Catherine Maurice's Let Me Hear Your Voice (1993)

When the dust has settled and a history of autism in the 20th century is written, Catherine Maurice's 1993 work will be recognized as a classic in the field. It will not be so recognized because it defines a new method or describes a new treatment or therapy for autism. In addition, it advances the causation debate not a whit. And it barely mentions the funding issue for autism services. What makes her book so powerful is that it is a perceptive parent narrative (she has two children diagnosed as autistic) that came out in that window of time between the first "solid" study (1987) claiming that some autistic children could be "cured" (and not simply "treated") and the explosion in number of cases of autism in the mid-1990s.

What makes her book special, in addition, is that her advice about dealing with autism is so clear, her prose so poignant and her analysis of autism so perceptive that her words seem to slice through a thicket of dense confusion surrounding autism like a shimmering and razor-sharp scythe. Trained as a literary critic, she uses her lambent pen not to engage in vacuous deconstructionism or post-modern paeans to the subjectivity of all knowledge, but to offer tender description of her children, piquant criticism of the powers that were (in autism research) and searching exposition of the emotions that a diagnosis of autism gives birth to in the heart of parents. Finally, she is unashamed to say that her Catholic faith, bathed in Scriptural imagery and strengthened by her trust in the power of the Virgin Mary, anchored her and her husband not only in times of deepest despair but in those of arresting joy. It really is a "must read" book for those who want the human, as well as the "scholarly," story of autism all rolled up in one book.

Meeting the Maurice's (Not Their Real Name)

Catherine and Marc Maurice, of New York City, welcomed their first two children into the world in 1985 and 1986. The younger, Anne-Marie, was a happy, inquisitive and vibrant child until, in her second year, she began to bewray the, by now typical, indicia of autism: withdrawal, social regression, limited vocabulary, insensitivity to touch and to the affection showered on her. Deeply concerned, the Maurice's took her to a few clinics before the "life sentence" was handed down just before Christmas 1987: "Autism" or "Probable" Autistic Disorder. This diagnostic "evangelium" was, no doubt, like a sword piercing her own soul, and it occurred the same week as the Maurice's received their third child, Michel, into the world. The shock and grief attendant upon receiving the "Autism" diagnosis was further compounded by insensitive doctors or medical staff who "piled on" by pronouncing the incurable nature of the disability. Pummeled from pillar to post, Catherine engaged in the kind of denial, anger, bargaining and, finally, acceptance that Elizabeth Kubler-Ross has taught us are the telltale signs of deep grief.

But then, in an unexpected turn of events, her sister (well, she has six of them) mentioned she had just read an article in Psychology Today telling of success in curing autism that a behavior therapist from UCLA, Dr. Ivar Lovaas, had reported. Eagerly searching for the popular article, and the scholarly study on which it was based, Catherine and Marc became convinced that they couldn't passively receive the diagnosis of autism, but must try, with whatever resources they have, to bring the "best" therapy to their daughter. So, they engaged a troika of care-givers: one a behavior therapist pursuing her master's degree at Columbia Univ. Teacher's College; one a speech therapist; and one a doctor, Martha Welch, whose controversial "holding therapy" as a treatment for autism was receiving a lot of support at the time (1988).

It would take me many essays to describe the ups and downs with the behavior analyst, and their gradual disenchantment with holding therapy, but suffice it to say that after about 18 months of intensive behavior intervention therapy, Anne-Marie had made marked progress. By the time she was six (just before the book was published), she was completely mainstreamed. Now we can understand the subtitle of the book: "A Family's Triumph Over Autism."

But just as the prophet Amos tells us that the Day of the Lord will be like running from a lion into the hands of a bear, so the Maurice's discovered that upon Anne Marie's "cure," little Michel seemed rapidly to be slipping away from them too. Though her narrative about his treatment isn't as wrenching or as detailed as that of Anne-Marie, Michel too, with the aid of a team of speech and behavior therapists, is brought back to the world of "normal" children (the word "neurotypical," to describe the average child, was not yet used). The reader is left breathlessly grateful by the end of the story.

Good Guys and Bad Guys

What makes this book further valuable is Maurice's ability to tuck in trenchant critiques of regnant scholarly theories about autism as she goes. While she only mentioned Leo Kanner in passing, she has the highest regard for Dr. Bernard Rimland, whose 1964 book on Infantile Autism gave birth to the autism "movement" in America, and Dr. Lovaas, whose intensive behavior intervention method was the key to her children's success. She doesn't mention any of the critiques that have been leveled at Lovaas, such as his strong endorsement of aversives in the early days; indeed, she does seemingly have the some of the character traits of Eric Hoffer's "true believer."

But there are no doubts who the "bad guys/girls" are: they are the Freudians, the psychologists who want to attribute an autistic condition to emotional bonding issues between parent (mostly mother) and child. Tops on her list of those deserving entry in the lexicon of opprobrium is Bruno Bettelheim, that overconfident Univ. of Chicago psychologist who authoritatively proclaimed in The Empty Fortress, that mothers, above all, were either negligently or willfully to blame for the autistic behavior and condition of their children. There is no doubt that Catherine Maurice's book is the first ringing parental endorsement of the method of ABA (applied behavior analysis) that appeared.

Conclusion

If you have spent all your life reading books, it is not hard to find fault with any book. No doubt Ms. Maurice's editors tried to coax her into saying something about the financial realities of autism treatment, since she seemingly easily hires multiple staff, from doctors to therapists, without regard to cost. I would say fewer than 5% of families could do that. Her few words on that subject are not a fitting coda to the book. Now, 14 years later, is the time to engage that dragon.

Yet, the dying whisper of the book in my mind will always be their indomitable courage, the persistent regard for scientific results on which to base one's quest for "cure" (in this regard it is interesting that Marc Maurice never really "trusted" Dr. Welch, while Catherine fell in love with her and her method, at first) and her commitment to be of help to parents who are climbing the same mountain.

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