Jack Pitney has written a splendid account of what he calls the politics of autism. The subtitle accurately conveys Pitney's convictions in this policy world—an arena of extraordinary complexity and conflict for those navigating within it.

The book is a revealing example of one mode of understanding the policy politics of any substantive area. One way is to describe the actors central to the topic's decision-making and what role they played in the legislative, judicial, or executive institutions of American government. Another analytic mode relies on the “stages” of activity to organize the sources of policy ideas and what happened from identifying problems to assessing the actions taken. Still another is construing the topic as the policy politics of a substantive industry: medical care, agriculture, defense, and so on. The assumption here is that a study of a policy in a particular industry will illustrate the politics of that industry's contested policies.

Pitney might have addressed autism as Medical Care Politics in America: The Case of Autism. But he did not, and therein lies an interesting set of analytic issues. Isn't autism a topic in medical care just as the politics of cancer or the politics of abortion? The short answer is no and for two good reasons.

First, cases of politics in, for example, an industry such as medical care do not add up to a politics of medical care. The stakes, contestants, and forms of policy politics vary. Conflicts over hospital closures, for example, differ greatly from the regulatory battles of the drug industry or the financing of Medicare. To repeat, the undeniably truthful assertion of politics in an industry does not entail that there is a politics of that industry.

The variation in how one can think about policy politics is substantial in other ways. One can emphasize the institutional setting of the struggle (Congress, the courts et al.), the interest group players (the American Medical Association or unions and governmental targets of influence), the topics of intense conflict (e.g., budgets or prison treatment of racial groups), the character of the dispute (quiet or noisy), and so on.

Pitney does not follow any one of these modes. He instead selects from the options those approaches most likely to resolve puzzles about American treatment of the science of autism, the realities of programs in place or proposed, and what he regards as the extraordinary complexity of this arena of policy politics.

The expression of this wide-ranging mode is clear from the table of contents. Pitney's introduction emphasizes that there are few if any studies of autism as an instance of substantial policy and politics. The short history of autism sets the stage for more detailed analyses in chapter three's attention to how medical actors, scientific researchers, and the quantitative fields of math interact in the intense disputes about the definition, scale, and knowledge of autism. Chapters 4 and 5 shift attention to schools and educational financing and how that makes for a bewilderingly complex arena of actors, with local, state and federal struggles. What is likely to happen to programs for autistic children and adults is chapter 6's serious subject.

The Pitney book, in summary, addresses the wide range of forces bearing on the past and present of the “field of autism” and leaves the reader all the more admiring of the industry and skill of its author.