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jessicaleza's review against another edition
Chapter 10 is about music therapy and autism. This chapter uses functioning language and person-first language.
Right off the back, from the very first sentence of the abstract, the non-autistic author is setting the tone for autism as a pathology that requires "treatment" and making it clear that they do not actually understand the nature of autism. The author states that autism's core features are "social impairments, limited speech, stereotyped behaviors, sensory-perceptual impairments, and
emotional dysregulation."
Damian Milton first began publishing about the double empathy problem in 2012, and this chapter was published in 2016, so this indicates that the author was not actually writing from a place of up-to-date knowledge about autism, nor is the author considering the social deficits of neurotypical or allistic people that prevent them from being able to successfully socialize with autistic people.
Limited speech is not a core feature of autism. Remember, this book is from 2015 - at this point, Aspergers and autism had been collapsed into one diagnostic label for many years, not to mention that many people labeled with autism under DSM-IV-TR or earlier could also be highly proficient speakers, although Autistic people might have communication differences (just like communication differs between any two given cultures).
Again notice that from the very beginning, autistic sensory processing differences are unapologetically cast as impairments. Ironically, later in the chapter sensory processing differences are described in a positive light when it results in savant-like music performance skills.
Finally, emotional dysregulation is absolutely NOT a core feature of autism. I am actually shocked that this abstract was able to make it through the editorial process and nobody pointed out the glaring factual errors being presented as fact.
The abstract continues, "Since ASD is a lifelong neurodevelopmental condition, music therapy is also appropriate in the treatment of adults with intellectual disability." Again, it is shocking that this statement made it through the entire editorial process and landed in publication. Autism is not synonymous with intellectual disability. Autism being a lifelong difference is irrelevant to the appropriateness of therapy for people with intellectual disability, who may or may not be autistic.
This is only the abstract. The chapter is firmly grounded in the medical model of disability and the pathology paradigm but the author does not acknowledge this, much less acknowledge the existence of alternative perspectives and explanations. For example, the author states that autistic people misread allistic nonverbal cues, but does not reflect on how allistics misread autistic nonverbal cues. The author describes the autistic communication style as "strange" (p. 187). Autistic people are described (with person-first language) as "overly dependent on routines, highly sensitive to changes in their environment, or intensely focused on inappropriate items." This expresses an unexamined endorsement of a hierarchy in which allistic people are placed on top and allistic people on bottom. Allistic subjectivity is cast as objectivity. The author's allistic identity and perspective is unmarked, it is autism that is marked by its strangeness and sensitivity, its "inappropriate" "intensity" ... this chapter is everything that Autistic people have been openly exhausted by since the 1990s. In the year of our lord 2016, this author denigrates Autistic eye contact as deficient. Pathologizing differences in eye contact as an impairment is such a wild perspective at a time when supposedly music therapists were developing the cultural reasoning to comprehend how eye contact is a cultural norm and white/western/WASP norms are not an appropriate ruler from which to denigrate other cultures as insufficient.
The reader is warned that these pathological traits "may lead to social isolation, frequent temper tantrums, and psychotropic long-term medication, as well as unemployment in higher functioning individuals" - so much to unpack in just one sentence, from the coding of meltdowns as 'temper tantrums' to the passivity of describing the allistic prescriber's use of psychiatric medication as if this is something that naturally emerges from Autistic traits. The allistic agents in these interactions are unmarked, unacknowledged, passive ghosts that can only be seen in negative space. There is no asking - what is the deficit in allistics that cause them to isolate autistic people?
The author offers clinical vignette's from their own practice, in which they sometimes reveal a passive-aggressive way of relating to their autistic subjects. For example, the author describes an autistic person by saying, "She was never able to immediately comprehend ironic comments or jokes with a double meaning, and today, she still dislikes having her leg pulled in this way." It was an intentional choice to use the phrase "having her leg pulled" within the same sentence that the author outright stated the subject did not appreciate it. The author is intentionally describing an autistic client in a way the author openly acknowledges the client does not like. I can only speculate why the author would find this to be an appropriate social behavior. Is this the empathy that autistic people are supposed to strive to attain?
The author goes on to scaremonger about the existence of autistic people, claiming that it is a "social and health concern within society" (p. 188). Music therapy, meanwhile, is praised as "effective" because it can be used to reduce stimming. There is no interrogation offered into the belief that eliminating stimming is desirable or why the author believes that doing this benefits autistic people. Applied Behavior Analysis is uncritically endorsed.
The author advocates for increased use of randomized control studies to investigate the use of music therapy as a "treatment" for autism so that music therapy will be seen not as complementary and alternative treatment, but as "best practice." The motivation is clear - this is a desire to elevate the profession of music therapy and to secure a growing market in which to sell music therapy services - it is not a call for the liberation and empowerment of autistic people to thrive and excel according to their own individual aspirations and values.
A perusal of the references cited shows this chapter was built on information from the 1950s through the 2010s, with most citations coming from the 1980s, 90s, and 2000s. Unfortunately, this chapter was already wildly out of date by the time it was published in 2016, and reading it now in 2023, only 7 years later, it is outrageously out of date.
Right off the back, from the very first sentence of the abstract, the non-autistic author is setting the tone for autism as a pathology that requires "treatment" and making it clear that they do not actually understand the nature of autism. The author states that autism's core features are "social impairments, limited speech, stereotyped behaviors, sensory-perceptual impairments, and
emotional dysregulation."
Damian Milton first began publishing about the double empathy problem in 2012, and this chapter was published in 2016, so this indicates that the author was not actually writing from a place of up-to-date knowledge about autism, nor is the author considering the social deficits of neurotypical or allistic people that prevent them from being able to successfully socialize with autistic people.
Limited speech is not a core feature of autism. Remember, this book is from 2015 - at this point, Aspergers and autism had been collapsed into one diagnostic label for many years, not to mention that many people labeled with autism under DSM-IV-TR or earlier could also be highly proficient speakers, although Autistic people might have communication differences (just like communication differs between any two given cultures).
Again notice that from the very beginning, autistic sensory processing differences are unapologetically cast as impairments. Ironically, later in the chapter sensory processing differences are described in a positive light when it results in savant-like music performance skills.
Finally, emotional dysregulation is absolutely NOT a core feature of autism. I am actually shocked that this abstract was able to make it through the editorial process and nobody pointed out the glaring factual errors being presented as fact.
The abstract continues, "Since ASD is a lifelong neurodevelopmental condition, music therapy is also appropriate in the treatment of adults with intellectual disability." Again, it is shocking that this statement made it through the entire editorial process and landed in publication. Autism is not synonymous with intellectual disability. Autism being a lifelong difference is irrelevant to the appropriateness of therapy for people with intellectual disability, who may or may not be autistic.
This is only the abstract. The chapter is firmly grounded in the medical model of disability and the pathology paradigm but the author does not acknowledge this, much less acknowledge the existence of alternative perspectives and explanations. For example, the author states that autistic people misread allistic nonverbal cues, but does not reflect on how allistics misread autistic nonverbal cues. The author describes the autistic communication style as "strange" (p. 187). Autistic people are described (with person-first language) as "overly dependent on routines, highly sensitive to changes in their environment, or intensely focused on inappropriate items." This expresses an unexamined endorsement of a hierarchy in which allistic people are placed on top and allistic people on bottom. Allistic subjectivity is cast as objectivity. The author's allistic identity and perspective is unmarked, it is autism that is marked by its strangeness and sensitivity, its "inappropriate" "intensity" ... this chapter is everything that Autistic people have been openly exhausted by since the 1990s. In the year of our lord 2016, this author denigrates Autistic eye contact as deficient. Pathologizing differences in eye contact as an impairment is such a wild perspective at a time when supposedly music therapists were developing the cultural reasoning to comprehend how eye contact is a cultural norm and white/western/WASP norms are not an appropriate ruler from which to denigrate other cultures as insufficient.
The reader is warned that these pathological traits "may lead to social isolation, frequent temper tantrums, and psychotropic long-term medication, as well as unemployment in higher functioning individuals" - so much to unpack in just one sentence, from the coding of meltdowns as 'temper tantrums' to the passivity of describing the allistic prescriber's use of psychiatric medication as if this is something that naturally emerges from Autistic traits. The allistic agents in these interactions are unmarked, unacknowledged, passive ghosts that can only be seen in negative space. There is no asking - what is the deficit in allistics that cause them to isolate autistic people?
The author offers clinical vignette's from their own practice, in which they sometimes reveal a passive-aggressive way of relating to their autistic subjects. For example, the author describes an autistic person by saying, "She was never able to immediately comprehend ironic comments or jokes with a double meaning, and today, she still dislikes having her leg pulled in this way." It was an intentional choice to use the phrase "having her leg pulled" within the same sentence that the author outright stated the subject did not appreciate it. The author is intentionally describing an autistic client in a way the author openly acknowledges the client does not like. I can only speculate why the author would find this to be an appropriate social behavior. Is this the empathy that autistic people are supposed to strive to attain?
The author goes on to scaremonger about the existence of autistic people, claiming that it is a "social and health concern within society" (p. 188). Music therapy, meanwhile, is praised as "effective" because it can be used to reduce stimming. There is no interrogation offered into the belief that eliminating stimming is desirable or why the author believes that doing this benefits autistic people. Applied Behavior Analysis is uncritically endorsed.
The author advocates for increased use of randomized control studies to investigate the use of music therapy as a "treatment" for autism so that music therapy will be seen not as complementary and alternative treatment, but as "best practice." The motivation is clear - this is a desire to elevate the profession of music therapy and to secure a growing market in which to sell music therapy services - it is not a call for the liberation and empowerment of autistic people to thrive and excel according to their own individual aspirations and values.
A perusal of the references cited shows this chapter was built on information from the 1950s through the 2010s, with most citations coming from the 1980s, 90s, and 2000s. Unfortunately, this chapter was already wildly out of date by the time it was published in 2016, and reading it now in 2023, only 7 years later, it is outrageously out of date.
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