Historical Perspective

Historical Perspective There has been tremendous progress made in the field of autism over the last six decades. While it was once a syndrome that was rarely discussed in public, we find information about autism spectrum disorder (ASD) all around us today — on television and radio, websites and internet searches, public service announcements, and in the views of celebrities sharing their stories. Political leaders discuss the importance of autism diagnosis, cause, and cure, and have earmarked federal dollars for research and treatment initiatives that will be instrumental in furthering the field in the years to come. Before discussing the current state of autism, however, let’s briefly review the history of this disorder and what we have learned over the years. In 1943, a doctor named Leo Kanner began observing a group of children who were previously thought to have mental retardation. He noticed that these children had difficulty developing speech, and did not socially interact with their peers. He also noted that these children engaged in ritualized and/or repetitive behaviors to the exclusion of other activities. These children had difficulties with transitions, and did not like changes in their routines or schedules. Some of them experienced regression in their functioning over time, losing skills that had been established previously. We know Kanner’s description will be familiar to you if you are a parent, caregiver, or teacher of a child on the autism spectrum. At the time, treatment for autism was very limited. Most of these children were placed in institutions, far from the public eye, to live out their lives. Professionals commonly held the view that “refrigerator mothers” were responsible for the symptoms observed in these children. Deficits in the children’s functioning were assumed to be linked to poor attachment and/or absentee parenting (Bettleheim, 1967). Because parents were often blamed for their children’s disorders, many experienced great shame for having a child with ASD. Much has changed in the last six decades. We now know that autism, a neurodevelopmental disorder, is most likely caused by a combination of genetic and environmental factors. Although we would like to think that parents are no longer blamed, all-too-frequent examples demonstrate how autism is still widely misunderstood. Around the same time that Kanner was identifying symptoms of autism, pediatrician Hans Asperger was studying another group of children (Wing & Gould, 1979). These boys and girls were also having problems in social interactions with their peers. Like their counterparts, they exhibited behavioral problems commonly seen in children with autism. However, this group of children did not have deficits in speech and language formation. In fact, these children often spoke early and frequently. They also did not display deficits in adaptive functioning. In other words, these children could feed themselves, dress themselves, participate in their personal care, and function independently in the community. Unlike the group that Kanner observed, most of these children did not have lowered cognitive abilities. They were often very bright and had specific areas of interest in which they could amass large amounts of information. Unfortunately, Asperger’s research was not discovered until three decades later. It was reintroduced to the field when other individuals interested in ASD began questioning the diagnostic criteria that were used at the time. His work has made a tremendous difference in the way we have come to view and understand the autism spectrum.