psychiatrist jakob lutz woulb become an antecedent of kanner's autism work, according to kanner himself. in 1937, lutz, working at the university of zurich, published a short book reviewing the available material on childhood schizophrenia, including the work of sukhareva, potter, grebelskaja-albatz and others. it was republished in a journal later in 1937. lutz visited kanner's department at johns hopkins in early 1938. lutz would also publish a chapter on the topic in a book that year. in june 1938, american psychiatrist louise despert of the new york state psychiatric institute published the paper schizophrenia in children. it included case studies of people that have subsequently been identified as having autism. the paper referenced two researchers, sukhareva and grebelskaya-albatz. it has been suggested that this paper was a major influence on kanner. kanner would later also claim despert's autism work as an antecedent of his own. leo kanner visited the autistic child donald triplett on 27 october 1938. kanner would later say that this was the first time he saw the pattern of autism. other pioneering researchers in 1938-1941 in december 1937, british psychiatrist mildred creak of maudsley hospital presented a paper titled psychoses in children. one part of it identified a group of five children that might today be considered autistic. the paper was published in march 1938.in 1939 and 1940, dutch psychiatrist alfons chorus of nijmegen's pedological institute published a pair of papers describing children that were autists and schizoid, which today would be considered autistic. in late 1938 or early 1939, the institute created a category for its child students called "autists", representing those who were particularly self-centred. (the institute's work with the autistic would later be explained by senior sister and psychologist ida frye in her doctoral desertion in 1968). in november 1940, husband-and-wife psychiatrists the american lauretta bender and austrian-american paul schilder of new york university and bellevue hospital published the paper impulsions: a specific disorder of behaviour of children. this paper describes in detail children with what would earlier be considered monomania, and later be considered "special interests":after having studied outspoken disorders (cases 3 and 4), we became aware that similar behavior in children is by no means rare. we saw children who were preoccupied with drawings of sexual content, others who were preoccupied with drawing of animals. they enjoyed their activities and interests, although from time to time they became aware that they were helpless to prevent them. the chief difficulties arose from the fact that their behavior led to a conflict with the surroundings. casually, these preoccupations might be referred to as obsessions and compulsions. the children, however, felt that they had an interesting and fascinating occupation and regretted merely the lack of understanding of adults. we propose the term "impulsions" for these preoccupations and activities. they do not represent merely a passing or fleeting impulse which suddenly breaks through the defenses and fears on the surface; they are preoccupations and actions which are in the foreground of the person's experience for weeks, months or even years. impulsions are not obsessions in the strict sense. they have something in common with the obsessive character trends.american psychiatrist charles bradley of the emma pendleton bradley home, published the book schizophrenia in childhood in march 1941, which described in extensive detail what is today considered childhood autism. he cited dozens of other early researchers on the topic, predominantly lutz, sukhareva, potter and homberger. in 1942, lauretta bender described the condition of childhood schizophrenia as a "definite syndrome", a "pathology at every level and in every field of integration within the functioning of the central nervous system". 1940-1950 kanner's publications on early infantile autism (1941-1949) in april 1941, kanner presented a paper titled "autistic disturbances of affective contact" to a staff conference in the henry phipps psychiatric clinic in baltimore. this would be published two years later. kanner published the paper "autistic disturbances of affective contact" in april 1943. it includes case studies of eleven children and their families who have particular things in common. he doesn't use the term autism as the name of the children's condition. he summarises:the combination of extreme autism, obsessiveness, stereotypy, and echolalia brings the total picture into relationship with some of the basic schizophrenic phenomena … but in spite of the remarkable similarities, the condition differs in many respects from all other known instances of childhood schizophrenia … all of the children's activities and utterances are governed rigidly and consistently by the powerful desire for aloneness and sameness … between the ages of 6 and 8 years, the children begin to play in a group, still never with the other members of the play group, but at least on the periphery alongside the group. reading skill is acquired quickly, but the children read monotonously, and a story or moving picture is experienced in unrelated portions rather than in its coherent totality … it is not easy to evaluate the fact that all of our patients have come of highly intelligent parents … one other fact stands out prominently. in the whole group, there are few really warmhearted fathers and mothers. for the most part, the parents, grandparents, and collaterals are persons strongly preoccupied with abstractions of a scientific, literary, or artistic nature, and limited in genuine interest in people. almost all the characteristics described in this paper, notably "autistic aloneness" and "insistence on sameness", are still regarded as typical of autistic spectrum disorder. as for the cause of the condition, it states:we must, then, assume that these children have come into the world with innate inability to form the usual, biologically provided affective contact with people, just as other children come into the world with innate physical or intellectual handcaps.the term kanner's syndrome was later coined to describe the children's condition, in particular to distinguish them from differing symptoms of asperger's children. this syndrome has also sometimes been known as classic autism. in september 1944, kanner published the paper "early infantile autism", giving his newly identified condition a new name. the paper has much in common with kanner's 1943 paper. it included only two case studies, but had a much more detailed introduction. kanner writes:during the past six years, i have become increasingly interested in a number of children, twenty by now, whose behavior differs uniquely and markedly from anything reported so far. among the individual patients there are great variations in the degree of the disturbance, in the manifestation of specific features, and in the step-by-step development in the course of time. yet in spite of this seeming divergence they all present essential common characteristics to such an extent that they cannot but be considered as fundamentally alike from the point of view of psychopathology. many of these children were brought to us primarily with the assumption that they were severely feeble-minded or with the question of auditory impairment. psychometric test performances yielded indeed very low quotients, and often enough absent or inadequate responses to sounds of any kind gave good reason for the suspicion of deafness. but careful examination showed very soon that the children's cognitive potentialities were only masked by the basic affective disorder; in fact, a few of the children had started out by amazing their parents with phenomenal feats of rote repetition. in all instances it could be established that hearing as such was not defective. the common denominator in all these patients is their disability to relate themselves in the ordinary way to people and situations from the beginning of life. their parents referred to them as always having been "self-sufficient", "like in a shell", "happiest when left alone", "acting as if people weren't there", "giving the impression of silent wisdom". the ease histories indicate invariably the presence from the start of extreme autistic aloneness which, wherever possible, disregards, ignores, shuts out anything that comes to the child from the outside … an excellent rote memory, retaining many poems, songs, lists of presidents, and the like, made the parents at first think of the children proudly as child prodigies … the same type of literalness exists also with regard to prepositions. alfred, when asked, "what is this picture about?" replied: "people are moving about …" the child's behavior is governed by an anxiously obsessive desire for the maintenance of sameness that nobody but the child himself may disrupt on rare occasions. changes of routine, of furniture arrangement, of a pattern, of the order in which everyday acts are carried out can drive him to despair … every one of the twenty children has a good relation to objects; he is interested in them; he can play with them happily for hours. the children's relation to people is altogether different. every one of the children upon entering the office immediately went after blocks, toys, or other objects without paying the least attention to the persons present.kanner's two papers became very influential in the english-speaking world, the americas and elsewhere. kanner published a third autism paper in 1949, entitled "problems of nosology and psychodynamics of early infantile autism". the first part aims to reinforce the separateness of early infantile autism from other conditions accepted by the medical community. he notes "early infantile autism bears no resemblance to heller's disease". he says it is however the same condition earlier identified by three women, "ssucharewa , grebelskaya-albatz, and despert." the paper also says much about the personality type of the parents of autistic children, including:one is struck again and again by what i should like to call a mechanization of human relationships. most of the parents declare outright that they are not comfortable in the company of people; they prefer reading, writing, painting, making music, or just "thinking". those who speak of themselves as sociable tend to qualify this by explaining that they have no use for ordinary chatter. they are, on the whole, polite and dignified people who are impressed by seriousness and disdainful of anything that smacks of frivolity.he also notes that the parents were typically "reared sternly in emotional refrigerators", and that "the parents did not seem to know what to do with the children when they had them. they lacked the warmth which the babies needed." contributions by asperger and frankl (1942-1944) hans asperger submitted a postdoctoral habilitation thesis on the topic of autism to the university of vienna in october 1942, which would be published with very few changes in june 1944. asperger's colleague george frankl published the paper "language and affective contact" in the same journal edition as kanner's 1943 paper. it describes different kinds of speech problems children have. in particular, he identifies a group of speech-troubled children defined by having a "lack of contact with persons", which can considered to be an autistic group. frankl's precise role in the development of the concept of autism is not clear. hans asperger published his paper "die „autistischen psychopathen" im kindesalter" (the "autistic psychopaths" in childhood) in june 1944. it was almost identical to the thesis he submitted in 1942. it included four cases studies and related analysis. this work offered by far the most detailed description of autism as yet published. asperger notes:if one has learned to pay attention to the characteristic expressions of the autistic nature, one finds this psychopathic disorder, especially in a milder degree, not so rare, even in children … …the individual personalities stand out from one another not only through the degree of the contact disorder, through the level of intellectual and character strengths, but also through numerous individual traits, special ways of reacting, and special interests (which are particularly independent and different within this group of people) … the difficulties which the young child has in learning the simple skills of practical life and in social adjustment come from the same disorder which causes the learning and behavioural difficulties of the school child, which causes the professional difficulties and the special achievements of the adolescent, and which speaks to the adult's marital and social conflicts … unfortunately, not in all cases, not even in most cases, does the positive, future-oriented traits of the autistic personality prevail. we have already talked about the fact that there are autistic characters of very different personality levels: from an originality bordering on genius to unrealistic, insular, inefficient oddballs to the most severely contact-disordered, automaton-like imbeciles … with the