An Ethnography of Severe Intellectual Disability: Becoming 'Dirty Little Freaks' is the first-hand account of an anthropology researcher and mother of a person with an intellectual disability. Using ethnographic methods, it focuses on how people with intellectual disabilities are treated at a particular care facility and how that care affects their lived experiences. I believe that reviewing what different audiences will gain from this book is important for a publication like Disability Studies Quarterly (DSQ) that has academic and non-academic readers. The book is primarily aimed at an academic audience, but it can still be beneficial for both people with an intellectual disability and caregivers to learn how care facilities are structured. Avery provides many personal observations. However, the book is mainly written as an academic text. As a content warning, this book contains depictions of surveillance and minor punishment of people with intellectual disabilities and mentions of institutionalization, sterilization, and eugenics.

Scholars of disability, particularly intellectual disability, and people who use ethnographic research methods will get a lot out of this book. Ethnographic research on people with intellectual disabilities often involves nuanced conversations on topics such as agency but are historically rooted in approaches that do not integrate disability studies and/or do not equitably center those personally affected by these perspectives. Such research diminishes and stigmatizes intellectually disabled ways of being and knowing because they are read as inaccessible and thus deficient to abled ways of being and knowing. Disability studies has historically struggled to equitably include perspectives on intellectual disability, often favoring physically disabled perspectives. Avery's book attempts to address these trends with an ethnographic study that theorizes equitable methods to represent the identity and material realities of people with intellectual disabilities.

Avery collected ethnographic fieldwork at a school for students with 'severe' (their distinction) intellectual disabilities aged fifteen to eighteen. Avery has a daughter with an intellectual disability and that positionality is both interrogated and used for analysis in productive ways throughout the text, following the tradition of other disability studies scholars who are parents/caregivers for people with disabilities, such as Eva Kittay. Ethnography has always questioned the familiarity of the researcher with their participants; however, Avery makes a compelling case for the benefits of having a researcher that is very close to the subject of intellectual disability.

One of Avery's most productive methods is using a lens of embodiment. Embodiment has been a key lens of disability studies and Avery relies most heavily on Margrit Shildrick's idea of leaky bodies. Leaky bodies refers to the effect of viewing disabled bodyminds as deficient and fleeting, causing an abled observer to then consider their own abled bodymind as transient. Avery uses this concept to frame the interactions of the abled staff to distance and contain the disabled students. Containment of contagion is the main thematic lens that Avery uses to focus her analysis. Containment is the function that dominates most of the interactions of the students in the material sense of staff containing the students' perceived contagion during social/cultural events such as mealtimes. In chapter five, "Contaminatus," Avery observes that the staff has strict rules against sharing food or utensils with the students that are grounded in ableist assumptions of segregation of abled and disabled. Chapter four, "Containment," applies a Foucauldian lens of surveillance to describe how the students are controlled and physically contained. Chapter six, "Extending the Metaphor," the last chapter to focus centrally on containment, extends to viewing challenging behavior from students as a contagion that needs to be contained through behavior management.

The containment theme is used to flesh out the embodied experiences of the students with intellectual disabilities, which is largely determined by how the staff treats them in these social/cultural interactions. Avery also brings in biological factors in an attempt to discuss how they are often underdetermined in people with an intellectual disability. For example, Avery often brings up the gut-brain axis, or the scientifically supported way that one's digestive health and cognition are linked, but the biological embodied experiences of people with intellectual disabilities are almost never considered in favor of psychological/social/cultural determinations. Here, Avery applies the concept of the bodymind, or the interrelatedness of both mind and body, to pursue a bio-psycho-sociocultural approach to the embodied experience of intellectual disability. I found this informative, as I am used to theorizing the bodymind in other disability contexts but not as is done here with intellectual disability. This book was incredibly helpful in advancing my understanding of the bodymind.

There are many possibilities for future research to fill the gaps that are opened by this study and its limitations. Avery was only able to interview a small number of parents or guardians of the students attending the school, not enough to develop a significant contribution to the study. A further ethnographic study on a family understanding of the embodied realities of their loved ones at care facilities would be fruitful. The study could have also been strengthened by a more intersectional analysis to further flesh out its claims on intellectual disability and embodiment. For example, throughout the text Avery occasionally mentions vectors of identity such as sex and gender, but they are not taken up as the primary lens of analysis until chapter nine, "Recasting the Net." The chapter adequately analyzes how sex and gender determine how students are treated by staff through the lens of contamination. An anecdote is given in which a male student is given preferential treatment and a female student is punished based on cis-gendered and heteronormative assumptions, which is connected to the larger conversations of gendered inequality among people with intellectual disabilities. However, sex and gender are the only vectors of identity that are given this degree of analysis. At the end of the chapter there is only a brief one-page discussion of race and colonialism that, if explored further, could have added more nuance to the text. An intersectional analysis is incredibly important for the development of the field of disability studies and could be especially beneficial for texts such as Avery's, since the study focuses on identity, ideas of the self, and embodiment.

Avery frames the organization of the book as a carefully folded origami structure where each chapter is a fold that builds to the conclusion. By the end of the book, Avery has formed all of the origami folds that compose the completed analysis for this project. Readers take it all in reflexively, with the implication to unfold and refold where they see fit. This scaffolded approach of folding and unfolding ideas aligns with the closing anecdote in which Avery confronts her own imperfect relationship to socially constructed ideas of intellectual disability to prompt us all to keep working and thinking, folding and unfolding.

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