Some of the major themes developed in Al Capone Does My Shirts include autism, family, responsibility, and imprisonment.

Autism, which is “a disease that affects the way [an individual’s] brain and sensory system work,” was not specifically identified until 1943. In 1935, the year in which the story takes place, children who exhibited its characteristic symptoms were given a variety of diagnoses and were frequently institutionalized. The term autism encompasses a wide range of manifestations. Natalie has idiosyncratic mannerisms, problems in relating to people, and the speech patterns of a preschooler but is nothing short of a prodigy when it comes to numerical calculations, so she would most likely be identified as autistic today. The best description of Natalie's condition is paradoxically provided in the book by a seven year old, Theresa Mattaman. Theresa says:

Natalie lives in her own world...sometimes it's a good world and sometimes it's a bad world. And sometimes she can get out and sometimes she can’t.

At her best, Natalie is “present” to what is going on around her and communicates with rudimentary words and phrases that are purposeful and not just rote reproductions of what other people say. At her worst, she is withdrawn and unreachable, entering into a state of catatonic unresponsiveness when the elements in her world overwhelm her. Through Natalie, the author communicates with remarkable clarity that the more extreme behaviors of autistic children are not primarily disciplinary issues but are the result of altered sensitivities that can spiral out of control. On the day before her second interview at the Esther P. Marinoff School, Natalie engages in a poignant struggle not to “leave” as “the forces inside her seem to collide.” Although on this occasion she manages, with Moose’s help, to redirect her attention and avoid a complete...

(The entire section is 763 words.)