Tag: Autism

Book review: Different Minds by Pete Wharmby

My next review is of Different Minds by Pete Wharmby, it has the lengthy subtitle “How can we help our autistic school children thrive”. I read Wharmby’s Untypical, about a year ago when my son was at online school as a result of Emotionally Based School Avoidance and one year into the waiting list for an autism assessment. One year on, he has just received his autism diagnosis.

Different Minds is divided into 10 thematic chapters entitled How did we get here?, The Mornings, The School Day, The Learning, The People, The Classroom, Socialising, The Behaviour, The Assessments and The Collapse.

Chapters usually start with a quote, a vignette from the life of Joe – an emblematic autistic child, and some bullet points on what is covered in the chapter.

Wharmby describes in the introduction that autistic people are “sparrows living in a world built by moles” which I think is rather beautiful. Neither sparrows nor moles are malicious but their views of the world are utterly different. This is the double-empathy problem, not only do autistic people not understand non-autistic people – the opposite is true too.

The overarching theme of the book is that the school routine as it is currently configured leaves autistic children in a state of almost continuous stress which leads to higher rates of anxiety and depression. These are not an intrinsic part of the autism diagnosis they are a result of the stresses of living in a world not built for autistic people. The proposals for schools and parents in this book are about reducing that stress.

Autistic children are a puzzle for teachers because they are different from their non-autistic peers, Wharmby went through teacher training in 2008 and had just a one hour session on autism. As an example of a teaching related difference, autistic children may have “spikey skill sets” – typically a child good at one subject will be good across a wide range of other subjects but an autistic child might not, furthermore they may be competent academically but unable, for example, to tie their shoelaces.

Wharmby recalls that the first autistic child he taught had notes of “bites other children” and “threw a chair” against his name when he received him into his class. This set his expectations for teaching that child – this is known as anchoring bias. The child turned out to be fine in lessons with Wharmby.

It may be that autistic children complain of the classroom environment because they are unusually sensitive to noise, light, smells, heat, cold and so forth; quite possibly they are finding their uniform very uncomfortable. Often on complaining they are told “Don’t be daft” but these are very real sensations for them.

It goes without saying that if teachers struggle to empathise with autistic children, through lack of training, then their classmates will face an even bigger challenge which can lead to isolation and bullying.

At one point Wharmby ponders whether autistic people fall into the “uncanny valley” for non-autistic people. Autistic children may struggle with appropriate eye contact, small talk, body language, minimal sharing of personal information turn taking, saying goodbye which marks them out as different.

We talked a bit about this as a family and wondered whether that was rather offensive but perhaps gave an insight into how other people interact with autistic people. An observation I made of my probably autistic father, and myself is that we are more charismatic than we give ourselves credit for – perhaps because social interactions are something we have to work hard at. This does not tally well with Wharmby’s account where he says that autistic children can be isolated by their peers and prone to bullying; although he mentions that becoming the “class-clown” is one way autistic children cope.

The very structure of the school day can be a struggle for autistic child who may exhibit monotropism – focus on a single topic – rather than switching between lessons every hour. Autistic children would benefit if their broader education could be linked to their special interests.

Interestingly Wharmby says autistic people often “get it wrong” when trying to empathise with someone by relating similar experiences to their own, apparently it makes it “about you”. This is news to me, if I’m talking to someone who has lost a parent then I’d probably mention somewhere in the conversation that my dad died a few years ago as an indication that I had some insight into how they were feeling – obviously I wouldn’t lead on this piece of information.

On assessments Wharmby talks about Rejection Sensitivity Dysphoria (RSD) – basically a very strong reaction to criticism often coupled with a struggle to accept praise. Following his guidance I will say that the vignettes of Joe’s school day in the book are a very powerful and compelling technique.

In the final chapter “The Collapse” Wharmby talks about how schools are the number one cause of burnout because of their obsession with attendance – I absolutely agree with this. He distinguishes between a meltdown which is a one off event (although autistic children attending school may have one every day), and burnout which is a longer term utter mental and physical exhaustion.

I found Untypical a bit of a harrowing read and I have to say the same of this book, Wharmby has a nice writing style but the continual state of stress and anxiety he describes for Joe, his emblematic child, is oppressive.

The intention of Different Minds is in part to understand how autistic children experience school but then to change schools to make them more tolerable. I must admit I came away from the book thinking that if school is only half as bad for my son as described in the book I should take him out immediately. Change happens slowly in schools, and whilst the Department for Education may pay lip service to making schools “inclusive” they are still very focussed on attendance and they seem to have more of an eye to cost and the status quo than the needs of autistic children.

To answer the question posed in the lengthy subtitle I fear the answer is “Take them out of mainstream schools”.

Book review: Thinking in Pictures by Temple Grandin

My next review is of Thinking in Pictures and Other Reports from My Life with Autism by Temple Grandin. For me it follows on from Pete Wharmby’s autobiographical book on autism, Untypical, and Steve Silberman’s history of autism, Neurotribes.

Thinking in Pictures is comprised of 11 thematic chapters which typically contain a mixture of reflections on the author’s personal experiences with autism, animal handling technology and research into autism and how it is treated. Grandin is very well known in the field of animal handling, one third of the animals slaughtered in the US are processed using machinery she has designed.

The core of Grandin’s experience of autism is visual thinking. She describes having a library of video clips in her mind which she combines in order to think new thoughts – verbal thinking is a second language to her. This makes some tasks easy, like designing animal processing equipment, and other tasks difficult – verbal tasks require her to find the right piece of video to capture the words, and abstract ideas are a real challenge. Similarly arithmetic is challenging for her.

Grandin was diagnosed as autistic relatively young, she learnt to speak quite late, was prone to tantrums and did not like being touched. She was born in 1947, 4 years after Leo Kanner’s landmark paper defining autism. This was at a time when autism was not widely known, and the diagnostic criteria were very strict. Her diagnosis was triggered by her mother who was very committed to getting the best for her daughter – she has written her own autobiography (A Thorn In My Pocket: Temple Grandin’s Mother Tells the Family Story by Eustacia Cutler).

In common with Wharmby, Grandin sees autism as very much a sensory issue. Sights, sounds and touch are often not processed in the same way by autistic people and it is from this their symptoms arise – sensory over-sensitivity overwhelms their brain’s ability to carry other tasks. Sounds may be garbled: their ability to hear frequencies is unimpaired but distinguishing words or separating different voices is challenging. Similar issues can apply with vision.

Grandin talks here about her “Squeeze Machine” a device she invented based on a cattle crush which allowed her to apply soothing pressure to herself – a device later marketed more widely – and to which she attributes the ability for her to empathise with others. She found touch from people stressful, and the feel of clothes very difficult to cope with.

In her early years Grandin was given very intensive teaching based on the Lovaas method which involves a lot of repetition and positive reinforcement. It was sufficient to get her into mainstream school but she was thrown out for misbehaviour and went to a small boarding school specialising in bright children with emotional problems. Here she seems to have clicked with one science teacher in particular who supported her in her interests and odd ways. Interestingly she later ponders the value of online school for some “high functioning” autistic people – as she points out learning to build social relationships with teenagers is not an important life skill outside of school!

Grandin entered the world of work in a crabwise fashion, writing to an agricultural journal to publish an article she had written on animal handling which led on to a regular column in the journal. This was to become a full-time job in designing animal handling equipment. She preferred to work as a consultant since this allowed her to get work without interviews and removed a lot of the social difficulties of a fixed workplace. Grandin felt she needed to learn social niceties explicitly rather than dropping into them naturally. She used her visual thinking both in terms of understanding machinery but also the behaviour/thoughts of cattle moving through machinery. She believes that animals must think visually, as she does. Her record is a testament to how good she is at her job.

Grandin talks in some detail about her use of antidepressants to address her autism related anxiety, this is part of quite a lengthy chapter discussing a wide range of drugs and how they have worked for different individuals.

Grandin says she would not want to give up her autism and lose the skills she has, this leads into a wider discussion of other potentially autistic people (Einstein, Wittgenstein, Van Gogh) and how their genius lay in part in their autism. I think it is common to see these retrospective diagnoses as problematic these days, it is something that Silberman touches on in his book. She also talks a bit about the parents of autistic children and their higher prevalence of autism, anxiety, depression or panic attacks. It seems that autism is very substantially genetic. There is also a chapter on “savant” skills, and how in some senses these might be considered “unthinking”.

The books finishes with a chapter on religion, Grandin believes in a personal God for logical reasons but points out that other autistic people have no personal God or are entirely fanatical about religion. Interestingly she sees the books she writes as her version of an afterlife and finds the destruction of culture very upsetting because it is taking away an afterlife. Thinking in Pictures ends rather abruptly on this point – there is no “conclusions” chapter.

I found Grandin’s descriptions of how she thought and animal handling technology the most interesting, the autism research feels a little dated to me (this revised edition of the book was published over 20 years ago) and have the air of notes transcribed with little synthesis.

Book review: Neurotribes by Steve Silberman

Following on from my earlier reviews of books on autism this one is of Neurotribes: The Untold History of Autism and the Potential of Neurodiversity by Steve Silberman.

The book is chronological with a couple of lengthy forewords and an introduction by Silberman describing his original contact with the autistic community stemming from the Silicon Valley culture in 2000.

It is easy to see autism as a modern illness, before the eighties clinically defined autism was very rare. However, even under the strict original definitions there were people like 18th century scientist Henry Cavendish who we would identify as autistic. Cavendish did the same walk every day, changing it only once when he met some people on his usual route after which he always used his new route, he ate a leg of mutton every evening. He attended the Royal Society once a week, where his colleagues were touchingly neuroaffirmative – they valued his contributions but knew to talk in his presence to elicit his input rather than talk to him directly – which would cause him to flee. Cavendish flourished because he came from a wealthy family which could support both his scientific tendencies and his personal oddities.

The term “autism”, as we understand it now, was first used almost simultaneously by Leo Kanner in the US in the diagnosis of “early infantile autism,” and Hans Asperger in Austria with the diagnosis “autistic psychopathy” in papers published in 1943 and 1944. The term autism had been coined by Paul Bleuler in 1911 to describe certain symptoms of schizophrenia – a focus on an inner world or the self. Autism was seen as a childhood presentation of schizophrenia.

Asperger worked in the Children’s Clinic in Vienna, he saw his role as finding the special skills of his patients which could be developed so that they could go on to lead fulfilling and hopefully independent lives.

The Children’s Clinic was to become central to the Nazi euthanasia program which saw the murder of nearly 800 children. A survey from a similar institute in Saxony in 1920 had asked effectively “Would it be ok if your child died in our care, you know, a bit “accidentally”.” to which the answer in some cases the answer was “Why are you asking us? Get on with it”. It was here that the Nazi eugenics programs originated. Asperger was at least complicit in this and his work was consequently ignored until the late eighties.

Kanner was Jewish born in the Ukraine 1896 but had left his job as a doctor in Germany in 1923 largely for economic reasons. He had written a book called Child Psychiatry in 1935 and went on to be the head of child psychiatry at the Johns Hopkins Hospital in Baltimore. He later employed two of Asperger’s former colleagues in his clinic at Johns Hopkins, they were Jewish and had fled the Nazis.

Until the 1950s the standard “treatment” for autistic children and indeed anyone with mental illness was institutionalisation in organisations with names like “Home for Non-educable feebleminded children”. As an aside the original name for the UK’s autistic society was the “Society for Psychotic Children”! Over the years various scandals were unearthed regarding these institutions. It wasn’t until the seventies that the US and UK moved to a legal framework in which disabled people had a right to education rather than institutionalisation.

Both Asperger and Kanner had a very narrow view of what constituted autism seeing it has having a very strict set of criteria, restricted to children. Under their criteria incidence was something like 4 in 10000 children. It wasn’t until Lorna Wing’s work in the eighties that Asperger’s work was finally recognised and the Diagnostic and Statistical Manual of Mental Disorders (DSM) was updated with new, broader diagnostic criteria. It was from Wing that the term “autistic spectrum” came into being. Even in the early nineties there was debate as to whether autism existed in adults. Nowadays the incidence of a more broadly defined neurodiversity is somewhere in the region of 15-20% of the population.

Diagnosis is about providing support – Wing saw that a lot of children needed support – he daughter included – and were failed by diagnosis. At one point a researcher says that for their research work in autism they applied diagnostic criteria rigorously whilst in private practice they were more permissive so that their patients could get the support they needed. All through the period covered by the book some autistic people have made it through to independent adulthood but it has been dependent on the support they are given. As Kanner said “if one factor is significantly useful, it is a sympathetic and tolerant reception by the school”.

If the environment changes to make life easier then there is less need for diagnosis. We could think of the “diagnosis crisis” as an “environment crisis”, we are building environments – particularly schools which are increasingly challenging for neurodiverse people.

The film “Rain Man”, released in 1989, was an amalgam of several people in real life familiar to the screenwriter Barry Morrow. It produced a sea change in the way autistic people were viewed by wider society.

All through the book parents and their children are central. Many times clinicians observed parents to be rather obsessive about their children’s condition and more often than not at least a bit autistic themselves. Even some of the clinicians involved were neurodivergent. Major figures in the book like Bernie Rimland started their journey as parents of autistic children determined to do their best for them. This is reflected today in the parents of autistic children, who in my experience have very deep knowledge of the bureaucratic systems to navigate in order to get support.

For a long time the focus of parents and the medical establishment has been finding a cure for autism, and there has always been a population of snake oil salesmen willing to sell that cure (or at least find a cause to blame). Autism was variously attributed to mothers, vaccines, vitamin deficiencies and ultimately genes depending on the mores of the time. Treatments were at times absolutely brutal – until quite recently electrocuting autistic children to change their behaviour was legal. This is where the anti-vaccine movement comes in rising to prominence as a result of the large increase in autism diagnosis due to the change in diagnostic criteria.

Nowadays more and more autistic people are saying they are not looking for a cure but rather a society that provides relevant accommodations. The cause of autism is generally seen as genetic, not a result of parents, the environment, vaccines or medicines.

The final chapters talk about autistic people being able to speak for themselves, starting in the late eighties with Temple Grandin. It is from this period that the terms neurodiverse and neurotypical come. The internet is core to this – social media often work well for autistic people since much of the social complexity is removed. One wonders how banishing children from social media will work for this group. The role that social media plays is not a new thing, in the early to mid-20th century ham radio and science fiction provided a community for many who would now be described as somewhat neurodivergent.

I loved this book, it is highly readable and it speaks to my concerns not only for my son but also for me.

Book review: Untypical by Pete Wharmby

Untypical by Pete Wharmby is a book about the personal experience of autism, and ways you can help autistic people in your life*. I picked it up because my son is on the waiting list for an autism assessment (1 year in and counting), and I have suspicions about myself – my wife’s suspicions are stronger!

Wharmby worked as a teacher for some time before a diagnosis of autism after the birth of his daughter and a bout of depression, he stopped teaching as a result of the COVID pandemic and is now self-employed as an author and speaker on autism. The book is very personal, I found it compelling reading.

Untypical is divided into 8 chapters covering different aspects of autism and life. Each chapter includes some bullet points on how you can help an autistic person, which can be summarised as “show some empathy given the information in this book” but you’ll need to read the book to get the details.

The first couple of chapters are on socialising and friends. The problem with socialising is not knowing the rules of communication, which are unwritten. Many autistic people have a phobia of telephones as a device for talking to people because the number of cues as to how to respond are reduced still further. Online friendship often works very well for them though. I am the most sociable person in my household (this really isn’t saying much) and the most likely to use a telephone although, with the exception of talking to parents, it is a last resort. I remember not feeling extrovert and sociable for a very large part of my life, nowadays I find it useful in addressing anxiety but I feel like I’m simulating being sociable. For autistic people this type of simulation is called masking, and it can be exhausting to maintain. Later, talking about the transition to university, Wharmby says that he used alcohol, probably to excess, to cope with the social side of university – this too sounds familiar.

Wharmby talks about falling into university almost by accident, it was the easiest next step having obtained good A-level results. This is the subject of the next chapter, “Tying shoelaces and Other Daily Challenges” which talks about the issues autistic people can have with getting started on something (autistic inertia), executive function (working towards a goal) and PDA (Pathological Demand Avoidance). If you are interested in PDA then When the Naughty Step Doesn’t Work by Dr Naomi Fisher and Eliza Fricker is well worth a read. This isn’t to say autistic people can’t do goal-oriented tasks – they just need to be cast in the right way. I think here of Alfred Wainwright’s Pictorial Guide to the Lakeland Fells, completed with machine-like precision over a 10 year period. Wainwright may or may not have been autistic but nevertheless his Pictorial Guide looks exactly like the product of a “special interest”. I feel the same way about much of my career, a lot of it was down to following the easiest path boosted by my “special interest” driven abilities.

In the context of autism a “special interest” or monotropism is a strong focus on a single subject. They provide a way of regulating moods and managing stress. The autistic sensorium is very cluttered and finding a single point of focus is soothing. Wharmby talks about computer games, Minecraft, Pokémon Go, Lego and trains as examples of his “special interests”. His go-to task for immediate stress relief is to read a Wikipedia page about a steam train. As I write I am just entering my weekly gas, electric and solar panel meter readings into a spreadsheet, a dataset which stretches back to 2004. My dad kept a notebook in the glove box of his car where, usually my mum, wrote the mileage, volume of petrol bought and cost whenever they visited a garage. I was very confused when I discovered my wife’s car had no such book!

The chapter on school is close to my heart, it is the reason my son is on a waiting list for an autism assessment. For autistic children school is a nightmare, on top of the forced socialisation they are usually very overwhelming sensory environments. We found that the “need for justice” mentioned later in Untypical is also an issue, particularly around group “punishments”. Wharmby observes that much “bad behaviour” can be attributed to child reaching the point of autistic meltdown. He has some words on the nightmare of group work which will speak to many adults. This chapter is very timely since the Education Select Committee’s SEND Inquiry report is very keen on inclusion in mainstream schools as a solution to the SEND crisis – the committee have noted that the Department of Education has failed to define what this means. Wharmby notes that when he was at school in the 1990s refusal to go to school did not appear to be an option. Attendance in school dropped after the the COVID pandemic – I think it demonstrated that school was not the only place to learn for a very large number of children and their parents. In addition the restrictions of the COVID pandemic pushed some autistic people into meltdown – all the social interaction rules changed, and then changed back again as normal life resumed.

The issues with work are largely those of school, with uncontrolled environments and people all over the place. He calls out hot-desking specifically. Wharmby also mentions that autistic people can be very sensitive to criticism (hence my footnote to this post). The most stressful part of my working life has been annual assessments, this are critical by design – the company typically wants to see a distribution in “grades” and will tend to criticism rather than support. I can also say this is stressful for a manager. The same applies in redundancy processes, the company will seek to show you are not up to the job in order to smooth your exit from their point of view.

Chapter 7 talks a bit about the overlap of autism and ADHD with the resulting restless brain. This is where “stimming” comes in. Stimming is a variety of repetitive actions (every autistic person has their favourite) which provide some relief from stress – these can be disturbing to the neurotypical. This chapter also talks about the stresses of all forms of travel for autistic people usually through unpredictability and crowded and noisy environments. I was struck with his comments on struggling with mindfulness meditation as a way of providing relaxation, I too have struggled with mindfulness – finding it incredibly difficult to focus on just my breath, for example, or dispassionately observing my thoughts passing by.

The final chapter is on the autistic need for justice, mentioning Greta Thunberg’s campaigning on climate change (Thunberg is autistic), and also intersectionality – the overlap of the autistic community with the trans community in particular but also the neglected areas of being a woman and autistic and black and autistic. He highlights a couple of online resources which provide wider coverage of the autistic community – I’ve signed up to the Neuroclastic newsletter.

I have to say that overall it is a bit of a harrowing read, Wharmby has a nice writing style but the continual state of stress and anxiety he finds himself in is oppressive for the reader let alone the author!

Wharmby writes near the end of the book that he considers himself an imposter as an autistic person, something that he attributes to his late diagnosis. I must admit to feeling the same, I don’t think I’m as autistic as he is but so much in this book struck a chord with me. At the age of 55, and semi-retired, I don’t see the point in seeking a diagnosis, for my son I see it as useful but I must admit to some qualms about medicalising him for the sake of fairly limited support. I also worry that owning up to autism will not help secure a job.

The rising diagnosis of autism is a hot topic currently, to me it seems that there have always been a lot of autistic people but we never recognised it as a distinct thing, even in white men and boys, let alone women and girls or any other ethnicity. If we look back the signs were there: my dad’s petrol consumption recording, the male Hopkinson’s all stimming as they organised themselves for a family photo, the trainspotters, a whole load of scientists who recorded detailed data on all many of things…

Untypical is definitely worth reading: it either describes you, someone you know or someone you will interact with and more knowledge can only be a good thing. It’s important because life expectancy for autistic people is much lower than for others, and with some adaption their/our lives could be so much better.

*For the benefit of Pete – this is not a critical review, my reviews are descriptive much to the chagrin of professional historians!

Book review: When the Naughty Step Makes Things Worse by Dr Naomi Fisher and Eliza Fricker

Another book in the parenting thread: When the Naughty Step Makes Things Worse by Dr Naomi Fisher and Eliza Fricker.

The title describes the central theme of the book; some children simply don’t respond to the widespread, traditional punishment / reward method of parenting. If you try to put them on the Naughty Step they will refuse to go, and get ever angrier about it. As the authors highlight a motivated child has a higher stamina for opposing your parenting strategies than you have for executing them! You will typically have other things to worry about; a child can fully commit their energies to opposition.

They describe these children as “pressure sensitive” – they are made anxious when they feel under pressure to do something and their behaviour arises from this – finding ways to avoid the thing, elsewhere this is given a diagnosis of “pathological demand avoidance” (PDA). Their answer to pressure sensitive children is “low demand” parenting with the aim of widening the child’s “window of tolerance” for demands over a long period.

Fisher talks about how parenting was “invented” in the 1950s with the work of Baumrind and their demandingness/responsiveness model. It extends behaviourism, which sees animals trained by a combination of reinforcement (reward) and punishment, to the training (raising) of children with the addition of responsiveness which is trying to meet the needs of the child and being emotionally warm with them.

I sometimes wonder what fraction of animals refuse to be trained under the behaviourism model. When I reviewed Other Minds (all about octopuses) I read about efforts to measure the intelligence of three octopuses:

… two octopuses in their study put in some effort to carry out the tests presented whilst Charles insisted on squirting water at the experimenters and being otherwise uncooperative. It does make you wonder whether measures of animal intelligence are more a combination of willingness and intelligence. 

The authors refer to behaviourism models of parenting, somewhat tongue in cheek, as Good Parenting(TM). It is relevant to highlight the contrast because much of the internal battle for a low demand parent is the opinions of others, and whether they are right: are we here because we are poor parents? what does my parenting look like to other people? What are people thinking? Largely the author’s prescription is to ignore these outsiders except where necessary (other family members and professionals with important roles).

Thinking about pressure sensitive children it is easy to see how they struggle at school where systems of punishment and reward are becoming ever harsher. Furthermore in a classroom environment there is little scope for responsiveness. Therefore schools end up being strictly authoritarian environments which absolutely don’t work for a fraction of children, and greatly stress a further proportion. My experience of schools is that they have little appreciation or understanding of the existence of pressure sensitive children. Many of the children mentioned in the book have been pushed out of the mainstream school system, some are in special schools or home education.

After the preamble chapters talking about the group of children in question, and earlier models of parenting, The authors spend several chapters talking about different aspects of low demand parenting in practice, communication, behaviours, emotions, and screens. They are pretty positive about screens – highlighting that games like Minecraft offer pressure sensitive children a complex world which they control completely and often it is the only thing they will engage in. Most of the practices of low demand parenting are captured in acronyms – REACH, FLASH, JOIN UP. The core is to throw away your previous concepts of Good Parenting(TM) and seek a more equal relationship with your child (rather than trying to force them into conformance), join them with what they are interested in (for a while my wife and I played Fornite with our son), and focus on the necessary (sitting at the table eating healthy homecooked meals without your elbows on the table may be an ideal but sitting in front of the TV eating beige food is actually fine).

It is a bit difficult to judge the age group this book targets, much of the start feels like a discussion of younger children – at primary school and earlier but there are frequent mentions of children going into adolescence. One of the stories in the final chapter tracks that of my now 13 year old son almost exactly – apparently fine and doing very well in school until the demands of secondary school were overwhelming with an exit into online school.

There is a chapter on self-care for parents, a subject touched on earlier in the book in coping with the disapproving looks of other parents. This chapter uses techniques like radical acceptance, visualisation and mantras which I’m familiar with from counselling.

Despite being over 400 pages long When the Naughty Step… is an easy read. The text is broken up with Fricker’s cartoons, personal stories and various tables and exercises. Each chapter ends with a dialogue between Fisher and Fricker (which I found really useful), a bullet point summary and some suggestions for further reading.

I sometimes worry I have joined the cult of Fisher / Fricker, in common with many parents whose children have not been entirely straightforward to raise, I will enthusiastically recommend their books (and webinars). I think the core of their success is that they identify very clearly how our children are, when few others do, and reassure us that it is not the end of the world, when most are trying to convince us it is.