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Historical and Contemporary Understanding of Autism

Tammi Reynolds, BA & Mark Dombeck, Ph.D.

Historical and Contemporary Understanding of Autism

We've taken some pains to differentiate autism as a distinct illness, separate from other recognized forms of mental and developmental illnesses such as mental retardation and obsessive compulsive disorder because it has not always been obvious that autism is separate from these other disorders. In fact, autism was only recognized as a distinct condition from these other disorders in the 1940s. Prior to that time, autism was thought of as a variety of mental retardation, or on occasion as a severe form of obsessive-compulsive illness. Without clear understanding of the disorder or how to treat it, many doctors and caretakers ended up institutionalizing people with autism.

The first recorded use of the term autism occurred around 1912 when psychiatrist Eugene Bleuler used the word to refer to patients who were self-absorbed and out of touch with the rest of the world. The word autism is derived from the Greek word autos, meaning self. The term was chosen to communicates the social and communicative isolation that is the foremost feature of the illness. However, Dr. Bleuler's use of the term referred to individuals with schizophrenia who displayed catatonic behaviors and not to people with autism as we know them today.

In the early 1940s two separate researchers offered the first published accounts of autistic syndromes as distinct disorders from mental retardation and other forms of mental illness. Dr. Hans Asperger described a mild form of autism which today has been identified as Asperger's Syndrome, an autism spectrum disorder. Dr. Leo Kanner's more general description of autism formed the basis for the modern understanding of autism proper. Drs. Kanner and Asperger independently chose the word autism to describe their patients because both recognized that the intense isolation experienced by their child patients was the central feature of the condition.

Though the distinctness of autism from mental retardation and obsessive-compulsive disorder is unquestioned today, an interesting wrinkle has developed as researchers have refined Drs. Kanner and Asperger's work. It turns out that autism is most properly thought of as a family of related diseases which today are known as Pervasive Developmental Disorders (PDDs), or sometimes, autism spectrum disorders. In addition to Autism, three other conditions round out the pervasive developmental disorder family, including Rett's Disorder, Childhood Disintegrative Disorder, and Asperger's Disorder. An additional diagnosis, Pervasive Developmental Disorder, Not Otherwise Specified (NOS), is used to indicate PDDs of unknown origin. All of the pervasive developmental disorders are characterized by communication and social impairments. They are differentiated from one another on the basis of research suggesting different causes for the underlying impairments, and by different impairment profiles and intensities of impairment typical of each condition. Though autism spectrum disorders are synonymous with pervasive developmental disorders, a person can have a pervasive developmental disorder and not carry the diagnosis of autism in particular.