Leo Kanner
Leo Kanner is widely credited with discovering autism. His 1943 case study, “Autistic Disturbances of Affective Contact,” described a bizarre new disorder so evocatively that children diagnosed in the following years were sometimes said to have “Kanner’s syndrome.” In 1943, Kanner was already a prominent figure in the new field of child psychiatry, but his work on autism is why he is remembered today.
Chaskel Leib Kanner was born in 1894 to a Jewish family in Austria. At age 12, he moved to Berlin to live with an uncle, attending school and serving in the medical corps of the Austro-Hungarian army at the outbreak of World War I, when he was twenty. After his graduation from medical school at the University of Berlin in 1921, he became a naturalized German citizen, a requirement to practice medicine.
Kanner worked at Berlin’s leading hospital, Charité, which attracted students and clinicians from all over the world. There he met a visiting physician from South Dakota. In 1924, concerned about his ability to support a wife and baby daughter, Kanner moved to the United States. Initially employed at Yankton State Hospital in South Dakota, Kanner’s writing on mental health quickly attracted the interest of Adolf Meyer, the leading psychiatrist in the United States. Meyer brought him to the Henry Phipps Clinic at Johns Hopkins University as a Commonwealth Fellow in 1928. At Phipps, Kanner encountered Lauretta Bender, another physician who did a great deal of early work on autism. Kanner established the first academic department of child psychiatry in the country at Johns Hopkins in 1930. In 1935, he published the first textbook in the field.
Kanner’s name may be indelibly linked with autism, but his clinical and reform activities had roots in eugenics and work on mental deficiency. Long before he described autism, he exposed abuses at the Maryland State Training School for the Feebleminded, also known as the Rosewood School. Hundreds of girls institutionalized there in the 1910s and 1920s were released by judges to work as domestic servants, a practice that Kanner blamed for both exploiting them and harming the Baltimore-area communities in which the girls were placed. His belief that institutionalization was the most enlightened, scientific solution to mental deficiency was in the mainstream. So was his claim that the girls’ presence in the community encouraged illegitimacy, prostitution, and other social ills.
Kanner endorsed both sterilization and sympathy for people with mental retardation, who did socially necessary “dirty work” ranging from collecting garbage to cleaning houses and picking cotton. His plea to consider the contributions of individuals with developmental disabilities, case by case, rather than dismiss them categorically as social menaces, aimed to distance American eugenics from its Nazi counterpart. It marked Kanner as an advocate of relative humanization at the time.
After asking Lauretta Bender about several strange cases of developmental regression she had treated at Bellevue Hospital and compiling the histories of other children seen in his own clinic between 1935 and 1943, Kanner described eight boys and three girls in an iconic 1943 article published in The Nervous Child. “Autistic Disturbances of Affective Contact” helped make autism a visible, and diagnosable, clinical syndrome.
Donald Triplett was case 1 in Leo Kanner’s famous 1943 article describing autism. Kanner saw him for the first time in 1938 at age 5. He eventually went to college, worked in his family’s bank, and led a successful life at odds with the pessimistic findings of Kanner’s 1972 follow-up study. (courtesy of Triplett family)
The views Kanner expressed about the causes of autism made it possible to consider him an advocate of psychogenesis, biogenesis, or both. He noted that autistic children often had perfectly normal siblings and believed little could be learned through systematic investigation into family backgrounds since these contained little or no evidence of psychosis. At the same time, Kanner repeatedly observed that the parents of autistic children had cold marriages and took mechanical approaches to people. “Maternal lack of genuine warmth is often conspicuous” in families where children were kept in “emotional refrigerators” that never defrosted, he wrote in 1949.
By the mid-1960s, when parent advocacy and new research began dismantling the consensus about psychogenesis, Kanner defensively insisted that he had never sanctioned mother-blame. But a definite constellation of interpersonal patterns and emotional traits—perfectionism, remoteness, hyper-rationality, rigidity—recurs in many of his accounts of parents and families. Is it any wonder that interested people concluded these contributed in some way to autism?