If we don’t use our words, we won’t be indistinguishable. (What’s wrong with saying, “use your words”? Many, many things, including the part where it’s ignoring communication that you actually did understand because you didn’t like how it was phrased. Thanks, Neurodivergent K.)But it’s not just about words, is it? Once we’re using words, you want…
In his excellent book Neurotribes, Steve Silberman has described in detail the development of autism research in England, especially at the Medical Research Council in London, during the 1970s and 1980s. Members of the MRC were familiar with the disorder Leo Kanner had described back in the 1940s. They occasionally observed cases of “infantile autism,” “childhood schizophrenia,” or what they often simply called “Kanner’s Syndrome” when they visited institutions for the insane or “feeble-minded.” However, the MRC also conducted field work, primarily within London, and this made MRC researchers aware of a larger number of children attending ordinary schools and adults living more or less independently, who appeared to share many of the characteristics of institutionalized autistics. It was difficult to know how to diagnose these children and adults, but if they had no diagnosis, they would also have no access to public services which might have helped them.
The re-discovery of the writings of Hans Asperger gave the MRC researchers the tools with which to understand what they had seen in the field. In Vienna before World War II, Asperger and his colleagues had studied a large group of children who suffered from what they called “autistic psychopathy.” Unlike Leo Kanner, Asperger did not consider this condition to be very rare—in fact, he argued that some traces of autism could be found in most creative thinkers. Moreover, he included children with a fairly wide variety of symptoms and skills within the group he labeled “autistic.” Asperger had given lectures, but had published nothing on his research before the Nazis murdered most of his patients. Later in the war, Asperger managed to re-establish a small school, and began to publish some of his findings, but the school, along with most of his research records, were destroyed by Allied bombers in 1944. What little of his work had appeared in print was in German-language publications little known among English speakers. As a result, Asperger’s ideas had virtually no influence in the United States and Great Britain in the decades immediately after the war.
But in 1971, a Dutch researcher published (in English) a comparison of Kanner’s syndrome (still identified as a mental illness) and Asperger’s “autistic psychopathy” (which the researcher considered a personality type). Through this article, the MRC researchers finally became aware of Asperger’s ideas, and they soon realized that his broad definition of autism might help resolve some of their diagnostic problems. In particular, psychiatrists Lorna Wing and Judith Gould, working with data from the Camberwell district in London, found the expected tiny number of children with “Kanner’s syndrome,” but also a much larger group who had significant problems with communication and social interactions, and who exhibited some of the same “repetitive” behaviors as autistics, but nevertheless did not fit Leo Kanner’s strict criteria for “autism.” Some members of this larger group did, however, fit Asperger’s description of “little professors,” who could talk learnedly about subjects that interested them, but still struggled in everyday interactions. (Still others fit into no existing diagnostic category.) Their findings led Wing and Gould to suggest that there might actually be not a single form of autism, but rather a “continuum” of conditions involving what they considered to be a characteristic autistic “triad of impairments” (communication, social interaction, repetitive behaviors). Wing later replaced the word “continuum” with “spectrum”—and this has become the standard way of referring to autistic disorders.
When Wing wrote about what she christened “Asperger’s syndrome” in 1981, she introduced to the English-speaking world a group of autistic people who were highly—often overwhelmingly–verbal. Nevertheless, in keeping with the standard expectations of all autism researchers in both England and America at the time, Wing belittled the intelligence of her subjects:
Asperger described people with his syndrome as capable of originality and creativity in their chosen field. It would be more true to say that their thought processes are confined to a narrow, pedantic, literal, but logical, chain of reasoning. The unusual quality of their approach arises from the tendency to select, as the starting point for the logical chain, some aspect of a subject that would be unlikely to occur to a normal person . . . Usually the result is inappropriate, but once in a while it gives new insight into a problem. Asperger also believed that people with his syndrome were of high intelligence, but he did not quote the results of standardized intellectual tests to support this. As will be seen from the case histories in the Appendix, the special abilities are based mainly on rote memory, while comprehension of the underlying meaning is poor. Those with the syndrome are conspicuously lacking in common sense.
This condescending statement almost certainly does not do justice to the real intelligence of those Wing studied. It does, however, recognize (for the first time in the English-speaking world) that some people on the autism spectrum had the capacity for logical thought. They may have been “lacking in common sense,” but they were clearly not “mentally retarded.” Wing and Gould’s research thus opened the door for further investigation of autistic intelligence–and in particular for critiques of the value of “standardized intellectual tests” for evaluating that intelligence. Those critiques will be the subject of the next post.
Less than a week into the 2015 school year, six-year-old Xavier Gresham was threatened with suspension from his elementary school in rural Louisiana for “disrupting class” by “speaking out of turn.” The boy’s mother argued that his doctor had diagnosed him as autistic and that consequently he needed help from the school district in order to get his behavior under control. But that help could not be provided unless the district itself evaluated him. Xavier’s mother claims that her request for a district evaluation had been refused on the grounds that her son was “too smart” to be autistic. If her statement is accurate, the school administration, and perhaps even the district’s special education staff, associated autism with intellectual disability and could not accept the possibility that someone who, like young Xavier, who was actually at the top of his class academically, might also have autism.
Such attitudes are, sadly, still fairly common in the United States today. They persist for historical reasons–because the majority of special education teachers, administrators, assessment specialists and educational consultants now in practice received their training in a period when the link between autism and intellectual disability was virtually unquestioned. It might surprise many of these professionals to learn that the scholar who first introduced the term “autism” to the United States in the 1940s and 1950s assumed that all—or virtually all–autistic people were of average or above-average intelligence. Leo Kanner, a child psychiatrist at Johns Hopkins University, carefully distinguished autism (which he considered a very rare phenomenon) from what he called “feeble-mindedness.” Indeed, he insisted that the children he studied were actually quite intelligent, even though they refused to submit to standard IQ testing. The proof of this, according to Kanner, lay in the remarkable mental skills they demonstrated:
The astounding vocabulary of the speaking children, the excellent memory for events of several years before, the phenomenal rote memory for poems and names, and the precise recollection of complex patterns and sequences, bespeak good intelligence in the sense in which this word is commonly used.
Kanner and his immediate successors considered autism a form of mental illness, and indeed, as more likely to affect smart and sensitive children than those of lesser intelligence. Through the 1950s and well into the 1960s, therefore, the intelligence of autistic children (adults were almost never discussed) was generally taken as a given. One scholar actually acknowledged that autistic children often behaved “almost as idiots,” yet insisted that their behavior could be explained by “withdrawal and emotional block.” “Intelligence is normal,” he stated, “and often better than normal.”
Over the course of the 1960s and 1970s, however, more and more researchers began to question this assessment. The increasing tendency was to view autism as a developmental disability rather than a mental illness. Its etiology was “biogenic” rather than “psychogenic”—it was caused by physical differences in the brain and nervous system rather than by psychological trauma. Thus, the premier scientific journal in the field, the Journal of Autism and Childhood Schizophrenia (many scholars, including Kanner, had identified autism as a form of early-onset schizophrenia) was eventually re-named the Journal of Autism and Developmental Disorders. Unfortunately this move towards a biogenic explanation was almost always coupled with the assumption that autism was a form of mental retardation. In one of the earliest studies to suggest a “biogenic” element in autism, the English psychiatrist Michael Rutter proclaimed that nearly half of the children he studied had IQs below 50. Investigators at Indiana University reported that a full 94% of the children they had tested, using a variety of instruments, scored in the “retarded” range. An overwhelming consensus was emerging: autism entailed cognitive deficits. Unfortunately, as we shall see, this consensus was based on faulty research.
As the new view of autism took hold, the “peculiar” behaviors associated with the condition were emphasized, while the accomplishments that Kanner and other early scholars had used to claim intelligence for autistics (large vocabularies, unusual skill at pattern recognition, prodigious memories, early reading ability) were explained away. For example: at a 1984 conference devoted specifically to teaching issues associated with autism, one American educator warned his colleagues that hopeful parents might mistake their child’s ability to read and write as evidence of intelligence. It was essential, he said, to make them realize that what appeared to be literacy was actually nothing more than “rote” memorization, involving no real comprehension. Parents, he said, should be encouraged to give up any hope that their children could move beyond basic living skills.
Before the turn of the new millennium, the hypothesis of mental retardation remained largely unquestioned. In 1996, a group of distinguished scientists reported to the National Institutes of Health on the state of autism research at the time. One point the scientists made was that “most, if not all persons with [autism] also have some degree of mental retardation.” The most respected researchers were convinced that autism entailed intellectual disability, and this meant that clinicians, teachers, and school administrators held similar views. In the last two decades of the twentieth century autism was discussed more frequently in newspapers and on television, and was even represented in films such as Rain Man; many ordinary Americans first learned about the existence of autism at this time. However, intellectual disability remained a consistent feature of media reports. A study of autism coverage in The New York Times, for example, reveals that “mental retardation” remained a major theme in articles on the subject throughout the 1980s and 1990s. As a result, the emerging public image of people with autism involved peculiar behaviors and occasional savant skills, but also general intellectual disability.
In Part 2 of this post, I will look at the ways in which ideas about autism and intelligence began to change–if only slightly–in England during the 1970s and 1980s.