The History Of Autism
It has been more than 50 years since Leo Kanner first described his classic autistic syndrome. Since then, the results of research and clinical work have helped us learn more about autism. More and more people are being diagnosed as autistic, although we still have a long way to go in creating a world that works for autistic people.
Read our charity’s timeline below to explore;the history of autism, meet some of our;’autism pioneers’ and find out more about the incredible work they’ve done.
Autistic People May Act In A Different Way To Other People
Autistic people may:
- find it hard to communicate and interact with other people
- find it hard to understand how other people think or feel
- find things like bright lights or loud noises overwhelming, stressful or uncomfortable
- get anxious or upset about unfamiliar situations and social events
- take longer to understand information
- do or think the same things over and over
If you think you or your child may be autistic, get advice about the signs of autism.
Restricted Or Repetitive Patterns Of Behavior Or Activities
These can include:
- an increase or decrease in sensitivity to specific sensory information from their surroundings, such as a negative reaction to a specific sound
- fixated interests or preoccupations
Autistic people are evaluated within each category, and the intensity of their symptoms is noted.
To receive an autism diagnosis, a person must display all three symptoms in the first category and at least two symptoms in the second category. Get more information on symptoms and how they may manifest in kids.
The exact cause of ASD is unknown. The most current research demonstrates theres no single cause.
Some suspected risk factors for ASD include:
- having an immediate family member whos autistic
- genetic mutations
An ASD diagnosis involves several screenings, genetic tests, and evaluations.
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What Is Autism Spectrum Disorder
Autism spectrum disorder is a developmental disability;that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.
A diagnosis of ASD now includes several conditions that used to be diagnosed separately: autistic disorder, pervasive developmental disorder not otherwise specified , and Asperger syndrome. These conditions are now all called autism spectrum disorder.
Autism As A Social And Emotional Disorder
Autism was first characterized as a social and emotional disorder in 1943 by Dr. Leo Kanner, a child psychiatrist in the United States. In a paper published in the journal Nervous Child titled Autistic Disturbances of Affective Contact, Kanner describes a distinct syndrome characterized by children who are highly intelligent but have tendencies towards social withdrawal with emotional limitations.
Meanwhile, across the Atlantic in Germany, Hans Asperger was defining a different form of autism. Asperger published his autism psychopathology article in 1944, describing autism as a disorder of normal intelligence children who have difficulties with social and communication skills. Later thought of as a milder form of autism and now commonly known as Aspergers disorder, children with Aspergers tend to suffer similar challenges with social interactions but do not have the same language development challenges often found in Kanners disorder.
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Changes In Meaning Of The Word Autism After Kanner
Above and beyond the distinctionbetween the concept that Bleuler coined the word “autism” to labeland the syndrome that is the subject of thisdocument, the syndrome has been broadened somewhat since Kannerfirst published his paper. Kanner reported a rate of occurrence of1 in 10000 whereas the ASA states the rate as 15 in 10000. Kannerfirst identified people who were clearly not mentally retarded. Sincethen, it has been observed that some mentally retarded people haveautistic symptoms whereas others don’t; so it is thought that theconditions overlap. This explains some of the difference in thereported rates of occurrence, though some now claim that itdoesn’t fully explain it.
Other terms that have been applied to what we now call “autism”.Childhood schizophrenia, infantile autism, Aspergers Syndrome,Kanner’s Syndrome. Probably lots of autistic people used to betermed retarded, or schizophrenic, though obviously those terms were not as specific as our current “autism” label.
A Surprising New Historical Analysis Suggests That A Pioneering Doctor Was Examining People With Autism Before The Civil War
Billy was 59 years old that spring or summer of 1846, when a well-dressed man from Boston rode into his Massachusetts village on horseback, and began measuring and testing him in all sorts of ways. The visitor, as we imagine the scene, placed phrenologists calipers on his skull, ran a tape measure around his chest and asked many questions relating to Billys odder behaviors. It was those behaviors that had prompted this encounter. In the parlance of the mid-19th century, Billy was an idiot, a label that doctors and educators used not with malice but with reference to a concept that owned a place in the medical dictionaries and encompassed what most of us today call, with more deliberate sensitivity, intellectual disability.
But what diagnosis might have fit better? If Billy were alive today, we think his disability, and that of others documented then in Massachusetts, would likely be diagnosed as autism. True, the actual word autism did not exist in their time, so neither, of course, did the diagnosis. But that does not mean the world was empty of people whose behaviors would strike us, in 2016, as highly suggestive of autistic minds.
Like that man on the horse, whose devotion to hard data, fortunately for detectives of autism history, was far ahead of his time.
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What Is Meant By The Autism Spectrum
When actress Jenny McCarthy discovered her son Evan had autism, as she tells it, she immediately envisioned scenes from Rain Man . In it, Dustin Hoffman portrayed an emotionally detached man having meltdowns over innocuous things like pancakes and missing an episode of Peoples Court.
In a 2008 interview McCarthy described the day her doctor gave her the news: I just stared at the doctor while remembering all the signs that led up to this moment. I felt each membrane and vein in my heart shattering into a million pieces. Nothing prepared me for this. I couldnt breathe. I wanted it gone. . . I looked at the doctor with pleading, tearful eyes. This cant be.
But as fate would have it, her deepest concerns were not at all what came to pass: McCarthy followed up by saying, He is very loving and sweet and not anything like Rain Man.
No, Evan wasnt like Rain Man, not exactly. Thats the uniqueness of autism spectrum disorder : no two people are affected in the exact same way. As the saying goes, If youve seen one child with autism, youve seen one child with autism.;
Why is it so unpredictable and the effects so wide-ranging? Thats not completely understood. What is known is that ASD, while having some common and identifiable characteristics, will express itself differently in each person. The degree of severity will vary and the behaviors associated with the disorder will differ, often dramatically.
This is the gist of what is meant by the spectrum.
Continued Use Of The Name
Despite being excluded from the DSM-5, Asperger’s syndrome sometimes is still used in both the United States and in other countries. A common reason for this is that a diagnosis of ASD can carry stigma, and people who were previously diagnosed with Asperger’s syndrome may still identify with the term and prefer it.
A 2017 study analyzing the effect of removing Asperger’s syndrome from the DSM found the change “has the potential to threaten the identity of those affected,” citing autism as a stigmatizing diagnostic label. Some advocacy groups and organizations continue to use the term as well, at least in part because some people continue to identify as having Asperger’s, not autism.
Even so, medical consensus continues to move away from the Asperger’s syndrome diagnosis. Following the DSM’s lead, the 11th revision of the International Classification of Diseases , to take effect on January 1, 2022, has moved Asperger’s syndrome under the autism spectrum disorder umbrella. The ICD-11 will be used by all World Health Organization member states.
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The Triad Of Impairments
- In 1979 Lorna Wing and Judith Gould examined the prevalence of autism, as defined by Leo Kanner, among children known to have special needs in the former London Borough of Camberwell.
- They found a prevalence in those with IQ under 70 of nearly 5 per 10,000 for this syndrome, closely similar to the rate found by Lotter. As well as;children with Kanner autism, Wing and Gould also found a larger group of children who had difficulties with;social interaction, communication and imagination , as well as;a repetitive stereotyped pattern of activities.;
- Although these children did not fit into the full picture of early childhood autism as described by Kanner, they were described as being on the;broader ‘autism spectrum’. The total prevalence rate for all autistic children with special needs in the Camberwell study was;approximately 20 in every 10,000 children . Gillberg et al in Gothenburg, Sweden, found very similar rates in children with learning disabilities.
- Other studies in different countries have also looked into;autism and numbers of autistic children;. These results range from 3.3 to 60.0 per 10,000. This could be;due to differences in definitions or case-finding methods .
The More Modern Meaning Of Autism Takes Shape
It wasnt until 1938 that Autism started to take on a more modern meaning and separation from schizophrenia. This;evolution was;because of Hans Asperger of the Vienna University Hospital’s research in investigating what came to be known as Asperger syndrome.
In 1943, Autism became even more defined when Leo Kanner came up with early infantile autism to describe the behavioral similarities in 11 children he was working with. Some of the behaviors these children shared were autistic aloneness and insistence on sameness.
Between Kanners diagnosis in 1943 and the late 1960’s, there was a lot of confusion around the term Autism, with it getting mixed up with terminology like infantile schizophrenia.
However, in the late 60s to mid 70s, autism started to get more attention, research, and definition. However, some of this research was very off the mark.
An example of this inaccurate research was done by Bruno Bettelheim, who believed that autism was caused by unloving, cold mothers. He coined the term refrigerator mothers, to describe these mothers.
This was countered by Bernard Rimland, who was a psychologist with an autistic child. In 1964, he published Infantile Autism: The Syndrome and its Implication for Neural Theory of Behavior that helped define and direct research at that time.
Treatments used in the 60s and 70s consisted of LSD, electric shock, and behavior change that focused on pain and punishment.
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History Of Autism: Timeline And Diagnosis
Autism diagnosis has changed drastically over the years. Today, the DSM-5 describes the condition as autism spectrum disorder. Here is a timeline of events that lead to this diagnosis.
1911: Eugen Bleuler , a Swiss psychiatrist, was the first person to use the term autism to refer to a group of symptoms related to schizophrenia. The word autism comes from the Greek word autos, which means self.
1926: In a scientific German psychiatry and neurology journal , a child psychiatrist from Kiev, Russia, Grunya Sukhareva, wrote about six children with autistic traits.
1943: Leo Kanner, Austrian-American psychiatrist, published a paper about 11 children with high intelligence but who displayed a desire for aloneness and obsessive insistence on sameness. He later described their condition as early infantile autism.
1944: Hans Asperger, an Austrian pediatrician, described a milder form of autism, which is known as Aspergers Syndrome. He reported cases where the patients were all boys and had high intelligence but had problems in social interactions.
1967: Bruno Bettelheim, an Austrian-born psychologist, popularized the theory that autism was the result of cold and inattentive mothers, coining the term refrigerator mothers. This theory has been debunked solidly. At this time, researchers did not consider the biology or genetics involved, but only looked at the impact of life experiences.
History Of Autism Science
Autism Spectrum Disorder might seem to be a fairly new condition, yet written evidences of its existence can be found as far back as the 1700s. The word Autism was coined after the Latin word Autismus in 1910 by Swiss psychiatrist Eugen Bleuler; however he applied the word to describing schizophrenia. The Latin word was in turn was derived from a Greek word, autos, meaning self. Once the condition we now know as autism was discovered in 1938, it was labeled with Bleulers word because people who are autistic have been observed to be morbidly self-absorbed to the exclusion of everyone else around them.
In 1938, a psychiatrist from Vienna University Hospital, Hans Asperger, adopted the term autistic psychopaths to what he was researching then, which is now known as Asperger Syndrome. It was not until 1981 that Asperger Syndrome became a specific classification within the autism spectrum.
In 1943, a psychiatrist from John Hopkins University, Leo Kanner, used the term autism in the modern sense. He then made a new classification which he called the Early Infantile Syndrome or Kanner Syndrome. It came about during his observation of 11 children who displayed similar symptoms. He described them as acting with autistic sameness and insistence on sameness.
Up to this day, there is still no scientifically proven single cause of autism.
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How History Forgot The Woman Who Defined Autism
Grunya Sukhareva characterized autism nearly two decades before Austrian doctors Leo Kanner and Hans Asperger. So why did the latter get all the credit?
by Lina Zeldovich;/;7 November 2018
It was 1924 when the 12-year-old boy was brought to the Moscow clinic for an evaluation. By all accounts, he was different from his peers. Other people did not interest him much, and he preferred the company of adults to that of children his own age. He never played with toys: He had taught himself to read by age 5 and spent his days reading everything he could instead. Thin and slouching, the boy moved slowly and awkwardly. He also suffered from anxiety and frequent stomachaches.
At the clinic, a gifted young doctor, Grunya Efimovna Sukhareva, saw the boy. Caring and attentive, she observed him with a keen eye, noting that he was highly intelligent and liked to engage in philosophical discussions. By way of a diagnosis, she described him as an introverted type, with an autistic proclivity into himself.
In 1925, Sukhareva published a paper describing in detail the autistic features the six boys shared. Her descriptions, though simple enough for a nonspecialist to understand, were remarkably prescient.
A Spectrum Disorder Is Variant Enough For The Definition To Change Over Time
In the earliest years experts believed that autism was somehow directly linked to schizophrenia; its now understood that this is not at all the case. Others may even wrongly assume that autism is an organic disease; not a disease in the same sense we typically think of disease.
General consensus among practitioners today, however, is that its a neurological condition affecting a persons ability to develop normally, and is likely rooted in a combination of unknown genetic irregularities, and possibly even some environmental factors.
Taking all the research gathered over the last century, combined with all the clinical observations described to date, we arrive at our current understanding of autism as a spectrum disorder with a wide range of cognitive variations, behaviors and expressions.
Is that the end of the story? Not likely. As the field of genetic science continues to develop, and science unravels the mysteries of human development, its more than possible that the umbrella of what we call autism spectrum disorder today will one day be deconstructed into more refined categories and perhaps removed from the DSM-5 all together.
For now, this is where autism lies on the spectrum of human understanding.
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First Accounts Of Autism: Defining Characteristics
It is likely that autism has existed through the ages, but the first ever clinical account of the disorder was published by Dr. Leo Kanner in 1943.3 Dr. Kanner, who developed the first child psychiatric service at a U.S. hospital, described a group of 11 children eight boys and three girls who had “autistic disturbances of affective contact.”4
Dr. Kanner based his report on direct observation, and much of what he set down has stood the test of time. He vividly depicted the essential features of autism, all of which are echoed in current-day diagnostic manuals. It is interesting to note that, just as in Kanner’s study, the rate of autism in males continues to be much higher than the rate in females.
Hans Asperger, an Austrian pediatrician, was working at nearly the same time as Kanner with a similar group of children on the other side of the Atlantic. A milder form of autism, Asperger syndrome, was named after him.
How Does Autism Affect Adults
Families who have autistic loved ones may worry about what life with ASD looks like for an adult.
Some autistic adults go on to live or work independently. Others may require continued aid or support throughout their lives. Each autistic person is different.
Introducing therapies and other remedies early in life can help lead to more independence and better quality of life.
Sometimes autistic people dont receive a diagnosis until much later in life. This is due, in part, to a previous lack of awareness among medical practitioners.
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