In The Ultimate Stranger, Dr. Delacato posits the idea that autism is a type of brain damage that affects one of the sensory functions (sight, smell, touch, hearing, taste) and that autisms-those bizarre gestures that dominate the lives of autistic children-reflect various kinds of sensory damage.

For example, early in his research, Delacato observed a class composed of blind school children "waving their hands in front of their faces, tapping their eyes! I knew those behaviors were 'autisms,' but that couldn't be!" The director of the school informed him that the repetitive motions were referred to as blindisms. When he visited a school for the deaf, he saw children "hitting themselves on the ear. I heard strange rhythmic vocal noises. All in that same rhythm-the rhythm of the autisms!" To his great surprise, the director called the gestures deafisms. Delacato began to wonder if autistic children were actually brain-injured. "Was the autistic children's alien behavior in reality their attempt to cure themselves? Were they trying to open up or normalize one or more of the five channels from the world to their brains?"

This fascinating first-person account represents a commonsense approach to autism. It also describes Delacato's treatment for autistic children, whose trials and successes are chronicled in detail. Just as he replaced the term autisms with the more suitable "sensoryisms," he also replaced outmoded treatment methods with a more successful and humane approach. First he identifies the damaged sensory system, then he develops a treatment that allows the child to assist in the development of his damaged function: "When I found which channel or channels into the brain were affected, I gave an outsized amount of stimulation to that channel."

For example, one child regularly bit her hand:

He concludes:

Delacato's typology includes fifteen sensoryisms. Each sensory function is categorized as hypo, hyper, or white noise. Children who demonstrated a hyperresponse "felt, smelled, tasted, heard, or saw too well." For example, those with hypersmell "vomit when they smell their own urine … many are so nauseated by these smells that they refuse to urinate or defecate until they can no longer restrain themselves."

Conversely, those suffering from a hyporesponse "didn't allow enough information to get to the brain. They needed greater stimulation to get through." Children with hypo-taste were "the garbage pails of our group, for they … eat anything and everything. These children are dangerous to themselves, in that they will eat or drink materials that are extremely poor in taste, such as gasoline."

A third group-the white-noise children-suffered from extreme endosomatic sensitivity. They routinely experienced "internal sensory interference that decreased their sensory systems' ability to deal with the world." The auditory-white-noise group heard "their own hearts beating, their digestion progressing, and their circulation, especially near their ears."

In a chapter entitled, "Reading the Sensoryisms," Delacato portrays the various groups. In "Treating for Survival," he explores treatments aimed at replacing the typical sensoryisms with experiences that transform self-destructive behavior and normalize "distorted sensory systems."

My only criticism of this work is the author's absolute rejection of the possibility of the psychogenesis of autism. In two chapters devoted to the subject, he discusses the pitfalls of psychoanalytic (read: Freudian) theory. But psychology did not begin with Freud, nor will the final word on the psyche be rendered by the adherents of Freud's outdated and reductionist theories. For example, Delacato's justifiable mockery of the psychoanalytic theory of breastfeeding, while informative, does not disprove the psychogenesis of autism. As a scientist, Delacato should recognize that the psyche is as complex as the physiological terrain that he explores. While it is true that the psyche cannot be reduced to the breast, it is also true that the psyche's influence cannot be discounted until more is known about this illness.

Delacato's sensory approach to autism offers a promising alternative to those who suffer from this distressing illness. He's to be congratulated for this innovative work and for his decision to present his findings in an upbeat, lively style: one accessible both to the layman and the professional.