User:Gkrolewski/History of autism

Original Article: Autistic individuals bypass nonverbal cues and emotional sharing that they find difficult to deal with. The development of the web has given them a way to form online communities and work remotely. Societal and cultural aspects of autism have developed: some in the community seek a cure, while others believe that autism is simply another way of being.

My Contribution: It is common that some autistic individuals bypass nonverbal cues and emotional sharing that they find difficult to regulate. The development of the web has given them a way to form online communities and work remotely, which can directly benefit those experiencing communicating typically. Societal and cultural aspects of autism have developed: some in the community seek a cure, while others believe that autism is simply another way of being.

Original Article: Describing a particular kind of mentally abnormal child, Asperger wrote: All abnormal symptoms can be derived from the disturbance of the instinctive functions: the disturbance of the understanding of the situation and the disturbance of relationships with other people; from this we understand the lack of respect for authority, the lack of disciplinary understanding at all; but we also understand the fact that nobody really likes these people, we understand the heartless wickedness.

Equivalent to this lack of instinct is not only the clumsiness in pure motor skills; but also the poor practical understanding, the success of practice that is so difficult to achieve, the "difficult mechanization".

After what has been said, it is not surprising that these children are always loners, falling out of any children's community: they themselves do not strive for any community, since they have no personal relationships with anyone (they never have a friend either), and the community also rejects them, since they are always a foreign body; but because of their peculiarities, especially because of their clumsiness, they are always an object of unanimous ridicule in the community, for which they know how to take revenge often enough.

But one thing is very often not only not disturbed in these severely constricted personalities, as in this boy, but is actually well developed above average, namely the intelligence in the narrower sense, the ability to think logically, to formulate one's thoughts well in language (they often find particularly original, almost linguistically creative expressions); very often astonishingly mature special interests are present, often really scientific (e.g. natural research) or technical interests, which of course are often quite cranky and eccentric.

My Contribution: Describing a particular kind of mentally abnormal child, Asperger wrote about the struggles that many children with autism face, including "disturbance of relationships, clumsiness in pure motor skills, and poor practical understanding." in Das Psychisch Abnormale Kind (The Mentally Abnormal Child).

Original Article: This work offered by far the most detailed description of autism as yet published. Asperger notes: If one has learned to pay attention to the characteristic expressions of the autistic nature, one finds this psychopathic disorder, especially in a milder degree, not so rare, even in children ...

...the individual personalities [of autistic people] stand out from one another not only through the degree of the contact disorder, through the level of intellectual and character strengths, but also through numerous individual traits, special ways of reacting, and special interests (which are particularly independent and different within this group of people) ...

The difficulties which the young child has in learning the simple skills of practical life and in social adjustment come from the same disorder which causes the learning and behavioural difficulties of the school child, which causes the professional difficulties and the special achievements of the adolescent, and which speaks to the adult's marital and social conflicts ...

Unfortunately, not in all cases, not even in most cases, does the positive, future-oriented traits of the autistic personality prevail. We have already talked about the fact that there are autistic characters of very different personality levels: from an originality bordering on genius to unrealistic, insular, inefficient oddballs to the most severely contact-disordered, automaton-like imbeciles ...

With the cleverest of them, the teachers sometimes overlook the poorer performance in the mechanizable learning requirements because of their other achievements, because of their clever answers. Most of the time, however, the teacher is in despair over the agonizing trouble that arises for both parts from this disruption in the way they work ...

We want to show that the basic disorder of autistic psychopaths is a narrowing of their relationships with the environment, that the personality of these children can be understood from this point of view, that it is "thoroughly organized" from that point of view ...

Very differentiated likes and dislikes in the area of the sense of taste are almost regularly found - the frequent occurrence in the same direction is more proof for us of the unity of our type ... Many of these children have an aversion to certain tactile sensations, which goes to abnormal degrees ...

Either [autistic children] don't notice the things around them at all, for example they don't care about toys at all, or they have an absurdly strong attachment to certain individual things, never take their eyes off a whip, a block of wood, a mere rudimentary doll, can't eat, can't go to sleep if the "fetish" isn't with them, make the most difficult scenes trying to snatch the thing they've held so passionately from them ...

That one has to keep oneself clean and in addition meet the numerous requirements of personal hygiene can only be taught to them with great difficulty, often not at all completely - even the adults, who then have mostly chosen intellectual professions, can walk around unwashed and unkept ...

The autistic psychopath is an extreme variant of male intelligence, male character. Typical differences between boys' and girls' intelligence can already be found within the normal range of variation: girls are generally the better learners, they are good at concrete, descriptive, practical, clean, eager work; on the other hand, logic, the ability for abstraction, the precise thinking and formulating, that independent research is much more in the possibilities of the boys ...

While, as already mentioned, we have not met any girl in whom the image of the autistic psychopath has been fully developed, we have met several mothers of autistic children who were themselves markedly autistic in their behaviour ...

The steadfastness and the power that lies in the "spontaneous" activity of the autistic, the narrowing down to individual areas of life, to an isolated special interest - this proves to be a positive value that enables these people to achieve special achievements in their areas. Especially with the autistic we see - with far greater clarity than with the "Normals" - that they seem predestined for a certain profession from their earliest youth, that this profession grows out of their special talents as a result of fate.

My Contribution: Asperger identified a typical behavior pattern seen among autistic children, and with extensive detail outlined his observations. He concludes that "...the individual personalities [of autistic people] stand out from one another not only through the degree of the contact disorder, through the level of intellectual and character strengths, but also through numerous individual traits, special ways of reacting, and special interests."

Asperger also details his lack of finding autistic traits in young girls, as his observations were geared towards behaviors found in young boys.

Original Article:

Leo Kanner was born in 1894 to a Jewish family in what is Ukraine today, and what was then the Austro-Hungarian Empire. He went on to study and work in Berlin. He then immigrated to the United States in 1924.

In 1930, the first child psychiatry clinic in the United States was established at Johns Hopkins Hospital, and Kanner was appointed to run it. In 1933, Kanner became associate professor of psychiatry at Johns Hopkins University.

In May 1933, American psychiatrist Howard Potter, (assistant director of the New York State Psychiatric Institute and Hospital), published a paper titled "Schizophrenia in Children". Potter defined six diagnostic criteria for childhood schizophrenia, which Kanner would later say was important when thinking about autism:


 * 1) A generalized retraction of interests from the environment.
 * 2) Dereistic thinking, feeling and acting.
 * 3) Disturbances of thought, manifested through blocking, symbolization, condensation, perseveration, incoherence and diminution, sometimes to the extent of mutism.
 * 4) Defect in emotional rapport.
 * 5) Diminution, rigidity and distortion of affect.
 * 6) Alterations of behavior with either an increase of motility, leading to incessant activity, or a diminution of motility, reacting to complete immobility or bizarre behavior with a tendency to perseveration or stereotypy.

In 1934, Soviet psychiatrist Evgenia Grebelskaya-Albatz (Евгения Гребельская-Альбац) of Moscow published the paper "Zur Klinik der Schizophrenie des frühen Kindesalters" (On the clinic of early childhood schizophrenia). It divided people with childhood "schizophrenia" into two groups, those with normal intelligence, and those with lesser intelligence. Kanner would later say that she was one of the three people to identify autism before he did.

Leo Kanner published the first American textbook on child psychiatry in 1935, titled Child Psychiatry. (While many sources say he published the first English-language book of that kind, Kanner himself credits this to William Ireland).

In 1937, Swiss psychiatrist Jakob Lutz of University of Zurich published a short book reviewing the available material on childhood schizophrenia, including the work of Sukhareva, Potter, Grebelskaja-Albatz and others. It was republished in a journal later in 1937. Lutz visited Kanner's department at Johns Hopkins in early 1938. Lutz would also publish a chapter on the topic in a book that year. Kanner later acknowledged Lutz's influence on his work.

In June 1938, American psychiatrist Louise Despert of the New York State Psychiatric Institute published the paper Schizophrenia in Children. It included case studies of people that have subsequently been identified as having autism. The paper referenced two researchers, Sukhareva and Grebelskaya-Albatz. It has been suggested that this paper was a major influence on Kanner. Kanner would later also claim Despert's autism work as an antecedent of his own.

By this time, two of Hans Asperger's close colleagues, psychiatrist (and friend of Kanner) George Frankl [de] and psychologist Anni Weiss, were now working at Johns Hopkins, having fled the Nazis.

Leo Kanner visited the autistic child Donald Triplett on 27 October 1938. Kanner would later say that this was the first time he saw the pattern of autism.

In April 1941, Kanner presented a paper titled "Autistic Disturbances of Affective Contact" to a staff conference in The Henry Phipps Psychiatric Clinic in Baltimore. This would be published in April 1943. It includes case studies of eleven children and their families who have particular things in common. He does not use the term autism as the name of the children's condition.

The term Kanner's syndrome was later coined to describe the children's condition, in particular to distinguish them from the differing symptoms of Asperger's children. This syndrome has also sometimes been known as classic autism.

Kanner and Asperger's colleague George Frankl published the paper "Language and Affective Contact" in the same journal edition as Kanner's 1943 paper. It describes different kinds of speech problems children have. In particular, he identifies a group of speech-troubled children defined by having a "lack of contact with persons", which can considered to be an autistic group. Frankl's precise role in the development of the concept of autism is not clear.

In September 1944, Kanner published the paper "Early Infantile Autism", giving his newly identified condition a new name. The paper has much in common with Kanner's 1943 paper. It included only two case studies, but had a much more detailed introduction.

Kanner writes: During the past six years, I have become increasingly interested in a number of children, twenty by now, whose behavior differs uniquely and markedly from anything reported so far. Among the individual patients there are great variations in the degree of the disturbance, in the manifestation of specific features, and in the step-by-step development in the course of time. Yet in spite of this seeming divergence they all present essential common characteristics to such an extent that they cannot but be considered as fundamentally alike from the point of view of psychopathology. Many of these children were brought to us primarily with the assumption that they were severely feeble-minded or with the question of auditory impairment. Psychometric test performances yielded indeed very low quotients, and often enough absent or inadequate responses to sounds of any kind gave good reason for the suspicion of deafness. But careful examination showed very soon that the children's cognitive potentialities were only masked by the basic affective disorder; in fact, a few of the children had started out by amazing their parents with phenomenal feats of rote repetition. In all instances it could be established that hearing as such was not defective.

The common denominator in all these patients is their disability to relate themselves in the ordinary way to people and situations from the beginning of life. Their parents referred to them as always having been "self-sufficient", "like in a shell", "happiest when left alone", "acting as if people weren't there", "giving the impression of silent wisdom". The ease histories indicate invariably the presence from the start of extreme autistic aloneness which, wherever possible, disregards, ignores, shuts out anything that comes to the child from the outside ...

An excellent rote memory, retaining many poems, songs, lists of presidents, and the like, made the parents at first think of the children proudly as child prodigies ...

The same type of literalness exists also with regard to prepositions.

Alfred, when asked, "What is this picture about?" replied: "People are moving about ..."

The child's behavior is governed by an anxiously obsessive desire for the maintenance of sameness that nobody but the child himself may disrupt on rare occasions. Changes of routine, of furniture arrangement, of a pattern, of the order in which everyday acts are carried out can drive him to despair ...

Every one of the twenty children has a good relation to objects; he is interested in them; he can play with them happily for hours. The children's relation to people is altogether different. Every one of the children upon entering the office immediately went after blocks, toys, or other objects without paying the least attention to the persons present. His third paper on autism, "Irrelevant and metaphorical language in early infantile autism" was published in September 1946. He concludes, "schizophrenic 'irrelevance' is not irrelevant to the patient himself and could become relevant to the audience to the extent to which it were possible to find the clues to his private and self-contained metaphorical transfers."

He released a new edition of his textbook Child Psychiatry in 1948, which included his newly identified condition, and did much to increase knowledge of it.

Kanner published a fourth autism paper in July 1949, entitled "Problems of nosology and psychodynamics of early infantile autism". The first part aims to reinforce the separateness of early infantile autism from other conditions accepted by the medical community. He notes "Early infantile autism bears no resemblance to Heller's disease". He says it is however the same condition earlier identified by three women, "Ssucharewa [a German spelling of Sukhareva], Grebelskaya-Albatz, and Despert."

The paper also says much about the personality type of the parents of autistic children, including:"One is struck again and again by what I should like to call a mechanization of human relationships. Most of the parents declare outright that they are not comfortable in the company of people; they prefer reading, writing, painting, making music, or just 'thinking'. Those who speak of themselves as sociable tend to qualify this by explaining that they have no use for ordinary chatter. They are, on the whole, polite and dignified people who are impressed by seriousness and disdainful of anything that smacks of frivolity."He also notes that the parents were typically "reared sternly in emotional refrigerators", and that "the parents did not seem to know what to do with the children when they had them. They lacked the warmth which the babies needed."

My Contribution: Leo Kanner was born in 1894 to a Jewish family in what is Ukraine today, and what was then the Austro-Hungarian Empire. He went on to study and work in Berlin. He then immigrated to the United States in 1924.

In 1930, the first child psychiatry clinic in the United States was established at Johns Hopkins Hospital, and Kanner was appointed to run it. In 1933, Kanner became associate professor of psychiatry at Johns Hopkins University.

In May 1933, American psychiatrist Howard Potter, (assistant director of the New York State Psychiatric Institute and Hospital), published a paper titled "Schizophrenia in Children". Potter defined six diagnostic criteria for childhood schizophrenia, which Kanner would later say was important when thinking about autism:


 * 1) A generalized retraction of interests from the environment.
 * 2) Dereistic thinking, feeling and acting.
 * 3) Disturbances of thought, manifested through blocking, symbolization, condensation, perseveration, incoherence and diminution, sometimes to the extent of mutism.
 * 4) Defect in emotional rapport.
 * 5) Diminution, rigidity and distortion of affect.
 * 6) Alterations of behavior with either an increase of motility, leading to incessant activity, or a diminution of motility, reacting to complete immobility or bizarre behavior with a tendency to perseveration or stereotypy.

In 1934, Soviet psychiatrist Evgenia Grebelskaya-Albatz (Евгения Гребельская-Альбац) of Moscow published the paper "Zur Klinik der Schizophrenie des frühen Kindesalters" (On the clinic of early childhood schizophrenia). It divided people with childhood "schizophrenia" into two groups, those with normal intelligence, and those with lesser intelligence. Kanner would later say that she was one of the three people to identify autism before he did.

Leo Kanner published the first American textbook on child psychiatry in 1935, titled Child Psychiatry. (While many sources say he published the first English-language book of that kind, Kanner himself credits this to William Ireland).

In 1937, Swiss psychiatrist Jakob Lutz of University of Zurich published a short book reviewing the available material on childhood schizophrenia, including the work of Sukhareva, Potter, Grebelskaja-Albatz and others. It was republished in a journal later in 1937. Lutz visited Kanner's department at Johns Hopkins in early 1938. Lutz would also publish a chapter on the topic in a book that year. Kanner later acknowledged Lutz's influence on his work.

In June 1938, American psychiatrist Louise Despert of the New York State Psychiatric Institute published the paper Schizophrenia in Children. It included case studies of people that have subsequently been identified as having autism. The paper referenced two researchers, Sukhareva and Grebelskaya-Albatz. It has been suggested that this paper was a major influence on Kanner. Kanner would later also claim Despert's autism work as an antecedent of his own.

By this time, two of Hans Asperger's close colleagues, psychiatrist (and friend of Kanner) George Frankl [de] and psychologist Anni Weiss, were now working at Johns Hopkins, having fled the Nazis.

Leo Kanner visited the autistic child Donald Triplett on 27 October 1938. Kanner would later say that this was the first time he saw the pattern of autism.

In April 1941, Kanner presented a paper titled "Autistic Disturbances of Affective Contact" to a staff conference in The Henry Phipps Psychiatric Clinic in Baltimore. This would be published in April 1943. It includes case studies of eleven children and their families who have particular things in common. He does not use the term autism as the name of the children's condition.

He summarises: The combination of extreme autism, obsessiveness, stereotypy, and echolalia brings the total picture into relationship with some of the basic schizophrenic phenomena ... But in spite of the remarkable similarities, the condition differs in many respects from all other known instances of childhood schizophrenia ...

All of the children's activities and utterances are governed rigidly and consistently by the powerful desire for aloneness and sameness ...

Between the ages of 6 and 8 years, the children begin to play in a group, still never with the other members of the play group, but at least on the periphery alongside the group. Reading skill is acquired quickly, but the children read monotonously, and a story or moving picture is experienced in unrelated portions rather than in its coherent totality ...

It is not easy to evaluate the fact that all of our patients have come of highly intelligent parents ...

One other fact stands out prominently. In the whole group, there are few really warmhearted fathers and mothers. For the most part, the parents, grandparents, and collaterals are persons strongly preoccupied with abstractions of a scientific, literary, or artistic nature, and limited in genuine interest in people. Almost all the characteristics described in this paper, notably "autistic aloneness" and "insistence on sameness", are still regarded as typical of autistic spectrum disorder.

As for the cause of the condition, it states:"We must, then, assume that these children have come into the world with innate inability to form the usual, biologically provided affective contact with people, just as other children come into the world with innate physical or intellectual hand[i]caps."The term Kanner's syndrome was later coined to describe the children's condition, in particular to distinguish them from the differing symptoms of Asperger's children. This syndrome has also sometimes been known as classic autism.

Kanner and Asperger's colleague George Frankl published the paper "Language and Affective Contact" in the same journal edition as Kanner's 1943 paper. It describes different kinds of speech problems children have. In particular, he identifies a group of speech-troubled children defined by having a "lack of contact with persons", which can considered to be an autistic group. Frankl's precise role in the development of the concept of autism is not clear.

In September 1944, Kanner published the paper "Early Infantile Autism", giving his newly identified condition a new name. The paper has much in common with Kanner's 1943 paper.