica. Questo articolo propone che questa tecnica discorsiva potrebbe aiutare a ridurre la distanza tra le persone affette da autismo e le persone con cui queste lavorano, perché una caratteristica chiave dell’autismo—la rigidità nel pensiero o azione—è anche un pericolo per le persone che non hanno diagnosi di autismo.

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Notes

  1. An ample literature in anthropology and clinical scholarship addresses these questions: how to interact with people with autism, how to treat people with autism, how to research with people with autism—in short, how people with and without autism do, can, or should interact (see for example Bakan 2014, Fein 2011, Hendriks 2012, Silberman 2012). Participants’ perspectives on these questions merit further discussion, but are beyond the scope of this article. Here, the focus rests on how professionals make meaning of autism and of their own work across a range of intervention philosophies and strategies.

  2. 14/45 professionals referred directly to some version of “the triad” of Lorna Wing or the DSM-IV, or “the three areas.” However, an additional 22/45 described all three characteristics, just not explicitly bounded together as a “triad.” Together, therefore 80 % of participants stressed the importance of all three characteristics.

  3. Referenced in 4 interviews.

  4. Referenced in 1 interview.

  5. Referenced in 6 interviews.

  6. Referenced in 4 interviews.

  7. Referenced in 9 interviews.

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Acknowledgments

This submission represents original work and has not been submitted or published elsewhere. Portions of this work were presented on March 19, 2014 at the Society for Applied Anthropology Annual Meeting in Albuquerque, NM, under the title “‘This Is the Italian Variant on TEACCH’: Italian Adaptation of a North Carolina Autism Service Model.” Research for this article was funded by an Institute of International Education Fulbright Grant, academic year 2012–2013; a Dissertation Research Assistance Grant under the supervision of Eileen-Anderson-Fye; a Baker Nord Center for the Humanities Graduate Research Grant at Case Western Reserve University; and an Arts & Sciences Dissertation Fellowship at Case Western Reserve University. Several Italian individuals and organizations made this research possible including Professor Roberto Malighetti and the Università degli Studi di Milano-Bicocca; Cascina Rossago; Cooperativa Aurora 2000 and the Spazio Autismo; Cooperativa I Percorsi; Cooperativa Spazio Aperto Servizi; Fondazione Istitute Sacra Famiglia ONLUS; Gruppo Asperger ONLUS; and Progetto Filippide.

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    M. Ariel Cascio

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Cascio, M.A. Rigid Therapies, Rigid Minds: Italian Professionals’ Perspectives on Autism Interventions. Cult Med Psychiatry 39, 235–253 (2015). https://doi.org/10.1007/s11013-015-9439-6

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Keywords

  • Autism
  • Ethnography
  • Health and human services
  • Italy
  • Metaphor