Free In a Different Key: The Story of Autism by John Donvan, Caren Zucker

inability to relate was present in children whose overall health and “intellectual endowment” was otherwise not significantly impaired.
    Thus, it was in a private letter to a mother that Kanner first announced his recognition of the condition that came to be called autism.
    Donald would be his Case 1.

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    WILD CHILDREN AND HOLY FOOLS
    L eo Kanner cultivated praise and attention, but in public he feigned indifference to the plaudits that came his way. This false modesty was on display in July 1969, long after he became famous for discovering autism, when he gave a speech to a group of parents in Washington, DC.
    “I didn’t go out of my way to discover this condition,” he said, after being honored for doing just that. No, he protested, to praise him on those grounds was just “a bit exaggerated.”
    “A sample of serendipity,” he called it. And then he explained how that meant being in the right place at the right time.
    “I wasn’t looking for anything,” he insisted.
    But then Kanner took the performance a little further than he usually did.
    “I did not discover autism,” he declared.“It was there before.”
    —
    I T WAS THERE BEFORE .
    In that single sentence, Kanner summed up his opinion on what remains one of the lasting questions in the field of autism: Was the collection of behaviors he described as “autistic disturbance” a phenomenon new to the mid-twentieth century, or had these behaviors always been present but simply unrecognized?
    This question was unanswerable for a number of reasons. One was the fact that medical notation and archiving were rudimentary before the twentieth century. Before World War I, no database wasever compiled from systematic observation of the behavioral traits of individuals in any population of a statistically meaningful size. Indeed, until the late nineteenth century, psychiatry was barely practiced at all—to say nothing of child psychiatry—in the sense of a professional discipline embracing a scientific methodology, a shared vocabulary, and an agreed-upon body of findings rooted in research and practice. In that regard, Kanner’s generation was among the pioneers. The undocumented past offered no statistical basis for asserting that autism emerged only around the time Kanner saw it in Donald.
    And yet when Kanner asserted the opposite—that autism was always there—that too seemed speculative.
    Kanner, however, knew that in psychiatry, the obvious often went unrecognized until someone looked at it with the right set of eyes. As he tried to explain in his speech, he had not “discovered” autism as much as found the eyes with which to see it.
    —
    K ANNER ’ S “ DISCOVERY ” OF autism was not a sudden aha moment, but a slow dawning recognition, one that took nearly four years from when he first met Donald. That recognition culminated in 1943 in a groundbreaking article starring a boy he called “Donald T.”
    By the time Kanner published his article in April of that year, the number of cases he was tracking had increased to eleven. Eight of his subjects were boys, and three were girls. The title of the article was the same as the name he coined for the condition: “Autistic Disturbances of Affective Contact.” He would soon replace this term with infantile autism , which merely meant, in medical terminology, that the autism was “present in earliest childhood.”
    He did not originate the terms autism or autistic . Rather, they were borrowed from the symptom list of a different condition altogether: schizophrenia. This would long be a source of confusion when autism was discussed, but it made sense from where Kanner sat at the time. By 1943, schizophrenia was a widely accepted label for a mental illness that included hallucinations, disordered thinking, and other breaks with reality. Swiss psychiatrist Eugen Bleuler had also documented atendency among some schizophrenia patients—who were overwhelmingly adolescents or adults—to detach from