Autism: a Q&A with Uta Frith

Autism was not identified before the 1940s. Weren’t there any autistic people before this?

Autism was not a new phenomenon starting in the middle of the 20th century, but it needed people like Leo Kannerand Hans Asperger to point out the striking constellation of poor social communication and stereotypic behaviours for others to see it too. Clinicians used the terms ‘infantile’ or ‘early childhood autism’ and located it among the neglected population of children who were born ‘mentally deficient’. Gradually clinicians became aware that most of this neglected population showed similar problems in varying degrees, and that specialist services were needed to educate children who could not communicate appropriately. They embraced the idea of the autism spectrum. So, just as there has been an increase in the autism spectrum diagnosis, there has been a corresponding decrease in the diagnosis of mental retardation.

But the spectrum idea had even wider implications. The constellation of social impairments and stereotypic behaviours can also be found in people whose intellectual abilities are average or superior. Previously these people would have been regarded as loners or possibly schizophrenic. It turned out that many families had an eccentric uncle, cousin, or grandfather! From the 1990s the diagnosis of Asperger syndrome became hugely popular and preferred to the diagnosis of autism. This popularity also reflected the gradual recognition of outstanding talents in autism, which is particularly visible in people who are also articulate. The loosening of criteria from early childhood autism, which remains rare, to the whole autism spectrum, which is not at all rare, has helped to make autism one of the most frequently used diagnostic categories today. In the US, 1 in 88 people currently have the diagnosis of autism spectrum disorder.

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