Hans Asperger, “‘Autistic Psychopathy’ in Childhood,” 1944

Hans Asperger, “‘Autistic Psychopathy’ in Childhood,” in Autism and Asperger Syndrome, edited by Uta Frith (Cambridge: Cambridge University Press, 1991), 37-92. Originally published as “Die ‘Autistischen Psychopathen’ im Kindesalter,” Archiv für Psychiatrie und Nervenkrankenheiten 117 (1944):76-136.

Complete original source available here.

Austrian physician Hans Asperger is famous for giving his name to Asperger syndrome, which was listed in the DSM in 1994 as one of autism’s four subcategories. (It was replaced in 2013 by the broader, single diagnosis, Autism Spectrum Disorder). Asperger described “a particularly interesting and highly recognisable type of child” in this 1944 article, one year after Leo Kanner published his iconic article on autism. Like Kanner, Asperger presented case studies. He described four boys, detailing their clinical characteristics and commonalities. Asperger also speculated that “the autistic personality is an extreme variant of male intelligence,” illustrating that appreciation for autism’s gender gap is not recent. The article concluded with a note about the “social value” of autistic individuals and a call for respectful, appropriate education for autistic children and all “complicated individuals.” Asperger’s work was publicized in the English-speaking world by British autism researcher Lorna Wing in the early 1980s. His article was translated into English in 1991 by Uta Frith, a German-born autism researcher who worked in England.


Hans Asperger

In what follows, I will describe a particularly interesting and highly recognisable type of child. The children I will present all have in common a fundamental disturbance which manifests itself in their physical appearance, expressive functions and, indeed, their whole behaviour. This disturbance results in severe and characteristic difficulties of social integration. In many cases the social problems are so profound that they overshadow everything else. In some cases, however, the problems are compensated by a high level of thought and experience. This can often lead to exceptional achievements in later life. With the type of personality disorder presented here we can demonstrate the truth of the claim that exceptional human beings must be given exceptional educational treatment, treatment which takes account of their special difficulties….

I have chosen the label autism…. The name derives from the concept of autism in schizophrenia. Autism in this sense refers to a fundamental disturbance of contact that is manifest in an extreme form in schizophrenic patients. The names ‘autism’, coined by Bleuler, is undoubtedly one of the great linguistic and conceptual creations in medical nomenclature….

While the schizophrenic patient seems to show progressive loss of contact, the children we are discussing lack contact from the start…. Essential symptoms of schizophrenia and the symptoms of our children can thus be brought under a common denominator: the shutting off of relations between self and the outside world….

Fritz V.

This boy was born in June 1933…. From the earliest age Fritz never did what he was told. He did just what he wanted to, or the opposite of what he was told. He was always restless and fidgety….

He was never able to become integrated into a group of playing children. He never got on with other children and, in fact, was not interested in them….

Although he acquired language very early, it was impossible to teach him the polite form of address (‘Sie’). He called everybody ‘Du’. Another strange phenomenon in this boy was the occurrence of certain stereotypic movements and habits…. [H]e would suddenly start to beat rhythmically on his thighs, bang loudly on the table, hit the wall, hit another person or jump around the room. He would do this without taking any notice of the amazement of those around him….

Above all, from very early on he had shown an interest in numbers and calculations. He had learned to count to over 100 and was able to calculate within that number-space with great fluency…. Even before any systematic teaching had begun, he has mastered calculations with numbers over ten…. [H]is ability to do fractions was unusual….

We see here something we have come across in almost all autistic individuals, a special interest which enables them to achieve quite extraordinary levels of performance in a certain area….

Clearly, it is possible to consider such individuals both as child prodigies and as imbeciles with equal justification….

Harro L.

This eight-and-a-half-year-old boy was referred to us by his school as unmanageable….

His early independence in certain things was outstanding. Since his second school year, that is, since he was only seven years old, he had travelled alone by train to school in Vienna….

On a more unpleasant note, Harro also showed his social unconcern in sexual play with other boys, allegedly going as far as homosexual acts, coitus attempts….

He never looked at his interlocutor while talking. His gaze was far away…. Often he did not respond to questions but let his talk run single-mindedly along his own tracks. He could describe his own experiences or feelings with an unusual degree of introspection. He could look at himself as a detached critical observer (‘I am dreadfully left-handed’). Although he was aloof from things and people—or perhaps because of this—he had rich experiences and his own independent interests. It was possible to talk to him as to an adult, and one could really learn from him….

Normal children acquire the necessary social habits without being consciously aware of them, they learn instinctively. It is these instinctive relations that are disturbed in autistic children. To put it bluntly, these individuals are intelligent automata. Social adaptation has to proceed via the intellect. In fact, they have to learn everything via the intellect….

Ernst K.

This seven-and-a-half-year-old boy was also referred to us by his school because of severe conduct and learning problems….

He was ‘very precise’: certain things always had to be in the same place, and certain events always had to happen in the same manner, or he would make a big scene….

To the very end of his stay on the ward he remained a stranger, walking between the other children without ever properly taking part in their games….

It was quite difficult to decide whether Ernst was particularly able or mentally retarded, but there are numerous unequivocally retarded people who show the typical and unmistakable characteristics of autistic psychopathy….

Characteristic stereotypies in particular are common to both the autistic and the brain-injured retarded child: for example, hopping, fidgeting, whirling, spinning of objects (often with surprising skill) or rhythmic rocking (for instance, of the upper body)….

Hellmuth L.

He had severe asphyxia at birth and was resuscitated at length. Soon after his birth he had convulsions, which recurred twice within the next few days, but have not since. His development was delayed and he started walking and talking toward the end of his second year. However, he then learnt to speak relatively quickly, and even as a toddler he talked ‘like a grown up’….

Listening to the boy talking, one was surprised at how clever he sounded. He kept his immobile dignity while speaking and talked slowly, almost as if in verse, seemingly full of insight and superiority. He often used unusual words, sometimes poetical and sometimes unusual combinations….

In everything he did, it was said, he had particular rituals. He was especially concerned with his clothes, did not tolerate a grain of dirt on them, washed his hands very frequently and observed his body and its functions very closely….

In Hellmuth’s case there were clear indications that his autism was due to brain injury at birth…. We can therefore draw the preliminary conclusion that there are cases where an organic disorder can result in a picture that, in numerous critical points, is closely similar to the picture presented by ‘autistic personality disorder’ of constitutional origin….

Genetic and Biological Factors

We want to state briefly that over the course of ten years we have observed more than 200 children who all showed autism to a greater or lesser degree. We  have been able to discern related incipient traits in parents or relatives, in every single case where it was possible for us to make a closer acquaintance…. In many cases the ancestors of these children have been intellectuals for several generations and have been driven into the professions by their nature. Occasionally, we find among these children descendants of important artistic and scholarly families….

It is fascinating to note that the autistic children we have seen are almost exclusively boys…. There is certainly a strong hint at a sex-linked or at least sex-limited mode of inheritance.

The autistic personality is an extreme variant of male intelligence….

The Social Value of the Autistic Psychopath

To our amazement, we have seen that autistic individuals, as long as they are intellectually intact, can almost always achieve professional success, usually in highly specialized academic professions, often in very high positions, with a preference for abstract content….

We are convinced, then, that autistic people have their place in the organism of the social community. They fulfil their role well, perhaps better than anyone else could, and we are talking of people who as children had the greatest difficulties and caused untold worries to their care-givers.

The example of autism shows particularly well how even abnormal personalities can be capable of development and adjustment. Possibilities of social integration which one would never have dreamt of may arise in the course of development. This knowledge determines our attitude toward complicated individuals of this and other types….

 

 

 

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