First English citation of "autism" (August 1912) - caution, long response ahead!

[Millie Webb]

----- Original Message -----
From: "Chuck Borsos" <sqeezbox at CRUZIO.COM>
To: <ADS-L at LISTSERV.UGA.EDU>
Sent: Sunday, December 15, 2002 1:13 AM
Subject: Re: First English citation of "autism" (August 1912)


> The contemporary usage of autism can be traced back to the
> descriptions of Leo Kanner and Hans Asperger in the 1940's.  This
> usage of autism is distinguished from Bleuler's usage, (although it
> seems to have been derived from Bleuler).


Actually, it was used almost exclusively for Kanner's autism (also called
"classic autism" or "childhood autism" -- the latter less accurately, for
reasons given in Firth's citation in this reply), because Hans Asperger's
work was largely ignored for more than thirty years: in part because it was
never published in English.  Uta Firth (cited below) was the first to
undertake a translation of Asperger's work (if I recall correctly).

 > Quoting Uta Firth, Autism: Explaining the Enigma, pg.7:
>
>     "Any treatment of the topic of childhood Autism must start with
> the pioneers Leo Kanner and Hans Asperger who, independently of each
> other, first published accounts of this disorder.  These
> publications, Kanner's in 1943 and Asperger's in 1944, contained
> detailed case descriptions and also offered the first theoretical
> attempts to explain the disorder.  Both authorities believed that
> there was present from birth a fundamental disturbance which gave
> rise to highly characteristic problems...."

>     It seems a remarkable coincidence that both chose the word
> 'autistic' in order to characterize the nature of the underlying
> disturbance.  In fact, it is not really a coincidence, since the
> label had already been introduced by the eminent psychiatrist Ernst
> Bleuler in 1911.  It originally referred to a basic disturbance in
> schizophrenia (another term coined by Bleuler),namely the narrowing
> of relationships to people and to the outside world,

Indeed it is remarkable, especially since they did not seem to equate the
syndromes they were describing, which are now more accurately referred to as
points on the "autistic spectrum", or "autistic spectrum disorders".  Of
course, most experts now agree that autism has little or nothing to do with
schizophrenia (the definition of which has also changed greatly since
1911!).  Schizophrenia seems controllable with medications (when
consistently taken, whether symptom-free or not), while there is little
evidence medication can help much in autistic spectrum disorders, except to
treat symptoms of loosely associated mental illnesses, such as obessive
compulsive disorder, chronic depression, anxiety disorders, or bipolar
disorder.  Most high-functioning "Aspies" (people with Asperger Syndrome)
are very aware that there is something very different about them, that makes
them seem odd to other people, but they cannot really define what it is or
how to effect change until behavioral strategies have been introduced and
consistently reinforced.   Many people with "Kanner's autism" are not aware
enough of other people and social mores to realize that they appear very
odd.  (Which is kind of a blessing, because it also does not therefore,
bother them and make them anxious.)

> Incidentally, I believe that Kanner and Asperger (as well as Rett,
> who described Rett Syndrome, which is a degenerative condition
> similar in some ways to Autism), were all Viennese trained, though
> Kanner worked in the United States (at John Hopkins if I remember
> right).
>
> Chuck Borsos
> Santa Cruz, CA
> --
>
Rett syndrome does cause similar symptomology, but seems to be progressive
and unstoppable.  Most points on the autistic spectrum are more fluid, and
coping strategies can be taught, once the differences in thinking patterns
have been recognized for what they are.  The biggest differences between
"high functioning autism" and Asperger Syndrome, btw, seem to be that the AS
child does not necessarily have ANY delay in speech acquisition (and in
fact, may speak exceptionally early, but have a very flat intonation -- my
sister used to say our son "talked like a robot" when he was two to three
years old), tend to have very high IQ's, read early, become almost
obsessively preoccupied with one topic over anything else in their world
(ceiling fans, dinosaurs, air vent covers, train schedules), are more aware
of their "oddness", and withdraw from others because they do not know what
to do in social situations and are "hurt" emotionally a lot.

If Asperger had worked in the US after the war, like Kanner did, we would
never have had to wait over forty years for his work to be translated and
recognized for the breakthrough it represented.  His clinic in Austria was
bombed several times, and virtually closed in 1945 when he lost his most
gifted and empathetic nurse to an air raid.  He kind of "dropped off the
radar" until Uta Firth translated much of his work and notes around 1984.
AS still was not widely recognized until the mid-1990's, when more
researchers picked up on it too, and started publishing more about it.
Children with AS are typically not diagnosed at all until around first
grade, when people finally start figuring out that their sensory
disintegration and behavior issues are actually cognitive and biological,
and not willful immaturity.  I personally know several Aspies who were not
diagnosed until around age ten or twelve in the late 1990's.

As you have ascertained by now, our son has Asperger Syndrome.  We know way
more about it now (he was diagnosed at six, and is now seven-and-a-half)
than we ever would have expected to know about autism at all.  His IQ is
over 140, but he has a rough time in school because his senses get
overwhelmed and he shuts down.  We found after his diagnosis that we had
already been automatically applying some of the strategies suggested to help
him cope, so he is well on his way now to at least appear "neuro-typical" by
the time he hits adolescence (when hormones gone ballistic may throw him
into it all over again).  But we will always have to watch him for
depressive episodes, and for bipolar tendencies.  As for the obsession with
one particular topic?  His happens to be dinosaurs, but is branching out
into dragons and the Middle Ages now.  Can anyone think of a particularly
"odd" professor you have ever had, who seemed obsessed with one small part
of one subspecialty of his or her field?  We probably all can (three-volume
grammars of obscure and dying Australian aboriginal languages, anyone?).  A
friend of mine (with an autistic math whiz) calls universities "protected
workshops for autistics".  :-)   -- Millie