Leo Kanner and Autism: A 75 Year Perspective

Leo Kanner played a paramount role in defining autism as a medical condition and in changing societal views towards people with disabilities. He used his academic position at Johns Hopkins and as an editor for medical journals to fight against discrimination,  prevent institutionalization, and to provide patients with better accommodations. He saved hundreds of individuals from the Nazi regime by getting them positions within the United States. As of late, the book Neurotribes by Steve Silberman has maligned Kanner’s role in the history of autism while praising that of Hans Asperger.  This biased appraisal of history has been made for the sole purpose of upholding some erroneous views stemming from the Neurodiversity movement.  This attempt at rewriting history has been subject to a past blog in Cortical Chauvinism.

James Harris, the previous director of Child Psychiatry at Hopkins, is a well respected clinician and academician who knew Kanner personally. His recently published article on “Leo Kanner and Autism: A 75 Year Perspective” dispels Silberman’s erroneous perspective. The article was recently published in The International Review of Psychiatry and published online this past April 18th.  The abstract reads as follows:

n 1943, Leo Kanner published the first systematic description of early infantile autism. He concluded that this was a neurodevelopmental disorder and that ‘these children have come into the world with an innate inability to form the usual, biologically provided contact with people’. Moreover, his astute descriptions of parental behavior in his first publications were prescient and underlie later recognition of the importance of genetics. Our understanding has grown over the ensuing years with revisions in diagnostic classification, recognition of the broader autism phenotype in families, appreciation of the importance of developmental models, advances in genetic methodology, better understanding of the relationship to intellectual deficits, recognition of syndromic autism in neurogenetic sydromes, advances in neuroimaging, and advances in animal models, both mutant mouse models and transgenic non human primate models. Kanner recognized diagnostic heterogeneity and opined that the children had not read those diagnostic manuals and did not easily fall into clear cut categories. Such heterogeneity continues to confound our diagnostic efforts. Always an advocate for children, when reviewing the DSM III criteria in 1980, Kanner emphasized that no matter how well developed our criteria each child must be treated as a unique person.

8 responses to “Leo Kanner and Autism: A 75 Year Perspective

  1. Thank you for this comment on Leo Kanner. For me Kanner’s paper on metaphorical language was also important, and he had to go to the parents to learn the meaning of their children’s strange comments.

    Metaphorical language is in fact echolalic speech, recitation of a remembered phrase in a new different context. Pronoun reversal is part of this use of out-of-context phrase fragments. I agree that the neurodiversity explanations are lacking both in scientific and historical understanding.

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  2. I have a question and is this: How can one reconcile Kanner’s description of autism as an innate inability to form the usual, biologically provided contact with people with Asperger’s syndrome that recognized autistic traits in verbally fluent individuals who demonstrate superior intelligence and creativity? The fact that an individual is “verbally fluent” and “demonstrate superior intelligence and creativity” indicate they have established some sort of contact with the world and its people. Otherwise their superior intelligence and creativity would not have been developed. There cannot be verbal fluency if it is not used to describe the world where we belong.

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    • I think that Kammer’s description was meant to indicate that autism was a neurodevelopmentl condition, brought on by factors that had their main influence during brain development. What happens after you are born depends largely on the environment.

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      • Another question: How could Lorna Wing support creating an Autism Spectrum that would include individuals who obviously didn’t show the traits id “autistic psychopathy” described by Asperger’s account?

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      • I think the term has been misued from what Asperger meant it to be. There have been many reports in this regard. However, your question is a valid one, as Lorna Wing brought Asperger into the public eye and sort of proclaimed his importance for diagnostic purposes.

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      • Did Lorna Wing realize that she made a lousy adaptation of Dr. Asperger’s clinical insights? In other words, she made him to say what she wanted him to say instead of what Asperger’s actually said.

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  3. Another question: How could Lorna Wing support creating an Autism Spectrum that would include individuals who obviously didn’t show the traits of “autistic psychopathy” described by Asperger’s account?

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