Research Programs, ‘Autistic Disturbances,”
and Human Difference
Historians of medicine like to make the point that explanations for disease reflect the historical moments in which those explanations were produced. They incorporate not only clinical observations but also notions of the “good life” or of the “typical person,” and anxieties about the pressures and stresses to which human bodies and minds are subject.1 Diagnostic categories are mutable things. They make groups of subjects visible and distinct by describing them, but they then set them free to carry on their business, to resist, reshape, and reform that definition through their own actions. In other words, disorders constitute a modern process for creating types of humans, or what Ian Hacking calls “making up people.”2
Disorders are useful ways for doctors to think about medical categories, but just what symptoms—or type of person—a disorder refers to may change a great deal over time, whether through bureaucratic fiat or through the activism of groups who adopt or reject a medical definition. In this respect, autism is like many other disorders. Practitioners may maintain that through the course of their long careers they have gained the ability to recognize autism on sight as, one expert suggested, one might learn by studying a range of examples to recognize the distinctive style of a particular artist.3 Still, much about the diagnostic criteria, practices of identification, modes of treatment, and daily experience of autism has changed, and changed radically.
Autism has commanded increasing international attention since the early 2000s, to judge from the press coverage, books, weblogs, and specialized research publications. The increase parallels the growth in federal funding authorizations for autism-related research in the United States.