cleverest of them, the teachers sometimes overlook the poorer performance in the mechanizable learning requirements because of their other achievements, because of their clever answers. most of the time, however, the teacher is in despair over the agonizing trouble that arises for both parts from this disruption in the way they work … we want to show that the basic disorder of autistic psychopaths is a narrowing of their relationships with the environment, that the personality of these children can be understood from this point of view, that it is "thoroughly organized" from that point of view … very differentiated likes and dislikes in the area of the sense of taste are almost regularly found - the frequent occurrence in the same direction is more proof for us of the unity of our type … many of these children have an aversion to certain tactile sensations, which goes to abnormal degrees … either don't notice the things around them at all, for example they don't care about toys at all, or they have an absurdly strong attachment to certain individual things, never take their eyes off a whip, a block of wood, a mere rudimentary doll, can't eat, can't go to sleep if the "fetish" isn't with them, make the most difficult scenes trying to snatch the thing they've held so passionately from them … that one has to keep oneself clean and in addition meet the numerous requirements of personal hygiene can only be taught to them with great difficulty, often not at all completely - even the adults, who then have mostly chosen intellectual professions, can walk around unwashed and unkept … the autistic psychopath is an extreme variant of male intelligence, male character. typical differences between boys' and girls' intelligence can already be found within the normal range of variation: girls are generally the better learners, they are good at concrete, descriptive, practical, clean, eager work; on the other hand, logic, the ability for abstraction, the precise thinking and formulating, that independent research is much more in the possibilities of the boys … while, as already mentioned, we have not met any girl in whom the image of the autistic psychopath has been fully developed, we have met several mothers of autistic children who were themselves markedly autistic in their behaviour … the steadfastness and the power that lies in the "spontaneous" activity of the autistic, the narrowing down to individual areas of life, to an isolated special interest - this proves to be a positive value that enables these people to achieve special achievements in their areas. especially with the autistic we see - with far greater clarity than with the "normals" - that they seem predestined for a certain profession from their earliest youth, that this profession grows out of their special talents as a result of fate.in regards to his work's academic antecedents, asperger frequently acknowledges bleuler, and also:there are certain similarities between the autistic psychopaths and the schizothyms of kretschmer, further with certain forms of the disintegrated by e. r. jaensch and above all with the "introverted thinking type" by jung.(it has been suggested that asperger was also likely aware of sukhareva's work.) the particular patterns asperger identified later became known as "asperger syndrome", particularly those that differed from the children described by kanner. despite many important english-publishing autism researchers being fluent in german, and his work being covered in some english language works, asperger's concept of autism would be almost unknown by non-german-speaking psychological professionals until the 1970s. it would take yet longer for substantial numbers of non-german-speaking people it describes to hear about it. fragile x syndrome (1943) main article: fragile x syndrome § history in july 1943, the british neurologist james martin and geneticist julia bell described a pedigree of x-linked intellectual disability. this would later be called fragile x syndrome, and is now considered one of the genetic causes of autism. icd-6 (1948) on 7 april 1948, the newly formed united nations established the world health organization (who). one of its first tasks was to create a global standard list of all health conditions, which was approved by an international conference at the end of april. the who adopted and greatly expanded an earlier list of fatal conditions, the ilcd-5. the first international classification of diseases (icd-6) soon became widely used in europe and elsewhere. it included "primary childhood behaviour disorders" (324), which was used to categorise all children with what was considered disordered behaviour. there was also the condition of "specific learning defects" (326.0). one of its "disorders of character, behaviour, and intelligence" was the "pathological personality" of "schizoid personality" (320.0). various categories of schizophrenia (300) were additionally represented, though not specifically "childhood" schizophrenia. (the dsm-ii would later explicitly state that its concept of childhood schizophrenia had no icd equivalent). the icd would not substantially change its representation of autism-related conditions until the icd-9 in 1975 1950-1960 the league for emotionally disturbed children the league for emotionally disturbed children was founded in new york in 1950 by 20 parents of emotionally disturbed children, including doctor and researcher jacques may. the group established the league school in brooklyn in 1953. enrolment was limited to children diagnosed with "childhood schizophrenia". the school helped establish a new method of teaching, led by teacher carl fenichel and assisted by psychiatrists alfred freedman and zelda klapper. in 1955, it changed its name to the national organization for mentally ill children. leo kanner noted in 1956 that the organisation had sponsored research that was "attempting to uncover metabolic and electrophysiologic abnormalities" in autistic children. in 1966, fenichel established the league school of boston. refrigerator mother theory in the early 1950s, the refrigerator mother theory emerged as an accepted explanation for kanner's early infantile autism. the hypothesis was based on the idea that autistic behaviors stem from the emotional frigidity, lack of warmth, and cold, distant, rejecting demeanor of a child's mother. parents of children with an asd experienced blame, guilt and self-doubt, especially as the theory was embraced by the medical establishment and went largely unchallenged into the mid-1960s. (while an inspiration for it, leo kanner himself eventually rejected the theory.) austrian-british psychologist anna freud and british psychologist sophie dann published a paper in 1951 that found that the extreme conditions of deprivation of affection of the nazi concentration camps did not induce autistic pathology in children. this was later used as an argument against the refrigerator mother theory. dsm-i (1952) the first edition of the american psychiatric association's diagnostic and statistical manual of mental disorders (dsm) was released in 1952. the dsm was created to give each of america's mental disorders a clear definition. two of the conditions it defined included reference to bleuler's understanding of "autism" - the symptom of keeping-to-oneself. each was named primarily using another of bleuler's terms, and defined with a paragraph. one was "schizophrenic reaction, childhood type" (000-x28), used in cases of "psychotic reactions", including those manifesting primarily autism. this diagnosis was used in cases where there were intellectual disturbances, repetitive behavior, or a retreat from reality. the other was "schizoid personality" (000-x42), which was characterized by avoidance of close relations with others, inability to express even ordinary aggressive feelings and autistic thinking. dirk van krevelen dirk van krevelen published the paper "een geval van 'early infantil autism'" (a case of early infantile autism) in 1952. it was the first european paper about "early infantile autism". in it, van krevelen notes that while the condition is well known by united states child psychiatrists, it is virtually unknown in europe. ronald fairbairn in 1952, british psychiatrist ronald fairbairn published the paper "schizoid factors in the personality" as part of a book. (an early form of it had been given as a lecture in november 1940). it included fairbairn's belief that the schizoid type was defined by "(1) an attitude of omnipotence, (2) an attitude of isolation and detachment and, (3) a preoccupation with inner reality", with last being by far the most important. fairbairn believed that people became schizoid because they had been unable to get the parental love they sought when they were small children. he also saw an equivalency between being "schizoid" and "introverted". kanner and eisenberg's 1956 papers in february 1956, american psychiatrist leon eisenberg published the paper "the autistic child in adolescence", which compared the childhood and adolescence of 63 autistic people. he found that almost one third had achieved at least a moderate social adjustment over the period, predominantly those who had possessed "meaningful language" by the age of 5. he also found that "the fundamental feature is a disturbance in social perception." in july that year, kanner and fellow johns hopkins researcher eisenberg published the paper "early infantile autism, 1943-1955". providing kanner's most concise definition of the condition yet published, the paper says:in the light of experience with a tenfold increase in clinical material, we would now isolate these two pathognomonic features, both of which must be present: extreme self-isolation and the obsessive insistence on the preservation of sameness, features that may be regarded as primary, employing the term as bleuler did in grouping the symptoms of schizophrenia. the vicissitudes of language development, often the most striking and challenging of the presenting phenomena, may be seen as derivatives of the basic disturbance in human relatedness.supporting the refrigerator mother hypothesis, the paper notes: "the emotional frigidity in the typical autistic family suggests a dynamic experiential factor in the genesis of the disorder in the child." bernard rimland american psychologist bernard rimland published an article in 1959 in scientific american, "joey the mechanical boy", about a 9-year-old with autism. this increased public awareness of the condition in the united states. 1960-1980 mildred creak's nine point definition (1961) until 1961, autistic children in the uk were often institutionalised from a young age. poor disease control in these institutions often led to a quick death. at this time, the british government sought to discover exactly how many psychotic children there were in the uk. they commissioned mildred creak of great ormond street hospital to lead a group to define the symptoms of childhood psychosis/schizophrenia, and the group completed their work the same year. they came up with a nine-point definition that soon became widely used in that country, and in time would form the definition of the condition used in most of the world. the nine points were more detailed than sukhareva's similar definition. they lacked the earlier definition's mention of ocd and clumsiness, and added the inclusion of anxiety. a major difference came in creak's ninth point: "a background of serious retardation in which islets of normal, near normal, or exceptional intellectual function or skill may appear." as the new definition took off, the autistic condition began to be seen as involving a lack of fantasy rather than an excess of it. united kingdom in 1962-1968 british teacher sybil elgar began a school for autistic children in the basement of her london home in 1962. later that year elgar, lorna wing and others established the uk's society for autistic children. (it became known as the national autistic society in 1982.) the society proposed the "puzzle piece" as a symbol for autism in 1963, because it fit their view of autism as a "puzzling condition". in 1965, the group set up the society school for autistic children, which was later named after sybil elgar. as of 2023, the society operates seven schools across england. british psychiatrist john k wing edited the first edition of early childhood autism; clinical, educational and social aspects in 1966, which included chapters from both ivar lovaas and lorna wing. later editions would contain different chapters. representative organisation scottish autism began in 1968, and continues independently today. (autism northern ireland would follow in 1991.) autism science in 1962 1962 saw a number of notable scientific publications about autism published. in january, charles ferster and marian demyer published the paper "a method for the experimental analysis of the behavior of autistic children". this was possibly the first paper to show how behaviorism could be used to teach autistic students. also in january, dirk van krevelen and christine kuipers published a paper in english regarding the work of hans asperger, "the psychopathology of autistic psychopathy". german psychiatrist gerhard bosch published the book der