Asperger’s 1944 paper in English / Part Four – Harro’s Case

 Hans Asperger, ‘Autistic psychopathy’ in childhood, 1944. 

Translated and annotated by Uta Frith

Harro L.

Our second case is a boy who also shows the main characteristics of autism in highly typical form, except that the relationships to the outside world are not as severely disturbed as in our first case. Instead, the positive aspects of autism become more obvious: the independence in thought, experience and speech.

This eight-and-a-half-year-old boy was referred to us by his school as unmanageable. He was in his third year at school, but was repeating the second year because he had failed in all subjects. The teacher believed that he ‘could if he only wanted to’. Occasionally, he made surprisingly clever remarks of a maturity way beyond his age. On the other hand, he often refused to co-operate, sometimes using bad language, for example, ‘this is far too stupid for me’, which threatened to undermine the discipline of the whole class. He hardly ever did his homework. Worse still were his conduct problems. He rarely did what he was told but answered back and with such cheek that the teacher had given up asking him so as not to lose face in front of the class. On the one hand, Harro did not do what he was supposed to do, on the other, he did exactly what he wanted to do himself and without considering the consequences. He left his desk during lessons and crawled on the floor on all fours. One of the principal reasons for his being referred by the school was his savage tendency to fight. Little things drove him to senseless fury, whereupon he attacked other children, gnashing his teeth and hitting out blindly. This was dangerous because he was not a skilled fighter. Children who are skilled fighters know exactly how far they can go and can control their movements so that they hardly ever cause real trouble. Harro was anything but a skilled fighter, and since he was very clumsy, could not control his movements and had no idea where to aim, he often allegedly caused injury to others. He was said to be extremely sensitive to teasing, and yet in many ways, with his strange and comical behaviour he directly provoked teasing. (Bullying by “normal” children is tolerated)

He was said to be an inveterate ‘liar’. He did not lie in order to get out of something that he had done — this was certainly not the problem, as he always told the truth very brazenly — but he told long, fantastic stories, his confabulations becoming ever more strange and incoherent.

His early independence in certain things was outstanding. Since his second school year, that is, since he was only seven years old, he had travelled alone by train to school in Vienna. His parents lived in a village approximately 25 km from Vienna. The father, who wanted his son to have better opportunities, disdained the village school and therefore sent him to school in Vienna. On a more unpleasant note, Harro also showed his social unconcern in sexual play with other boys, allegedly going as far as homosexual acts, coitus attempts.

From the family history, we note that Harro was an only child. He was a forceps delivery, but no disturbances were observed that might relate to any birth injury. His mental and physical development was unremarkable. As a small child, he was supposed to have been perfectly ordinary, except that his stubbornness and independence were evident very early.

The father, who brought the child to us, was a strange man, and very similar to his son. He appeared to be something of an adventurer. He originally came from Siebenburgen (Transylvania) and during the First World War, under great danger from the Romanian army, fled to Austria via Russia. By profession he was a painter and sculptor, but out of financial necessity he was making brooms and brushes. While there was severe unemployment at the time we saw the boy, the contrast of the two jobs was certainly striking. The father, who himself comes from peasant stock, is a typical intellectual. He professed to be completely and painfully self-taught. One could make out from what he said that he had nothing to do with anyone in the village where he lived and where he must have been considered highly eccentric. He said himself that he was nervous and highly strung but that ‘he controlled himself to such an extent that he appeared to be indifferent’.

The mother, whom we never saw (we felt that the father did not want us to see her) was also supposed to be highly strung. In both the father’s and mother’s families there were said to be many highly strung people. No more details were obtained.

Appearance and expressive characteristics

Harro was a rather small boy, 4 cm below average in height, and of stocky and muscular build. His arms and legs looked as if they were too short for his body. In some ways, he looked like a miniature adult, especially since his facial features were very mature. His typically lost gaze was often faraway. Sometimes he appeared to be in deep thought, then he would draw together his brows and assume a strange, slightly funny dignity. His posture too was odd. He stood broadly, arms held away from the body, as a portly gentleman or a boxer might do. He had few facial expressions and gestures. His dignified seriousness was only rarely interrupted, for instance, when he secretly laughed to himself. It was usually impossible to make out what had struck him as funny at that moment.

His voice fitted this picture well. It was very deep and appeared to come from very far down, in the abdomen. He talked slowly and in a deadpan way without much modulation. He never looked at his interlocutor while talking. His gaze was far away. With a tense, even cramped, facial expression, he tried to formulate his thoughts. In this, he succeeded remarkably well. He had an unusually mature and adult manner of expressing himself, not, as one occasionally sees in children, by using ready-made copied phrases, but drawn from his own quite unchildlike experience. It was as if he coined each word to fit the moment. Often he did not respond to questions but let his talk run single-mindedly along his own tracks. He could describe his own experiences or feelings with an unusual degree of introspection. He could look at himself as a detached critical observer (‘I am dreadfully left-handed’). Although he was aloof from things and people — or perhaps because of this — he had rich experiences and his own independent interests. It was possible to talk to him as to an adult, and one could really learn from him. This phenomenon is well demonstrated by his behaviour during intelligence testing, as described below.

++++++++++++++++++++++++++++++++ Time for a rant…

I’m including one of Uta Frith’s comments here, as I think it sums up the “Stink Pot” attitude that has taken over the “ASD Asperger Industry” since the formalization of certain “religious-cultural” approaches in psychology – the assertion that a rigid and dogmatic belief system (on which modern psychology is based – essentially Old Testament fascism) is the “legitimate interpretation” of what is going on in the brain, mind and body of  a “difficult” child, and in fact in all children. 

Over and over again, the emphasis is conformity to a particular CULTURAL expectation; children are regarded as objects that must obey the Puritanical human-hating fixation of certain adults: (Stink pots) who cannot bear the idea that some small part of human behavior is outside their control. Children are expected to respond “correctly” (unnaturally) without any personal expression, hesitancy, protest, assertion of independence, intelligence or creativity and without any explanation or justification for this “gag order” that is imposed by hostile and “ungenerous” adults who believe that human behavior is by default “bad” and that any impulse on the part of children to “unfold naturally” is to be stamped out. 

Children expect and need genuine interest in who they are as an individual; to receive support and guidance toward becoming an independent and confidant adult; to be loved by competent parents whom they can look up to and admire – but, it is these healthy expectations that must be denied – vigorously and permanently – in obedience to the anti-democratic social hierarchy. This “mission” on the part of psychologists, (Puritanical “liberal” do-gooders, to be blunt) has ruined childhood education in the U.S. It’s the “black box” system of cold manipulation that pervades American schools: you can find thousands of kids like Fritz and Harro – out of control, violent and ultimately ignorant; suited only for the “prison system” and chronic mental and emotional disturbance – and addictions.

FRITH: “Asperger believes that his examples of answers to the similarity questions demonstrate depth and originality of thinking. However, a striking feature of the answers is their seamless mixture of general knowledge and personal memory. Perhaps this indicates that the children had little idea of the purpose of the questions. The normal listener would realise that general questions require general answers, and refrain from recounting specific autobiographical incidents.”

This statement may seem innocuous, but the requirement that “normal people” can read the mind of the “inquisitor” (it is magic after all) and be terrified by the punishment that will be dished out if compliance is not forthcoming, is extortion; the child or adult is commanded to regurgitate the proper Biblical-theological-ideological-psychological and now, “politically correct” word response on demand. This hyper-control of human behavior and thought is what kills human happiness and creativity of expression – and damages the very “soul” that these cruel and “sick” authoritarians claim to be saving…

++++++++++++++++++++++++++++++++++

Intelligence testing (Asperger himself seems to have had a more realistic and open-minded approach to his students)

Some of the “problems” for Harro that follow seem to point to differential development: observational and analytical ability (intuitive visual brain) far exceeds physical co-ordination; mechanical skills are weak in comparison to our type of intellect. I have experienced this obstacle often; I could not write as I do, and indeed didn’t, before computer processing was available. My handwriting is atrocious; I could never learn to use a typewriter, and even when using my PC, I write everything using one finger – “hunt-and-peck” method. Believe it or not. Without the aid of software (for rewriting, editing and rearranging text) writing would be impossible. My “brain” creates the verbal content easily: it’s making it conform to a traditional presentation that is difficult.

First, some general remarks about the testing methods that we use in our department. The main difference from traditional testing (for example, the ‘Ich bin ein ganz iirchterlicher Linkser’

Harro’s social impairment included being aloof as well as odd. He showed, for instance, aggressive disrespect for teachers, and kept himself apart from his peers.

(Odd jump – something missing?) Binet test, from which we have taken some subtests) is that we use a clinical approach where we are not interested merely in the passing and failing of single tests but, instead, in the qualitative aspects of performance. First we score the performance according to the level reached, and represent this graphically to obtain a test profile. In this way, one can see the discrepancies between the performances in various tests, which would otherwise have been submerged in the overall IQ score. More importantly, we observe how the child solves various problems, his methodof working, his individual tempo, his concentration and, above all, his ability to relate and communicate. We adapt the way we test according to the personality of the child, and we try to build up good rapport. Of course, every good tester would do this anyway. Thus, it is important to help the anxious, inhibited child who lacks self-confidence, for example, by starting off the task for him or by helping him along. The chatty and hyperactive child, or the child who does not keep a distance, on the other hand, has to be restrained and somehow made to do the required work.

Obviously, any help given needs to be taken into account later when scoring, which is not easy. We also try to find out what special interests each child may have. We always let the children produce something spontaneously, and we let them expand on their responses by asking more questions. If there is a particular failure or if there are specific problems on some subtest, then we ask questions that are not part of standardprocedure until we have clarified the reason for the difficulty.

This method of testing demands much greater experience than schematically laid down methods with rigid scoring. However, if carried out well, it can tell us not only about the intellectual ability of the child, but also about important personality functions. It was almost as difficult to carry out the testing with Harro as it was with Fritz. Very often, he shut off completely when a question did not interest him. Sometimes he did not seem to hear the question. A lot of energy went into simply making him do the tasks. Again and again he went off on a tangent and had to be brought back. However, once his attention was engaged, his performance could be remarkably good.

Any tests that did not yield anything of special interest will be omitted, but I will describe in detail the results of the similarities subtest. Here, where Harro was able to produce answers spontaneously, he became lively and interested, and one even had to cut him off, since he threatened to go on for ever.

(similarity test)

tree/bush ‘The bush, that is where the branches grow straight off the ground, completely jumbled up, so that it can happen that three or four cross over each other, so that one has a knot in one’s hand. The tree, that is where there is first a stem and only then the branches, and not so jumbled up, and rather thick branches. This happened to me once, that is where I cut into a bush, I wanted to make myself a sling, I cut off four branches and then I have an eight-part knot in my hand. This comes when two branches rub against each other, then there is a wound there, then they grow together.’

stairs/ladder ‘Stairs are made out of stone. One doesn’t call them rungs, they are called steps, because they are much bigger, and on the ladder they are thinner and smaller and round. It is much more comfortable on the stairs than on the ladder.’

stove/oven ‘The stove is what one has in the room as a firebringer(!) and the oven is where you cook something.’

lake/river ‘Well, the lake, it doesn’t move from its spot, and it can never be as long and never have that many branches, and it always has an end somewhere. One can’t compare at all the Danube with the Ossiach Lake in Corinthia — not in the least little bit.’

glass/wood ‘Glass is transparent. Wood, if you wanted to look through it, you would have to make a hole in it. If one wants to beat on a piece of wood then one has to beat a long time until it breaks, unless it’s a dry twig. Then that would break easily. With the glass you need to hit only twice and then it’s broken.’

fly/butterfly ‘The butterfly is colourful, the fly is black. The butterfly has big wings so that two flies could go underneath one wing. But the fly is much more skilful and can walk up the slippery glass and can walk up the wall. And it has a completely different development! [Now he becomes over-enthusiastic, talks with exaggerated emphasis.] The fly mother lays many, many eggs in a gap in the floorboards and then a few days later the maggots crawl out. I have read this once in a book, where the floor talks — I could die laughing [ !] when I think of it — what is looking out of this little tub? A giant head with a tiny body and a trunk like an elephant? And then a few days later they cocoon themselves in and then suddenly there are some dear little flies crawling out. And then the microscope explains how the fly can walk up the wall: just yesterday I saw it has teeny weeny claws on the feet and at the ends tiny little hooks; when it feels that it slips, then it hooks itself up with the hooks. And the butterfly does not grow up in the room as the fly does. I have not read anything about that and I know nothing about it (!), but I believe (!) that the butterfly will take much longer with his development.’

envy/meanness ‘The mean one has something and doesn’t want to give it away, and the envious one wants to have what the other one has.’  

School attainment tests

Since most children who come to us for observation also have learning difficulties, we frequently use scholastic attainment tests. Naturally, we are aware of environmental influences here, for example, neglect of educational needs. Incidentally, when do environmental influences not play a role where test performances are concerned? It is a grave error to think that the responses to Binet tests come entirely from within the child and show no environmental effects!

reading He read a story shoddily and with errors. However, one could notice clearly that he read for meaning and that the content of the story interested him. He wanted to read faster than he was able to and for this reason was not very accurate. As this observation suggests his reading comprehension was excellent. He could reproduce what he had read in his own words, and he could say what the moral of a story was even though the moral was not explicitly presented in the text (the fable of the fox who was punished for his vanity).

 writing to dictation His handwriting, as to be expected from his general clumsiness, was very poor. He carried on writing carelessly and messily, crossing out words, lines going up and down, the slant changing. His spelling was reasonably accurate. As long as his attention was focused on a word, he knew how to spell it. It was very significant, then, that he made more spelling errors when copying than at dictation. Really, one would expect that copying should not present any problems at all, since, after all, the word was there in front of him; but this very simple and straightforward task simply did not interest him.

mathematics Here his ‘autistic originality’ was particularly evident.

(Again I recognize the “problem” being the disconnect between visual thinking and “math language”. His “work around” computations remind me of the “visual system” I created based on patterns that were evident in calculus problems: I manipulated the equations using this “visual superstructure” – it worked well enough to pass three semesters of calculus and calculus-based physics. But it was a lot of work. I had no problem with the “concepts” of physical phenomena. I find myself using similar visual methods of conversion for many tasks; it’s like translating from one language into another; in this case it requires changing from intuitive visual processing to “conventional processing”.

A few examples: (Harro’s tests)

27 and 12 equals 39. He spontaneously explained how he had worked this out: ‘2 times 12 equals 24, 3 times 12 equals 36, I remember the 3 [he means 27 is 3 more than 2 times 1 2], and carry on.’

58 plus 34 equals 92. ‘Better: 60 plus 32, 1 always go for the tens.’  

34 minus 12 equals 22. ’34 plus 2 equals 36, minus 12 equals 24, minus 2 equals 22, this way I worked it out more quickly than any other.’  

47 minus 1 5 equals 3 2. ‘Either add 3 and also add 3 to that which should be taken away, or first take away 7 and then 8.’

52 minus 25 equals 27. ‘2 times 25 equals 50, plus 2 equals 52, 25 plus 2 equals 27.’

A word problem (consider that the boy was only eight-and-a-half years old, and was only in the second year of the primary school!).

A bottle with a cork costs 1.10 schillings, the bottle costs just one more schilling than the cork, how much does each cost? After five seconds he gave the correct solution and explained when asked: ‘When a bottle costs 1 schilling more, then you have to leave one schilling aside, and something of the 10 groschen still needs to be left, so I have to divide by 2, so the cork costs 5 groschen and the bottle costs 1 schilling and 5 groschen.’

Fascinating as his mastery of numbers may be, we can nevertheless see the disadvantages of his original methods. They were often so complicated — however ingenious — that they resulted in errors. To use the conventional methods that are taught at school, for example, starting with tens and then units when subtracting, did not occur to Harro.

Here we come to an important insight: in autism there is a particular difficulty in mechanical learning, indeed there is an inability to learn from adults in conventional ways. Instead, the autistic individual needs to create everything out of his own thought and experience. (Intuitive thinking dominates – it is not “conscious” processing but a much older “unconscious” function that occurs automatically. “Staring at nothing” is a symptom” of intuition in progress! It is actually quite common in scientists. (Feynman’s famous steps for problem solving.) More often than not this results in defective performance, even in the more able autistic individuals.

His mind wandered off on his own problems and he would not know what the lesson was about. He took away from the lesson only those things for which he had a particular affinity and could think about in his own way. According to the school report he hardly ever knew what homework he had to do, and could not therefore do the appropriate work at home despite the father’s efforts. It is not surprising, then, that in the previous year he had not been able to advance to the next form despite his undoubted ability which was recognised by the school. 

Behaviour on the ward and educational treatment

The peculiarities of Harro’s behaviour can all be explained in terms of his contact disturbance, that is, his extremely limited relationship to his environment. (Yikes! A misunderstanding) Through the length of his stay on the ward he remained a stranger. One would never see him join in a game with others. Most of the time, he sat in a corner buried in a book, oblivious to the noise or movement around him. Usually, of course, such fanatical reading is rare before the age of ten. The other children found him odd and he became an object of ridicule because of the way he looked and the ‘dignity’ that went with it (children are particularly sensitive to this!) Nevertheless, they  treated him with a certain shyness and respect, and with good reason.

Any teasing by other children was met with brutal and ruthless aggression. He did not see the funny side of things and lacked any sense of humour, especially if the joke was on him. (Bullying is never funny; rampant bullying is epidemic in the U.S.; there are children who have committed suicide because of relentless attacks by their classmates. It’s a brutal social tool that is meant to confer “the right” of those higher on the social pyramid to inflict punishment on “lesser beings” – this is the American Way of life.  

He could be shamelessly recalcitrant when disciplinary requests were made. He always answered back, for example, ‘I wouldn’t even dream of doing this’. Even if he happened to be temporarily impressed by the teacher’s authority, he would at least grumble to himself.

Harro did not form any close relationships, either with another child in the ward or with an adult. His interest could be engaged, and then it could be very stimulating to talk to him. Nevertheless, he never became warm, trusting or cheerful, just as the staff could never quite warm towards him, and he never became free and relaxed.

All his movements eloquently expressed his problem. His facial expressions were sparse and rigid. With this went a general stiffness and clumsiness. Nevertheless, there were no neuropathological symptoms indicating spasticity. The clumsiness was particularly well demonstrated during PE lessons. Even when he was following the group leader’s instructions and trying for once to do a particular physical exercise, his movements would be ugly and angular. He was never able to swing with the rhythm of the group. His movements never unfolded naturally and spontaneously — and therefore pleasingly — from the proper co-ordination of the motor system as a whole. Instead, it seemed as if he could only manage to move those muscular parts to which he directed a conscious effort of will. What was true of many of his responses in general was also true here: nothing was spontaneous or natural, everything was ‘intellectual’.

Nevertheless, through patience and practice improvement was achieved in a number of practical skills. Like all autistic children, Harro was especially clumsy if not downright obstinate when it came to daily chores such as getting washed. One had to fight hard to teach him the important social habits of everyday life. The many practical skills needed in daily life present little problem to normal children. They can copy and learn them from adults with ease. This is, of course, what teachers expect. The teacher who does not understand that it is necessary to teach autistic children seemingly obvious things will feel impatient and irritated. Autistic children cannot cope with precisely such simple matters. It is impossible to say whether this is because of motor clumsiness or because of a failure to understand. Both seem to go together. Furthermore, they are particularly sensitive about personal demands, and it is far easier to engage their interest intellectually. It is not surprising, therefore, that autistic children show negativism and malice to seemingly petty and routine demands, and that it is there that serious conflicts often arise.

How, then, should one treat these difficulties? We have already noted in the first case that more can be achieved by ‘switching off one’s affect and by using an impersonal, objective style of instruction. Here, with the more able and less disturbed Harro, we found a way which we believe to be successful with more autistic children. The boy was more amenable when a request appeared not to be directed towards him in particular, but was verbally phrased in a very general, impersonal way, as an objective law, standing above the child and the teacher, for instance, ‘One always does such and such . . .’, ‘Now everyone has to . . .’, ‘A bright boy always does . . .’.

Another important point is this: normal children acquire the necessary social habits without being consciously aware of them, they learn instinctively. It is these instinctive relations that are disturbed in autistic children. To put it bluntly, these individuals are intelligent automata. Social adaptation has to proceed via the intellect. In fact, they have to learn everything via the intellect. One has to explain and enumerate everything, where, with normal children, this would be an error of educational judgement. Autistic children have to learn the simple daily chores just like proper homework, systematically. With some children who admittedly were somewhat older than Harro, it was possible to achieve a relatively smooth integration by establishing an exact timetable in which, from the moment of rising at a particular time, every single occupation and duty was outlined in detail. When such children left the hospital they were given a timetable. It was, of course, made up in consultation with the parents and adapted to the individual needs of each family. The children had to give an account of how well they followed the timetable, sometimes by keeping a diary. They felt that they were firmly tied to this ‘objective law’. In any case, many of them have pedantic tendencies veering towards the obsessional, and it was possible to use such tendencies for this regulatory purpose.

In this way Harro too achieved better adaptation, though not without difficulty. He certainly began to respond better to the demands of group teaching. Several months after he left, we heard that he was much happier at school. Unfortunately, we have not heard from him since, as his parents, we believe, have moved.  

The difficulties these children have with instinctive adaptations are, then, amenable to partial compensation through an intellectualising approach. The better the intellectual ability the more successful this approach. Now, the autistic personality is certainly not only found in the intellectually able. It also occurs in the less able, even in children with severe mental retardation. It is obvious that in the latter case adaptation is much more difficult to achieve. A further case will be given as an example.

OMG! There is more….

My suggestion at this point is that much confusion exists due to conflating “meeting cultural demands and expectations” with proper biological development. My image of this entire process of “dealing with autists” can be shown by this image: Asperger children are not built to “join the neurotypical social circus”. 

.

Training is torture for wild animals and Asperger humans.

I refer the reader to my post on how hunter-gatherers raise their children:

Jarod Diamond / Hunter-Gatherer Parenting

https://aspergerhuman.wordpress.com/jared-diamond-hunter-gatherer-parenting/

AND http://www.seattletimes.com/education-lab/between-the-ears-is-teaching-part-of-human-nature-or-is-it-just-plain-weird/

 

 

 

 

 

 

 

 

 

 

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