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J Autism Dev Disord

DOI 10.1007/s10803-016-2746-0

LETTER TO THE EDITOR

History and First Descriptions of Autism: Asperger Versus
Kanner Revisited
Nick Chown1 • Liz Hughes2

Ó Springer Science+Business Media New York 2016

Abstract When reading Michael Fitzgerald’s chapter en- psychisch abnorme kind’ (Fitzgerald 2008) published in a
titled ‘Autism: Asperger’s Syndrome—History and First Vienna weekly. In his recent Samuel Johnson Prize win-
Descriptions’ in ‘Asperger’s Disorder’ edited by Rausch, ning book ‘Neurotribes’ based on detailed research into the
Johnson and Casanova, a while ago, one of us was struck history of autism research, Steve Silberman (2015) takes
by his contention that Kanner was guilty of plagiarism as this issue beyond one of possible plagiarism and non-at-
well as non-attribution of Asperger’s 1938 paper ‘Das tribution. He has discovered evidence that Kanner rescued
psychisch abnorme kind’ (Fitzgerald in Asperger’s disor- Asperger’s chief diagnostician (Georg Frankl), and a psy-
der. Informa Healthcare, New York, 2008) published in a chologist (Anni Weiss) who had also worked for Asperger,
Vienna weekly. Steve Silberman has discovered evidence from the Nazis in 1944 so must have been aware of
that Kanner rescued Asperger’s chief diagnostician from Asperger’s work and conclusions. It is clear to us that
the Nazis in 1944 so must have been aware of Asperger’s Fitzgerald was correct about the publication of the two
work and conclusions. Fitzgerald was on the right track but accounts of autism not being coincidence. However, the
it appears that Kanner may have plagiarised Asperger’s issue here appears to be possible plagiarism of ideas about
ideas rather than his 1938 paper. autism rather than of any particular publication.
In a previous letter to the editor of this journal on the
Keywords Academic ethics  Asperger  Autism  Kanner subject of the initial publications on autism by Asperger
and Kanner, one of us concluded that ‘maybe we should
All students of autism know about the apparent coinci- just leave it that two great individuals made ground-
dence that Hans Asperger and Leo Kanner reported on their breaking contributions in our field so that, in the end, it
‘discovery’ of autism in consecutive years (Asperger 1944; does not really matter who was first’ (Chown 2012). That
Kanner 1943) and that this is generally regarded as a co- conclusion appeared reasonable at the time of writing, but,
incidence. When reading Michael Fitzgerald’s chapter en- whilst acknowledging Kanner’s contributions, we must
titled ‘Autism: Asperger’s Syndrome—History and First now consider whether Silberman’s findings suggest that it
Descriptions’ in ‘Asperger’s Disorder’ edited by Rausch, does matter who was first. Much of Asperger’s account of
Johnson and Casanova, a while ago, one of us was struck autism has stood the test of time, whereas some ‘key’
by his contention that Kanner was guilty of plagiarism as aspects of Kanner’s account have not. Of course, we have
well as non-attribution of Asperger’s 1938 paper ‘Das Kanner to thank for rescuing Asperger’s colleagues and the
knowledge of autism they brought with them. And if
Kanner had not rescued them it is possible that the initial
& Nick Chown identification, and subsequent development of our under-
npchown@gmail.com
standing of autism, would have been delayed. However,
1
C/de Tarragona, 81, Palau-solità i Plegamans, had Kanner made their knowledge available (maybe, in
08184 Barcelona, Spain tandem with his own ideas about autism) a many decades
2
26 Waingap View, Whitworth, Lancashire OL12 8QD, wait before Asperger’s understanding of autism became
England, UK public knowledge might have been avoided. The delay in

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where Kanner had implied that it was something of relevance only to children. International Classification of Diseases (ICD) for the first mony of Kanner’s ideas. we Asperger syndrome (AS) (1989. over many generations. to Kanner. and that a number of his clinical included in the DSM and the World Health Organisation’s descriptions of ’classic autism’ in children remain valid today 123 .1 We believe subject of very little systematic empirical inquiry’. almost exactly 50 years since Asperger’s original paper 1 It cannot be denied that Kanner played the vital role in establishing was published. It took many nostic and Statistical Manual of Mental Disorders (Re. a major part of the disservice done by Kanner to autistic ger. his clinic. where Asperger worked. p. attribute the whole picture exclusively to the type of the sive lack of responsiveness to other people’’ was replaced early parental relations with our patients’ (ibid. each other’s work. In this respect. The explanation of this phe- autism research and diagnostic criteria. present from birth. it is by the Asperger-influenced ‘‘qualitative impairment in clear from his own words that he considered early parental reciprocal social interaction’’ (ibid. a report by Le Couteur et al. and that these Kanner’s. confirming that Frankl had worked at the Lazar thus denying recognition or support to autistic adults for Clinic in Vienna. and were therefore over Asperger’s account of autism. Schopler et al. 631) writing in their think it may have rolled in a somewhat different direction introduction that ‘Asperger syndrome has so far been the had Asperger’s views been in the ascendancy. Asperger’s legacy remains in the field. aloneness’’. inextricably intertwined’’ (ibid. Silberman discovered that Kanner’s It was Kanner’s insistence on infantile autism which was assistant Georg Frankl had previously worked for Asper. Another important issue was Kanner’s a letter written in 1939 to his mentor. p. and the hege. (1989) into Bettelheim’s popularity and influence. In 1987 the Kanner-influenced ‘‘perva. reported on their development of a diagnostic tool for Whilst acknowledging the role Kanner played in setting autism. years for the so-called ‘refrigerator mother’ theory of aut- vised) (DSM III-R) of the American Psychiatric ism—now more closely associated with Bruno Bettel- Association. Kanner’s parenting their development of an autism diagnostic interview made theory became far more entrenched than we think it would no mention of Asperger. (1943) original definition of autism’ together with various Although he added the qualification that ‘The children’s attempts to ‘translate the Kanner definition into an empir. ‘‘extreme autistic Frankl’s ‘‘good background in paediatrics and close con. In the same year that Schopler otherwise have done. p. for 11 years. Although Asperger’s Disorder of autism. indeed. because it archive of the Johns Hopkins hospital. which Kanner was aware of the work of Asperger.. Kanner regarded it as to come to the attention of researchers of autism and a new and startling phenomenon. in the criteria adopted for the new diagnosis of Autism Whilst. nomenon. An examination of the historical record shows that of autistic traits as being on a continuum. appear to us to have had an time (the DSM was by then in its fourth edition. relations to be a major contributing factor. and it Asperger would have recognised as being on the autistic therefore appears that Asperger identified autism before continuum. et al. In several decades. up to now.. original account of traits were not uncommon in the population whereas autism was far more influential than Asperger’s (and the Kanner regarded them as rare. Kanner commended very narrow definition of his syndrome. Almost 10 years after the paper by Schopler heim—to be discredited and abandoned. He found a biographical file relating to Frankl in the people. 188) through many lish until 1981. and the adverse impact on the trajectory of the diagnostic aspects ICD in its tenth edition). 389) in the Diag. Kanner wrote that in the parents of the group of speakers. 250. p. Whereas ‘‘Asperger saw threads of genius and disability Asperger’s original paper was not translated into Eng. only game in town for many years). in the very title of this two clinicians worked separately. lay in women who demonstrated little Kanner’s views had a ‘head start’ of more than 40 years emotional contact with their offspring. It seems that sive desire for the maintenance of sameness’’. in some cases inaccurate. (1980. It took time for his interpretation of autism family trees. and were unaware of diagnosis with its reference to a spectrum of autism. J Autism Dev Disord making Asperger’s knowledge available. 91) wrote that the main children he had seen ‘there are very few really warm- sets of guidelines for diagnosing autism were ‘Kanner’s hearted fathers and mothers’ (Kanner 1943. and led to some rather unfortunate developments was removed from the DSM-5. Asperger regarded the range of manifestations Kanner. 250). and even longer for his views to influence tigation and explanation. it has been received opinion that the Spectrum Disorder and. p. In 1994. p. as he had effectively excluded very many of the children who supervised Frankl (and Weiss) during those years. Unsurprisingly. and an ‘‘anxiously obses- nection for 11 years to the Lazar Clinic’’. requiring urgent inves- diagnosticians. Due to and his colleagues. and their families and other carers. criteria based on Asperger’s work were autism in the diagnostic canon. aloneness from the beginning of life makes it difficult to ical rating scale’. Gillberg and Gillberg reviewed studies relating to the autism ball rolling in the English-speaking world. the regarded as responsible for the emotional stunting of the year before Asperger’s paper was translated for English child.

M. and at all Kanner. the Feinstein. Reichler. Both authors read and to the understanding of autistic children by their parents. However. A. provided by the rescue of his two Lazar Centre colleagues Schopler. Rausch.. 76–136. it is difficult to avoid the conclusion that Kanner played the role of establishing autism with the benefit of Asperger’s work. there can be no doubt that Kanner knew about Asperger’s instead of Kanner’s. approved the final manuscript. C. only.. that one was born with. Journal of Autism and Develop- Fitzgerald was on the right track in suggesting that pla. Toward objective classification of childhood autism: Childhood not been missed.. & McLennan. it might have been more difficult for theories such salter.. 30(4). DeVellis. might have struggled to make headway. and in fair com. (1944). & Daly. first descriptions. response to Michael Fitzgerald. work. 363–387. 2. Asperger’s disorder. & M. (2010). K. N. P. 10(1). with Holdgrafer. Asperger syndrome—some nised much earlier that autism was not ‘just’ a condition of epidemiological considerations: A research note. views of Asperger. and that this could actually be a positive thing. E. J.J Autism Dev Disord that if Asperger’s work and beliefs had been in circulation. Crows Nest: Allen & Unwin.. giarism and non-attribution may have been at play as there Silberman. it would have been recog. Nervous levels of intellectual ability. NC drafted the letter. S. Lord. being somewhat out of step with the Fitzgerald. Footnote 1 continued (Feinstein 2010). (2008). But. whether deliberately or otherwise. who might not have been too dissimilar. S. Gillberg. support for adults. M. Rutter. M. Kanner wrote his seminal article (Feinstein 2010). and higher-functioning individuals. L. 123 . Autistic disturbances of affective contact. or one that affected lower-functioning children Child Psychology and Psychiatry. (1980). or even alongside. European Archives of Psychiatry and Clinical Neuro- science. 91–103. Rios. But they were not given a chance. as that of the ‘refrigerator mother’ to gain credence and Chown. (2012). If Asperger’s work had been made public a lot Asperger. Autism Rating Scale (CARS). New York: Wiley. Johnson.. R. Asperger acknowledged the family pattern of autism. A history of autism: Conversations with the pioneers. Die ‘‘Autistischen Psychopathen’’ im Kinde- earlier. but never ‘‘cure’’ them. New York: Informa Perhaps. C. & Gillberg.). F. He understood that this was a lifelong state of being. Journal of childhood. I. NeuroTribes: The legacy of autism and how to are clear indications that Kanner may have plagiarised think smarter about people who think differently. and cannot fail to have been influenced by it. petition with Kanner’s theories. M. 19(3). but could be seen in people of all ages.. We strongly suspect that Child. and that intelligent support could bring out the best in these References children. Journal of Autism and Devel- However.. (1989). Autism diagnostic autism would have been made available earlier had the interview: A standardized investigator-based instrument. F. due Author Contributions LH identified the topic and contributed to the drafting of the letter. as Freudian thinking was in vogue at the time opmental Disorders. (2015). C. Journal opportunity to publicise Asperger’s account of autism of Autism and Developmental Disorders.. 2263–2265. In J. it is probable that the lives although he signally failed to acknowledge Asperger’s of very many people with autism would have been contribution for many years. R. 42(10). A. mental Disorders. J. 631–638. 217–250. Asperger’s ideas (rather than his 1938 paper). Casanova (Eds. Robertson. as they would always be autistic.. L. (1943). Healthcare. (1989). ‘History and First descriptions’ of Autism: A delay the development and proliferation of good theory. 117(1). Autism: Asperger’s syndrome—history and clinical zeitgeist. Le Couteur. H. given Silberman’s findings. improved. E. most importantly.