A Brief History of Asperger Syndrome

Pre-Industrial The history of Asperger syndrome dates to at least the 16th century when Johannes Mathesius (1504 — 1565), a compiler of the German monk Martin Luther (1483 — 1546), includes a story of a 12-year-old boy who may have been severely autistic in his Table Talk of Martin Luther. Mathesius notes that Luther thought the boy was a soulless mass of flesh possessed by the devil, and suggested that he be suffocated. In 1798 Victor of Aveyron, a feral child, was caught. The child showed several signs of autism. A medical student by the name of Jean Itard treated him using a behavioral program designed to help him form social attachments and to induce speech via imitation.

Early 20th Century Eugen Bleuler (1857 — 1939), a Swiss psychiatrist, in 1910 used autismus (English translation autism) to describe morbid self-admiration symptoms of schizophrenia. Bleuler wrote, autistic withdrawal of the patient to his fantasies, against which any influence from outside becomes an intolerable disturbance. The Austrian psychiatrist and pediatrician. Hans Asperger (February 18, 1906 — October 21, 1980) first used the word autism when he adopted Bleuler’s terminology autistic psychopaths in 1938 in a child psychology lecture at the Vienna University Hospital.

Leo Kanner In 1943 the Austrian-born child psychiatrist Leo Kanner (1894 — 1981) of the Johns Hopkins Hospital, described a syndrome known as classic autism or Kannerian autism, that is characterized by significant cognitive and communicative deficiencies, including delayed or absent language development. He introduced the label early infantile autism in the report of 11 children with striking behavioral similarities. Almost all the characteristics described in Kanner’s first paper on the subject, notably autistic aloneness and insistence on sameness, are still regarded as typical of the autistic spectrum of disorders. Kanner’s reuse of autism led to decades of confused terminology like infantile schizophrenia, and child psychiatry’s focus on maternal deprivation during the mid-1900s led to misconceptions of autism as an infant’s response to refrigerator mothers. Starting in the late 1960s autism was established as a separate syndrome by demonstrating that it is lifelong, distinguishing it from mental retardation and schizophrenia and from other developmental disorders.

Hans Asperger Hans Asperger was the director of the University Children’s Clinic in Vienna, spending most of his professional life in Vienna and publishing largely in German. In 1944, Asperger described in the paper ‘Autistic psychopathy’ in childhood four children in his practice who had difficulty in integrating themselves socially. Although their intelligence appeared normal, the children lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. Their speaking was either disjointed or overly formal, and their all-absorbing interest in a single topic dominated their conversations. Asperger called the condition autistic psychopathy and described it as primarily marked by social isolation. Asperger called his young patients little professors, and believed the individuals he described would be capable of exceptional achievement and original thought later in life. Asperger was unaware of Kanner’s description published a year before his because the two researchers were separated by an ocean and a raging war, and Asperger’s descriptions were ignored in the United States. During his lifetime, Asperger’s work, in German, remained largely unknown outside the German-speaking world. According to Ishikawa and Ichihashi in the Japanese Journal of Clinical Medicine, the first author to use the term Asperger’s syndrome in the English-language literature was the German physician, Gerhard Bosch. Between 1951 and 1962, Bosch worked as a psychiatrist at Frankfurt University. In 1962, he published a monograph detailing five case histories of individuals with PDD that was translated to English eight years later, becoming one of the first to establish German research on autism, and attracting attention outside the German-speaking world.

Lorna Wing and Uta Frith Lorna Wing is credited with widely popularizing the term Asperger’s syndrome in the English-speaking medical community in her 1981 publicationof a series of case studies of children showing similar symptoms. Wing also placed AS on the autism spectrum, although Asperger was uncomfortable characterizing his patient on the continuum of autistic spectrum disorders. She chose Asperger’s syndrome as a neutral term to avoid the misunderstanding equated by the term autistic psychopathy with sociopathic behavior. Wing’s publication effectively introduced the diagnostic concept into American psychiatry and renamed the condition as Asperger’s; however, her accounts blurred some of the distinctions between Asperger’s and Kanner’s descriptions because she included some mildly retarded children and some children who presented with language delays early in life. Asperger’s work became more widely available in English when Uta Frith, an early researcher of Kannerian autism, translated his original paper in 1991.

Distinct diagnosis AS became a distinct diagnosis in 1992, when it was included in the 10th published edition of the World Health Organizations diagnostic manual, International Classification of Diseases (ICD-10); in 1994, it was added to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as Asperger’s Disorder. Today AS is recognized as an important subgroup, however, questions remain concerning many aspects of AS. For example, whether it should be a separate condition from high-functioning autism is a fundamental issue requiring further study. There is little consensus among clinical researchers about the use of the term Asperger’s syndrome, and there are questions about the empirical validation of the DSM-IV and ICD-10 criteria. It is likely that the definition of the condition will change as new studies emerge and it will eventually be understood as a multifactorial heterogeneous neurodevelopmental disorder involving a catalyst that results in prenatal or perinatal changes in brain structures.

Reference Material modified from Wikipedia’s History of Asperger syndrome, Asperger syndrome, Autism, and Hans Asperger pages (GNU Free Documentation License) with addtional material from: Baron-Cohen, Simon; What’s so special about Asperger Syndrome?; Brain and Cognition; Volume 61, Issue 1, Pages 1-4; June 2006. Ami, Klin Ph.D. and Fred R., Volkmar M.D.; Editorial Preface; Journal of Autism and Developmental Disorders; Volume 35, Issue 2, Pages 141-143; April 2005.

~ by Phoenix on April 14, 2008.