Modern Views of Autism

In a seminal paper describing the first 11 cases of autism, Kanner pointed to the innate disturbance of affective contact occurring in the infancy of these children and to unusual personality traits in their parents (1). These observations could have indicated genetic mechanisms underlying the syndrome; however, the predominance of psychoanalytical theories and the particular focus on maternal deprivation in post–World War II child psychiatry led to misconceptions of autism as an infant’s response to early disturbances of the mother–child relationship (termed the “refrigerator mother”). The word “autism” was first used by Bleuler to index a cardinal sign of schizophrenia, and its use to describe the syndrome unfortunately led to 30 years of controversy about the validity of autism as a distinct syndrome vis-vis adult psychoses. The subsequent period of confused terminology (for example, “infantile schizophrenia,” “early childhood psychosis,” and “symbiotic psychosis”) largely reflected untested psychoanalytical models and prevailed up to the late 1960s.