OUT OF SILENCE

Juxtaposing the pain of childhood autism with theories of how language develops and functions, Martin (A Story That Stands Like a Dam, 1989, etc.) evokes the miracle of speech and the tragedy of its loss—in a loving tribute to his nephew, Ian, and his family. After speaking his first word at 18 months, Ian woke up from a feverish sleep induced by a DPT shot unable to speak at all; isolated by inner demons, inexplicable tantrums, obsessions, and rituals, he was to be deprived for four and a half years of the ordering, socializing, connecting function of language. Martin traces the history of autism, names award-winning psychiatrists (such as Bettelheim) who blamed it on parents, covers the recognition of its epidemic proportions, especially among the children of middle-class parents in the 60's, and touches on the quiet substitution of an altered DPT vaccine in 1992 for the lethal variety that destroyed Ian. Martin's concern is with language, semantics, neurophysiology, learning theory, even the importance of narrative (at which he excels). He offers the medical reasons why Ian reacts to loud noises and to changes in his routines with terror and rage, and for the inner voices that confuse him even as he pursues peace through ritual, custom, familiarity. Eventually Ian attends school and learns to convey the ``nightmare'' of his life, the inscrutable world he inhabits, the conflicts among his thoughts, desires, expressions, and behavior. It is in this triumph that the greatest pathos of the book lies, showing a divided consciousness, aware and at war. A remarkable story demonstrating immense knowledge that has no power, good intentions that betray, and, at the very heart of it, the terrible price a child and his family paid because the most important information was in the small print that a country physician did not read. Crucial reading for parents and professionals.