The word 'Autism' was coined in 1911 by a psychiatrist named Eugen Bleuler, when he used the Greek word "Autos", which means self, to describe individuals who withdrew from social interaction with others. However, Bleuler's use of the term referred to schizophrenic individuals who displayed catatonic behaviors (later renamed "Catatonic Schizophrenia") and not to Kanner Autistic people as we think of them today. Bleuler is also credited with having coined the term Schizophrenia in April 1908. Before it had been labelled as an early form of dementia, but Bleuler realized the condition was neither a dementia, nor did it always occur in young people.
Eva Sukhareva, a Soviet child psychiatrist, was the first person to ever publish a detailed description of autistic symptoms in 1925. The original paper was in Russian and published in German a year later. Sula Wolff translated it in 1996 for the English-speaking world, 70 years later.
Sukhareva initially used the term "schizoid psychopathy", "schizoid" meaning "eccentric" at the time, but later replaced it with "autistic (pathological avoidant) psychopathy" to describe the clinical picture of autism. As Sukhareva’s autism research was translated and published in German-language journals within a year of its domestic publication in Russian, there existed no serious barrier to access of these materials by Asperger and Kanner. The precise reason for her extensive research remaining uncited in the work of these two scientists, however, cannot be precisely determined and is still a matter of discussion by experts.
In 1938, 13 years after Sukhareva's findings, a psychiatrist named Leo Kanner observed, for the first ever time, the behaviour of 11 children at the John Hopkins Hospital in Baltimore, USA. They had previously, and incorrectly, been described as either emotionally disturbed or intellectually impaired.
Although some of them seemed to fit into the latter category, there were also aspects of their behaviour and abilities which distinguished them apart. During the following five years Kanner researched the condition intensely. This research culminated in Kanner's 1943 publication called "Autistic Disturbance of Affective Contact". Kanner correctly wrote that Autism appeared to be an inborn developmental disability which affects the social and emotional understanding of those who have it. This was in complete and total contrast to Bleuler's Schizophrenia, which Bleuler noted, usually starts from the mid-teens onwards.
Kanner reported that 3 of his 11 patients never spoke at all and that other children did not use what language they had to communicate.
Kanner's findings did not generate a great deal of interest or response at the time, as the majority of people in the English speaking world had more things to worry about than Autism or any other psychiatric conditions, namely an event called the Second World War. In 1952, the 1st Edition of the DSM listed Autism under the heading of "Childhood Schizophrenia", but by the mid-1950's, professional interest and awareness of Autism was increasing in the USA, UK and Western Europe. When the 2nd Edition was published in 1968, it was listed as being a condition in its own right.
At the time of Leo Kanner's death, at the age of 86, on Saturday. 4th April 1981, he had the satisfaction of seeing his findings acknowledged and of Autism being accepted as a developmental condition, across the world.
Leo Kanner's account of a five-year-old boy called Donald is listed below. He was taken by his beleaguered parents to John Hopkins University in 1938. He acted like no five-year-old Kanner had ever seen before.
Kanner recalled of Donald that... "He wandered about smiling, making stereotyped movements with his fingers, crossing them about in the air. He shook his head from side to side, whispering or humming the same three-note tune constantly. He spun with great pleasure anything he could seize upon to spin. When he was taken into a room he completely disregarded the people and instantly went into objects, preferably those that could spin. He angrily shoved away the hand which was in the way or foot that stepped one of the blocks".
"He learned my name", Leo Kanner recounted decades later, "but he would never see me if he met me because he would never look up enough and had enough eye contact to recognize faces. ... Also, whilst he spoke, it was not for communication, and if in order to satisfy his needs some communication was needed, he would not be able to distinguish between the pronouns "I" and "you" rather echoing religiously some of the things that he was interested in".
"For instance, if he wanted milk, he remembered constantly that his mother always asked him, 'Donnie, do you want your milk?' And his way of asking for milk was 'Donnie, do you want your milk?' Well, this was only a part of some of his peculiar behaviour".
"Yet, strangely, by the age of two and a half he could name the presidents and vice presidents of the United States backwards and forwards and recite the 25 questions of the Presbyterian catechism".
In school, Fritz, according to Kanner, "He quickly became aggressive and lashed out with anything he could get hold of (once with a hammer). ... Because of his totally uninhibited behavior, his schooling failed on the first day. ... Another strange phenomenon in this boy was the occurrence of certain stereotypic movements and habits".
As with Donald, "The content of his speech was completely different from what one would expect of a normal child," Asperger said of Fritz. "Only rarely was what he said in answer to a question."
Kanner concluded these children had a psychological disorder called "Infantile Autism".
Leo Kanner noticed that the children all had the same traits. I have listed most of them below.
The children Kanner observed all failed to relate to people in a 'normal' fashion and appeared to be at their happiest when left alone. This lack of social responsiveness appeared to Kanner to start early in life as the Autistic infants failure to put his arms out to the parent who was about to lift him up.
The children were extremely upset by changes of routine or surroundings. A different route to school, a rearrangement of the furniture or moving of belongings would cause a severe temper tantrum or disturbance. The child would not be calmed until the familiar order was restored. Some of the children would perform some of their rituals at the same time of day.
The 11 children Kanner observed all showed an ability to memorize large amounts of effectively meaningless material such as an encyclopedia index page. This ability was out of line with their apparent severe mental handicap, or so it was believed.
The children repeated language they had heard but failed to use words to communicate beyond their immediate needs. The echolia probably explains the pronouns which Kanner remarked upon - that the children would use "you" when referring to themselves and "I" to other persons. The latter would nowadays be classed as an aspect of Semantic-pragmatic disorder. This usage would also follow from a direct repetition of the other speaker's remarks.
Leo Kanner noticed that many of the children reacted strongly to certain noises such as voices, vacuum cleaners, banging and bus engines.
This was shown in the children's repetitive movements, verbalisations and interests. Kanner reported that 3 of his 11 patients never spoke at all and that other children did not use what language they had to communicate. He also reported clumsiness in only one case of the Autistic children he saw and remarked upon the dexterity of four of the patients. He concluded that "Several of the children were somewhat clumsy in gait and gross motor performance but all were very skilful in terms of fine motor co-ordination". Kanner felt that the children showed a good relationship to objects and often showed surprising dexterity in spinning objects or solving jigsaw puzzles.
Other behavioural habits noticed by Kanner were a profound lack of emotion and a marked abnormality of speech. He was also struck by their alert, attractive and intelligent appearance.
