history of autism history of autism the history of autism spans over a century, autism has been subject to varying treatments, being pathologized or being viewed as a beneficial part of human neurodiversity. the understanding of autism has been shaped by cultural, scientific, and societal factors throughout history, and its perception and treatment change over time as scientific understanding of autism develops. before 1800 autistic people before autism a few examples of people now understood to be autistic were described long before autism was named. the table talk of martin luther, compiled by his notetaker, mathesius, contains the story of a 12-year-old boy who may have been severely autistic. the earliest well-documented case of autism is that of hugh blair of borgue, as detailed in a 1747 court case in which his brother successfully petitioned to annul blair's marriage to gain blair's inheritance. henry cavendish was a prolific natural philosopher, first published in 1766. during his life, cavendish was considered eccentric and his behavior was described as "peculiarly shy" by contemporaries. when researching cavendish as a subject for a 2001 article in the journal neurology, neurologist oliver sacks determined that evidence for an asperger's diagnosis was "almost overwhelming". the wild boy of aveyron, a feral child found in 1798, showed several signs of autism. he was non-verbal during his teenage years, and his case was widely popular among society for its time. such cases brought awareness to autism, and more research was conducted on the natural dimensions of human behavior. the medical student jean itard treated him with a behavioral program designed to help him form social attachments and to induce speech via imitation. 1800-1900 early descriptions of autistic symptoms (1877-1908) in 1877, british doctor john down used the term developmental retardation to describe conditions including what would be considered autism today. also in 1877, german doctor adolf kussmaul defined the condition aphasia voluntaria - when people choose not to speak. german psychiatrist hermann emminghaus wrote allgemeine psychopathologie zur einführung in das studium der geistesstörungen (general psychopathology as an introduction to the study of mental disorders) in 1878. using a very similar typology he later wrote the first textbook on child psychiatry, die psychischen störungen des kindesalters (the psychic disturbances of childhood) in 1887. these were both very influential on the categorisation of mental conditions. while autistic people could fit into certain categories, there was no category that aligned closely with autism. in 1887, john down gave a lecture which describes idiots savants, people whose mental abilities were generally poor, but which had strong abilities in a particular area. he notes that "in none of the cases of "idiot savant" have i been able to trace any history of a like faculty in the parents or in the brothers and sisters..." french psychiatrist pierre janet published the book lés obsessions et la psychasthénie (the obsessions and psychasthenia) in 1903. it included the newly defined condition of psychasthenia, which became a prototype of carl jung's later introverted personality type, and was believed by grunya sukharev to be a component of schizoid psychopathy in childhood. early defined conditions: dementia praecox, dementia praecocissima, and dementia infantilis (1880-1908) the term dementia praecox (premature dementia) was first used by german psychiatrist heinrich schüle in 1880, and also by 1891 by arnold pick, a czech professor of psychiatry at charles university in prague. the term was greatly popularised in 1899 through the sixth edition of german psychiatrist emil kraepelin's book psychiatrie. ein lehrbuch für studirende und aerzte (psychiatry. a text-book for students and physicians). this condition was defined very broadly by today's standards. the primary disturbance in dementia praecox was seen to be a disruption in cognitive or mental functioning in attention, memory, and goal-directed behaviour. autistic people seen to have these attributes were diagnosed with this condition. italian psychiatrist sante de sanctis briefly mentioned a condition in a 1906 paper he called dementia praecocissima (very premature dementia), which was a form of dementia praecox that started very early in people's lives. he wrote about it in more detail in a 1908 paper. it was a very broadly defined condition he considered "very similar to the hebephrenic or catatonic symptom complex of puberty and adolescence." austrian educator theodor heller defined a condition called dementia infantilis (infantile dementia) in 1908. this condition would go on to be called heller's syndrome and childhood disintegrative disorder. the dsm currently considers it part of autism spectrum disorder. it is a rare genetic condition. in 1925, sante de sanctis published another paper about "dementia praecocissima". it had some overlap with heller's syndrome. 1900-1920 children's rights (1913) in 1913, the mental deficiency act was passed in england and wales, ensuring institutional care for all children identified as "mental defectives". eugen bleuler: autism as a symptom of schizophrenia (1908) eugen bleuler created the concept of autism, using it to describe a type of behaviour. eugen bleuler was a swiss psychiatrist who was the director of the burghölzli mental hospital, which was associated with the university of zurich. in april 1908 he gave a lecture explaining that dementia praecox was very different to other forms of dementia. he proposed that it be given the unique name schizophrenia - a split mind. the term would be increasingly adopted over the next fifty years. what is now known as "schizophrenia" is different from what bleuler described. he included what is today considered as autism, schizoid personality disorder and various schizophrenia spectrum disorders in his definition. the neo-latin word autismus (english translation autism) was coined by blueuler in july 1910. he first used it in print to describe a symptom of schizophrenia in the scientific paper "zur theorie des schizophrenen negativismus" (on the theory of schizophrenic negativism). he derived autismus from the greek word: αὐτός, romanized: autós, lit. 'self', and used it to mean morbid self-admiration, referring to "autistic withdrawal of the patient to his fantasies, against which any influence from outside becomes an intolerable disturbance". bleuler created the term in reference to sigmund freud's term autoerotismus, shortening the latter term because he did not believe sexuality to be critical in the etiology of autistic symptoms. he characterized the autistic patient as one who "wants to shut himself off from reality". autistic people, then, are those "most severe schizophrenics, who no longer have any intercourse at all, live in a world of their own". bleuler believed that the idiosyncratic behaviours of schizophrenics displaying autistic behaviour were due to them engaging with personal fantasy rather than with the world as it is. he believed they drew on an early childhood mental state that was unable to form theory of mind.august hoch defined the shut-in character type. august hoch: the shut-in personality (1908-1910) in two papers first publicly presented in november 1908 and may 1910, and published in 1909 and 1910 respectively, swiss-american psychiatrist august hoch of the new york state psychiatric institute defined the concept of the shut-in personality. it was characterised by reticence, seclusiveness, shyness and a preference for living in fantasy worlds, among other things. hoch also said they had "a poorly balanced sexual instinct strikingly fruitless love affairs". this personality was identified because a high proportion of patients with dementia praecox had shut-in behaviour before more serious symptoms appeared. introversion (1909) carl jung coined the term introverted. in september 1909, swiss psychiatrist carl jung used the term introverted in a lecture at clark university. a transcript of this lecture was then published with two others in a journal in 1910, the first time the term appeared in print. in the lecture he mentions that love that is "introverted", "is turned inward into the subject and there produces increased imaginative activity". jung had earlier worked under bleuler at burghölzli. carl jung's 1921 book psychologische typen was published as personality types in english in 1923. it described the "introverted" in detail for the first time. (various new editions were published until 1949). jung writes:if i may anticipate, i consider the viewpoint which inclines, with weinger, to describe the introverted attitude as philautic, autoerotic, egocentric, subjectivistic, egotistic, etc., to be misleading in principle and thoroughly depreciatory. it reflects the normal bias of the extraverted attitude in regard to the nature of the introvert. we must not forget - although the extrovert is only too prone to do so - that perception and cognition are not purely objective, but are also subjectively conditioned. the world exists not merely in itself, but also as it appears to me.. although he will shrink from no danger in building up his world of ideas, and never shrinks from thinking a thought because it might prove to be dangerous, subversive, heretical, or wounding to other people's feelings, he is none the less beset by the greatest anxiety if ever he has to make it an objective reality. that goes against the grain. and when he does put his ideas into the world, he never introduces them like a mother solicitous for her children, but simply dumps them there and gets extremely annoyed if they fail to thrive on their own account. his amazing unpracticalness and horror of publicity in any form have a hand in this. if in his eyes his product appears correct and true, then it must be so in practice, and others have got to bow to its truth... he generally has bad experiences with rivals in his own field because he never understands how to curry their favour; as a rule he only succeeds in showing them how entirely superfluous they are to him. in the pursuit of his ideas he is generally stubborn, headstrong, and quite unamiable to influence. his suggestibility to personal influences in strange contrast to this. he has only to be convinced of person's seeming innocuousness to lay himself open to the most undesirable elements. they seize hold of him from the unconscious. he lets himself be brutalised and exploited in the most ignominious way if only he can be left in peace to pursue his ideas. he simply does not see when he is being plundered behind his back and wronged in practice... in his personal relations he is taciturn or else throws himself on people who cannot understand him, and for him this is one more proof of the abysmal stupidity of man. if for once he is understood, he easily succumbs to credulous overestimation of his prowess... often he is gauche in his behaviour, painfully anxious to escape notice, or else remarkably unconcerned and childishly naïve. a more concise definition of the introverted type was given by jung in february 1936, in his paper "psychologische typologie" (psychological types). it included:he holds aloof from external happenings, does not join in, has a distinct dislike of society as soon as he finds himself among too many people. in a large gathering he feels lonely and lost. the more crowded it is, the greater becomes his resistance. he is not in the least "with it," and has no love of enthusiastic get-togethers. he is not a good mixer. what he does, he does in his own way, barricading himself against influences from outside. he is apt to appear awkward, often seeming inhibited, and it frequently happens that, by a certain brusqueness of manner, or by his glum unapproachability, or some kind of malapropism, he causes unwitting offence to people... gannushkin, kraepelin's eccentrics (1914-1915) emil kraepelin defined the verschrobene (eccentric) character type. both russian psychiatrist pyotr gannushkin's 1914 paper "the state of the question of the schizophrenic constitution", and the verschrobene (eccentric) type of the eighth edition of emil kraepelin's psychiatry textbook (1915), detailed character types that would later be considered schizoid by grunya sukhareva. kraepelin writes of an as-of-yet poorly understood group of patients who may be intellectually well-endowed, yet are "absent-minded, forgetful, and show fluctuations in their intellectual capacity." they are eccentric in the sense that they tend to hold "extravagant and unworldly ideas," have a rambling or confused mode of expression, and tend to not to adjust themselves to others' experiences and instead "occupy themselves with completely hopeless and out-of-the-way plans". 1920-1930 non-psychotic schizophrenic personality, introduction of the term schizoid (1920-1929) the term schizoid began to be used just before 1920. it was used to describe people who had symptoms similar to "schizophrenia", but were not as pronounced. german psychiatrist of