THE LIVES OF THE SILENT

A behavioral expert looks at the lives of noncommunicative patients and discusses strategies for helping them.

At the heart of Houvouras’ book is a segment of the population he calls “the silent”: nonverbal, nonvocal, speech-impaired people, those with “minimal communication” who are “consigned to a life where they may talk minimally or not at all.” Over his years interacting with such people, from those on the autistic spectrum living in group homes to people isolated by other societal factors, the author, director of experiential training at the Florida Institute of Technology, has seen many treatment fads come and go (like the assisted-typing method of facilitated communication, or FC), all of which he dismisses as not being grounded in science. He instead champions applied behavior analysis (ABA), which “emphasizes individualized assessments and behavior plans.” Houvouras draws on his long experience to tell the stories of some of “the silent” whom he’s known over the years, detailing their struggles and their setbacks resulting from ineffective treatment strategies. There’s “Mr. A. Number 1,” for instance, who was a child when the author first met him and who’d been let down by the state, the educational system, and a care network that opted against using ABA. Readers also meet a gentle, almost entirely nonverbal autistic man in his 20s named Dan, whose family doggedly pursued FC even though Houvouras maintained that the technique is a failure that should be dropped from the therapeutic repertoire. The author is adept at translating his experiences in clinical practice into relatable human stories; he acknowledges that people with conventional communication skills can find “the silent” to be alien or off-putting, and he effectively highlights the universal human characteristics that a lack of conversational abilities often masks. The author’s belief that we all have “the abilities to overcome and redefine ourselves” comes across as strongly sincere, as does his empathy for those who live beyond “the clutter, the clatter, and the need to hear an answer.” Readers with nonverbal loved ones will find much of this book invaluable.

An opinionated and deeply compassionate examination of the lives of communication-impaired people.