In recent years there has been a glut of publications on autism outside of mainstream medical literature. These have included carers’ accounts and personal narratives. First-person accounts of Asperger syndrome seek to provide an alternative narrative to ‘deficient focused’ medical accounts. Perspectives are reversed in these texts. The persons with autism describe tentatively, but with increasing confidence, how they see both themselves and the ‘neurotypical’ world they find themselves in. In these books the exotic is made ordinary and understandable, and they help diminish the stereotype of the ‘autist’ (their preferred term) as the ‘other’, which is often the stance of other people writing about people with autism.

Deborah Lipsky represents the best of this tradition of ‘neurodiversity’ in her blunt, sometimes wry, exploration of anxiety, which she believes is central to the autistic state. She strips away the veneer from habitual beliefs and assumptions about autism. The book reflects its practical roots in a training manual on management of ‘meltdowns’. She provides realistic appraisal as well as practical advice in managing anxiety. Her pragmatic account is far removed from more typical narratives of disability with their focus on transformation and redemption. Her triumphs are small, her assessments shrewd, and her reflections often self-deprecatory. There is vein of healthy humour leavening some very real distress and bewilderment.

She is at her more secure in the experiential explorations of her own anxiety and those of other people with autism. She describes at length her need for ‘scripts’ in every situation, the need for predictability and accountability. The apparent slippage in the real world which to her countenances injustices and condones irregularity leaves her nonplussed.

It is when she delves into the jargon of neurobiology that she falters. To the medical profession this is a closed world with its own discourse and its own scripts, one which does not lend itself to easy translation. This detour aside, the book's strength is in formulating strategies to identify triggers for anxiety and evolving solutions.

Robust copy-editing may have avoided repetitions throughout. Despite this, this book is of value to people with autism, their carers and professionals. If the asides on Cold War politics or the far-out evolutionary theories about an ‘autistic super-race’ leave you bemused, hang in there, for the book delivers, plumbing hidden depths in both showing and telling.