12 Dec

Excerpts from “I Am Not Broken”
By : Eric Garcia
National Journal, 9 Dec 2015

PSY­CHI­AT­RIST EU­GEN BLEULER first used the word “aut­ism” in 1910; he viewed it as a symp­tom of schizo­phrenia.

Thirty-three years later, a child psy­chi­at­rist at Johns Hop­kins Uni­versity Hos­pit­al named LEO KANNER in­tro­duced his work on early in­fant­ile aut­ism. His first ma­jor study on the sub­ject was based on ob­ser­va­tions of 11 chil­dren—eight of them verbal and three of them what he called “mute.” He found that all the chil­dren had strong in­tel­lec­tu­al ca­pa­city and “ex­cel­lent rote memory,” which en­abled them to mem­or­ize things like a French lul­laby, Psalm 23, or an in­dex page of an en­cyc­lo­pe­dia.

But he also noted that when they formed sen­tences, these sen­tences were par­roted re­pe­ti­tions of pre­vi­ously heard word com­bin­a­tions. Loud noises and mov­ing ob­jects, he found, caused the chil­dren great dis­tress. In ad­di­tion, he noted that “the child’s be­ha­vi­or is gov­erned by an anxiously ob­sess­ive de­sire for same­ness.”

Around the same time, an­oth­er doc­for—HANS ASPERGER was conduct­ing his own work across the At­lantic in Vi­enna, on what he called “aut­ist­ic psy­cho­pathy.” In a 1944 study, As­per­ger no­ticed pat­terns in the boys he ob­served, in­clud­ing “a lack of em­pathy, little abil­ity to form friend­ships, one-sided con­ver­sa­tion, in­tense ab­sorp­tion in a spe­cial in­terest, and clumsy move­ments.”

As­per­ger saw “aut­ist­ic psy­cho­pathy” as something that oc­curred across a wide vari­ety of people. By con­trast, ac­cord­ing to Steve Sil­ber­man, au­thor of Neur­o­tribes: The Leg­acy of Aut­ism and the Fu­ture of Neurodi­versity, Kan­ner saw aut­ism as a very rare form of child psy­chos­is and “framed his pa­tients as a strictly defined and mono­lith­ic group, to the point of be­ing will­ing to over­look sig­ni­fic­ant dif­fer­ences between them.”

Dur­ing the last leg of World War II, a school As­per­ger had opened for chil­dren with “aut­ist­ic psy­cho­pathy” was bombed, des­troy­ing much of his re­search. As­per­ger con­tin­ued work­ing after the war and lived un­til 1980, but much of his writ­ing went un­trans­lated from its ori­gin­al Ger­man.

Then, in 1981, LORNA WING, a doc­tor work­ing in the United King­dom and the moth­er of a daugh­ter with aut­ism, used As­per­ger’s 1944 study—which “had nev­er been trans­lated in­to Eng­lish,” ac­cord­ing to Sil­ber­man—as the basis for her own study, “As­per­ger Syn­drome: A Clin­ic­al Ac­count.” Wing’s work was in­stru­ment­al in shap­ing dis­cus­sions about the aut­ism spec­trum.

Here in the United States, the Amer­ic­an Psy­chi­at­ric As­so­ci­ation did not have sep­ar­ate cri­ter­ia for dia­gnos­ing “in­fant­ile aut­ism” in the Dia­gnost­ic and Stat­ist­ic­al Manu­al of Men­tal Dis­orders un­til 1980; and it wasn’t un­til 1987, that there was an ex­pan­ded dia­gnos­is for “aut­ist­ic dis­order.”

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