Review by Nils Skudra
This week, I had the opportunity to watch In a Different Key, an intriguing and comprehensive documentary that examines the origins of the autism diagnosis and how public understanding of autism has evolved over the decades.
Directed by Caren Zucker, a filmmaker whose son Mickey is on the spectrum, the documentary delves into the life of Donald Triplett, the first person diagnosed with autism, and provides an in-depth examination of his experiences in comparison to those of young autistic individuals today. I felt that this documentary merited a film review considering the various nuances that it sheds light on, including the diverse range of the autism spectrum, the racial disparities in autism diagnoses, and the ways in which media representation of autism has influenced popular perceptions of autistic individuals.
The documentary opens by introducing Donald Triplett, an elderly and congenial resident of the small town of Forrest, Mississippi. Caren reveals that Donald was the first person to be diagnosed with autism in the 1940s, a time which saw the emergence of the term “autism.” Because of her own experiences as the parent of an autistic child, Caren indicates that she is seeking out Donald to learn about his formative years as a person on the spectrum during a period in which public understanding of developmental disabilities was extremely limited. In her subsequent interview with Donald, she uncovers some of the dark truths of how children with autism and other IDD’s were treated.
During the early 20 th century, prevailing scientific thought categorized individuals with IDD’s by labels according to the severity of their symptoms, including “idiot” and “moron,” terms which are now considered insults.Because these individuals were deemed incapable of becoming integrated into society, they were often placed in institutions known as “preventariums,” which were officially intended to protect children with IDD’s from bringing harm to themselves or to others but in fact were characterized by horrific abuse and mistreatment, sometimes involving experiments in which staff members would hit the children to study their responses to pain. Furthermore, eugenics laws that provided for the sterilization of individuals with mental or developmental disabilities were widespread throughout the U.S. during this period, and their constitutionality was upheld by the renowned U.S. Supreme Court justice Oliver Wendell Holmes, Jr.
In discussing Donald’s upbringing, his relatives indicate that he was raised in an affluent family, as his father was a prominent lawyer and owner of the local bank in Forrest. They recount that he first began displaying signs of autistic behavior during his early childhood, which prompted his parents to place him in an institution due to their doubts about being able to manage his symptoms. However, hismother decided to take Donald out of the institution and bring him home because of the conditions thathe faced in the institution, and his parents agreed that they would raise him at home and try to managehis behaviors.
Donald’s father Beamon compiled a comprehensive account outlining his son’s peculiar
tendencies, including “an unusual memory for face and names,” an ability to “hum and sing many tunes accurately,” a series of repetitive behaviors that were “carried out in exactly the same way in which they had been performed originally,” and a strong introversion. This document provided the basis for the autism diagnosis that was formulated by Leo Kanner, an accomplished Austrian Jewish psychiatrist in
Baltimore who compiled summaries of the symptoms exhibited by Donald and ten other young children, in 1943, thus leading to Donald’s diagnosis as an individual on the autism spectrum.
Throughout her coverage of Donald’s story, Caren also draws upon her own experiences with her adolescent son Mickey. She recalls that she could not find any adult support services for him in her New Jersey community, which prompted her to place Mickey in a transitional program in Arizona. As part of this program, Mickey lives in an apartment and is regularly visited by a social worker who provides him with instruction in daily life tasks, such as organizing his bedroom and adhering to a daily routine.
Caren notes that Mickey has a strong aptitude for science, as he assigns names and numbers to his stuffed animals in accordance with the Periodic Table of Elements. He also displays a repetitive tendency to meow and talk about cats, which led her to believe that having a pet cat would make him happy while teaching him responsibility. However, when he visited the animal shelter with his classmates, he displayed a clear discomfort toward the idea of holding a cat, dispelling Caren’s hopes of Mickey becoming a responsible pet owner.
The services that Mickey receives today present a sharp contrast to Donald Triplett’s experience since there were no autism support services during the 1940’s. Remarkably, however, Donald was able to thrive and lead a successful career due to the support of his parents and his community, which warmly embraced him. In addition, his father asked the bank manager to ensure that there would always be a place for Donald in the bank, thereby guaranteeing that he would have secure employment.
To this very day, Donald’s relatives state, the bank has been a second home for him, and he regularly visits the building and enthusiastically greets its staff members. While this is truly admirable, it is important to note that Donald owed much of his success to his parents’ affluent position in the community since they wielded considerable influence in finding him employment during a period in which most businesses would certainly not hire an IDD individual and in which there were no federal protections against such discrimination. Furthermore, although there are now more advanced autism
support services, many families are unable to take advantage of these services due to low-income status and racial disparities in how services are allocated.
One of the significant nuances that the documentary touches upon is the role of systemic racism in determining who may be diagnosed with autism and therefore rendered eligible for autism support services. Stephanie Parks, an African American researcher who studies autism diagnoses in minority communities, recalls that she could not access services or secure a diagnosis for her son at a time when
he was displaying severe autistic symptoms, including meltdowns, which her
pediatrician dismissed on the grounds that he was “a little slow but would eventually catch up.” She notes that this is reflective of the systemic racial bias in the psychiatric field since black and Hispanic children are less likely to be diagnosed with autism than their white counterparts, which makes it more difficult for them to receive autism support services. A major factor that has influenced this systemic racism is the media representation that autism received during the 1960’s, in which children with autism
were depicted as coming from affluent white families, consequently shaping the prevalent perception of who fits the autistic mold. Furthermore, Stephanie observes that there have been significant disparities in how black mothers of autistic children are treated in comparison to white mothers: In one scenario, she found that pediatricians recommended contacting Child Protective Services in response to a black
mother’s testimony about spanking her child to try to quiet their severe autistic behaviors while, in the case of a white mother in a similar situation, the pediatricians recommended bringing a support specialist to the house so that the mother would have some time off from dealing with her child’s symptoms.
The documentary also addresses the ways in which contemporary media representation of autism has influenced public perception of individuals on the autism spectrum. While Rain Man was the first film to feature an autistic protagonist, its depiction of Raymond as a severely challenged individual with savant-like tendencies (exemplified in the scene where he instantly counts the exact number of toothpicks on the floor) shaped the 1980’s-era public imagination of people with autism as having certain intellectual abilities but lacking the ability to live as fully integrated members of society. Since
then, there have been a wide variety of films and television series that have exemplified the growing understanding of autism, such as The Good Doctor, in which the protagonist Shaun Murphy is a highly accomplished and brilliant physician who devises innovative surgical solutions while struggling to improve his social skills and learn the important aspects of being in a relationship. Although these productions have contributed to an increased understanding of the strengths and abilities of people with autism, the documentary points out that they also present a very skewed depiction which leaves
out individuals on the “low-functioning” range of the autism spectrum, as they tend to have more profound and severe challenges than their higher-functioning counterparts. One commentator observes that while low-functioning autistic individuals are typically regarded with a focus on their challenges rather than their strengths, the opposite is true for high-functioning individuals, who are viewed through an emphasis on their strengths while their challenges tend to be overlooked or downplayed.
In summation, In a Different Key is a brilliantly made documentary that addresses many complex nuances of autism, its associated support services, and the ways in which public understanding has evolved over the decades. Through its examination of Donald Triplett’s story, the documentary sheds light on how support services for autistic individuals have significantly expanded since the 1940’s while
acknowledging that access to these services continues to be impacted by families’ income status and systemic racial disparities in the diagnoses of children with autism. Although the documentary provides an in-depth look at the diverse experiences of families with children on the spectrum, it presents an optimistic outlook for their future integration through its discussion of new school programs which actively encourage the pairing of autistic children with their neurotypical peers in the hope of facilitating
empathy and acceptance at a young age. By watching this documentary, families of children with autism will hopefully be inspired to utilize these support services in order to ensure their children’s future success as fully integrated members of society.