A few examples of autistic symptoms and treatments were described long before autism was named. The Table Talk of Martin Luther, compiled by his notetaker, Mathesius, contains the story of a 12-year-old boy who may have been severely autistic. Luther reportedly thought the boy was a soulless mass of flesh possessed by the devil, and suggested that he be suffocated, although a later critic has cast doubt on the veracity of this report. The earliest well-documented case of autism is that of Hugh Blair of Borgue, as detailed in a 1747 court case in which his brother successfully petitioned to annul Blair's marriage to gain Blair's inheritance.The Wild Boy of Aveyron, a feral child caught in 1798, showed several signs of autism; medical student Jean Itard treated him with a behavioral program designed to help him make social attachments and to induce speech via imitation. Henry Cavendish, the English scientist and philosopher who discovered Hydrogen, is believed by Oliver Sacks to have been autistic. He lived a solitary life, spoke to very few people and most of his discoveries were only known to the public after his death.
The term autism first came to use in 1908 by psychiatrist Eugen Bleuler. He used it to describe one of his schizophrenic patients who had withdrawn into his own world. The Greek word ''autós'' meant self and the word “autism” was used by Bleuler to mean morbid self-admiration and withdrawal within one self. A Soviet child psychiatrist, Grunya Sukhareva, described a similar syndrome that was published in Russian in 1925, and in German in 1926.
The pioneers in research into autism were Hans Asperger and Leo Kanner. They were working separately in the 1940’s. Asperger described very able children while Kanner described children who were severely affected. Leo Kanner studied 11 children.The children had features of difficulties in social interactions, difficulty in adapting to changes in routines, good memory, sensitivity to stimuli (especially sound), resistance and allergies to food, good intellectual potential, difficulty repeating words and difficulties in spontaneous activity.Hans Asperger, working separately, studied a different group of children. His children also resembled Kanner’s descriptions. The children he studied, however, did not have echolalia (difficulty repeating words) as a linguistic problem but spoke like adults. He also mentioned that many of the children were clumsy and different from normal children in terms of fine motor skills.
Donald Triplett was the first person diagnosed with autism. He was diagnosed by Kanner after being first examined in 1938, and was labeled as "case 1". Triplett was noted for his savant abilities, particularly being able to name musical notes played on a piano and to mentally multiply numbers. His father, Oliver, described him as socially withdrawn but interested in number patterns, music notes, letters of the alphabet, and U.S. president pictures. By the age of 2, he had the ability to recite the 23rd Psalm and memorized 25 questions and answers from the Presbyterian catechism. He was also interested in creating musical chords.
Bruno Bettelheim studied the effect of three therapy sessions with children who he called autistic. He claimed that the problem in the children was due to the coldness and ill treatment of their mothers. He separated the children from their parents. Kanner and Bettelheim both worked towards making hypotheses that showed autistic children had emotionally distant mothers. Bernard Rimland was a psychologist and parent of a child with autism. He disagreed with Bettelheim. He did not agree that the cause of his son’s autism was due to either his or his wife’s parenting skills. In 1964, Bernard Rimland published a book - ‘Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior’.Child psychiatry's focus on maternal deprivation led to misconceptions of autism as an infant's response to "refrigerator mothers".
Autism came to be better known in the 1970’s. The Erica Foundation started education and therapy for psychotic children in the beginning of the 80s. As many parents still confused autism with mental retardation and psychosis.
It was in the 1980's that Asperger’s work was translated to English and published and only then did it come into public knowledge. It was in the 1980’s that research on autism gained momentum. It was increasingly believed that parenting had no role in causation of autism and there were neurological disturbances and other genetic ailments like tuberous sclerosis, metabolic disturbances like PKU or chromosomal abnormalities like fragile X syndrome.
Lorna Wing, along with Christopher Gillberg at BNK (Children's Neuro-Psychiatric Clinic) in Sweden in the 1980’s found the Wing’s triad of disturbed mutual contact, disturbed mutual communication and limited imagination (Triad of Impairment). In the 1990’s they added another factor making it a square. The factor was limited planning ability.
Ole Ivar Lovaas studied and furthered behavioural analysis and treatment of children with autism. Lovaas achieved limited success at first with his experimental behaviour analysis. He developed it to target younger children (less than 5 years of age) and implemented treatment at home with increased intensity (a measurement of the amount of “therapy time”) to about 40 hours weekly. Lovaas wrote ‘Teaching Developmentally Disabled Children: The Me Book’ in 1981. In 2002, Lovaas wrote, ‘Teaching Individuals With Developmental Delays: Basic Intervention Techniques’.
As late as the mid-1970s there was little evidence of a genetic role in autism, but in 2007 it was believed to be one of the most heritable psychiatric conditions. Although the rise of parent organizations and the de-stigmatization of childhood ASD have affected how ASD is viewed, parents continue to feel social stigma in situations where their child's autistic behavior is perceived negatively, and many primary care physicians and medical specialists express some beliefs consistent with outdated autism research.
It took until 1980 for the DSM-III to differentiate autism from childhood schizophrenia. In 1987, the DSM-III-R provided a checklist for diagnosing autism. In May 2013, the DSM-5 was released, updating the classification for pervasive developmental disorders. The grouping of disorders, including PDD-NOS, autism, Asperger syndrome, Rett syndrome, and CDD, has been removed and replaced with the general term of Autism Spectrum Disorders. The two categories that exist are impaired social communication and/or interaction, and restricted and/or repetitive behaviors.
The Internet has helped autistic individuals bypass nonverbal cues and emotional sharing that they find difficult to deal with, and has given them a way to form online communities and work remotely. Societal and cultural aspects of autism have developed: some in the community seek a cure, while others believe that autism is simply another way of being.
By Tritee Basu and Ahana Mukherjee
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