Review: Grant Macaskill, Autism and the Church: Bible, Theology, and Community (Waco, TX: Baylor University Press, 2019)

Since first being credentialed by a presbytery in 2014, several topics have occupied my thoughts for extended periods of time regarding how best to preach and to pastor people wrestling with difficult issues, but none so much as the matter of mental wellbeing, which for the past two years has been a focal area of concern. In my understanding, mental wellbeing pertains to everything from poor coping with too much stress to mental disabilities. One of the issues within this web of concerns is how to pastor Christians who are autistic.

In this regard, Grant Macaskill has written a profoundly helpful book that dives deeply into what autism is and how the church should relate to autistic Christians. Macaskill approaches this subject as a genuine scholar, drawing upon medical research to highlight substantive matters for understanding autism and incorporating his background in New Testament studies to reflect upon what the Scripture says that can help us reflect upon the church’s responsibility to care for her autistic members. Macaskill does come from a Reformed perspective and ecclesiastical background.

One of this book’s most obvious strengths is its thoroughness. All of us, including pastors, may too readily think that we understand what autism is, leaving us to think that we can easily figure out the best way to relate to those who are autistic. The truth is, however, that autism is far more complicated than most people imagine, especially from relying on portrayals in the media. There are several ways in which Macaskill’s book prompts hard thinking about autism and the church, and it is worth highlighting some ways that I have been moved to reflect on these issues after reading it.

First, autism should not be classified strictly as a disability. This is a crucial point, perhaps especially for pastors, that we must keep in mind. Readers will note that nowhere in this post do I use phrases like someone “has autism,” a person “struggling with autism,” or most pointedly calling it a disability. This careful phrasing throughout is purposeful, not only because this is a sensitive issue, but also because we need to be mindful that just because someone functions or thinks somewhat differently than most does not mean they are disabled. Sometimes, yes, an autistic person may have accompanying conditions that make at least parts of life more difficult for them or even hinder them from having a usual level of independence. Still, this is not necessarily inherent in autism. For this reason, the best way to refer to autism is with the phrase “neuro atypical.”

Second, drawing on the last point that autism is a neurological atypicality, we must reckon with what that means about pastoral care. There are many discussions occurring in the Reformed world today about “immutable characteristics” that may or may not be attached to individuals. Sadly, these debates might too readily affect the way that we consider autism. For autism is not a preference, set of choices, or inclination. It is different from many of these other problematic issues being discussed in Reformed churches because it truly is a matter of neurology. It is an atypical way that a person’s brain is hardwired in a very physical sense. For this reason, we must carefully insist that the church must care for autistic people but not as though this is a “problem” that can ever be overcome. This needs further unpacking though.

Autism may be evidenced in many different ways. Sometimes these are hardly noticeable, if at all. Other times these evidences might be real struggles in relating well to others. The issue facing pastors here is that it is very difficult to parse out when an autistic believer struggles in a relationship because of a side-effect of their autism or because of a sin issue. In my own experience, it takes great care to work through these matters with an autistic person, often being very difficult, and even more often being hard to convince the person I am pastoring of the distinction.1 This difficulty is not inherent in pastoring a neurologically atypical person, since indeed autistic people are all individuals, just like every other church member. 

So, as we may well need to help an autistic church member by pastoring them in how to relate well to other believers, we must remember that the goal is not to overcome the fact that they are autistic, which itself is not a problem, but to help them see ways that their life and Christian walk would be bettered if they could develop new methods or perspectives for relating to their Christian brothers and sisters. Autism is not a sin, as we must plainly affirm. Autistic people sin and may have struggles that might be somewhat anticipated in those who are neurologically atypical. Yet, is that not true of everyone else in our churches? Sins and struggles often come in bundles and the elders in Christ’s church are called to pastor them all, regardless of what causes we might (more or less legitimately) ascribe to them. The pastoral task is to work with believers to help them walk with Christ by pointing them to the gospel, calling them to repentance, and helping them process life in this fallen world no matter what background or underlying factors may contribute to the way that they already process it.

Much of the book reflects upon the New Testament theme of the body of Christ. Macaskill’s point is that the Scripture informs us that the church is supposed to be divers because God intended it to be so. The payoff is twofold. The obvious point is that neuro-atypical Christians are just as much core members of the church as every other believer. Autistic Christians are every bit as much part of the body of Christ, namely including the local expression of Christ’s body, as those who are not autistic. That leads to the second, perhaps less obvious point that pastoring neuro-atypical people well entails that we do not sideline them in church participation but recognize that they are potentially strong contributors to church life, bringing their own strengths. Pastoral care means acknowledging that autism is not simply an obstacle for someone to overcome but can be a factor that helps someone contribute in a uniquely beneficial way. 

In his providence, God may have gifted your church with autistic members. In this era, when the world is ripe with godlessness, we should celebrate that God protected them from being killed in the womb simply because they are atypical and may (emphatically potentially) add additional responsibilities to parents who care for them. But further, we should realize that God intended these people as they are to be in our churches, so we should not wish that God would remove their autism. Macaskill’s book left me wondering about what the new creation means regarding autism. That question, however, is not one I think at least I can answer in this age. I know I have more study to do on this topic, and all those related to mental wellbeing, but Macaskill’s book is a good place to start for those who want to begin looking at this issue.

©Harrison Perkins. All Rights Reserved.


1. I am convinced that the Bible’s position on homosexuality is clearer than Macaskill suggests in some of his later remarks. His comments are certainly not liberal or unorthodox on this point, and a peripheral issue within the scope of the whole work. The simple point is that most readers of this blog should simply take the position that we can make stronger arguments than suggested in this volume.


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  1. Thanks for this. One of our most valued church members is a young lady with autism. Interestingly, years ago, her mother pointedly asked that I not refer to her as “autistic” as if that were her defining trait. So prefers “has autism” to “autistic.” I guess part of the learning process is learning how best to support these families in a way they find helpful. But I would not trade this young lady for anyone else. Among other things, she prays her mind without guile, and we are all blessed for it.

    • I wrestled with phrasing throughout the whole thing. It’s a tricky issue. Hopefully people can see that I tried to be sensitive

      Glad it was useful

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