Pretending to be normal: living with Asperger's syndrome.

The title aroused instant guilt—the name seemed vaguely familiar and I felt I should know what Asperger's syndrome was—but I didn't. I do not remember a case in 40 years' practice, though maybe I missed one or two along the way. This made the book a bit like the kind of detective story where you know the most crucial fact at the beginning but still have to follow the painstaking unravelling of the plot to achieve eventual enlightenment. Resisting the temptation to remedy my ignorance first, however, enabled me to enter more fully into the experience of the writer. My irritation and puzzlement must mirror the way in which a person growing up with an unidentified handicap has to discern what ‘normality’ is and how he or she is different. Hence the title—because Asperger's syndrome was not diagnosed until Liane Willey was adult, married and had a daughter in whom the condition was recognized, so enabling the writer herself to make sense of difficulties which had beset her all her life. Asperger's syndrome, described as “a relatively new autism-related diagnosis”, results in a variety of difficulties in physical, psychological and social functions, of varying severity. Problems of physical co-ordination, behavioural eccentricities and language peculiarities can co-exist with a high degree of intellectual ability. Liane Willey herself was identified as academically gifted despite the quirks of perception, behaviour and speech that caused bafflement to her family, her school and herself. Painfully she learned strategies enabling her to survive and eventually to prosper. Now with the ultimate advantage of a diagnosis, she can offer the fruits of her experience to others affected (she would not wish us to use the term ‘afflicted’) by the condition. She is an accomplished writer and I found the book highly readable. Vivid descriptions remain in the mind; “voices sting my ears like a wet towel slapped against my eardrums”, “small group conversations make my nerves feel like they are wearing stilts on an icy pavement”. Each chapter starts with a poetic prologue that is illuminating, not embarrassing. A series of excellent appendices form the last third of the text. These would be invaluable to patients and families, with advice on how and when to explain the condition to others, strategies for adapting to college, employment and home-making, and general ways of coping with difficulties the syndrome causes its subjects. (The section on study skills would serve well for anyone destined for higher education.) A final list of support organizations and other resources includes web sites from which I may yet remedy my deficient knowledge of the technicalities of the subject, and in particular its incidence, which might give me a clue about how many cases I have probably failed to recognize in my time.