Hans Asperger’s 1944 paper, translated and annotated by Uta Frith (annotations omitted here) May collect annotations at the end. I’ve highlighted in bold a few statements that are significant. A comment or two in red.
Will be posted in parts: rather long.
‘Autistic psychopathy’ in childhood
By HANS ASPERGER
In what follows, I will describe a particularly interesting and highly recognisable type of child. The children I will present all have in common a fundamental disturbance which manifests itself in their physical appearance, expressive functions and, indeed, their whole behaviour. This disturbance results in severe and characteristic difficulties of social integration. In many cases the social problems are so profound that they overshadow everything else. In some cases, however, the problems are compensated by a high level of original thought and experience. This can often lead to exceptional achievements in later life. With the type of personality disorder presented here we can demonstrate the truth of the claim that exceptional human beings must be given exceptional educational treatment, treatment which takes account of their special difficulties. Further, we can show that despite abnormality human beings can fulfil their social role within the community, especially if they find understanding, love and guidance. There are many reasons for describing in detail this type of abnormally developing child. Not the least of them is that these children raise questions of central importance to psychology and education.
Name and Concept
I have chosen the label autism in an effort to define the basic disorder that generates the abnormal personality structure of the children we are concerned with here. The name derives from the concept of autism in schizophrenia. Autism in this sense refers to a fundamental disturbance of contact that is manifest in an extreme form in schizophrenic patients. The name ‘autism’, coined by Bleuler, is undoubtedly one of the great linguistic and conceptual creations in medical nomenclature.
Human beings normally live in constant interaction with their environment, and react to it continually. However, ‘autists’ have severely disturbed and considerably limited interaction (socially – but there is a whole lot more “in the world” to interact with) The autist is only himself (cf. the Greek word autos) and is not an active member of a greater organism which he is influenced by and which he influences constantly. Bleuler’s formulations of schizophrenic autism included the following:
The schizophrenic patient loses contact with reality to varying degrees. He ceases to care about the real world. He shows a lack of initiative, aimlessness, neglect of reality, distractedness, but also impulsive and bizarre behaviour. Many of his actions, as well as his whole attitude to life, are insufficiently externally motivated. Both intensity and extent of attention are disordered. There is lack of persistence, but occasionally certaingoals are held on to tenaciously. One often finds ‘whimsical obstinacy’, that is, the patient wants something and at the same time the opposite. One finds obsessional acts, automatic acts, automatic commands etc. Schizophrenic patients often live in an imaginary world of wish fulfilment and ideas of persecution.
All but the last mentioned feature of Bleuler’s concept of autism can be found in the type of personality disorder to be described here. While the schizophrenic patient seems to show progressive loss of contact, the children we are discussing lack contact from the start. Autism is the paramount feature in both cases. It totally colours affect, intellect, will and action. Essential symptoms of schizophrenia and the symptoms of our children can thus be brought under a common denominator: the shutting-off of relations between self and the outside world. However, unlike schizophrenic patients,our children do not show a disintegration of personality. They are therefore not psychotic, instead they show a greater or lesser degree of psychopathy.The fundamental disorder that we have identified in our children affects all expressions of their personality and can explain their difficulties and deficits as well as their special achievements. Once one has learnt to pay attention to the characteristic manifestations of autism, one realises that they are not at all rare in children, especially in their milder forms. A few prototypical cases will be described below.