What’s Normal? A Look at Asperger Syndrome

By DAVID CORCORAN

It was an exciting moment for me and, I imagine, for other parents of children with the baffling neurological disorder called Asperger syndrome when The New York Times Magazine published Lawrence Osborne’s “Little Professor Syndrome” in June 2000.

The title may have been condescending, but the article itself was terrific, perhaps the best yet about Asperger’s in a mainstream publication: a 4,500-word exploration, in remarkably vivid and sympathetic language, of a world that few readers had visited.

So it was doubly exciting when Mr. Osborne, a widely published health
and science journalist, expanded the article into a book, “American Normal,” published last month.

Asperger’s, as most readers probably still need to be told, is a
lifelong disorder of unknown origin that usually shows up around 18 months to 3 years. Generally thought to be a form of autism, it is characterized by normal or above-normal intelligence, social awkwardness, verbal rigidity and, most conspicuously, a fixation with an obscure topic that can be learned by rote.

People with Asperger’s have a hard time relating to other people. But
they can and do go on for hours about their obsession Ñ Civil War battles, lighting fixtures, members of Congress, train engines (hence, “little professors”).

The syndrome has no known cure. But growing awareness of it, coupled
with the federal law that requires schools to provide appropriate services to students with disabilities, means that many more children than in the past are receiving needed attention and can hope to grow into happy and productive
adults.

Still, what Asperger’s awareness has lacked is a wide-ranging book by
a writer with journalistic and literary credentials Ñ a book that could do for Asperger’s what Oliver Sacks’s “Man Who Mistook His Wife for a Hat” did for other obscure brain disorders. But those of us who were hoping that “American
Normal” would be that book are in for a severe disappointment.

It takes the form of a transcontinental odyssey in which Mr. Osborne
drops in on children with Asperger’s and adults who are too old to have had it diagnosed in childhood but who clearly show its symptoms. (Some are parents of Asperger’s children, suggesting that the condition may run in families.)

He is an acute observer, and his descriptions are penetrating and
tinged with empathetic humor. Nicky, a
9-year-old in Adelanto, Calif., who writes tiny poems in the shape of
diamonds and has already scored in
the 99th percentile on an SAT, has a mind that is “disturbingly
hyperfactual and blithely associative.”

A. J., whose obsession is vacuum cleaners, “loved the promotional
video that came with the new Phantom
model and watched it over and over, while rocking back and forth.”
When his grandmother disciplines
him by telling him he won’t be able to touch the new vacuum, “a
sullen look of castigated impotence
would suddenly come over his face.”

But when Mr. Osborne leaves the company of people with Asperger’s,
the book runs seriously off track.
Much of it is devoted to long, tangential and unrewarding meditations
on the American psychiatric
establishment, the horrors of highway sprawl and the possibility that
various figures Ñ Thomas
Jefferson, the Canadian pianist Glenn Gould Ñ may have had
Asperger’s. Mr. Osborne himself suspects
that he may have undiagnosed Asperger’s, and he returns at tiresome
length to his obsession with the
“Iron Chef” television program and his insistence on staying in Red Roof
Inns.

His larger point, and the meaning of the title “American Normal,” is
that Asperger syndrome may be less
a disorder than a societal and psychiatric construct Ñ a condition
that he concedes is real, but one whose
diagnostic criteria are “so complicated and so contradictory and so
blurred around the edges as to
sometimes stretch credulity.” The implication is that society’s
obsession with “normality” has led it to
diagnose anything abnormal as an illness, one that needs to be
treated with expensive drugs and
psychotherapy.

It’s a familiar indictment. (The introduction approvingly quotes Dr.
Mel Levine, a pediatrician at the
University of North Carolina, as saying, “We’re pathologizing all
human behavior, and in so doing we’re
creating an institutionalized nightmare Ñ a truly mad system in which
everyone is `sick.’ “) But
Asperger’s is an odd candidate, because few experts believe that
drugs and psychotherapy can do
anything more than relieve some of its side afflictions like
depression and attention deficit disorder.

In one of his digressions, Mr. Osborne takes us to a Malaysian tribe,
some of whose members have an
exaggerated reflex called latah, which causes them to go into a
trance when startled and behave in ways
that would embarrass them if they knew what they were doing Ñ
cursing, taking off their clothes, singing
bawdy songs. Yet in the tribal culture, such people are treated with
affectionate amusement. By contrast,
Mr. Osborne says, Americans with Asperger’s are viewed as having a
“disorder” that needs “curing.”

What if “around a core biological illness,” he asks, “a large
superstructure of behaviors and moods had
been created by the society itself?”

But the difference between latah and Asperger’s is plain from Mr.
Osborne’s descriptions of the two
syndromes. One is limited to special circumstances, and it does not
disable its sufferers; the other is
pervasive, meaning that it invades nearly every aspect of a patient’s life.

This book trivializes its subject by making it a vehicle for a
diatribe against psychiatry and the larger ills
of society. In the end, it turns out to be less about Asperger
syndrome than about its author. The subject
is not as fascinating as he seems to think it is.

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