The History of Autism

Introduction

Science has come a long way since the year 1908 when autism was first discovered. Autism has been referred to as a range of neuropsychological conditions. But the question arises where and how did the term autism originate and how has it changed over time? Some people might think that autism is something which has been newly discovered, but the truth is it has been there on the books for the past 70 to 80 years, however it has become more prevalent now due to which our thinking about this condition has drastically changed as time passed by. Below are few key events in the history of autism.

Where did the term “autism” come from?

Autism basically comes from the Greek word which is “autos” and it means “self”. This word is known to describe the condition in which a person gets removed from social interactions. It would mean that he becomes an “isolated self”.  In the year 1908, the word autism was used as a description for a subset of schizophrenia patients. These patients were very self-absorbed and withdrawn, just keeping to themselves. A Swiss psychiatrist called Eugen Bleuler was among the first persons to use this term. Around the year 1911, he started to use this term whenever he would refer to a group of symptoms which were related to schizophrenia.

In the year 1943, Leo Kanner, an M.D from Johns Hopkins University, who was also an American child psychiatrist published a paper wherein it described around 11 children who were highly intelligent, but they started to display a powerful desire to be kept alone. Later on, he named this condition as “early infantile autism”. Those children started showing social as well as emotional problems.

Almost at this same time, in the year 1944, another German scientist by the name Hans Asperger also identified a similar condition which is now known as “Asperger’s Syndrome”. In this case, Hans described a milder form of autism as this syndrome. The cases which he had reported were of all boys who were highly intelligent, but they had trouble while carrying out social interactions or carrying out any other specific obsessive interest. Those boys whom Hans studied did not have echolalia or any kind of linguistic problem, but they spoke like grownups. Hans also mentioned that most of the children were looking clumsy and very different from the normal children, when it came to judging them on the fine motor skills.

Until the 1960s, the terms autism and schizophrenia remained linked in the minds of many of the researchers. Only after this, the medical professionals started to have a separate understanding of autism when it came to children. In the year 1967, a famous psychologist named Bruno Bettelheim popularized a theory wherein “refrigerator mothers” as he had given them the term lead to autism in their children by not loving them enough. However, this is not the truth. Both Kanner and Bettelheim worked on making the hypothesis that had shown autistic children having frigid parents. Post the completion of the World War II, there was a lot of psychoanalytic work which was carried out on autism, wherein researchers solely looked at the impact of the experiences of life. In such cases, the role of genetics or biology was not considered much. By now, the scientists could make out that there is no link between schizophrenia or autism.

Another psychologist by the name Bernard Rimland, who also was a parent to an autistic child disagreed with the thesis of Bruno. He did not agree to the reasoning that the main cause of his own son’s autism could be due to either his or his wife’s parenting abilities or skills. In the year 1964, Bernard published “Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior.” The medical condition was better known in the 1970s. A foundation known as The Erica Foundation started its own education as well as therapy for psychotic children during the beginning of the 80s. Many parents at that time still confused autism with psychosis or mental retardation.

In the year 1977, a research which was conducted on twins found out that autism was mostly caused by the genetic as well as biological differences which happen during brain development. Hence, one can say that in the 1960s and 1970s, the research into the treatment of autism was mainly focused on its medications such as electric shock, any kind of behavioral techniques and LSD. The behavioral change technique was more reliant on pain as well as punishment.

In the year 1980, in one of the Diagnostic and Statistical Manual of Mental Disorders or DSM, infantile autism was listed for the very first time. This condition officially seemed to be separated from another condition called childhood schizophrenia. In the year 1987, the DSM then replaced infantile autism with a much more expansive definition known as autism disorder, wherein it also includes a checklist of diagnostic criteria.

One of the first studies was published by one of the UCLA psychologists, Ivar Lovaas, a renowned doctorate holder. It was their first study which showed how intensive behavior therapy would help the children suffering from autism, thereby providing a new lease of life and hope to their parents.

In the year 1988, there was a movie released starring Dustin Hoffman called Rain Man. Dustin was starring as an autistic savant who also had a photographic memory and was very much good at calculating huge form of numbers quickly in his mind. This movie basically served to raise public awareness with regards to the autism disorder. However, not every kid suffering from autism would have skills of that level. Around the 80s, Asperger’s work was translated into English and published as well, coming into light. Also, it was during this period that the research on autism started gaining momentum. It was also believed that parenting had no role in causing autism in any way. 

Ole Ivar Lovaas also studied as well as furthered the behavioral analysis as the treatment of those children having autism. Ole did gain success, but limited at first with this kind of experimental behavior analysis. He further developed the analysis to target the younger children who were less than five years of age and also implemented home treatment along with increasing the intensity to approximate 40 hours on a weekly basis. This is basically the time which should be given for therapy sessions for an autistic child.

Ole wrote two books on autism techniques and development. In 1981, he wrote “Teaching Developmentally Disabled Children: The Me Book” and in the year 2002 he wrote another book titled “Teaching Individuals with Developmental Delays: Basic Intervention Techniques”. In the year 1991, the then government made autism as one of the special education categories, wherein even public schools would identify such special children on the spectrum and offer them certain special services.

Asperger’s syndrome was made part of the DSM in the year 1994. This lead to expanding the autism spectrum so as to include the cases which are mild and wherein the individuals would tend to offer certain special services. In the year 1998, a myth started doing the rounds wherein it was said that mumps, measles, rubella or the MMR vaccine would lead to autism. This was published as a study in The Lancet, but later on the vaccine and autism link was debunked. During the year 2000, there was another myth attached to a vaccination and autism linkage due to which the vaccine manufacturers had to remove thimerosal, which is a mercury based preservative. It was completely taken off from all the routinely provided vaccines to the children due to the fear of public. Later on, this myth was also debunked.

In short to summarize, during the 1980s and 1990s, the role of behavioral therapy as well as the use of high controlled learning environments stood out as a primary treatment for various forms of autism as well as its related conditions. Today, the cornerstone of autism therapy is said to be two important therapies. One is language therapy and the second being behavioral therapy. There are other kinds of treatments which are also required for autism.

In the year 2009, as per the United States Centers for Disease Control Prevention or the CDC, it was estimated that one in 100 children were suffering from autism spectrum disorder. This number had seen an up from 1 in 150 children in the year 2007. The CDC reports that this increase is at least in parts due to improved screening as well as various diagnostic techniques. In the year 2013, the DSM folded all the subcategories of the conditions into one umbrella of diagnosis for autism spectrum disorder. Now, Asperger's Syndrome is no longer considered to be a separate form of this condition. The autism spectrum disorder has been categorized into two, one being the impaired social communication and the second being the restricted or repetitive form of behavior.

Symptoms

One of the common symptoms which is mostly associated with all types of autism is an inability to communicate easily with others. They also lack the skill of social interaction. In certain cases, people suffering from autism do not communicate at all, while some others have a hard time to interpret body language which is also termed as a form of non-verbal communication. There are certain individuals who find it difficult to hold a conversation.

Few of the other symptoms which are linked with autism can include unusual form of behaviors in any of the below areas:

• Physical form of coordination
• Interest in certain objects or specialized information
• Reactions to certain sensations

Most of these symptoms can be identified in the early days of development in the child. In most cases for children who suffer from severe autism, they can be diagnosed only by the age of 3.

Types

With the passing of time, psychiatrists have developed a systematic way of further describing autism and all of its related conditions. All of such similar conditions are basically placed within a group of conditions which is known as Autism Spectrum Disorders. Based on the severity of the symptoms, they are then classified as various levels such as 1, 2 or 3. There was a term called as Pervasive Development Disorder which was used in the initial times, but now it is no longer used. Hence if the child earlier was called as PDD, then in the new criteria it would be diagnosed as Autism Spectrum Disorder.

Causes

There is no known cause for autism, it is said to run in the family. Many of the researchers agree that the cause can be most likely linked with genetics, biochemical, metabolic and neurological. There are few other researchers who believe that environmental factors also play a role.

Treatment

Based on the need of the individual person, the treatment for autism would be prepared. However, treatment for autism can be generalized into four different categories.

• Medical and dietary change therapy: The main goal here is to make it easier for the individual to take part in various activities.
• Complementary therapy which consists of music therapy or art therapy: These treatments help to increase the communication as well as learning skills in the autistic individual.
• Behavioral therapy and communication therapy: This treatment would include programs which are designed to address the various key areas. Few of those areas are communication, social skill and sensory.
• Occupational therapy and physical therapy