Bernard Rimland, Infantile Autism: The Syndrome and Its Implications for a Neural Theory of Behavior (New York: Appleton-Century-Crofts, 1964).
Bernard Rimland, a research psychologist and father of a son with autism, was perhaps the single most important figure in the transition from psychogenesis to biogenesis. He was a founding member of the Autism Society of America in 1965 and of the Autism Research Institute in 1967. His 1964 book, Infantile Autism: The Syndrome and Its Implications for a Neural Theory of Behavior, helped to close the door on theories that defined autism as an emotional disturbance to be blamed on parents. In this excerpt, Rimland not only argued that psychogenesis was unscientific and inhumane, but efficiently summarized the case for biological causation.
Two decades have passed since Kanner published his classic paper describing the paradoxical and bewildering disturbance of behavior in children which he called “early infantile autism.” The presence of the disturbance in early infancy, the strange pattern of motor and language behavior which is reproduced with incredible accuracy in case after case, the occurrence in the same child of behavior typical of both genius and idiocy, and the complete absence of any evidence of physical or neurological defect have led many investigators to consider early infantile autism the most baffling of the behavior disorders….
Despite the voluminous literature that has developed, the origin of the disease is as much a mystery today as it was twenty years ago. There is no known cause, and no known cure….
Many who have on the problem of autism regard this finding [that parents of autistic children display unusual patterns of personality and intelligence] as evidence for the psychogenic etiology of the disease. This appears to be a plausible hypothesis and so should be subjected to critical evaluation to determine if it merits acceptance. Unfortunately, plausibility rather than consistency with evidence seems to be the criterion for many of the writers on early infantile autism. Consequently the hypothesis has been accepted without evaluation, and the literature on autism contains many papers in which it is asserted rather than suggested that psychogenic factors play a major part in the etiology of the disease. Ineed, a substantial proportion of these papers carry no indication that biological factors play even a minor part in the disease….
The Case for Biological Causation
Unlike the hypothesis that autism is psychogenically determined, there are a number of points of information which support the hypothesis that autism may result from a rare recessive trait, or be otherwise determined by biological factors. Kanner, in his various publications (especially with Eisenberg), has cited the first five points listed below as evidence against the psychogenic view. The remaining points have been identified by the present writers or others who have concerned themselves with this problem.
- Some clearly autistic children are born of parents who do not fit the autistic parent personality pattern.
- Parents who do fit the description of the supposedly pathogenic parent almost invariably have normal, non-autistic children.
- With very few exceptions, the siblings of autistic children are normal.
- Autistic children are behaviorally unusual “from the moment of birth.”
- There is a consistent ratio of three or four boys to one girl.
- Virtually all cases of twins reported in the literature have been identical, with both twins afflicted.
- Autism can occur or be closely simulated in children with known organic brain damage.
- The symptomatology is highly unique and specific
- There is an absence of gradations of infantile autism which would create “blends” from normal to severely afflicted.
Psychogenesis as an Inadequate and Pernicious Hypothesis
Perhaps it should be made explicit at this point that the writer does not presume to have shown that autism is biologically determined and that the psycho-social environment plays no part in its etiology. What the writer does assert is that a careful review of the evidence has revealed no support for the psychogenic point of view. The evidence is instead highly consistent with expectation based on organic pathology….
In a court of law, it is impermissible to convict a person solely on evidence consistent with the hypothesis that he is guilty—the evidence must also be inconsistent with the hypothesis that he is innocent. This simple point of justice has been neglected, consistently, by those who deal with families having children afflicted with autism, and the damage and torment this practice has wrought upon parents whose lives and hopes have already been shattered by their child’s illness is not easy to imagine nor pleasant to contemplate. To add a heavy burden of shame and guilt to the distress of people whose hopes, social life, finances, well-being, and feelings of worth have been all but destroyed seems heartless and inconsiderate in the extreme….