Welcome to November, Autistic History Month. How appropriate it is that Steve Silberman’s book, Neurotribes: The Legacy of Autism and the Future of Neurodiversity, has just won the prestigious Samuel Johnson nonfiction prize.
Silberman’s ground-breaking book discusses the history of autism, including little-known details of the earliest days of the diagnosis. Silberman ferreted out previously-unknown information that turns contemporary ideas upside down. I had long known that Dr. Asperger and Dr. Kanner were not really describing a different condition — both labeled the cluster of traits “autism” and both doctors were studying patients from a wide range of autistic expression, from those who need a great deal of support to those “little professors” who, despite being disabled as well, often fly under the radar. In other words, there is no significant difference between “Asperger’s” (as described by Dr. Asperger, not necessarily as described in the DSM-IV) and “Kanner’s autism.”
Silberman discusses this phenomenon in much greater depth than I had previously been aware, however. I knew about Donald Triplett, the first person ever diagnosed by Dr. Kanner. Triplett still lives in the town where he grew up. Although the townspeople are aware of Triplett and shelter him a fair bit, he is also quite independent. This Atlantic article mentions that Triplett drives his own car and plays golf. Donald Triplett would seem to match up with Hans Asperger’s description of autism.
What Steve Silberman revealed that I had not been aware of before reading his book was that Dr. Asperger was studying patients who required a great deal of support — much more than indicated by the DSM-IV description of Asperger’s Syndrome. In other words, both doctors were looking at children from all over the autism spectrum. Both doctors were studying a cohort of children nearly indistinguishable from the cohort the other doctor was studying. Both doctors recognized that the state of being they called “autism” had a wide range of expression. Neither doctor contributed to a compartmentalization of “types” of autism.
So why is there such division today? Silberman’s book addresses that issue (and so much more. If you haven’t read Neurotribes yet, you really must!) I can’t even begin to do Silberman’s recounting justice in this synopsis. Asperger downplayed and hid his subjects who required more support because he was working in Nazi Germany where disabled people were called “ballast” and “useless eaters” and sentenced to death. Fearing for the lives of the patients he had grown quite attached to, Asperger promoted the “little professor” subjects, emphasizing their intelligence, potential future productivity, and usefulness to the Nazi regime. This is why we have come to associate a particular set of traits with the label “Asperger’s Syndrome” to the point where one might sometimes wonder if a race of ubermensch were being described.
The greatest surprise of all however, was the connection between Asperger and Kanner. Silberman dug deeply into historical documents in one of the greatest academic detective stories I’ve seen in a while. As it turns out, When Asperger’s clinic was bombed and his workers were scattered, many of them went to work for Dr. Kanner in America. Evidence strongly indicates that Dr. Kanner named the condition he was studying “autism” because his employees told him that is what Dr. Asperger had called it.
The history of autism is not a path of parallel discovery like Newton and Leibnitz with the calculus. It is a single path of discovery that began with Dr. Asperger and was taken up by Dr. Kanner (who chose to take credit for the discovery of autism rather than share the credit with his overseas colleague.) Kanner, however, emphasized the patients who needed more support. He emphasized them to such an extent, in fact, that the understanding that autism is a spectrum was lost for over four decades.
Thanks to the hard work and award-winning writing of Steve Silberman, the historical understanding of the autism spectrum is getting new attention. The history of autism could revolutionize the future for Autistic people. Thank you, Steven Silberman. Thank you so much.