The Evolution of Autism

History of Autism

Assuming that Autism is a neurological disorder and not caused by “bad” parenting or environmental toxins then it has, most likely, always existed among human beings; however, it was not scientifically described or empirically researched until the 20^th century.

Early 1900s

In the early 1900s autism was thought to be a form of childhood schizophrenia, feeble-mindedness, or childhood psychosis.

The term autism was first used by the Swiss psychiatrist Paul Eugen Bleuler between 1908 and 1912. He used it to describe schizophrenic patients who had withdrawn from social contact, appeared to be living in their own world, and were socially disconnected. The root of the word autism is derived from the Greek “autos” which means “self”. That root is combined with the Greek suffix “ismos,” meaning the act, state, or being of. Bleuler used the word “autism” to mean morbid self-admiration and withdrawal into self. It suggests a state of being absorbed by oneself, lost in oneself, removed from social interaction, and isolated from social interaction. While Bleuler described and documented characteristics of autism, his adult patients were diagnosed as having schizophrenia and children were diagnosed as having childhood schizophrenia.

1920s and 1930s

In 1926, Dr. Grunya Efimovna Sukhareva, a Russian psychiatrist described what would later become the core deficits of Asperger Syndrome in boys that she labeled as having schizoid personality disorder of childhood. In 1933, Dr. Howard Potter described children who would now be identified as autistic as having a childhood form of schizophrenia.

1930s and 1940s

The two main pioneers in autism research, Hans Asperger and Leo Kanner, began working separately in the 1930’s and 1940’s. In 1934 Hans Asperger of the Vienna University Hospital used the term autistic and in 1938 he adopted the term “autistic psychopaths” in discussions of child psychology. However, Leo Kanner of Johns Hopkins Hospital began using the term autism to describe behaviors that are now recognized as Autism Disorder or classical autism. Leo Kanner is the one who is usually credited for using the term autism as it is known today.

Kanner’s 1943 descriptions of autism were the result of his observations of eleven children who showed a marked lack of interest in other people, difficulties in social interactions, difficulty in adapting to changes in routines, good memory, sensitivity to stimuli (especially sound), and a highly unusual interest in the inanimate environment. These socially withdrawn children were described by Kanner as; lacking affective contact with others; being fascinated with objects; having a desire for sameness; and being non-communicative in regard to language before 30 months of age. Kanner emphasized the role of biology in the cause of autism. He felt that the lack of social connectedness so early in life must result from a biological inability to form affective relationships with others. However, Kanner also felt that parents displayed a lack of warmth and attachment to their autistic children. In his 1949 paper, he attributed autism to a “genuine lack of maternal warmth.”

In 1944, working separately from Kanner, Hans Asperger described a “milder” form of autism, known today as Asperger Syndrome. Asperger also studied a group of children who possessed many of the same behaviors as described in Kanner’s descriptions of autism. However, the children he studied demonstrated precocious vocabulary and speech development but poor social communication skills. These children appeared to have a desire to be a part of the social world, but lacked the necessary skills. He also mentioned that many of the children were clumsy and different from normal children in terms of fine motor skills.

1950s

During the 1950s, Bruno Bettelheim, a University of Chicago professor and child development specialist, furthered Kanner’s 1949 view that autism resulted from a lack of maternal warmth. Bettleheim’s view of autism being caused by emotionally cold and distant mothers became known as the Refrigerator Mother Theory of autism. The idea behind the theory was that children became autistic because mothers didn’t interact, play, or them; in a sense, they were “frigid.” He published articles throughout the 1950s and 1960s to popularize this position. Proponents of this view were searching for a place to lay blame for autism.

It was also during this decade and into the next that parents were counseled to institutionalize their children in order for them to receive appropriate treatment.

1960s

Beginning in the 1960s there was increased awareness within the professional community that the refrigerator mother theory did not adequately account for autism. The theory ignored the fact that siblings of autistic children were not autistic despite having the same mother, and scientific advancements began to suggest more biological causes.

In 1964, Bernard Rimland, a psychologist with an autistic son, stressed the biological causes of autism in his book “Infantile Autism: The Syndrome and its Implications for a Neural Theory of Behavior.” The publication of this book directly challenged the prevailing refrigerator mother theory of autism. In 1965, Rimland established the Autism Society of America, which was one of the first advocacy groups for parents of children with autism. He established the Autism Research Institute in 1967 to conduct research on treatment for autism.

In 1967 autism continued to be classified under schizophrenia in the International Statistical Classification of Diseases and Related Health Problems. This promoted the view that autism was a mental illness rather than a developmental disability.

1970s

There was a push during this decade to better define autism and, with scientific advancement, there was better understanding of autism as having a neurobiological basis.

1980s

The publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 finally set autism apart from schizophrenia as it was now categorized as a neurodevelopmental disorder. Autism research continued to increase during the 1980s along with recognition within the scientific community that autism resulted from neurological disturbances rather than pathological parenting.

It was during this decade that Asperger’s work was translated to English and published. The term, “Asperger’s Syndrome” was first used in 1981 by the British psychiatrist Lorna Wing. She also developed the Wing’s Triad of Impairments, which is Impairment in Imagination, Impairment in Social Communication, and Impairment in Social Relationships to describe autism.

1990s

In 1994 Asperger’s syndrome was officially added to the DSM-IV as a progressive developmental disorder. Two nonprofit groups, the National Alliance for Autism Research and Cure Autism Now, were founded to stimulate autism research and raise awareness about the disorder. Research starts to suggest that autism is a spectrum disorder. Near the end of the decade, as autism rates rose, it was speculated that autism was due to mercury in vaccines.

2000s

In 2000, vaccine makers removed thimerosal, a mercury-based preservative, from all routinely given childhood vaccines. Public fears were that exposure to the preservative were related to autism. The National Institute of Health estimated that autism affected 1 in 250 children in 2001. The Institute of Medicine found no credible evidence of a link between thimerosal or any other vaccine and autism in 2004.

The prevalence of autism increased significantly during this decade as a result of better detection, broader diagnostic criteria, and increased public awareness. In 2007 the Centers for Disease Control and Prevention reported that approximately 1 in 150 children were diagnosed with autism. Part of this increase is a result of better understanding of autism as a spectrum disorder.

2010s

A hundred years later, the term autism describes a neurodevelopmental condition that results in significant social cognitive and social communicative impairment. Current research is focused on identifying biologically distinct subtypes of autism. The belief is that once subtypes are understood advance can be made in regard to understanding cause and developing effective treatments. The ultimate goal of this line of research is to eventually find a cure and be able to prevent it.

Until that time, the prevalence of autism continues to increase. In 2012, the Centers for Disease Control and Prevention reported that approximately1 in 88 children are diagnosed with an autism spectrum disorder.

The upcoming publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in May 2013 will remove Asperger Syndrome and PDD-NOS as separate from autism. Instead, diagnosis will be autism spectrum disorder in an attempt to more accurately reflect the continuum and severity of the types of symptoms and behaviors displayed.

It will be interesting to see how these diagnostic changes and research into the biological subtypes of autism impact the future evolution of this neurodevelopmental disorder.

Source:

http://ct-educationadvocates.com/information/autism/ the-evolution-of-autism/

Autism Through Ages Baffles Science

   For years past people with autism were placed in institutions all over the world. Autism is not a modern problem, even though it has only recently gained vast recognition. It is difficult to discuss the history of autism treatment without paying particular attention to the history of "autism" as a concept and the ways in which autism has been conceptualized and theorized about over the past 100 years.

The ways in which we understand and think about autism have directly and indirectly formed our conceptual responses to autism over the years. The very concept of "treatment" carries with it many presumptions about the nature of autism, its origins and its potential outcomes. The history of autism is not a linear one, and regardless of the past or present debates over treatment, origin or outcome, as more and more studies and research are conducted the greater the understanding of autism will become.

Swiss psychiatrist Eugen Bleuler first introduced the term autism in 1911. Autism and autistic stem from the Greek word "autos," meaning self. The term autism originally referred to a basic disturbance in schizophrenia, in short, an extreme withdrawal of oneself from the fabric of social life, but not excluding oneself.

          Bleuler also coined the term ambivalence to designate one of the major symptoms of schizophrenia, the others being autism, disturbances of effect (emotion) and association (thought disorders). Ambivalence is a coexistence of two opposing drives, desires, feelings or emotions toward the same person, object or goal. The ambivalent person may be unaware of either of the opposing wishes. Bleuler felt that there were normal instances of ambivalence--such as the feeling, after performing an action, that it would have been better to have done the opposite; but the normal person, unlike the schizophrenic, is not prevented by these opposing impulses from deciding and then acting. Bleuler's schizophrenia differs in terms from the Freudian theories, in which ambivalence was described as feelings of love and hate toward the same person. (E.L. Horwitz, "Madness, Magic, and Medicine: The Treatment and Mistreatment of the Mentally Ill." [Lippincott, 1977])

          In the early 1900s, psychologist Carl Gustav Jung introduced the well-known personality types, extroverts and introverts, further broadening Sigmund Freud's psychoanalytical approach. However, this approach appears to have indirectly classified the autistic person as a schizophrenic introvert. Jung saw the activity of the extrovert directed toward the external world and that of the introvert directed inward upon him- or herself. Jung, who removed from the term the sexual character ascribed to it by Freud, called this general activity or drives of the individual the libido. The extrovert is characteristically the active person who is most content when surrounded by people; carried to the neurotic extreme, such behavior appears to constitute an irrational flight into society, where the extrovert's feelings are acted out.

          The introvert, on the other hand, is normally a contemplative individual who enjoys solitude and the inner lifeof ideas and the imagination. Severe introversion was believed to be characteristic of autism and some forms of schizophrenia. (C.G. Jung, "Psychological Types." [tr. 1923, repr. 1970]) Jung did not suggest strict classification of individuals as extroverted or introverted, since each person has tendencies in both directions, although one direction generally predominates. Jung theorized a patient could achieve a state of individuation, or wholeness of self. (E.H. Ackernecht, "A Short History of Psychiatry." [Hafner, 2d ed., rev., 1970])

          In 1944, American Bruno Bettelheim directed the Chicago-based Ortho-genic School for children with emotional problems, placing special emphasis on the treatment of autism. Bettelheim believed that autistic children had been raised in unstimulating environments during the first few years of their lives, when language and motor skills develop. He saw parents unresponsive to their child as an underlying cause of autistic behavior. (L. Wing, ed., "Aspects of Autism." [1988]) Although subsequent studies of the parents of autistic children have discredited Bettelheim's psychological explanation, his ideology carried into the general populace for generations to follow, germinating red herring terms like "refrigerator mother."

          The highly complex treatment of childhood autism began with the early-childhood development pioneers Leo Kanner and Hans Asperger, who each published accounts of this disorder. Kanner published his report in 1943 while at Johns Hopkins. He conducted a case study of 11 children who appeared to share a number of common characteristics that he suggested formed a "unique 'syndrome' not heretofore reported." He titled the article, "Autistic disturbances of affective contact," and characterized the children as possessing, from the very beginning of life, what he called an "extreme autistic aloneness." The following year, Asperger published "Autistic psychopathy in childhood." The article presented a case study of several children whom he described as examples of "a particularly interesting and highly recognizable type of child." Both Kanner and Asperger believed that the children suffered from a fundamental disturbance that gave rise to highly characteristic problems.

They both chose the word autism, a term coined by Bleuler in reference to the aloneness experienced by schizophrenic patients, in order to characterize the nature of the underlying disturbance. The common feature of this disturbance was that the children seemed unable to entertain normal relationships with people.

          In contrast to Bleuler's schizophrenia, the disturbance observed by Kanner and Asperger appeared to have been there from birth. Kanner's paper has become the most quoted, while Asperger's paper, written in German during World War II, was largely ignored. The belief has grown that Asperger described quite a different type of child, not to be confused with the one Kanner described.

Asperger's definition of autism or, as he called it, "autistic psychopathy," is far wider than Kanner's, including cases that showed severe organic damage and those that shaded into normality. In 1943 and 1944, "autistic disturbances" and "autistic psychopathy" became known as syndromes. (U. Frith, "Autism: Explaining the Enigma." [1989]) Asperger's syndrome as defined today is clearly not what Asperger intended, but having this special category has proved clinically useful.

          Kanner's syndrome is often used to indicate the child with a constellation of classic, "nuclear" features, resembling in astonishing detail the features that Kanner identified in his first, inspired description. Again, the category is clinically useful since it communicates a prototypical pattern. From the 1980s through the early 1990s, the cause, prognosis, and treatment of autism were vigorously under study. Research suggested that a genetic defect caused the disorder, which was presumed to be some form of autoimmune disease or degenerative disease of nerve cells in the brain.The preferred treatment for the autistic child was special education, stressing learning in small increments, and a strict behavioral control of the child.

          In general, about half of the children with autism were considered mute; those who remained mute through age 5 were given a poor prognosis for recovery. The children with autism who spoke were given a prognosis that they would fare better, and possibly even recover. (Autism, ENCARTA'95; Computer program; [1995]) Since 1911, the understanding of autism has grown to such a degree that we know there is not yet a cure.

          However, researchers all across the nation are working diligently to produce more information on autism, and possibly a cure. "Cure" means "restoration of health; recovery from disease." To "recover" means "to regain a normal or usual condition, as of health." While "cure" and "recovery" prognoses for autism might have been the expectation of 80s and early 90s, they do not represent expectations today.

Today we know that with highly structured and appropriate interventions the behaviors of a child or adult with autism may change to the point where he or she may appear to no longer have autism to the untrained person. However, while they have changed, they still have the autism.

          In 1995-1996, only 5.6 million children (ages 0 to 21), or about 12 percent of public school children, were enrolled in special education programs. The number of students participating in federal programs for children with disabilities has increased at a faster rate than the total public school enrollment.

          Between 1977 and 1995 alone, the number of students involved in federal programs for children with disabilities increased 47 percent, while the total public school enrollment decreased by 2 percent. These counts are based on reports from the 50 states and submitted to Congress to aid in the enactment of the Individuals with Disabilities Education Act by the National Center for Education Statistics, U.S. Department of Education, "Digest of Education Statistics," 1997.

It is also noted in this study that as early as 1976, as new types of disability categories began to emerge (specific learning disabilities, serious emotional disturbance, multiple disabilities, other health impairments, autism, preschool disabled), the percentages of federal programs for students with mental retardation disability began to lower.

          It is evident that autism as a diagnosis was non-existent prior to the early 1900s, and the people who had what we call autism today were diagnosed with some other disorder. It was not until the mid 1900s that people with autism were no longer institutionalized for their problem. Despite the persistence of old theories, no factors in the psychological environment of a child or adult have been shown to cause autism. There is no proof that autism is due to bad parenting, neglect, abuse or tragedy. Children with autism are not unruly youngsters who choose not to behave. Professionals have long since disproved all of these "causes" and theories. Unfortunately, the general understanding of the word autism hasn't kept up with the newer medical research shared today. It is proven that people with autism can lead happy and productive lives when appropriate supports and therapies are provided.

By Robert Williams Jr., June 12, 2000 at Health24 News

http://www.pediatricservices.com/prof/prof-26.htm