Did you, like me, use to think autism was some form of mental retardation?
If so, you and I weren’t wrong. But we weren’t right either.
In my case, it wasn’t until the 1990s that I began to understand that there are intelligent, socially functioning autistic people in the world – those with Asperger’s, etc. Though I was a bit surprised, I thought it was just that I hadn’t been paying enough attention.
Then, recently, I encountered sociologist Gil Eyal’s 2010 book Autism Matrix: The Social Origins of the Autism Epidemic.
That’s when I learned that until the DSM-III-R in 1987 (the third revised edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association) the concept of a high-functioning autistic person didn’t officially exist. Psychiatrist Lorna Wing, who has an autistic son, had been promoting the idea for some time, but only since 1987 has her idea – high-functioning autism – been recognized.
The concept of autism was first presented in the 1940s, more or less simultaneously, by New York psychiatrist Leo Kanner and Austrian psychologist Hans Asperger. Almost from the start, according to Gil Eyal, it had an unusually close, and ambiguous, relationship with mental retardation and schizophrenia.
Then in the 1960s there was an earthquake in the mental health system – the beginning of the deinstitutionalization of mental retardation. Here’s what Eyal says:
The deinstitutionalization of mental retardation was a massive change, not only materially – large institutions emptied, some razed to the ground, some converted into more humane service centers – but also symbolically. Deinstitutionalization acted as a sort of “moral blender” into which disappeared the old categories that reflected the needs of custodial institutions (moron, imbecile, idiot, feeble-minded, mentally deficient, mentally retarded …… emotionally disturbed, psychotic, schizophrenic child, and so on). The moral blender of deinstitutionalization scrambled these categories, giving rise to a great undifferentiated mass of “atypical children”. [p.3 – The Autism Matrix]
We have a habit of forgetting our past, don’t we?
Anyway, it seems that autism emerged from that and grew. Because mental retardation and schizophrenia were considered dead-end diagnoses for children (untreatable), affluent families began seeking second opinions, making it clear that they would prefer an autistic diagnosis.
To make it easier to fit children into autism, the idea of an autism spectrum developed, with varying degrees of autism.
Kanner was hotly against that. He insisted that autism was a rare condition, that weakening the criteria to allow more children in would render the concept meaningless.
But Kanner lost and the spectrum survived. Not only did the concept of high-functioning autism come into being, but also its cousin, Asperger’s syndrome.
The Autism Matrix – with 240 dense pages – isn’t a book you can read in a day. But if you hope to understand autism, or you think you do already and you plan to argue with others about it, this book is a must read. One post can’t do it justice, so I intend to return to it soon.