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Whether Asperger’s syndrome is radically different from classical infantile autism (in a child of three, all forms of autism may look the same) or whether there is a continuum from the severest cases of infantile autism (accompanied, perhaps, by retardation and various neurological problems) to the most gifted, high-functioning individuals, is a matter of dispute.
(Isabelle Rapin, a neurologist who specializes in autism, stresses that the two conditions may be separate at the biological level even if they are sometimes similar at the behavioral level.) It is also unclear whether this continuum should be extended to include the possession of isolated “autistic traits”—peculiar, intense preoccupations and fixations, often combined with relative social withdrawal or remoteness—such as one encounters in any number of people conventionally called “normal,” or seen, at most, as a little odd, eccentric, pedantic, or reclusive.
It has attracted in the popular mind an amazed, fearful, or bewildered attention (and perhaps engendered mythical or archetypal figures: the alien, the changeling, the child bewitched). A majority of Kanner-type children are retarded, often severely; a significant proportion have seizures, and may have “soft” neurological signs and symptoms—a whole range of repetitive or automatic movements, such as spasms, tics, rocking, spinning, finger play, or flapping of the hands; problems of coördination and balance; peculiar difficulties, sometimes, in initiating movements, akin to what is seen in parkinsonism.
And yet it was only in the nineteen-forties that it was medically described—almost simultaneously, as it happened—by Leo Kanner, in Baltimore, and Hans Asperger, in Vienna, both of whom, independently, converged on the term “autism.”Kanner’s and Asperger’s accounts were in many ways strikingly (at times uncannily) similar—a nice example of historical synchronicity—but Asperger’s account, published in German, remained largely unknown for four decades, and was translated into English only in 1991. The use of language always appears abnormal, unnatural. There may also be, very prominently, a large range of abnormal (and often “paradoxical”) sensory responses, with some sensations being heightened and even intolerable, others (which may include pain perception) being diminished or apparently absent.
But though there may indeed be a devastating picture at the age of three, autistic youngsters, contrary to expectations, may go on to develop fair language, a modicum of social skills, and even high intellectual achievements; they may develop into autonomous human beings, capable of a life that may at least appear full and normal—even though, beneath it, there may remain a persistent, and even profound, autistic singularity.
Hence Kanner’s formulation—with its strengths, and faults—dominated thought on autism for many years. There may be, if language develops, odd and complex language disorders—a tendency to verbosity, empty chatter, cliché-ridden and formulaic speech; the psychologist Doris Allen describes this aspect of their autism as a “semantic-pragmatic deficit.” In contrast, Asperger-type children are often of normal (and sometimes very superior) intelligence, and generally have fewer neurological problems.
Both Kanner and Asperger emphasized “aloneness”—mental aloneness—as the cardinal feature of autism; this, indeed, is why they called it “autism.” In Kanner’s words, this aloneness, “whenever possible, disregards, ignores, shuts out anything that comes to the child from the outside.” This lack of contact, he felt, was only in regard to people; objects, by contrast, might be normally enjoyed. There is a poverty of facial expressions and gestures. Kanner and Asperger had looked at autism clinically, providing descriptions of such fullness and accuracy that even now, fifty years later, they can hardly be bettered.
And now, finally, I was on my way to Fort Collins, in Colorado, to see Temple Grandin, one of the most remarkable autistic people of all: in spite of her autism, she holds a Ph. in animal science, teaches at Colorado State University, and runs her own business.
Autism, clearly, is a condition that has always existed, affecting occasional individuals in every period and culture. The children totally follow their own impulses, regardless of the demands of the environment [but] there can be excellent ability of logical abstract thinking.” While Kanner seemed to see autism as an unmitigated disaster, Asperger felt that it might have certain positive or compensating features—a “particular originality of thought and experience, which may well lead to exceptional achievements in later life.”It is clear even in these first accounts that there is a wide range of phenomena and symptoms in autism—and many more can be added to those that Kanner and Asperger listed.