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Book Review: Damian Milton's 'A Mismatch of Salience'

Updated: Feb 10, 2020

A review of ‘A Mismatch of Salience: Explorations of the nature of autism from theory to practice’ by Dr. Damian E. Milton (2017)

Book cover: A Mismatch of Salience by Dr. Damian Milton
'A Mismatch of Salience' by Dr Damian Milton

It was a real pleasure to read this illuminating book by Dr. Damian Milton. Damian is an esteemed colleague of Studio 3 and an expert in the autism field. He works for the National Autistic Society, is on the committee at Research Autism, and also teaches and lectures at the University of Kent. He is a committed advocate for the meaningful participation of autistic people within the field of autism research and activism, and is himself autistic.

This publication is structured as a series of essays and writing that together provide a holistic and comprehensive overview of autism theory and practice, making it an invaluable guide and starting point from which to delve deeper using the extensive list of additional resources and references. The writing is engaging and of a high academic standard, and the topics discussed have been extensively researched. The knowledgeable academic voice is intermingled with deeply personal accounts from the author, including sections of poetry. Damian’s unique voice provides a real insight into his own lived experiences, and it is impossible not to empathise with Milton in a way that is very rare for an academic book of this standard.

The book ranges from discussing the theories (or rather, lack of theories) that exist around autism, to what Damian describes as a mismatch of salience. Key to this view is what Damian describes as the double empathy problem, which demonstrates that empathy is a two-way street.

The double empathy problem has greatly informed much of our own practice here at Studio 3 when it comes to understanding the perspectives of the individuals we are working with, and our own contribution to challenging situations.

In his recent publication, ‘The Reflective Journey’, Professor Andrew McDonnell references Damian’s double empathy theory as a significant factor when it comes to supporting individuals with autism. Throughout the text, Milton emphasises the importance of understanding how stress can affect behaviour and emotion, and that autistic people in particular can be more sensitive to external stressors.

This book is invaluable as a resource containing insider knowledge that challenges the assumptions made about autism by neurotypical people, and is essential reading for anyone working with or supporting an individual with autism. Damian emphasises how important it is to keep the perspective and experiences of the autistic individual at the centre of their support system:

‘For many philosophers, the way we talk about something is ‘more than just words’, but frames the way we think about ourselves and one another. By viewing the ‘autistic person’ as the ‘disordered other’, it can reduce an individual’s sense of self-worth and self-esteem.’ (p.15)

Damian’s work as an advocate for the rights of people with autism is reminiscent of the work of Jim Sinclair, an Autism Rights advocate who famously stated:

‘Grant me the dignity of meeting me on my own terms--recognize that we are equally alien to each other, that my ways of being are not merely damaged versions of yours.’ (1992)

For the non-autistic reader, this book provides a keen insight into the world of autism and the lived experiences of individuals with a diagnosis, as well as guidance on how to interact with and support those individuals in a meaningful way. Milton successfully weaves together academic research and personal experience in a highly sophisticated way that is at once engaging, informative, and deeply meaningful.

We would recommend this book, not only to practitioners who work in the field, but also to a broader audience of individuals who want a useful insight into 'this thing we call autism'.

Reviewed by Rachel McDermott,

Studio 3 Digital Content Editor


McDonnell, A. (2019) The Reflective Journey: A Practitioner's Guide to the Low Arousal Approach. Available from:

Milton, D. E. (2017) A Mismatch of Salience: Explorations of the nature of autism from theory to practice, West Sussex: Pavillion Publishing and Media. Available from:


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