Brief Introduction to Autism History

Autism is understood today as a complex developmental disability characterized by difficulties with communication, interaction, and behavior. With symptoms apparent early in life, researchers and clinicians agree that no single factor is responsible. They locate autism’s origins in a combination of genetics, neurology, and biochemistry. The precise causes of autism, and its developmental mechanisms, remain as mysterious as ever.

Autism is invariably represented as a puzzle. It affects different individuals very differently. So striking is the variation—some individuals cannot use language or care for themselves while others are highly intelligent, verbal, and self-sufficient—that autism now ranges over a wide spectrum of cognitive, social, and emotional abilities. Autism Spectrum Disorder, or ASD, has recently entered the vocabulary of diagnosis and disability in part because autism may or may not prove to be a unified syndrome. In the future, it is possible that we will refer to autism in the plural: autisms.

Autism’s historical career has been brief and controversial. The term was introduced during the early twentieth century and appeared in the clinical literature in the 1940s, most famously in a 1943 article by Leo Kanner. At the time, autism was hardly a familiar word, let alone a clinical syndrome or diagnosis. Between 1900 and 1943, case histories and reports on autistic-like conditions, including hospitalism, appeared in Europe as well as in the United States. The terms childhood schizophrenia and childhood psychosis were used to describe autism in children until at least 1970, leading to much confusion about what these terms meant and how to differentiate them.

Prior to the 1960s, psychogenesis was the dominant theory about autism. Its key explanation was that autism was instigated by emotionally abusive parents—particularly mothers—who could be entirely unaware of the damage they were doing to their children. When those mothers withheld the love necessary for normal development, infants and young children responded by retreating into autism, which offered a haven from parental hostility at the perverse price of radical separation from all human attachments. Psychogenesis began losing credibility in the 1960s and a new explanatory paradigm centered on biology rather than psychology gained ground, fueled by neuroscientific research and parent activism. The word “autism” appeared in psychiatry’s diagnostic bible, the DSM, in its first 1952 edition, but it was not listed there as an independent syndrome until 1980. Autism’s definition has never been stable. Its diagnostic criteria have always been in flux.

Public awareness of autism has grown dramatically in recent decades for many reasons. Biological psychiatry persuasively redefined various mental illnesses and emotional disorders as developmental disabilities, shifting attention away from the interpersonal realm and moving it decisively toward the brain. Memoirs by Temple Grandin, Donna Williams, and other autistic individuals were published in the 1980s and 1990s, providing astonishing insights into the subjective experience of autism for the first time. In the late 1990s, well-publicized controversies about whether childhood vaccines were implicated in autism frightened parents and worried public health officials, nourishing anti-vaccination movements that have produced outbreaks of measles globally. Most recently, debates about “neurodiversity” have entered popular culture and online resources have multiplied for people living “on the spectrum.”

Autism is more familiar and visible today in the United States than it has ever been before, yet we still know remarkably little about its history. The Autism History Project is an effort to document part of that history in all its drama, complexity, and importance.