Caring for a child with autism

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2 Caring for a child with autism

3 Chapter 3 A concise history of autism To fully explain the development of ideas and understanding about autism, it is necessary to go back to the early twentieth century. Around this time a Swiss psychiatrist, Eugen Bleuler, first used the term autistic to describe the withdrawn behaviour found in schizophrenia. The word autism is derived from the Greek word for self, autos and refers to the tendency to retreat into a private world. Autism was not suddenly created with Bleuler s first use of the term. Autism as a condition undoubtedly existed in earlier centuries. Uta Frith (1989) in Autism: Explaining the Enigma provides a fascinating history and believes that accounts ranging from the blessed fools of Russia to abandoned children such as the wild boy of Aveyron are evidence of autism in earlier eras. Leo Kanner, an Austrian psychiatrist, is credited as the first person to use the term autistic to describe a group of children displaying signs of a unique syndrome, never formally recognised before. In a preliminary report, Kanner remarks that since 1938 a number of children has come to his attention, all under 12 years of age, and showing common characteristics. The paper, Autistic disturbances of affective contact, published in 1943, provides case studies of the children, and over fifty years later it still serves as a fascinating and informative account of the disorder. Kanner s conclusion shows a depth of understanding and an enlightened position, still supported today: 45

4 46 CARING FOR A CHILD WITH AUTISM We must, then, assume that these children have come into the world with innate inability to form the usual, biologically provided affective contact with people, just as other children come into the world with innate physical or intellectual handicaps For here we seem to have pure-cultural examples of inborn autistic disturbances of affective contact. (1943, p.50) Unbeknown to Kanner, working in Baltimore USA, similar conclusions were being drawn in Vienna. Hans Asperger had also discovered a group of children displaying particular features, indicative of a new syndrome. Asperger s first paper on the subject was published in 1944, just a year after Kanner. Within this work, Asperger described children who seemed unable to enjoy normal affective relationships with people. Like Kanner, Asperger believed the disturbance was present from the beginning of life. The children described in both papers all displayed problems of affective contact. However, the individuals in Asperger s paper spanned a wider range of abilities than Kanner s sample, and provided the earliest account of an autistic spectrum. Asperger syndrome is now a useful diagnostic label to describe individuals functioning at a higher level on the autistic spectrum. Despite the overlap in Kanner s and Asperger s work and the coincidental use of the label autism, their ideas were formed independently of each other, and the two never met. Asperger s paper, written in German towards the end of World War II, has received belated recognition only recently, whereas, Kanner s work in the USA was immediately acknowledged, and major clinics of the time responded with their own cases of autism. Important dates in the history of autism 1943 Kanner publishes first paper Autistic disturbances of affective contact to describe a unique disorder Asperger publishes first paper Autistic psychopathy in childhood and the notion of an autistic spectrum is suggested An article by Bruno Bettelheim is published, which suggests autism is caused by parents failure to bond with their children.

5 A CONCISE HISTORY OF AUTISM Parents in the UK form the Society for Autistic Children the world s first voluntary organisation for the condition (later renamed the National Autistic Society) Sybil Elgar opens the first NAS school. Bernard Rimland s text Infantile Autism argues that autism is organic in nature Victor Lotter s study into incidence rates is published. Lotter estimates that 4.5 children in every 10,000 will have autism. Division TEACCH (Treatment and Education of Autistic and Related Communication handicapped CHildren) is founded in North Carolina, USA Division TEACCH becomes the first comprehensive, state-wide, community-based programme of services Folstein and Rutter s study implicates a genetic basis for the cause of autism The Journal of Autism and Childhood Schizophrenia is renamed the Journal of Autism and Developmental Disorders. This signals an important shift in the classification of the condition. The results from Wing and Gould s Camberwell study lead to the use of the term the triad of impairments Autistic spectrum disorders are first recognised by the third edition of the Diagnostic and Statistical Manual (DSM III), an international system to classify disorders. Previously autism had been regarded as a psychosis and a form of schizophrenia Lovaas publishes results indicating that behavioural strategies can help the majority of children with autism. (See ABA entry in Chapter 13 Therapies and approaches ) Elliot House opens, the first centre in the UK to offer diagnosis, assessment and professional training in the field of ASDs An international consortium is established for research into genetics Autism-Europe s charter of rights is adopted as a written declaration by the European parliament MIND Institute, an American centre for research into neurological disorders, is established Following the Internet conference Autism99, autismconnect is launched ( providing a first port of call for anyone interested in autism.