AUTISM: A SHORT HISTORY

by Michael McKeon, Dublin City University

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The history of autism as a concept and the ways in which autism has been viewed and talked about have shown that it is not a modern difficulty, even though it has only recently gained vast recognition. This is a chronological look at autism from ancient times to the present day, where history provides a small window to understand the ideas of autism and how the understanding of autism has been arrived at. The history of autism is not a linear one and regardless of the past and present debates over origin and treatment, as more studies and research are conducted the greater our understanding of autism will become.

Rig Veda—Ancient times

In many ancient cultures, religious texts like the Rig Veda of India run to hundreds of thousands of words and survived by word of mouth from many generations before being written down. The ability to memorise these long religious text is one of the savant skills associated with autism and in societies that valued such a skill it is hard not to imagine that an autistic person lacking ability in many other respects might be considered special and even holy for possessing a good memory.

Saint Francis (1226)

The Fioretti di Santo Francesco d’Ascesi (The little flowers of St Francis of Assisi) has detailed descriptions of ‘Brother Juniper’. An interpretation of the English translation suggests that Brother Juniper displays many of the classic attributes of a person with autism and his actions and manner indicate that he was a person with autism.

Dewey (1600)

The historian Horace Dewey proposed that some of the holy fools of Russia might have been people with autism. In a case from the sixteenth century, a boy who sought to avoid human contact and was put in the care of the local priest after being captured by peasants, grew up to be known as the Blessed Simon of Jurev.

Itard (1801)

In 1801, a French doctor, Jean-Marc-Garpard Itard, was given charge of a 12-year-old child who had been found living wild in the woods. The child was mute and thought to have been isolated from human contact and displayed many strong characteristics that suggest a very strong autistic tendency. It is at this point in history that the idea of special education began, as a formal way in which both educators and psychologists can provide appropriate support and therapies to promote productive and happy lives for people with autism.

Bleuler (1911)

The eminent psychiatrist Eugen Bleuler introduced the label of autism/autistic in 1911, as a basic disturbance in schizophrenia, namely the narrowing of relationships to people and the outside world, a narrowing so extreme that it seemed to exclude everything except the person’s own self- This narrowing could be described as a withdrawal from the fabric of social life into the self- The word autism/autistic, coined by Bleuler, comes from the Greek word autos meaning ‘self’.

Kanner (1943)

Leo Kanner, a psychiatrist at John Hopkins University in the USA, recognised children sent to his clinic as displaying similar unusual behaviours and characteristics, which he named ‘autism’. Kanner described in detail the characteristics of eleven children he saw between 1931 and 1943, where certain features were universal in a diagnosis as:

  • A profound lack of affective / emotional contact with other people
  • Intense insistence on sameness in their routines
  • Muteness or abnormal speech
  • Fascination with manipulating objects
  • An attractive, alert and intelligent appearance
  • High level of visio-spatial or rote memory, but major learning deficits in other areas.

Kanner’s work at that time was slow to catch on, but it is now the focus of international research and is the most quoted in the whole literature on autism. Kanner’s Syndrome is used to describe a child with a collection of the classic features Kanner identified in his first description of autism.

Asperger (1944)

A Viennese physician, Hans Asperger, working at the same time as Leo Kanner, published a paper which described a pattern of behaviours in several young boys who had normal intelligence and language development, but who also exhibited autistic-like behaviours and marked deficiencies in social and communication skills. Asperger’s paper, written in German and published during the Second World War, was largely ignored at the time. Asperger noted the similarities to Kanner’s Syndromem but also observed some major differences:

  • Asperger noted that his case-study patients spoke ‘like little adults’; while Kanner reported that 3 of his 11 patients did not speak at all, and the remainder rarely used language to communicate.
  • Asperger observed that both gross coordination and fine motor skills were affected, while Kanner reported that the former was poor and the latter was very good.
  • Asperger suggested that his patients were ‘abstract thinkers’ and therefore performed best spontaneously. Kanner believed that learning by rote would be the best method of advancing an autistic person.

Nowadays the label of Asperger Syndrome tends to be reserved for the rare intelligent and highly verbal, near-normal autistic child, which is not what Asperger intended.

Bettelheim (1944)

In 1944, American Bruno Bettelheim directed the Chicago-based Ortho-Genic School for children with emotional problems, placing special emphasis on the treatment of autism. Bettelheim believed that autistic children had been raised in unstimulating environments during the first few years of their lives, when language and motor skills develop. He saw parents who were unresponsive to their child as an underlying cause of autistic behaviour. Although subsequent studies of the parents of autistic children have discredited Bettelheim’s psychological explanation, his ideology carried into the general populace for generations to follow, causing offensive, red-herring terms like ‘refrigerator mother’.

Wing and Gould (1981)

With the extensive research work of Lorna Wing and Judith Gould in the late 1970s in Camberwell (UK), it became apparent that both the diagnoses of Kanner and Asperger were accurate. By examining a large sample of children in one area of London, Wing and Gould were able to show that Kanner’s Syndrome and Asperger’s Syndrome were both part of a range of disorders affecting social interaction and communication. This led to the notion of ‘autistic spectrum disorders’ and to the idea of a ‘triad of impairments’ that is commonly applied when dealing with social and communication problems presented in a child.

From the 1980s through the early 1990s, the cause, prognosis, and treatment of autism were vigorously studied. Research suggested that a genetic defect caused the disorder, which was presumed to be some form of auto-immune disease or degenerative disease of nerve cells in the brain. The preferred treatment for the autistic child was special education, stressing learning in small increments, and a strict behavioural control of the child. Since 1911, the understanding of autism has grown, but as yet there is no cure. While cure and recovery prospects for autism might have been the expectation of the 1980s and early 1990s, current expectations are more modest—the development of approaches that may enable the person with autism to lead a high-quality life.

The knowledge we currently have about autism springs from the various perspectives of biology, education, psychology, dietetics, first-hand experience, and art and literature. History has shown that autism has not ranked very highly in our cultural consciousness, as very few resources have been available to individuals with autism themselves, to families supporting autistic relatives or to researchers. While education for school children is available and improving, the service to enable ongoing education and support after school remains very limited.

For more information on the history of autism:
http://www.autisticsociety.org/article153.html
http://www.awares.org/static_docs/about_autism.asp?docSection=2
http://www.as-if.org.uk/history.htm

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