Clara Park: The Siege

I was encouraged to continue with simple reading by watching the work of the teachers at Dr Carl Fenichel’s League School for Seriously Disturbed Children. The welcome I received there was a model to show what help skilled professionals can give to parents. I watched for a full day a classroom of children as remote as Elly, and came away with new strength and ideas for months of work. Without this experience, and without the encouragement of Elly’s psychiatrist, I do not think I would have presumed to teach Elly reading.

As I typed these words, I received a call from the mother of an autistic child in a city half a continent away. She described the limits on her boy’s comprehension, how he could not reply if she said ‘Tell me’, but could respond if she said ‘Say the words’. The counsellor at the clinic she attended had overheard such an exchange and asked how she could expect the child to learn to talk if she herself talked such strange English to him. It is a natural response — to one who has not lived with the problem.

She was helped in this by her pleasure in two books that I name because other parents may be able to use them: Phyllis Krasilovsky’s The Very Little Girl and The Very Little Boy (Doubleday, 1960, 1962). In these, a story so simple that even Elly can follow it traces by pictures the growth of a tiny child towards strength and adequacy. I would also urge all parents of defective children, especially those who do not draw, to photograph often the houses and people that constitute their child’s past.

She began to paint in the English nursery school, at four and three-quarters, and painted daily in her American one. She also painted intermittently at home.

When her paintings were unbalanced, they were unbalanced in an orderly way — for example, three shapes at the bottom of her paper, every day for a week.

At seven and three-quarters she made, all on one day, a most interesting series of drawings that showed she well understood die process of visual abstraction from a human situation. She began with a picture of a birthday party, represented as a rectangle surrounded by recognizable heads — not the full figures she had drawn occasionally before. These she identified verbally as ‘girl, lady, boy, lady, boy’ around the table in strict order. A second picture showed the same rectangle, but the heads had turned to simple spots of colour, still identified by the same words. Later pictures in the series show members of her family, identified by name, as mere blocks of colour. But this series remains unique. It is no longer uncommon for her to draw members of the family, and she even labels them herself in writing. But only this once have human beings ever been hidden by abstractions - or, rather, not hidden, but represented, since the whole process was conscious and deliberate. It was also accompanied by considerable gaiety.

The reader will by now have noted how many of my transcriptions of what Elly says carry exclamation points, and wonder why. To appreciate the tone of Elly’s speech, it is important to realize that (requests aside) it consists largely of assertions, made with varying degrees of emphasis ranging from simple underlining through enthusiasm to transported delight. A musing or inconclusive tone is rare. Anxiety almost always leads to a questioning rise in intonation, and question marks or exclamation points could really be put after almost everything she says. A ‘no’, for example, that she is sure will be honoured is ‘No.’ One that she suspects I may not accept but which is still important to her will be edged ‘No?’

I can imagine one famous theoretician-therapist explaining to me how an autistic child takes hold of a symbolic representation to express its inner emptiness and despair, saying as clearly as it can that the only way it has found to defend itself against its destructive environment has been to make itself a cipher. I supply this interpretation to show that I can do it as well as another. But it was an analyst who warned me against constructs.

I remember the question of a psychologist-friend who came to visit: ‘Did the psychiatrist say you could do that?’ I said I hadn’t asked him, but that when he saw Elly he seemed very pleased with her progress. ‘It certainly is an unusual arrangement,’ she said.

Described in A Physician Looks at Psychiatry , John Day, 1958.

Author of ‘They Said Our Child Was Hopeless’; in an unpublished letter to Dr Bernard Rimland.

Cited by Rimland, Infantile Autism, p. 209, in a discussion that readers who are interested in this possibility will find extremely rewarding.

Dr Bettelheim is by far the most optimistic of any writer on infantile autism. He reports that of the 40 autistic children treated at his school, all improved, 17 making a ‘fair’ adjustment and 15 a ‘good’ one. Although it is not made clear what the ‘adjustment’ consists of, the implication is strong that it includes normal or quasi-normal cognitive and affective functioning as an adult in a nonsheltered environment. Of the three cases around which the book is centred, however, only one recovered in this sense, and no follow-up data is given for the other 37. Moreover, it may be questioned how many of these cases would be accepted as autistic by other specialists. Rimland has developed a detailed questionnaire to facilitate a differential diagnosis between autism and childhood schizophrenia and to increase the likelihood that the growing number of people who discuss infantile autism are talking about the same condition. So far, Dr Bettelheim has been unwilling to furnish completed questionnaires on any of his cases.

There is no additional evidence of this. The Institute neurologist thought that, at three and a half, she was clearly right-handed.