※ [本文轉錄自 tmlu 信箱]
作者: tm@bbs.sob.com.tw
標題: ◇ [參考]Autism FAQ (12):History
時間: Mon Oct 14 21:53:27 2002
作者: Jf (寫給往事的一封匿名信) 看板: NTUStar_rain
標題: [參考]Autism FAQ (12):History
時間: Thu Sep 27 19:51:14 2001
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Autism FAQ - History
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It has been presumed that before the discovery of the pattern of
symptoms now known as autism, that people did exist with the syndrome,
and were lumped together either with the mentally retarded or the
insane. We might expect to have inherited sufficiently-detailed
descriptions of such people that we would be able to see a pattern
suggesting autism among them, but there have not been many
descriptions that suggest autism. One such description is of a boy
found in the 19th century and named Victor. At the time, some assumed
he had grown up without human contact in the forest. The story was
recorded in the book The Wild Boy of Aveyron.
Discovery
Leo Kanner published his first paper identifying autistic children in
1943, asserting he had noticed such children since 1938 (see reference
to Kanner, "Autistic Disturbance of Affective Contact", see Selected
Articles section below). Before Kanner noticed and recorded a pattern
of symptoms, such children would be classified as emotionally
disturbed or mentally retarded. Kanner observed that these children
often demonstrated capabilities that showed that they were not merely
slow learners, yet they didn't fit the patterns of emotionally
disturbed children. Thus he invented a new category, which he called
Early Infantile Autism, which has since sometimes been called Kanner's
Syndrome. Hans Asperger (see section Well Known Researchers and
Practicioners and reference to Asperger, "Autistic Psychopathy in
Childhood" in Selected Articles section below) essentially made the
same discoveries at the same time, independently of Kanner, but the
patients he identified all had speech, so the term Asperger's Syndrome
or Asperger Syndrome is often used to label autistic people who have
speech.
The word "autism"
Note that before before Kanner incorporated it into his label, the
word "autism" already had a meaning: "escape from reality" (coined, I
think, by Eugen Bleuler in 1912, who had already coined the term
"schizophrenia"). Kanner borrowed Bleuler's term either because Kanner
indeed believed the children were trying to escape from reality, or he
felt that whatever was going on, the children gave that impression.
Today, one hears the word autism in the context of Kanner's syndrome
much more often than one hears it used with Bleuler's original
meaning, and someone who regularly deals with Kanner's syndrome might
misunderstand when the word is used in its original sense. For
example, if a psychologist says "I sense some autism in this patient,"
s/he could be using established terminology to say the particular
patient is escaping from reality, yet s/he would not necessarily be
talking about someone who suffers from the developmental disorder that
this FAQ is about.
Older Theories/Origin
After Kanner and Asperger's discovery, parents were observed to treat
their autistic children without the warmth and affection which is
normally observed between parent and child. Freudian psychology had a
ready-made theory waiting for this syndrome and this observation: that
if certain basic psychological bonds between parent and child fail to
form that the child will fail to progress. A Freudian theory of autism
remained in vogue in the 50s and early 60s. Though the theory fit
Freudian psychology hand-in-glove, there are two obvious alternative
possible explanations that the Freudian theory dismisses: one is that
the parents' observed stilted interaction with the child was the
result of the child's Autistic behavior; the other is that Autism is
an extreme instance of a genetically-inherited personality trait that
was present to a milder extent in such observed parents.
Older Treatments
Based upon psychological theories of the basis of autism, some
children were removed to their parents' home and put in foster care to
see if they would recover. When this proved insufficient to cure them,
some attempts were made to bring children through psychological states
which they missed out on by virtue of being in a dysfunctional family.
Some success has been reported (as has been reported for every
treatment ever put forward) but no clear-cut success that would lead
to universal, long-term adoption of the methods.
Changes in meaning of the word autism after Kanner
Above and beyond the distinction between the concept that Bleuler
coined the word "autism" to label and the syndrome that is the subject
of this document, the syndrome has been broadened somewhat since
Kanner first published his paper. Kanner reported a rate of occurrence
of 1 in 10000 whereas the ASA states the rate as 15 in 10000. Kanner
first identified people who were clearly not mentally retarded (since
this was the unexplained group of people at the time). Since then, it
has been observed that some mentally retarded people have autistic
symptoms whereas others don't; so it is thought that the conditions
overlap. This explains some of the difference in the reported rates of
occurrence, though some now claim that it doesn't fully explain it.
Other terms that have been applied to what we now call "autism".
Childhood schizophrenia, infantile autism, Aspergers Syndrome,
Kanner's Syndrome. Probably lots of autistic people used to be termed
retarded, or schizophrenic, though obviously those terms (as then
used) were not as specific as our current "autism" label.
Politics
The parents of autistic children are naturally less-than-objective
about their own roles in the cause of their childrens' conditions. In
the 60s, this was fueled by a widespread belief that the condition was
caused by the way the parents treated their children. When evidence to
the contrary (see section Theories) was uncovered yet not widely
known, parents had to act as their own advocates. Parents still
sometimes find themselves in the position of trying to explain how the
fault does not lie with themselves since the general public's
information on autism is still sometimes dated or wrong.
Controversies
There remain a lot of controversies about treatment and probably have
been from almost the first. See section above, "Controversies".
Past Articles/Books
This article and book, written by a prime advocate of the Freudian
theory of the cause of autism were highly influential in attitudes
about Autism for a long time.
Bruno Bettelheim.
"Joey: A 'mechanical boy.'" Scientific American, 200, 116-127.
Bruno Bettelheim.
The Empty Fortress: Infantile autism and the birth of the self
(Collier-MacMillan, 1967).
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